background. Clostridium difficile infection (CDI) has been extensively described in healthcare settings; however, risk factors associated with community-acquired (CA) CDI remain uncertain. This study aimed to synthesize the current evidence for an association between commonly prescribed medications and comorbidities with CA-CDI. methods. A systematic search was conducted in 5 electronic databases for epidemiologic studies that examined the association between the presence of comorbidities and exposure to medications with the risk of CA-CDI. Pooled odds ratios were estimated using 3 meta-analytic methods. Subgroup analyses by location of studies and by life stages were conducted.

A key step in the systematic review process is the assessment of the methodological quality (or risk of bias) of the included studies. At JBI, we have developed several tools to assist with this evaluation. As evidence synthesis methods continue to evolve, it has been necessary to revise and reflect on JBI's current approach to critical appraisal and to plan a strategy for the future. In this first paper of a series focusing on risk of bias assessment, we introduce our vision for risk of bias assessment for JBI. In future papers in this series, the methodological approach taken for this revision process will be discussed, along with the revised tools and guidance for using these tools.

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Objective: The inconsistency demonstrated across strata when using different scales has been attributed to quality scores and stratification continues to be done using risk of bias domain judgments. This study examines if restricting primary meta-analyses to studies at low risk of bias or presenting meta-analyses stratified according to risk of bias is indeed the right approach to explore potential methodological bias. Study Design and Setting: Re-analysis of quality subgroups in an existing meta-analysis based on 25 different scales Results: We demonstrate that quality stratification itself is the problem because it induces a spurious association between effect size and precision within stratum. Studies with larger effects or lesser precision tend to be of lower quality-a form of collider stratification bias (stratum being the common effect of the reasons for these two outcomes) that leads to inconsistent results across scales. We also show that the extent of this association determines the variability in effect size and statistical significance across strata when conditioning on quality. Conclusions: We conclude that stratification by quality leads to a form of selection bias (collider stratification bias) and should be avoided. We demonstrate consistent results with an alternative method that includes all studies.

The ligamentum teres (LT) has been studied since the 19th century, and its anatomy and biomechanical function have been well described. Recent advancements in hip arthroscopy have caused increased awareness of LT pathology. Previous reports have estimated the incidence of LT tears during hip arthroscopy to be 4% to 51%, and LT tears have been estimated to be the third most common reason for hip pain in athletes. Biomechanical studies have shown the LT's role in stability of the hip. Despite the growing body of literature on LT anatomy and function, its role as a causative factor in hip pain and hip instability has yet to be clearly defined, and the treatment of LT tears remains controversial. However, in certain cases where hip subluxation and overt instability are related to a traumatic full-thickness tear of the LT, reconstruction of the ligamentum has been suggested. We describe a technique for arthroscopic LT reconstruction using either a semitendinosus autograft or allograft in the supine position.

Our study demonstrated that WC patients had significantly lower baseline PRO scores when compared with a matched-pair control group. However, both groups demonstrated statistically significant postoperative improvement in all scores. Patients with WC status started and ended with lower absolute scores but benefited from arthroscopic intervention for hip injuries. While patient and physician expectations may be adjusted accordingly, these results may reflect favorably on the use of hip arthroscopy for labral tears in the WC population.

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