We aimed to assess the impact of additional proximal margin (PM) resection on survival outcomes in patients with perihilar cholangiocarcinoma (pCCA) with intraoperative PM R1. MEDLINE, Cochrane, Embase, and Web of Science databases were systematically searched from inception to November 2024. Studies that compared survival outcomes among three patient groups were included. Patient groups were those with primary PM R0 resection, those who underwent additional resection to achieve secondary R0 (PM R1R0), and those with final PM R1. The primary outcome was overall survival (OS). A total of 2419 studies were screened. Eight studies were finally enrolled in this meta-analysis, including 157 patients in the PM R1R0 group, 296 patients in the final R1 group, and 976 patients in the primary R0 group. Patients who achieved PM R1R0 through additional resection demonstrated significantly worse survival than those with primary R0 resection (hazard ratio [HR] 0.65; 95% confidence interval [CI] 0.54-0.80). Moreover, their survival outcomes were no different from those with final R1 margins (HR 0.82; 95% CI 0.63-1.06). The current data showed that additional PM resection does not provide statistically significant survival benefits for pCCAs with intraoperative PM R1. The clinical application of additional resection in these patients needs further validation and investigation.

The link between quality of life and education has attracted increasing interest from the scientific community, but the intersection between the two fields remains underexplored. The aim of this study is to map the intersection of research in this field through a bibliometric analysis, aiming to identify the most influential publications, dominant keywords, research trends, the most prolific journals and their characteristics, as well as the geographical and institutional distribution of studies. The Web of Science database was queried with a broad intersection of keywords, and the data were analyzed using the Bibliometrix package in R version 4.5.1 (RStudio IDE). The dataset includes 4,883 documents published between 1984 and September 2025, contributed by 17,492 authors, with an average annual growth rate of 16.71% and an average of 13.27 citations per article. The results highlight a growing interest in converging themes such as higher education, well-being, and mental health. The purpose of the study is to provide a comprehensive and structured overview of this emerging research area, supporting future theoretical development and evidence-based policy and educational strategies. The study provides an integrated picture of how education and quality of life intersect, contributing to strengthening interdisciplinary dialogue and opening new directions for future research.

This study explores the relationship between employee organizational commitment and logistics performance through a systematic and bibliometric analysis of existing literature. The objective is to identify research gaps and propose a conceptual framework that structures and clarifies this relationship. The analysis is based on eighty-five peer-reviewed articles extracted from the Web of Science database, covering the period from 2015 to 2025. Using VOSviewer and Biblioshiny software, the study applies the PRISMA protocol to ensure methodological rigor in article selection and data analysis. The findings reveal a consistent scientific output, with notable international collaborations and growing academic recognition of this topic. Results underscore the key role of organizational commitment—encompassing affective, normative, and continuance dimensions—as a transversal factor enhancing logistics performance through human, organizational, and technological pathways. Furthermore, the analysis highlights how employee engagement contributes to agility, resilience, and sustainability in logistics operations. The study’s originality lies in the development of an integrative conceptual model linking organizational commitment to sustainable logistics performance. It provides both theoretical and managerial insights while identifying avenues for future research, particularly in exploring contextual variations across industries and countries.

Electroconvulsive therapy, BDNF and major depressive disorder: A meta-analysis with biological subgroups and clinical assessment of outcomes.

Purpose This paper aims to propose an integrative framework of fairness by synthesizing insights from organizational justice (OJ) and diversity and inclusion (D&I) literature. It clarifies how divergent understandings of fairness contribute to polarized reactions to diversity, equity and inclusion (DEI) efforts and positions fairness as a shared foundation for bridging divides. Design/methodology/approach A systematic review of 300 peer-reviewed articles from the Web of Science database was conducted. Articles were thematically analyzed to identify divergences and convergences in OJ and D&I conceptualizations of fairness, culminating in an integrative theoretical framework grounded in OJ models. Findings Fairness perceptions underpin polarized responses to DEI. Integrating OJ's focus on individual-level cognitive-affective processes with D&I's emphasis on intergroup dynamics and organizational contexts identifies three values that are central to fairness: individuality, group membership and morality. DEI backlash can be understood as perceived violations of meritocracy, procedural transparency, and moral clarity. Research limitations/implications The study is limited to published literature and theoretical exploration. Future research should examine how individuality, group membership, and morality interact to shape fairness perceptions across contexts. Practical implications The integrative fairness framework offers a basis for repairing relationships and advancing DEI with rigor. Restorative justice can help restore trust, while OJ measures offer a rigorous way to assess DEI programs' quality, implementation and impact across all groups. Originality/value This review bridges disciplinary divides by articulating a multidimensional understanding of fairness. Aligning OJ's theories and measures with D&I's understanding of identity and structural contexts addresses conceptual gaps and advances fairness research.

Background:This study attempted to assess the efficacy and safety of different herbal injections in combination with conventional therapy (CT) for the treatment of postinfarction ventricular remodeling using a net meta-analysis.Methods:The search was conducted as of April 2024 in the China Knowledge Network Database, Chongqing Vip Database (VIP), Wanfang Platform Database (Wanfang), China Biomedical Literature Service System (SinoMed), PubMed, Web of Science Database, EMBASE, Cochrane Library for information about We searched the Cochrane Library for randomized controlled trials (RCTs) of herbal injections for postinfarction ventricular remodeling. Quality was assessed by the Cochrane Risk of Bias tool, and a net meta-analysis was performed to compare the efficacy and safety of different herbal injections in combination with conventional therapies. Data were analyzed and plotted using RevMan5.4, Stata18.0 MP software software.Results:A total of 1948 records were retrieved, and 24 eligible RCTS were included, involving 2343 patients and 12 injections. The results of network meta-analysis showed that compared with conventional treatment, Shuxuetong injection + CT was significantly more likely to improve the clinical efficacy; Salvianolate injection + CT had the lowest incidence of adverse drug reaction. In terms of improving left ventricular ejection fraction, Guanxin Ning injection + CT was the best; In reducing left ventricular end-diastolic diameter, Xinmailong injection + CT has the best effect; In terms of reducing LVESD, Shenxiong injection + CT is the best. Chuanxiong Rhizoma injection + CT has the best effect on reducing left ventricular end-diastolic volume; In terms of reducing left ventricular end-systolic volume, Shenfu injection + CT has the best effect. The differences among the groups were statistically significant. Fourteen RCTS included reported the occurrence of adverse reactions, and the overall adverse reactions of TCM injection combined with conventional treatment were less than those of the control group.Conclusion:Current evidence suggests that the use of Chinese herbal injections in addition to conventional therapies may safely and effectively improve ventricular remodeling in patients with acute myocardial infarction and, to varying degrees, enhance cardiac function, quality of life, and prognosis.

Objective This study aimed to conduct a systematic review of the expression levels of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in cerebral amyloid angiopathy (CAA). Methods This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PubMed, Embase, and Web of Science databases were searched to identify relevant studies. Two researchers independently screened the literature, extracted data, and assessed the study quality. Results Five studies evaluating a total of 442 participants were included. The findings revealed dysregulation of the MMP/TIMP system in the cerebral blood vessels of patients with CAA. Specifically, in comparison with patients without CAA, those with CAA showed significantly upregulated expression of TIMP-3 and TIMP-4 in the cerebral blood vessels, and TIMP-4 levels were positively correlated with the severity of CAA. MMP-9 expression in patients with CAA-related intracerebral hemorrhage (CAA-ICH) was significantly higher than in those without hemorrhage, while TIMP-3 expression was lower in patients with CAA-ICH; these findings suggest that an imbalance between MMP-9 and TIMP-3 may increase the risk of hemorrhage. Cerebrospinal fluid (CSF) and serum biomarker studies showed that patients with CAA had decreased TIMP-4 levels in the CSF and significantly lower serum MMP-2 levels. Conclusion The findings of this study indicated an imbalance in the MMP/TIMP system in CAA, which may be involved in its vascular pathological mechanism. However, the existing evidence is insufficient to support the use of MMPs/TIMPs as reliable biomarkers for CAA. Therefore, further evaluation of their diagnostic and therapeutic value is required in future studies. Systematic review registration This systematic review was registered in PROSPERO (Unique Identifier: CRD420251230405). The protocol can be accessed at: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251230405 , CRD420251230405.

The application of computational fluid dynamics (CFD) in the cardiovascular field has been increasingly observed to analyze hemodynamic conditions within intravascular lumens. This study aims to quantitatively elucidate the development of CFD technology on hemodynamics over the past two decades through literature retrieval and bibliometric analysis. The literature retrieval is conducted using the Web of Science database, where all academic articles concerning hemodynamic analysis using CFD technology in the past 20 years are included. The retrieval strategy was primarily based on three aspects: time, cardiovascular anatomical parts, and cardiovascular diseases. Over the past two decades, the publication of CFD-focused articles in the cardiovascular field has grown steadily at an average annual rate of 10.19%, with a stable distribution across anatomical parts. A similar overall trend is observed for research on cardiovascular diseases (11.89% annual growth). However, in recent years, the growth rates for publications on individual diseases have begun to diverge significantly. The quantitative evidence from literature retrieval and bibliometric analysis shows the continuous development of CFD technology in the cardiovascular field over the past two decades. The consistent distribution of research across different cardiovascular anatomical parts suggests a balanced development process. However, the development of CFD technology on specific cardiovascular diseases might perform distinctively in the coming years.

Achievement motivation theory has been applied across a wide range of academic contexts, and use of achievement motivation as a theoretical foundation for examining individual sport consumption behavior aimed at improving physical condition has received increasing attention. This study employed the preferred reporting items for systematic reviews and meta-analyses framework for systematic review and meta-analysis to synthesize research trends and developments in this area. The Web of Science database was used for data collection due to its strong reputation for scientific indexing and comprehensive coverage. An exhaustive keyword search was conducted, yielding 1,143 publications that met the selection criteria. For data processing and visualization, CiteSpace-based knowledge graphs were extensively applied. The identification of influential publications, key researchers, and leading institutions supporting the findings reflects the rapid growth of academic output on achievement motivation in sport consumption behavior in recent years and demonstrates the field's expanding global influence.

Debate regarding whether additional surgery should be the preferred treatment option for patients with early gastric cancer who have undergone noncurative endoscopic resection is ongoing. This meta-analysis aims to provide clarity for clinicians and patients to facilitate better informed treatment decisions. Our meta-analysis involved searches of PubMed, Embase, and Web of Science databases. We analyzed the following prognosis-related indicators in groups receiving additional surgical or nonsurgical treatment: 5-year overall survival (OS), 8-year overall survival (OS), 5-year disease-specific survival (DSS), 5-year disease-free survival (DFS), 5-year recurrence-free survival (RFS), 5-year cancer-specific survival (CSS), and clinicopathological data. After applying strict inclusion and exclusion criteria, 26 studies published in English through May 2024 were included, comprising data from 9177 patients with early-stage gastric tumors following noncurative endoscopic resection. These patients were categorized into additional surgery (n = 4903) and nonsurgical (n = 4274) groups. The following outcomes were significantly better in the additional surgery group: 5-year OS (odds ratio [OR] = 3.37, 95% confidence interval [CI] = 2.91-3.91, p < 0.00001; hazard ratio [HR] = 0.51, 95% CI = 0.41-0.64, p < 0.00001), 8-year OS (OR = 1.96, 95% CI = 1.22-3.16, p = 0.005), 5-year DSS (OR = 3.08, 95% CI = 2.08-4.55, p < 0.00001), 5-year DFS (OR = 4.17, 95% CI = 1.53-11.4, p = 0.005), 5-year RFS (OR = 9.14, 95% CI = 3.63-23.01, p < 0.00001), and 5-year CSS (OR = 2.54, 95% CI = 1.32-4.9, p = 0.005). Additionally, subgroup analysis revealed that patients over 70years old benefitted more from surgery (OR = 3.09, 95% CI = 2.37-4.02, p < 0.00001). The results of the analysis were significant, with minimal heterogeneity. Our review revealed that the prognostic indicators of patients in the additional surgery group were greater and cannot be ignored.

The accelerating impacts of climate change, widespread forest degradation, and escalating biodiversity loss have intensified global concern about the complex and interdependent relationships among climate, forest, and wildlife systems. These interactions influence ecosystem structure, habitat suitability, species distribution, and wildlife behaviour, thereby reshaping human and natural systems across multiple spatial and temporal scales. Over the past two decades, scientific literature addressing climate, forest, and wildlife dynamics has expanded significantly, exhibiting an annual growth rate of 15.06%, driven by advances in ecological modelling, remote sensing, biodiversity monitoring, climate analytics, and international conservation and policy frameworks. This study employs a comprehensive bibliometric approach to systematically examine the evolution, structure, and collaborative patterns of global research on climate, forest, and wildlife interactions. A total of 8,271 documents published between 2000 and 2025 were retrieved from the Scopus and Web of Science databases, spanning 1,423 scholarly sources. The dataset included 19,760 author keywords and 20,933 Keywords Plus, reflecting the thematic breadth and conceptual diversity of the field. Bibliographic records were analysed using the Bibliometrix package in RStudio to evaluate publication trends, source dynamics, citation impact, thematic diversity, keyword evolution, authorship patterns, and international collaboration networks, thereby revealing the intellectual structure and developmental trajectory of this research domain. The findings indicate that this field is rapidly expanding, strongly interdisciplinary, and characterized by robust collaboration alongside an increasingly diverse thematic scope. While the diversity of keywords and publication sources reflects conceptual richness and methodological innovation, it also highlights the absence of a standardized vocabulary and limited thematic consolidation. Growing global collaboration further underscores the increasing relevance of climate, forest, and wildlife research in addressing contemporary environmental challenges and informing policy decisions.

Gynecologic function and dysfunction in transmasculine and gender diverse individuals using testosterone therapy: a systematic review.

This study used a dual method of bibliometric analysis and clinical evidence integration to systematically explore the intervention effect of different training intensities of Tai Chi on fatigue-insomnia-depression triad (FSD) in cancer patients and the current status of research. By analyzing 41 high-intensity literatures from 2004 to 2024 in the Web of Science database, an intensity stratification model based on the ACSM standard was constructed (low intensity &lt;3 MET, medium intensity 4-6 MET, high intensity &gt; 7 MET). The study confirmed that the standardized mean difference (SMD) of moderate-intensity Tai Chi on FSD triad was 0.57, significantly better than low intensity (SMD = 0.22), and its mechanism was related to the reconstruction of HPA axis function (recovery to 89% of healthy controls) and a 39.6%–43.2% decrease in inflammatory factors IL-6/TNF-α; however, high-intensity training may weaken the benefits of sleep (PSQI score increased). There are key gaps in current research, such as 78.3% of the intensity was not quantified and the evidence for critically ill patients (ECOG ≥ 2) accounted for only 5.3%. The study finally proposed to construct a “movement-intention” dual-axis classification framework, and suggested conducting a multi-center intensity-stratified RCT and integrating biomarker monitoring to provide evidence-based decision support for Tai Chi’s precise intervention in FSD.

Abstract Research aim: The integration of technology in internal auditing is reshaping how audits are conducted, enabling greater efficiency, transparency and decision-making. This study aims to provide comprehensive insights into the intellectual structure, key contributors, thematic developments and theoretical foundations of technology integration in internal auditing. It also identifies critical gaps in the current literature for future research. Design/ Methodology/ Approach: This research employed bibliometric techniques using VOSviewer and RStudio software. A total of 1037 articles published between 1993 and 2025 were retrieved from the Web of Science database and analysed to map the evolution, impact and direction of scholarly work on technology integration in internal auditing. Research finding: This bibliometric study uncovers publication trends, core journals, influential institutions and authors, key countries and most cited articles. It also identifies thematic clusters, trending topics, conceptual structures, theoretical lenses and emerging keywords. The results offer a structured overview of how the field has evolved over the last three decades and highlight the intellectual foundations guiding the domain. Theoretical contribution/Originality: This study is among the first to conduct a focused bibliometric analysis exclusively on internal auditing and technology integration. Unlike prior studies that reviewed either broad audit domains or single technologies like artificial intelligence (AI) or blockchain, this study provides a holistic and longitudinal view across multiple technologies. Practitioner/Policy implication: It contributes by mapping thematic developments, theoretical integration and future research opportunities specific to internal auditing. Research limitation: While this study provides a comprehensive mapping of technology integration in internal auditing, its reliance on Web of Science data may limit coverage, highlighting the need for future, theory-driven and interdisciplinary research that addresses underexplored themes such as ethical AI governance and explainability.

Suicidal ideation and suicidal behaviour constitute major public health concerns and represent key predictors of suicide, particularly in psychiatric hospital settings and during the post-discharge period. Evidence consistently indicates that suicide risk remains elevated after discharge from psychiatric hospitalisation, especially among adolescents and young adults. The objective of this systematic review was to synthesize empirical evidence on suicidal ideation in hospital contexts, with a specific focus on predictors, trajectories, and post-hospitalisation outcomes. A systematic search was conducted using the Web of Science database with the keywords “suicidal ideation” and “hospitalisation,” applying filters for open-access articles published in English over the last two decades. From an initial pool of 718 records, 50 studies met inclusion criteria based on relevance, methodological rigor, and direct focus on suicidal ideation or suicidal behaviour in inpatient or post-discharge contexts. The results indicate that suicidal ideation following hospitalisation follows heterogeneous longitudinal trajectories, with chronic and persistent patterns conferring the highest risk for suicide attempts and rehospitalisation. Key risk factors include hopelessness, emotional dysregulation, prior suicide attempts, trauma exposure, and adverse psychosocial environments, whereas family connectedness and continuity of care emerge as protective factors. The discussion underscores that psychiatric hospitalisation may temporarily stabilize acute crises while shifting vulnerability to the post-discharge phase, highlighting discharge as a critical intervention point. In conclusion, suicide risk after psychiatric hospitalisation is a dynamic and multidimensional process. Effective prevention requires sustained and temporally responsive strategies that extend beyond hospitalisation and integrate clinical, psychosocial, and emerging digital approaches.

This paper analyzes the convergence of education, archaeological heritage, and tourism in studies and projects that promote sustainable management policies for the current scenario. The findings of an Integrative Systematic Review have been delineated. The objective of this study is to detect experiences and initiatives that manage to equate heritage, tourism, and education, giving them similar importance in their intentions, results, and implications through an integrated systematic review of the literature. An overarching commitment to the conservation and promotion of archaeological heritage characterizes these initiatives. They encompass a diverse spectrum of actions, including the deliberate provision of educational resources and training programs, the intention to foster sustainable cultural tourism, and the facilitation of experiences aligned with educational tourism. The PICOC strategy guided the formulation of the research questions. Concurrently, the PRISMA protocol was utilized to conduct the meta-analysis and extract the results from the Web of Science database during the period between 2020 and 2024. The findings from the final sample of 35 are encouraging, as the majority advocate a variety of management policies (administrative, economic, educational, cultural, social, etc.) which, when integrated, are reinforced and made operational. The research work has indicated the necessity to expand the scope of research focused on identifying a balance between the various management policies (administrative, economic, educational, cultural, social, etc).

BackgroundNew evidence shows that gut microbiota dysbiosis may play a crucial role in the development process of benign prostatic hyperplasia (BPH). However, at present, the specific characteristics of the gut microbiota in patients with BPH have not been fully clarified.MethodsThe PubMed, MEDLINE and Web of Science databases were systematically searched to find the clinical and preclinical studies related to the relationship between BPH and gut microbiota from the establishment of the databases to October 7, 2025. And the studies reporting on gut microbiota and BPH were analyzed.ResultsA total of 10 preclinical studies and 6 clinical studies were included. These studies covered 413 patients with BPH, 338 controls, and 5 different types of BPH mouse models in total. Compared with the control group, there were significant differences in β-diversity in the BPH group. A significant increase in the Firmicutes/Bacteroidetes (F/B) ratio was regarded as a marker of the pathological condition. Specifically, changes in the abundances of Prevotella, Ruminococcus, and Lactobacillus may play a key role in the pathogenesis of the occurrence and development of BPH. The imbalance of interleukin-6 (IL-6) and interleukin-18 (IL-18), as well as changes in the levels of intestinal tight junction protein-1 and claudin-1, may also be related to the pathogenesis of BPH.ConclusionsChanges in the abundances of specific gut microbiota and their metabolites, such as an increased F/B ratio and a decreased abundance of Lactobacillus, as well as the levels of inflammatory indicators and markers of intestinal barrier dysfunction, may play a crucial role in the pathogenesis of BPH. These factors may become effective diagnostic means and potential therapeutic targets for BPH.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12894-025-02003-2.

HighlightsWhat are the main findings?A systematic bibliometric and visualization analysis fills the gap in quantitative reviews of autonomous vehicle path planning and trajectory tracking.Research hotspots and frontier topics are identified, revealing the evolution from traditional control to optimization and learning-based methods.What are the implications of the main findings?By moving beyond descriptive literature analysis toward deeper technical insight, this study clarifies the internal logic and development pathways of the field.The revealed trends and emerging directions provide explicit guidance for future research on intelligent planning, decision-making, and control of autonomous vehicles.With the rapid development of the automotive industry, autonomous driving has attracted growing research interest, among which path planning and trajectory tracking play a central role. To better understand the evolution, current status, and future directions of this field, this study conducts a comprehensive bibliometric analysis combined with latent Dirichlet allocation (LDA) topic modeling on publications related to autonomous vehicle path planning and trajectory tracking indexed in the Web of Science database. Multiple dimensions are examined, including publication trends, highly cited authors, leading institutions, research domains, and keyword co-occurrence patterns. The results reveal a sustained growth in research output, with trajectory planning, path optimization, trajectory tracking, and model predictive control (MPC) emerging as dominant topics, alongside a notable rise in learning-based approaches. In particular, reinforcement learning (RL) and deep reinforcement learning (DRL) have become increasingly prominent in complex decision-making and tracking control scenarios. The analysis further identifies core contributors and institutions, highlighting the leading roles of China and the United States in this research area. Overall, the findings provide a systematic overview of the knowledge structure and evolving research trends, offering valuable insights into key opportunities and challenges and supporting future research toward safer and more intelligent autonomous driving systems.

Background The increase in the number of global cancer cases is expected to lead to a greater caregiving burden. However, few studies have investigated the risk of suicidality among cancer caregivers. Objective The aim of this systematic review was to explore the risk of suicidality among cancer caregivers. Methods For this systematic review, a comprehensive search of the PubMed, Embase, Cochrane, Web of Science databases, PsycINFO and Scopus databases was conducted from inception to 16 July 2025. A meta-analysis was performed to determine the odds ratios (ORs) for case-control and cross-sectional studies and the adjusted hazard ratios (aHRs) for cohort studies. Results Seven studies were included (four cohort studies, one case-control study and two cross-sectional studies), and 638,188 study subjects and 4,203,957 nonexposed subjects. The meta-analyses revealed that the ORs was 1.91 (95% confidence interval [CI]: 1.46–2.49) in the case-control study, cross-sectional studies, and one cohort study which reported ORs, and the aHRs was 1.32 (95% CI: 1.16–1.50) in the three cohort studies. Caregivers of patients with highly aggressive cancers had a greater risk of suicidality (aHR = 1.66; 95% CI: 1.48–1.86). Within the first 7 years following a patient’s cancer diagnosis, the risk of suicidality among caregivers remained elevated (aHR = 1.42; 95% CI: 1.04–1.94). Conclusion The results indicate the need for both clinical and societal awareness to reduce the risk of suicidality among cancer caregivers, especially those with highly aggressive cancers. Trial registration Registered prospectively in PROSPERO (https://www.crd.york.ac.uk/prospero/) with the registration number (PROSPERO CRD420251011926) and date of registration(15/03/2025).

Antrochoanal polyps (ACPs) are cystic non-neoplastic lesions that most commonly originate from the maxillary sinus and may extend posteriorly through the choana. Transnasal endoscopic removal is preferred for symptomatic ACPs. ACPs can recur after surgical removal, and while a 15% recurrence rate was published in a systematic review on pediatric ACPs, this has not been well-established in adults. The purpose of this systematic review was to determine the recurrence rate of maxillary sinus ACPs following surgical resection in adults. A systematic review was conducted on ACP resection using Medline, Embase, and Web of Science databases from 1946 to July 2025. After excluding duplicate and non-English articles, 395 abstracts were screened, and 63 articles were selected for full-text review. Articles were included if they were original studies that reported recurrence rates after surgical resection of maxillary sinus ACPs in patients ≥ 16 years old. Articles were excluded if study populations had minimum follow-up of less than 6 months or mean follow-up of less than 12 months. After full-text review, 16 studies met inclusion criteria with 439 patients being utilized for analyses. Mean age was 33.8 years and 39.7% were female. Endoscopic middle meatal antrostomy with ACP removal was performed in 80.8% of cases. Following surgery, patients experienced an overall recurrence rate of 9% (95% CI: 6%-14%), with a mean follow-up of 36.8 months. ACPs recurred in about 9% of adults following surgical resection. Further research is needed to determine whether certain patient factors and surgical techniques are associated with ACP recurrence.