Systematic Meta-analysis Research Articles

Wound closure techniques after wide excision for hidradenitis suppurativa: a systematic review and meta-analysis.

Hidradenitis suppurativa (HS) is a chronic inflammatory disease that affects intertriginous skin areas, clinically characterized by recurrent inflamed nodules, abscesses, sinus tracts, and severe scars. Systemic treatments may provide temporary relief, while wide surgical excision offers prolonged disease-free periods. We evaluated the most efficient wound closure methods following wide excision of HS lesions in terms of recurrence, functionality, and quality of life. A systematic literature search was conducted in PubMed, Embase, Cochrane, and ClinicalTrials.gov, adhering to the PRISMA 2020 criteria. We included original studies published until February 2024, focusing on wound closure methods post-wide excision for HS. Data from 121 papers were analyzed using network and direct meta-analysis methods to compare recurrence and postoperative complication rates. From 1181 articles, 121 were included in the meta-analysis after removing duplicates and excluding publications that did not meet the inclusion criteria. Recurrence rates were associated with the type of reconstruction technique as follows: primary closure, 25% (95% confidence interval [CI], 20-30%); skin grafts, 18% (95% CI, 14-22%), and flaps, 12% (95% CI, 9-15%). Secondary intention healing showed a recurrence rate of 28% (95% CI, 23-33%). Flaps were associated with the lowest recurrence rates compared to other surgery techniques.

The efficacy and safety of dual orexin receptor antagonists in obstructive sleep apnea: A systematic review and meta-analysis of randomised controlled trials.

Dual orexin receptor antagonists (DORAs) are indicated for the treatment of insomnia disorder. However, DORAs may change sleep parameters, thus having adverse effects on patients with obstructive sleep apnea (OSA). This meta-analysis clarified the impact of DORAs in OSA treatment on sleep architecture and respiratory parameters. We systematically searched PubMed, Embase, and Cochrane Central databases for randomised control trials published up to May 2024. The search focussed on studies discussing the effects of DORAs on sleep architecture in patients with OSA. Nonrandomised studies were excluded. A meta-analysis using a random-effects model was performed. The patients were categorised into subgroups based on the treatment protocol (single or multiple dosages). The Cochrane risk of bias tool for randomised trials assessed the risk of bias. Our meta-analysis included four randomised placebo-controlled trials, encompassing 126 patients with a mean age of 49.1 years. The effects of DORAs on sleep architecture and respiratory parameters were examined. The main findings were as follows: DORAs significantly increased the total sleep time and improved sleep efficiency. However, they did not affect rapid eye movement sleep. DORAs also showed a trend towards decreased wake after sleep onset and did not increase the apnea-hypopnea index. DORAs did not increase the percentage of total sleep time with oxygen saturation lower than 90% and 85% compared with placebo, respectively. Furthermore, DORAs were not associated with significantly higher adverse effects compared with placebo. This meta-analysis demonstrated that DORAs improve sleep and do not impair nighttime respiratory function in patients with OSA.

Balancing Post-Vasectomy Adequate Sperm Clearance with Patient Compliance: Time to Rethink?

Background/Objectives: The American Urological Association (AUA) vasectomy guidelines’ current recommendation to obtain the first post-vasectomy semen analysis (PVSA) from 8 weeks to 16 weeks post-vasectomy is based predominantly on azoospermia rates. However, non-compliance with semen analysis after vasectomy is a known problem in this patient population. An approach that optimizes clearance and compliance is essential when adopting appropriate post-vasectomy care guidelines, specifically the scheduling of the first PVSA. We aimed to conduct a systematic review and meta-analysis of studies assessing compliance and clearance to determine the optimal time of first PVSA. Methods: Databases (MEDLINE, EMBASE, POPLINE) were searched for studies that contained the following: rate of azoospermia and rare nonmotile sperm (RNMS), compliance, recanalization, persistent RNMS, pregnancies, and incidence of repeat vasectomy. Results: A total of 28 studies were included in this review. The patient compliance was 47–100% and trended downward with increasing time to first PVSA. There was a positive trend in azoospermia rate as post-vasectomy time increased, but this plateaued at 8 weeks. Compliance and post-vasectomy semen analysis clearance (PVSAC) converged at 5.7 weeks, with rates of 74.5% and 74.6%, respectively. A proportion of 1.5% of patients exhibited persistent RNMS. Recanalization events had an incidence rate of 1.5%. Repeat vasectomies were performed in 1.6% of patients. Conclusions: Based on our study optimizing post-vasectomy semen clearance with follow-up compliance, we recommend initial PVSA between 6 to 18 weeks post-vasectomy, as this offers improved compliance over current AUA guidelines which recommend PVSA at 8 to 16 weeks and allows for the identification of instances of “subclinical recanalization” that may be missed at later time points.

Effects of Exercise on Pain and Disability after Lumbar Disc Herniation Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract Objective To evaluate the effects of postoperative exercise on pain, disability, and quality of life (QoL) after lumbar disc herniation (LDH) surgery. Design We systematically searched the PubMed, EMBASE, Cochrane Library, and PEDro databases up to May 2024. Two reviewers independently selected and assessed relevant randomized controlled trials investigating the effectiveness of postoperative exercise after the surgical treatment of patients diagnosed with LDH on low back pain, disability, and QoL assessed using visual analog scale (VAS), Oswestry Disability Index (ODI), and 36-item short-form health survey (SF-36). Results Compared with the control group, the exercise intervention group had significantly lower VAS scores both in the short-term (effect: 95% confidence interval [CI] = −1.14 [−1.69, −0.58], I2 = 91.4%, n = 9 studies) and long-term follow-up (effect: 95% CI = −0.99 [−1.89, −0.08], I2 = 58.9%, n = 4 studies). The exercise intervention group also showed a significant reduction in ODI in the short-term follow-up (effect: 95% CI = −5.00 [−7.72, −2.29], I2 = 79.3, n = 7 studies), but not in the long-term follow-up (effect: 95% CI = −0.80 [−3.97, 2.38], I2 = 0.0%, n = 4 studies). Among the SF-36 factors, physical function, pain, general health, energy and vitality, and social function significantly improved in the exercise intervention group compared with the control group. Conclusions Exercise after LDH surgery was effective in reducing pain and disability and improving QoL.

The Impact of Undernutrition and Anemia on HIV-Related Mortality Among Children on ART in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Although there have been significant advancements in providing HIV-infected children with access to antiretroviral therapy (ART), the mortality rates have remained unacceptably high. Inadequate nutrient intake or absorption is a widespread problem in several African nations, resulting in undernutrition and anemia. However, the pooled effect of malnutrition and anemia on HIV-related death related to children receiving ART was not investigated in sub-Saharan Africa. We searched multiple electronic databases (PubMed/MEDLINE, Embase, CINAHL, and Web of Science) for observational studies published between January 1, 2010, and April 24, 2024 that reported the risk factors or effects of undernutrition and, anemia on HIV-related mortality among children. Study selection, data extraction, and quality evaluation were carried out separately by two reviewers. A meta-analysis was conducted using random effect models. The review included 27 studies with a combined total of 61,796 study participants. The study findings showed that severe wasting (HR: 2.49; 95% CI: 1.87-3.30), being underweight (HR: 2.11; 95% CI: 1.64-2.72), and Anemia (HR: 2.58; 95% CI: 2.08-3.19) were highly linked to HIV-related death among children. The risk of death due to anemia was greater among children under the age of 5 years than older children. Undernutrition and anemia in sub-Saharan African children increased the risk of HIV-related death. The impact of malnutrition and anemia among under 5 years old children with HIV/AIDS was more pronounced, suggesting that these conditions at this early age can have more serious consequences for a child's survival. The importance of combining nutrition with HIV treatment programs in sub-Saharan African countries is crucial.

The incidence of kidney cancer in Iran: a systematic review and meta-analysis

The incidence of kidney cancer in Iran: a systematic review and meta-analysis

Health Literacy in Fall Prevention Strategy: A Scoping Review.

Although the significance of health literacy (HL) in fall prevention strategies is growing, limited knowledge is available regarding the relationship, impact, and role of HL in falls. This scoping review aimed to explore and synthesize the current evidence regarding the role of HL in enhancing fall prevention in hospital and community settings. We adhered to the Joanna Briggs Institute manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews. PubMed, CINAHL, EMBASE, and the Cochrane Library were searched until November 2023 using Medical Subject Headings and text words. Studies related to HL and falls, regardless of study design, were considered eligible. We screened 99,249 records, of which 27 were included: 12 interventional studies, seven observational studies, four qualitative studies, and four mixed methods studies. Two-thirds of the studies were conducted in community-based settings. Four observational studies reported that HL was associated with fall-related outcome including fall incidence. Although intervention studies did not encompass all elements of HL based on the Health Literacy Framework, eight out of 12 intervention studies reported effect of HL-embedded fall prevention interventions, and HL was effective in fall-related outcomes including fall incidence in six studies. Three of 14 studies reported the measurement properties of fall-related HL. While HL can be increased through tailored information, verbal debriefing, interactive communication, and culturally adapted interventions, low HL impedes the understanding of education, engaging interventions, and using technological devices in implementing fall prevention interventions in qualitative and mixed methods studies. This scoping review suggests that nurses need to recognize and assess patients' HL as a potential risk factor for falls and implement fall prevention interventions based on the HL level of participants. Further research is required to develop culturally adapted and fall-relevant HL measures applicable to various vulnerable populations and settings.

The clinical efficacy of laser in the nonsurgical treatment of peri-implantitis: a systematic review and meta-analysis.

To systematically assess studies regarding the efficacy of lasers in the nonsurgical treatment of peri-implantitis. Electronic and manual searches were performed by two reviewers independently. Randomized controlled trials (RCTs) comparing lasers vs. mechanical debridement or air abrasive on primary outcome (probing depth (PD)) and secondary outcomes (bone loss, bleeding on probing (BOP), clinical attachment level (CAL) and plaque index (PI)) were included. Data extraction and quality assessment were conducted independently. Weighted mean difference (WMD) or standardized mean difference (SMD) and 95% confidence interval (CI) were calculated for continuous outcomes. Publication bias, leave-one-out analysis and GRADE assessment were conducted. 13 eligible publications were included in the review and 12 in the meta-analysis. Solid-state lasers significantly improved in PD (WMD = -0.39, 95% CI (-0.70, -0.09), p = 0.01, moderate-certainty evidence), BOP (SMD =-0.76, 95% CI (-1.23, -0.28), p = 0.002, moderate-certainty evidence) and CAL (WMD =-0.19, 95% CI (-0.39, -0.00), p = 0.05, moderate-certainty evidence), but not in bone loss (WMD = 0.03, 95% CI (-0.13, 0.18), p = 0.74, low-certainty evidence) and PI (SMD =-0.19, 95% CI (-0.42, 0.04), p = 0.11, moderate-certainty evidence) compared with the control group. However, the diode lasers showed no clinical advantages. No publication bias was detected, and leave-one-out analysis confirmed the robustness of findings. In the nonsurgical treatment of peri-implantitis, solid-state lasers yielded positive influence in term of PD, BOP and CAL, while diode laser provided no beneficial effect. Future well-designed large RCTs are still needed, considering the limitations of included studies. This review aimed to guide clinicians in choosing the appropriate laser for peri-implantitis, enhancing treatment strategies and attaining better outcomes.

Indocyanine green fluorescence imaging for lymph node detection and long-term clinical outcomes in colorectal cancer surgery: A systematic review and meta-analysis.

The indocyanine green fluorescence imaging (ICG-FI) technique is increasingly being used in laparoscopic colorectal surgery for lymph node mapping. However, there is no definitive standard regarding whether the application of this technique can significantly increase the detection rate of metastatic lymph nodes and improve long-term prognosis. PubMed, Embase, Web of Science, and Cochrane Library databases were searched to include studies including ICG-FI in laparoscopic colorectal surgery. Data on the detection rate of lymph nodes, metastatic rate of ICG-positive nodes, and long-term clinical outcomes were extracted following inclusion criteria. Eighteen studies with a total of 1552 patients 922 with ICG-guided laparoscopic and 630 without ICG technique were finally included. Clinical stage II/III colorectal tumors were the most commonly studies types. The patients using the ICG-FI technique had more harvested lymph nodes (weighted mean: 23.5 vs. 18.9; WMD=4.6; p<0.00001) during dissection but a lower metastasis rate of ICG-positive nodes (61/218 [28%] vs. 96/333 [28.9%]; OR=1.45; p=0.08). Compared with conventional laparoscopic colorectal surgery, additional ICG-FI technique did not improve the 3year overall survival rate (272/289 [94.1%] vs. 269/289 [93.1%]; OR=1.19; p=0.61), relapse-free survival (246/289 [85.1%] vs. 249/289 [86.2%]; OR=0.92; p=0.72), and local recurrence rate (22/289 [7.6%] vs. 28/289 [9.7%]; OR=0.77; p=0.38). The overall detection rate of sentinel lymph nodes, lymph flow, and metastatic rate of ICG-positive nodes with the help of ICG-FI were 86.8%, 89.9%, and 22.8%, respectively. No patients experienced major adverse events during ICG injection preoperatively or postoperatively. Indocyanine green fluorescence imaging-guided procedure, compared to conventional laparoscopic dissection, can assist in obtaining a greater number of harvested lymph nodes and metastatic lymph nodes, however, it did not significantly improve the long-term clinical outcomes. Level III systematic review of randomized control and nonrandomized studies.

Criterion-Related Validity and Reliability of the Six-Minute Run Walk Test Among Children: Findings from a Systematic Review and Meta-Analysis

ABSTRACT The aim of this study is to examine the available scientific evidence on the reliability and criterion validity of 6-minute run walk field-based test when administered to children and adolescents. Systematic searches were performed in three electronic databases (MEDLINE/PubMed, SPORTDiscuss and Scopus) from their inception until February 2024, with an update on August 15, 2024. Studies were considered eligible if they provided information on the criterion-related validity and/or reliability of the 6-minute run walk test when conducted by children (aged 12 years and under) and/or adolescents (aged 13 to 17 years). To examine reliability and validity, two separate meta-analyses were implemented. In the meta-analysis focused on criterion-related validity, the five studies included indicated a fair validity (r = 0.56 [95% CI: 0.44–0.66]) and high homogeneity (I2 0%). In the meta-analysis focused on reliability, the pooled data from the five studies employing Pearson’s correlation coefficient (n = 585) revealed strong reliability values (r = 0.82 [95% CI: 0.75–0.87]), albeit with a moderate level of heterogeneity (I2 71% prediction interval 0.55–0.94). The evidence suggests that the 6-minute run walk field-based test demonstrated fair criterion-related validity and strong test-retest reliability when conducted with children and adolescent.

Lipid variability in drug-naïve individuals affected with Major Depressive Disorder: a systematic review and meta-analysis

Background This study aimed to provide a comprehensive synthesis of the evidence examining lipid profiles in drug-naïve MDD patients. Materials and methods We searched PubMed, Scopus, and ISI Web of Science up to August 2023 for total cholesterol, HDL-C, LDL-C, and triglyceride levels in drug-naïve MDD patients. Results A total of 17 articles comprising 2174 individuals including drug-naïve MDD subjects and controls were included. Our results showed that concentrations of total cholesterol were lower in drug-naïve MDD patients compared with healthy controls (SMD −0.49, 95% CI −0.881 to −0.105; p = 0.015; I2 = 90.6%). However, comparison of other lipid levels between MDD patients and healthy controls demonstrated no significant difference. The results revealed that the association of total cholesterol levels with MDD is more prominent in male-dominant studies (SMD −1.20, 95% CI −2.23 to −0.18, I2 = 87.9%) than in female-dominant studies (SMD −0.25, 95% CI −0.63–0.13, I2 = 89.0%). In meta-regression, none of the factors including year of publication, Newcastle-Ottawa Scale score, sample size, BMI, and mean age of participants had a significant influence on the association between cholesterol levels and MDD. Conclusions Lower levels of total cholesterol, especially in males, are associated with MDD, so early lipid monitoring and targeted interventions are necessary.

Effects of Fermented Kimchi Consumption on Anthropometric and Blood Cardiometabolic Indicators: A Systematic Review and Meta-Analysis of Intervention Studies and Prospective Cohort Studies.

Increasing global kimchi consumption has prompted interest in its health impact. However, comprehensive reviews of the influence of kimchi on cardiometabolic risk factors, especially meta-analyses, remain limited. This review assessed the impact of fermented kimchi consumption on cardiometabolic risk factors by systematically reviewing human intervention and prospective cohort studies, and conducting a meta-analysis of intervention studies. A literature search of PubMed, EMBASE, Scopus, Web of Science, RISS, KISS, and ScienceON databases was conducted through April 30, 2024. The inclusion criteria encompassed studies that examined the effects of fermented kimchi, without any added ingredients or lactic acid bacteria, on health outcomes, including anthropometric measures, blood pressure, cardiometabolic and glycemic indicators, inflammatory cytokines, and the incidence of related chronic diseases. Data extraction and quality evaluation were conducted independently by 3 researchers. Pooled effect sizes were calculated as weighted mean differences (WMDs) with 95% CIs employing random-effects models. Five intervention studies (205 participants) and 4 prospective cohort studies (42 455 participants) were selected. A meta-analysis of the intervention studies revealed a significant reduction in fasting blood glucose (WMD: -1.93 mg/dL; 95% CI: -3.82, -0.03; I2 = 17.4%) following the consumption of fermented kimchi. After excluding studies that contributed to increased heterogeneity, significant inverse associations were observed between fermented kimchi consumption and triglycerides (WMD: -28.9 mg/dL; 95% CI: -53.2, -4.5; I2 = 0.0%), systolic blood pressure (WMD: -3.48 mmHg; 95% CI: -5.95, -1.01, I2 = 0.0%), and diastolic blood pressure (WMD: -2.68 mmHg; 95% CI: -4.75, -0.62; I2 = 0.0%). Prospective cohort studies linked higher kimchi intake with a lower incidence of cancer and metabolic syndrome and an increased likelihood of achieving normal body weight. This review supports beneficial effects of fermented kimchi on cardiometabolic health. However, due to the limited number of studies, these findings should be interpreted cautiously, highlighting the need for further research in diverse populations. PROSPERO registration No. CRD42024532020.

Adherence to secondary antibiotic prophylaxis among patients with acute rheumatic fever and/or rheumatic heart disease: a systematic review and meta-analysis

ObjectivesWorldwide, a number of studies have been conducted to assess the prevalence of adherence to secondary antibiotic prophylaxis and to identify the associated factors (reasons) for poor adherence among patients...

Modified Balloon Use After Rotational Atherectomy Reduces Major Adverse Cardiovascular Event Rates in Severely Calcified Coronary Lesions: A Systematic Review and Meta-Analysis

Modified Balloon Use After Rotational Atherectomy Reduces Major Adverse Cardiovascular Event Rates in Severely Calcified Coronary Lesions: A Systematic Review and Meta-Analysis

Systematic Review and Meta-Analysis of Surgical Versus Non-Surgical Management for Varicocele: Comparative Evaluation of Fertility Outcomes and Complication Rates

Systematic Review and Meta-Analysis of Surgical Versus Non-Surgical Management for Varicocele: Comparative Evaluation of Fertility Outcomes and Complication Rates

Esophageal food bolus impaction in children: A 15-year experience and a review.

We aimed to analyze the episodes of esophageal food bolus impaction (EFI) occurred over a time of 15 years in children admitted to a large pediatric emergency department (PED), documenting their clinical presentation, underlying pathology, management, biopsy rate, and follow-up visits. Additionally, to combine our institutional experience with the existing literature, a comprehensive review was conducted. We reviewed the medical records of all children presenting to our PED with EFI from 2010 to 2024. The comprehensive review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement for systematic reviews. Electronic databases including PubMed/Medline and EMBASE were screened. The data obtained was synthesized to map out the actual status and current literature on pediatric EFI. We identified 54 cases of EFI. Overall, 22 patients (41%) had underlying pathology. Previous episodes were reported in 14 cases (26%). Urgent endoscopy was performed in 31 cases (57%). The presence of underlying pathology was associated with the need for endoscopic removal (p = 0.013), as well as the history of previous episodes (p = 0.016). Biopsies were performed in 14 cases (26%). Pediatric gastroenterologists showed a higher rate of performed biopsies compared to surgeons, as well as higher rate of follow-up visits. An underlying disease was found during later clinical follow-up in 5 out of 54 cases of EFI (9%). A comprehensive review of 16 studies revealed high rates of underlying pathology and low rates of biopsies and follow-up visits among children with EFI. Increased vigilance in identifying underlying pathologies in children with EFI is crucial. The importance of performing biopsies, regardless of prior anatomical conditions, and the need for ongoing follow-up to ensure timely and accurate diagnoses should be addressed through shared protocols.

Meta-Analysis: Evaluating Placebo Rates Across Outcomes in Eosinophilic Oesophagitis Randomised Controlled Trials.

High placebo responses have limited drug development in eosinophilic oesophagitis. The optimal configuration of trial outcomes is uncertain. To inform more efficient future trial designs, to characterise clinical, endoscopic and histologic placebo responses in eosinophilic oesophagitis randomised controlled trials (RCTs). We updated a Cochrane systematic review and meta-analysis, searching multiple databases to January 1, 2024, to identify placebo-controlled RCTs evaluating medical therapies for patients with eosinophilic oesophagitis. The primary outcome was the pooled proportion of study-defined clinical, endoscopic and histologic responders and remitters randomised to placebo, using an intention-to-treat approach and random-effects model. Sources of heterogeneity were explored using meta-regression. We included 25 RCTs. The pooled proportion of clinical response was 41.0% [95% CI: 29.7%-52.8%] with substantial heterogeneity (I2 = 74.9%). On meta-regression, older age and a higher probability of being randomised to placebo reduced the likelihood of clinical response to placebo. The pooled proportion of histologic remission defined as a peak eosinophil count [PEC] ≤ 6 eosinophils per high power field [HPF] or ≤ 1 eosinophil/HPF was 4.3% [95% CI: 2.6%-6.2%] (I2 = 23.6%) and 1.3% [95% CI: 0.5%-2.5%] (I2 = 0%), respectively. The standardised mean difference in the Eosinophilic Oesophagitis Endoscopic Reference Score to placebo was -0.25 [95% CI: -0.41, -0.10]. Over 40% of patients in eosinophilic oesophagitis trials respond clinically to placebo, and this is associated with trial design factors such as randomisation ratio and trial population. Objective endoscopic and histologic measures are associated with very low placebo responses.

Radial artery haemostasis after coronary angiography: A scoping review.

Nursing care in interventional cardiology is vital during perioperative stages, especially with coronary angiography. Radial artery access is now preferred, requiring proper haemostasis to prevent complications. Standardised protocols are needed for effective and economical haemostasis methods. This review aims to map the literature on haemostasis of the radial artery after coronary angiography, an area not previously reviewed. Following the Joanna Briggs Institute methodology for scoping reviews, two reviewers independently selected studies based on eligibility criteria. Data were extracted using a specially developed tool, with disagreements resolved through discussion or a third reviewer. Data synthesis is presented in tabular form and narrative summary. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews guidelines were followed. Searches were conducted in PubMed, CINAHL Complete, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus, Opengrey, DART-Europe e-theses portal and six key interventional cardiology reference sites. From 43 manuscripts, four haemostasis methods for the radial artery after coronary angiography were identified: manual compression (n = 5), compression bandages (n = 16), compression devices (n = 30) and haemostatic patches (n = 7). Nearly 70% (n = 30) of references focused on compression devices. Nine techniques were used to evaluate haemostasis methods, with visual inspection (34 references) and Doppler ultrasound (17 references) being the most common. Only nine haemostasis methods lacked an associated protocol. This scoping review identifies four primary haemostasis methods post coronary angiography: manual compression, compression bandages, compression devices and haemostatic patches, with compression devices being the most frequently discussed. The variability in evaluation techniques, predominantly visual inspection and ultrasound, underscores the need for standardised guidelines. The absence of protocols for some methods further highlights the necessity for uniform standards to improve consistency and reliability in clinical practice. Standardising these methods and protocols is essential to enhance patient outcomes and advance the field.

Are social media use and popularity in the peer group linked during adolescence? A meta-analytic review.

Popularity in adolescence has been the subject of considerable empirical inquiry over the last two decades. As research on this dimension of social experience evolved, fundamental shifts occurred in the modalities through which adolescents communicate. Social networking platforms, instant messaging applications, and other forms of social media emerged as organizing features of adolescent peer groups. In the current paper, we present a systematic review and meta-analysis examining evidence that social media activity is associated with both popularity and goals for becoming popular. Syntheses were conducted based on 34 effect sizes from 12 studies (N = 7776; 4037 girls and 3739 boys) using three-level Meta-analytic techniques. Average effect sizes across studies were of small to medium magnitude and were not influenced by Meta-analytic moderators. Although the findings provide support for expected positive associations between social media activity and popularity, unresolved questions remain.

Evaluating the clinical potential of bioceramic-rods for revascularization in osteonecrosis of the femoral head: a systematic review.

To evaluate the safety, reliability, and effectiveness of bioceramic rods (BR) in treating osteonecrosis of the femoral head (ONFH), compared with other treatments such as core decompression and autologous bone grafting. Systematic review and meta-analysis. Pubmed, Embase, and CNKI databases from January 2011 to July 2023. Included studies involved patients treated with bioceramic rods. Studies were required to have a follow-up time of more than six months and no statistically significant differences in baseline information between groups in controlled studies. Exclusions included literature reviews, case reports, conference abstracts, animal experiments, and studies without defined success criteria or lacking analysis on factors influencing efficacy. The primary outcome measure was the Harris Hip Score (HHS) improvement rate. Secondary outcomes included the femoral head stability and survival rate, alongside the hip replacement rate. The systematic review revealed significant improvements in symptom relief and functional recovery using BR for the treatment of ONFH. An average follow-up of 20.44 months showed an overall HHS improvement rate of 33.93%. Hip preservation efficacy with BR was superior to core decompression and autologous bone grafting. The overall femoral head survival rate was 84.42%, with results sustained for three years. The success rate of hip preservation was notably higher with early intervention, which showed better outcomes when the overall HHS improvement exceeded 27%, and rates of excellent and good outcomes approached 90%. Bioceramic rods offer a safe, minimally invasive, reliable, and effective treatment option for ONFH, ensuring substantial symptom relief and functional recovery. The technique's success in early disease stages suggests a strong potential for broader clinical adoption. Although additional benefits from combining BR with stem cells, platelet-rich plasma, and traditional Chinese medicine are noted, definitive conclusions on enhanced therapeutic effects remain inconclusive.