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Background Methods Results Conclusions Ancillary immunohistochemistry testing for p16 loss has been proposed as a diagnostic tool for melanoma, but its accuracy remains uncertain.A systematic review and meta‐analysis were conducted on 26 studies involving 979 melanomas and 974 nevi.Through bivariate analysis of data across all cut‐off values, the sensitivity and specificity were calculated to be 0.55 (95% confidence interval [CI]: 0.38, 0.70) and 0.85 (95% CI: 0.70, 0.94), respectively. Summary estimates of diagnostic accuracy fell below recommended thresholds for effective tests, but subgroup analysis suggested that p16 loss could aid in diagnosing ambiguous lesions as melanoma in certain scenarios. However, the presence of p16 expression in these contexts does not definitively rule out melanoma. The findings were limited by underpowered exploratory study designs at risk for bias in patient selection and test interpretation.While the use of p16 immunohistochemistry for detecting melanoma is not universally reliable, it may serve as a confirmatory test in differential diagnoses involving common, congenital, acral, Spitz, and deep penetrating nevi. Nevertheless, further studies are needed to validate its utility. Until then, the application of p16 immunohistochemistry in melanoma diagnosis should be regarded as experimental. [ABSTRACT FROM AUTHOR]

Improving the nutrient efficiency in pork production is required to reduce the resource competition between human food and animal feed regarding diet components edible for humans and to minimize emissions relevant to climate or the environment. Thereby, protein utilization efficiency and its equivalent nitrogen utilization efficiency (NUE) play a major role. Breeding for more nitrogen (N) efficient pigs bears a promising strategy to improve such traits, however, directly phenotyping NUE based on N balance data is neither cost‐efficient nor straightforward and not applicable for routine evaluations. Blood urea nitrogen (BUN) levels in the pig are suitable to predict the NUE and, therefore, might be an indicator trait for NUE because BUN is a relatively easy‐to‐measure trait. This study investigated the suitability of NUE as a selection trait in future breeding programs. The relationships to classical growth performance and feed efficiency traits were analysed as well as the relationship to BUN to infer the role of BUN as an indicator trait to improve NUE via breeding. The analyzes were based on a Landrace F1 cross population consisting of 502 individuals who descended from 20 Piétrain sires. All animals were genotyped for 48,525 SNPs. They were phenotyped in two different fattening phases, i.e., FP1 and FP2, during the experiment. Uni‐ and bivariate analyses were run to estimate variance components and to determine the genetic correlation between different traits or between the same trait measured at different time points. Moderate heritabilities were estimated for all traits, whereby the heritability for NUE was h2 = 0.293 in FP1 and h2 = 0.163 in FP2 and BUN had the by far highest heritability (h2 = 0.415 in FP1 and h2 = 0.460 in FP2). The significant genetic correlation between NUE and BUN showed the potential of BUN to be considered an indicator trait for NUE. This was particularly pronounced when NUE was measured in FP1 (genetic correlations rg=−0.631 and rg=−0.688 between NUE and BUN measured in FP1 and FP2, respectively). The genetic correlations of NUE and BUN with important production traits suggest selecting pigs with high growth rates and low BUN levels to breed more efficient pigs in future breeding programs. [ABSTRACT FROM AUTHOR]

Background: There is limited epidemiological evidence on outcomes associated with dupilumab exposure during pregnancy; monitoring pregnancy outcomes in large populations is required. Objective: To investigate the potential association between exposure to dupilumab in pregnant women with atopic dermatitis and any adverse pregnancy, neonatal, congenital and post‐partum outcomes. Methods: We performed a multicentre retrospective cohort study across 19 Italian tertiary referral hospital. Childbearing women were eligible if aged 18–49 years and carried out the pregnancy between 1 October 2018 and 1 September 2022. Results: We retrospectively screened records of 5062 patients receiving dupilumab regardless of age and gender, identifying 951 female atopic dermatitis patients of childbearing age, 29 of whom had been exposed to the drug during pregnancy (3%). The median duration of dupilumab treatment prior to conception was 22.5 weeks (range: 3–118). The median time of exposure to the drug during pregnancy was 6 weeks (range: 2–24). All the documented pregnancies were unplanned, and the drug was discontinued in all cases once pregnancy status was reported. The comparison of the study cohort and the control group found no significant drug‐associated risk for adverse pregnancy, congenital, neonatal or post‐partum outcomes. The absence of a statistically significant effect of exposure on the event was confirmed by bivariate analysis and multivariate analysis adjusted for other confounding factors. Conclusions: This cohort of pregnant patients exposed to dupilumab adds to the existing evidence concerning the safety of biologic agents in pregnancy. No safety issues were identified regarding the primary outcome assessed. In clinical practice, these data provide reassurance in case of dupilumab exposure during the first trimester. However, the continuous use of dupilumab throughout pregnancy warrants further research. [ABSTRACT FROM AUTHOR]

Regional floods result from various flood generation mechanisms. Traditional analyses mainly link flooding to extreme rainfall, with limited input from soil moisture. Total water storage (TWS) is a holistic measure of basin wetness, including additional storage components from surface water, snow, and groundwater. Utilizing a new 5‐day Gravity Recovery and Climate Experiment and its Follow On (GRACE(‐FO)) data set, we investigated the linkage between short‐term TWS anomaly (TWSA) and regional flooding. The 5‐day TWSA solutions revealed flood signals missed by monthly TWSA solutions. Global basins exhibit distinct storage‐discharge co‐evolution patterns, offering new insights into flood mechanisms and propensity. Our bivariate event analyses show the annual maximum river discharges co‐occur more often with the TWSA maxima than with precipitation in many basins. Further analyses revealed TWSA's time‐lagged effect on river discharge, particularly in basins susceptible to floods triggered by saturation‐excess runoff. The 5‐day TWSA provides a new source of information for enhancing global flood preparedness. Plain Language Summary: Every year, floods impact millions of people and result in significant economic losses. Despite this, we still face uncertainties in flood forecasting. In this study, we evaluated a new 5‐day total water storage anomaly (TWSA) data set derived from the Gravity Recovery and Climate Experiment (GRACE) satellites for flood early warning. TWSA measures changes in snow, surface water, soil moisture, and groundwater storage, providing a direct way to assess how wet an area is. The 5‐day TWSA data help us understand for the first time the connection between sub‐monthly TWSA and regional river flooding. Our findings show the 5‐day TWSA reveals new flood signals that were previously not captured using monthly TWSA data. This finding fills a crucial gap in global flood early warning systems, helping us better predict and prepare for floods. Key Points: We investigated the role of total water storage anomalies (TWSA) in mediating regional flooding using a new 5‐day GRACE(‐FO) data setRegional floods tend to have higher number of joint occurrences with the 5‐day TWSA extremes than with precipitation extremesThe causal strength of 5‐day TWSA on river discharge is relatively high, suggesting its potential value for flood early warning [ABSTRACT FROM AUTHOR]

Introduction Material and Methods Results Conclusions Postnatal perineal pain is prevalent following childbirth and can impact women both physically and emotionally. The aim of the study was to study the effect of collegial midwifery assistance on perineal pain and pain medication 1 month after birth and to investigate the associations between the type of tear and perineal pain, satisfaction with healing, and resumption of intercourse.A follow‐up questionnaire was sent 1 month postpartum to women with a first spontaneous vaginal birth participating in a randomized controlled trial (Oneplus trial). Data were collected from December 2019 to May 2020. Differences in perineal pain between women attended by one or two midwives were analyzed according to intention‐to‐treat using bivariate analyses. Associations between the type of tear and perineal pain, satisfaction with healing, and resumption of sexual intercourse were investigated using univariable and multivariable logistic regression. The category no tear/first‐degree tear was compared separately to each of the other tear categories. Trial registration number: ClinicalTrials.gov, NCT03770962.Out of 2233 women, 1762 responded within 30–60 days postpartum. Of women in the no tear/first‐degree tear category, 27.7% reported perineal pain during the past week, in contrast to women with OASI, where 64.2% reported perineal pain. Women with OASI experienced the highest odds of perineal pain (aOR 4.51, 95% CI 2.72–7.47) compared to those with no tear/first‐degree tear, followed by women with major second‐degree tears (aOR 1.87, 95% CI 1.45–2.41), women with an episiotomy (aOR 1.78, 95% CI 1.11–2.87), and those with minor second‐degree tears (aOR 1.43, 95% CI 1.06–1.94). Women with episiotomy reported the highest odds ratios for dissatisfaction with tear healing (aOR 3.48, 95% CI 1.92–6.31). No significant differences in perineal pain and pain medication were observed between women allocated to collegial midwifery assistance and those allocated to standard care.Women with OASI reported the highest odds of perineal pain 30–60 days after birth compared to women with no tear or first‐degree tear, followed by women with major second‐degree tears. Women subjected to an episiotomy reported highest odds ratios of dissatisfaction with tear healing. [ABSTRACT FROM AUTHOR]

Summary: Dexmedetomidine (DEX) has been described as a safe sedative in clinical practice, but its effects on the pathophysiological traits of obstructive sleep apnea (OSA) are unclear. We estimated the effects of DEX sedation on the four key pathophysiological traits of OSA (pharyngeal collapsibility, dilator muscle function, arousal threshold, and loop gain) in adult patients with OSA by conducting a secondary analysis of a prospective diagnostic trial. Pathophysiological traits estimated from polysomnography and the respiratory parameters under natural sleep and DEX‐induced sleep were compared. Bivariate and multivariate linear regression analyses were used to estimate the relationship between pathophysiological traits and OSA severity for both sleep states. Adult patients with OSA had a significantly higher pharyngeal collapsibility (Vpassive: 44.9 [15.7 to 53.8] vs. 53.3 [34.2 to 66.3] %eupnea, p < 0.001), arousal threshold (178.5 [132.5 to 234.6] vs. 140.5 [123.2 to 192.3] %eupnea, p < 0.001), and loop gain (LG1: 0.74 ± 0.25 vs. 0.60 ± 0.17, p < 0.001; LGn: 0.52 ± 0.12 vs. 0.44 ± 0.08, p < 0.001) during DEX‐induced sleep compared with natural sleep. There was no significant difference in dilator muscle function or PSG respiratory parameters between natural versus DEX‐induced sleep states. Bivariate regression analysis showed varying degrees of correlation between OSA traits and severity. Multiple regression analysis indicated that collapsibility was the strongest predictor of the apnea–hypopnea index for both sleep states. Dexmedetomidine sedation in patients with OSA increased the pharyngeal collapsibility without impairing dilator muscle function, while elevating arousal threshold and increasing loop gain. [ABSTRACT FROM AUTHOR]

The aim was to estimate the relative contribution of imprinting effects from both paternal and maternal sides to phenotypic variation in milk production traits including 305 days milk yield (MY), average daily milk production (ADM), fat percentage (F%), protein percentage (P%), 305 days fat yield (FY), 305 days protein yield (PY), ratio of fat percentage to protein percentage (F:P) and somatic cell score (SCS) in Iranian Holstein cows. To do this, each trait was analysed with a series of four animal models, which were identical for fixed and additive genetic effects but differed for combinations of paternal and maternal imprinting effects. The log‐likelihood ratio test (LRT) and Akaike's information criteria (AIC) were used to select the best model for each trait. Correlations between traits due to additive and imprinting effects were estimated by bivariate analyses. For all traits studied, fitting the imprinting effect led to a better data fit. Also, it resulted in a noticeable decrease in additive genetic variance from 8% (SCS) to 28% (F:P). A significant maternal imprinting effect was detected on all traits studied. Estimates of maternal imprinting heritability (hmi2$$ {h}_{\mathrm{mi}}^2 $$) were 0.07 ± 0.02, 0.04 ± 0.01, 0.06 ± 0.01, 0.05 ± 0.01, 0.5 ± 0.01, 0.09 ± 0.02, 0.07 ± 0.02 and 0.06 ± 0.01 for MY, ADM, F%, P%, FY, PY, F:P and SCS, respectively. For F:P, in addition to the maternal imprinting effect, a significant paternal imprinting component was also detected with a 7% contribution to phenotypic variance of F:P. Estimates of direct heritability (ha2$$ {h}_{\mathrm{a}}^2 $$) were 0.29 ± 0.02, 0.17 ± 0.01, 0.22 ± 0.02, 0.11 ± 0.01, 0.18 ± 0.02, 0.22 ± 0.02, 0.15 ± 0.04 and 0.06 ± 0.01 for MY, ADM, F%, P%, FY, PY, F:P and SCS, respectively. Maternal imprinting correlations (rmi) were in a wide range between −0.75 ± 0.15 (P%‐SCS) and 0.95 ± 0.11 (MY‐ADM). Additive genetic correlations (ra) ranged between −0.54 ± 0.05 (MY‐P%) and 0.99 ± 0.01 (MY‐ADM) and phenotypic correlations (rp) ranged from −0.30 ± 0.01 (MY‐F%) to 0.93 ± 0.01 (MY‐ADM). The Spearman's correlation between additive breeding values including and excluding imprinting effects deviated from unity especially for top‐ranked animals implying re‐ranking of top animals following the inclusion of imprinting effects in the model. Since including imprinting effects in the model resulted in better data fit and re‐ranking of top animals, including these effects in the genetic evaluation models for milk production traits was recommended. [ABSTRACT FROM AUTHOR]

Objective: Olfactory dysfunction (OD) is a condition primarily affecting older adults. Several factors have been implicated in OD, such as age, socioeconomic status, and neurodegenerative disease; however, the effect of military service still requires additional investigation. Here, we aim to determine if there is an association between prior military service and OD among older adults. Methods: This cross‐sectional study included 2268 adults from Round 1 of the National Social Life, Health, and Aging Project. OD was defined as 0–3 odors correctly identified on the 5‐item Sniffin' Sticks test. Bivariate analysis was conducted to calculate crude odds ratios (cOR) for the association of prior military service with OD and identify covariates for regression. Associations between prior military service and OD were assessed using logistic regression, and adjusted odds ratios (aOR) were calculated controlling for age, gender, race/ethnicity, education, stroke history, dementia, diabetes, and mental health. All analyses were weighted using survey weights to account for sampling design. Results: OD was present in 489 adults (21.6%). Among those with OD, the average age was 71.0 ± 7.9 years, whereas the average age in those without OD was 67.0 ± 7.2 years. Among adults with OD, 34.4% reported prior military service, compared to 27.7% of adults without OD (cOR = 1.37; 95% CI: 1.05–1.79). However, after adjusting for covariates, prior military service was not associated with OD (aOR: 1.09; 95% CI: 0.79–1.50). Older age (aOR: 1.07; 95% CI: 1.05–1.09) and worse mental health (aOR: 1.68; 95% CI: 1.14–2.49) were associated with OD. Conclusion: Prior military service was not associated with OD among older adults after controlling for covariates. More nuanced research is needed to examine correlations between OD and specific elements of military service such as duration, toxin exposure, and head trauma. Level of Evidence: Level 4. [ABSTRACT FROM AUTHOR]

Objective: Musculoskeletal ultrasound (MSUS) is widely used in adult rheumatology practice for diagnosis of arthritis and procedural guidance; however, it is not yet common practice in pediatric rheumatology. MSUS is advantageous to the pediatric population because it lacks radiation and eliminates need for sedation. This study aims to assess interest in, access to, and barriers to MSUS training in pediatric rheumatology fellowship programs in North America. Methods: A survey was developed by pediatric rheumatology providers with experience in medical and/or MSUS education and distributed via REDCap anonymously in March 2022 (Supplementary Material). Eligible participants included current and recently graduated (<1 year) pediatric rheumatology fellows at a North American program. Descriptive statistics and bivariate analyses using design‐based Pearson chi‐squared tests were performed. Results: Overall response rate was 78% (88/113), and 75% reported some form of MSUS training during fellowship. Only 36% indicated their program had a formal MSUS curriculum. Of those with MSUS training, 23% reported adult‐only MSUS education. Eighty‐four percent felt MSUS would be beneficial to their career. Major barriers to MSUS training included lack of MSUS‐trained faculty, lack of time, and lack of hands‐on MSUS sessions. Those who had access to MSUS training were significantly more interested in MSUS than those without (P = 0.0036). Conclusion: This study demonstrates that North American pediatric rheumatology fellows have a strong interest in learning MSUS, but they face significant challenges in accessing MSUS training (lack of MSUS‐trained faculty, time, and access to hands‐on training). MSUS should be incorporated into fellowship curriculum; however, implementation remains a challenge. [ABSTRACT FROM AUTHOR]

Objectives: The main goal of presurgical evaluation in drug‐resistant focal epilepsy is to identify a seizure onset zone (SOZ). Of the noninvasive, yet resource‐intensive tests available, ictal single‐photon emission computed tomography (SPECT) aids SOZ localization by measuring focal increases in blood flow within the SOZ via intravenous peri‐ictal radionuclide administration. Recent studies indicate that geographic and center‐specific factors impact utilization of these diagnostic procedures. Our study analyzed successful ictal SPECT acquisition (defined as peri‐ictal injection during inpatient admission) using surgery‐related data from the Pediatric Epilepsy Research Consortium (PERC) surgery database. We hypothesized that a high seizure burden, longer duration of video EEG monitoring (VEEG), and more center‐specific hours of SPECT availability would increase the likelihood of successful ictal SPECT. Methods: We identified study participants (≤18 years of age) who underwent SPECT as part of their phase 1 VEEG from January 2018 to June 2022. We assessed association between ictal SPECT outcomes (success vs. failure) and variables including patient demographics, epilepsy history, and center‐specific SPECT practices. Results: Phase 1 VEEG monitoring with ictal SPECT injection was planned in 297 participants and successful in 255 participants (85.86%). On multivariable analysis, the likelihood of a successful SPECT injection was higher in patients of non‐Hispanic ethnicity (p = 0.040), shorter duration VEEG (p = 0.004), and higher hours of available SPECT services (p < 0.001). Higher seizure frequency (p = 0.033) was significant only in bivariate analysis. Patients treated at centers with more operational hours were more likely to experience pre‐admission protocols prior to VEEG (p = 0.002). Significance: There is inter‐center variability in protocols and SPECT acquisition capabilities. Shorter duration of EEG monitoring, non‐Hispanic ethnicity (when on private insurance), extended operational hours of nuclear medicine as noted on multivariate analysis and higher seizure frequency in bivariate analysis are strongly associated with successful ictal SPECT injection. Plain Language Summary: In pediatric patients with drug‐resistant epilepsy, single‐photon emission computed tomography (SPECT) scans can be helpful in localizing seizure onset zone. However, due to many logistical challenges described below, which include not only the half‐life of the technetium isotope used to inject intravenously during a seizure (called the ictal SPECT scan) but also available nuclear scanner time in addition to the unpredictability of seizures, obtaining an ictal SPECT during a planned elective inpatient hospital stay is not guaranteed. Thus, as healthcare costs increase, planning a prolonged hospital stay during which an ictal SPECT scan is not feasible is not optimal. We leveraged our prospective surgery database to look at center‐specific factors and patient‐specific factors associated with an ictal SPECT injection in the first, pediatric‐focussed, large‐scale, multicenter, prospective, SPECT feasibility study. We found that longer availability of the scanner is the most important center‐specific factor in assuring ictal SPECT injection. Although seizure frequency is an important patient‐specific factor on bivariate analysis, this factor lost statistical significance when other factors like patient insurance status and video EEG duration were also considered in our multivariable logistical model. [ABSTRACT FROM AUTHOR]

Premise: Most traits are polygenic and most genes are pleiotropic, resulting in complex, integrated phenotypes. Polyploidy presents an excellent opportunity to explore the evolution of phenotypic integration as entire genomes are duplicated, allowing for new associations among traits and potentially leading to enhanced or reduced phenotypic integration. Despite the multivariate nature of phenotypic evolution, studies often rely on simplistic bivariate correlations that cannot accurately represent complex phenotypes or data reduction techniques that can obscure specific trait relationships. Methods: We apply network modeling, a common gene co‐expression analysis, to the study of phenotypic integration to identify multivariate patterns of phenotypic evolution, including anatomy and morphology (structural) and physiology (functional) traits in response to whole genome duplication in the genus Brassica. Results: We identify four key structural traits that are overrepresented in the evolution of phenotypic integration. Seeding networks with key traits allowed us to identify structure–function relationships not apparent from bivariate analyses. In general, allopolyploids exhibited larger, more robust networks indicative of increased phenotypic integration compared to diploids. Discussion: Phenotypic network analysis may provide important insights into the effects of selection on non‐target traits, even when they lack direct correlations with the target traits. Network analysis may allow for more nuanced predictions of both natural and artificial selection. [ABSTRACT FROM AUTHOR]

Objective: Scholars have struggled to understand Donald Trump's surprising levels of Latino support in two consecutive presidential elections. We test three hypotheses to better understand the strength and weakness of Trump, Biden, and both political parties. Methods: We conduct bivariate and multivariate analyses of pre‐ and post‐election surveys to identify sources of support (beyond national origin differences) that explain how Trump improved his level of support among Latino voters to reach the low‐ to mid‐ 30 percent range. Results: Intra‐Latino differences in ideology, identity (gender and religion), and immigration attitudes help explain Trump's relatively strong showing among Latinos in 2020. Conclusion: While the nation's electorate is becoming more demographically diverse, many predictions associated with the notion of "demography as destiny" should be tempered given the political heterogeneity among Latino voters. [ABSTRACT FROM AUTHOR]

The analysis of multiple bivariate correlations is often carried out by conducting simple tests to check whether each of them is significantly different from zero. In addition, pairwise differences are often judged by eye or by comparing the p‐values of the individual tests of significance despite the existence of statistical tests for differences between correlations. This paper uses simulation methods to assess the accuracy (empirical Type I error rate), power, and robustness of 10 tests designed to check the significance of the difference between two dependent correlations with overlapping variables (i.e., the correlation between X1 and Y and the correlation between X2 and Y). Five of the tests turned out to be inadvisable because their empirical Type I error rates under normality differ greatly from the nominal alpha level of .05 either across the board or within certain sub‐ranges of the parameter space. The remaining five tests were acceptable and their merits were similar in terms of all comparison criteria, although none of them was robust across all forms of non‐normality explored in the study. Practical recommendations are given for the choice of a statistical test to compare dependent correlations with overlapping variables. [ABSTRACT FROM AUTHOR]

Establishing marine species distributions is essential for guiding management and can be estimated by identifying potential favorable habitat at a population level and incorporating individual‐level information (e.g., movement constraints) to inform realized space use. In this research, we applied a combined modeling approach to tracking data of adult female and juvenile South American sea lions (Otaria flavescens; n = 9) from July to November 2011 to make habitat predictions for populations in northern Chile. We incorporated topographic and oceanographic predictors with sea lion locations and environmentally based pseudo‐absences in a generalized linear model for estimating population‐level distribution. For the individual approach, we used a generalized linear mixed‐effects model with a negative exponential kernel variable to quantify distance‐dependent movement from the colony. Spatial predictions from both approaches were combined in a bivariate color map to identify areas of agreement. We then used a GIS‐based risk model to characterize bycatch risk in industrial and artisanal purse‐seine fisheries based on fishing set data from scientific observers and artisanal fleet logs (2010–2015), the bivariate sea lion distribution map, and criteria ratings of interaction characteristics. Our results indicate population‐level associations with productive, shallow, low slope waters, near to river‐mouths, and with high eddy activity. Individual distribution was restricted to shallow slopes and cool waters. Variation between approaches may reflect intrinsic factors restricting use of otherwise favorable habitat; however, sample size was limited, and additional data are needed to establish the full range of individual‐level distributions. Our bycatch risk outputs identified highest risk from industrial fisheries operating nearshore (within 5 NM) and risk was lower, overall, for the artisanal fleet. This research demonstrates the potential for integrating potential and realized distribution models within a spatial risk assessment and fills a gap in knowledge on this species' distribution, providing a basis for targeting bycatch mitigation outreach and interventions. [ABSTRACT FROM AUTHOR]

Introduction: First episode psychosis (FEP) services ensure higher recovery rates compared to usual care. The aim of this study was to investigate the different dimensions of recovery and its predictors. Methods: This cross‐sectional study recruited within those admitted to the Ferrara FEP service since 2012 that at the time of analysis were still receiving psychiatric care. At admission, demographic, social and clinical information were collected. In September 2022, patients were assessed with the Health of the Nation Outcome Scale to evaluate clinical/functional recovery, the Recovery Assessment Scale to evaluate personal recovery, and the G12 item of the Positive and Negative Syndrome Scale to evaluate insight. Patients in recovery were compared to those not in recovery by bivariate analyses. Adjusted logistic regressions were performed to investigate predictors of recovery. Results: Within 141 admitted, and 105 still receiving care, 54 patients completed the assessment. Most (51.9%) were in clinical/functional, 61.1% in personal recovery, and 38.8% both. Psychiatric hospitalization positively predicted clinical/functional recovery, whereas being prescribed oral antipsychotics was a negative predictor. Personal recovery was predicted by male sex and showed a negative association with overall severity of symptomatology. Those in personal recovery were more likely to have been prescribed long‐acting antipsychotics, but this was not significant in the multivariable analysis. Poor insight negatively predicted clinical/functional recovery but had no impact on personal recovery. Conclusion: Our findings confirm that clinical/functional and personal recovery are semi‐independent dimensions and not always overlap. Further research is needed to promote interventions targeted at all recovery dimensions. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic disrupted the provision of surgical services in Australia. To prepare for a surge of COVID‐19 patients, elective surgery was mandatorily reduced or ceased at multiple timepoints in Australian states between 2020 and 2022. Operative exposure is a critical component of surgical training in general surgery, and readiness for practice is an ongoing priority. However, the impact of COVID‐19 on operative exposure in Australian General Surgical Trainees (AGST) has not been quantified. Methods: This study was a retrospective longitudinal cohort study using de‐identified operative logbook data for Australian General surgical Trainees (AGST) from the Royal Australasian College of Surgeons (RACS) Morbidity and Audit Logbook Tool (MALT) system between February 2019 and July 2021. Bivariate analysis was used to determine the impact of COVID‐19 on general surgical trainees' exposure to operative surgery and trainees' operative autonomy. Results: Data from 1896 unique 6‐month training terms and 543 285 surgical cases was included over the data collection period. There was no statistically significant impact of the COVID‐19 pandemic on AGST operative exposure to major, minor operations, endoscopies, or operative autonomy. Conclusions: The impact of COVID‐19 on surgical trainees globally has been significant. Although this study does not assess all aspects of surgical training, this data demonstrates that there has not been a significant impact of the pandemic on operative exposure or autonomy of AGST. [ABSTRACT FROM AUTHOR]

Objective: Rapid eye movement (REM)‐dependent obstructive sleep apnea syndrome (OSAS) is a specific subtype of OSAS having some phenotypic characteristics like a preference for a younger age, female gender, and milder severity. Such favorable features could make it possible to consider an overall benign course for this phenotype. However, accumulating data introduced its association with several cardiometabolic and vascular disorders recently. The primary objective of this study was to address the disease from the inflammation perspective and evaluate the potential inflammatory status in this variant via two accessible blood parameters: platelet distribution width (PDW) and systemic immune‐inflammation index (SII). The secondary aim was to investigate whether this status, together with other disease characteristics, demonstrates consistency under different definitions of REM‐dependent OSAS published previously. Patients and methods: The medical records of 35 patients with mild‐to‐moderate REM‐dependent OSAS, 35 age‐ and sex‐matched patients with REM‐independent OSAS, and 25 non‐OSA controls were retrospectively analyzed. Baseline features, polysomnographic characteristics, PDW, and SII were compared between the groups. Secondly, the analyses were repeated using different definitions of REM‐dependent OSAS. Bivariate analyses were performed, and a multiple stepwise regression model was applied to adjust for body mass index (BMI) and cardiovascular risk (CVR) factors. Results: Mean PDW and SII were increased in patients with REM‐dependent OSAS as compared to non‐OSA controls (p =.022 and.029). The significance remained stable after adjustment for BMI and CVRs and was consistent according to different definitions. The Comparison of patients with REM‐independent OSAS and non‐OSA controls, as well as the two different subtypes of OSAS, did not yield significance. Conclusion: Based on the current findings, patients with REM‐dependent OSAS appear to be susceptible to inflammation and should be carefully monitored for the negative consequences of that issue. To our knowledge, this study is the first to evaluate SII and PDW in REM‐dependent OSAS. [ABSTRACT FROM AUTHOR]

Background: Increasing surgical specialist workforce density in sub‐Saharan Africa is essential for improving access to surgical care. However, out‐migration creates a significant challenge to attaining provider targets. We aimed to determine the rates and trends of retention of surgeons in the College of Surgeons of East Central and Southern Africa (COSECSA) regions. Methodology: An online, web‐based survey was distributed to COSECSA surgeons who graduated from 2004 to 2020. Current practice and migration patterns were visualized using descriptive analyses and logistic regression models. Results: Response rate was 48% (270/557). Most respondents trained as general surgeons and practiced in Ethiopia, Kenya, Zimbabwe, and Zambia. Majority practiced in public hospitals (74%), and were active in research (81%), teaching (84%) and leadership (55%). Overall country (85%), regional (92%) and Africa retention rates (99%) were high with 100% country retention in Rwanda, Botswana, Lesotho, and Namibia. Tanzania had the lowest retention (61%). Highest inter‐regional migration occurred from East to Southern Africa (26%), and continental out‐migration occurred from Zambia, Zimbabwe, and Kenya. On bivariate analysis, out‐migration from training country and region was associated working with a non‐governmental organization (p = 0.002 and 0.0003) or a specialized hospital (p = 0.046 and 0.011). A multiple regression model with type of institution and leadership was a poor fit (McFadden R2 = 0.055; p = 0.082). Conclusion: Retention rates of surgeons trained by COSECSA in the region remain remarkably high. This can be taken as an indicator of success of the training model to increase surgical workforce density, however, contributory factors need to be qualitatively explored. [ABSTRACT FROM AUTHOR]

Extreme precipitation‐related hazards like flash floods pose a widespread risk to humans and infrastructure around the world. In the current study, the Fisher information was applied to understand the nonstationarity of the extreme precipitation regimes, whereas copula was used to quantify the likelihood of joint occurrence of two extreme precipitation indices and associated risk assessment in the upper Midwestern United States (UMUS). The trend analysis revealed an increasing trend in 37% of the stations in heavy precipitation amount in the UMUS. The regime shift analysis showed the non‐stationary nature of extreme precipitation in about half of the total stations in UMUS. Further, the bivariate analysis using copula demonstrated the risk of the joint occurrence of extreme precipitation indices potentially causing flash floods. The risk index analysis indicated about 28.8% of stations under moderate, 10.6% of stations under high and 0.4% of stations under very high risk of flash flooding. The results from the study can provide important insights for the (re)design of resilient and sustainable water infrastructure in the changing climate condition and can also inform managers and planners for better response and preparedness toward extreme precipitation‐related hazards in this region. The results from this study can also help in a more accurate risk assessment, especially in the socio‐economically vulnerable community. [ABSTRACT FROM AUTHOR]

Global warming increases the atmospheric water‐holding capacity, consequently altering the frequency, and intensity of extreme hydrological events. River floods characterized by large peak flow or prolonged duration can amplify the risk of social disruption and affect ecosystem stability. However, previous studies have mostly focused on univariate flood magnitude characteristics, such as flood peak or volume, and there is still limited understanding of how these joint flood characteristics (i.e., magnitude and duration) might co‐evolve under different warming levels. Here, we develop a systematical bivariate framework to project future flood risk in 11,528 catchments across the globe. By constructing the joint distribution of flood peak and duration with copulas, we examine global flood risk with a bivariate framework under varying levels of global warming (i.e., within a range of 1.5–3.0°C above pre‐industrial levels). The flood projections are produced by driving five calibrated lumped hydrological models (HMs) using the simulations with bias adjustment of five global climate models (GCMs) under three shared socioeconomic pathways (SSP126, SSP370, and SSP585). On average, global warming from 1.5 to 3.0°C tends to amplify flood peak and lengthen flood duration across almost all continents, but changes are not unidirectional and vary regionally around the globe. The joint return period (JRP) of the historical (1985–2014) 50‐year flood event is projected to decrease to a median with 36 years under a medium emission pathway at the 1.5°C warming level. Finally, we evaluate the drivers of these JRP changes in the future climate and quantify the uncertainty arising from the different GCMs, SSPs, and HMs. Our findings highlight the importance of limiting greenhouse gas emission to slow down global warming and developing climate adaptation strategies to address future flood hazards. Plain Language Summary: Floods with large peak flow or prolonged duration can have considerable impacts on infrastructure and ecosystems, and may become more severe in a warmer planet. However, due to the complex interplay between the climate system and hydrological processes, our understanding of future flood risk remains limited. We use copula‐based approach to establish the joint distribution of flood peak and duration to examine future flood risk under varying levels of global warming. The results show that most catchments across the globe are likely to experience heightened flood risk in response to climate change, with an amplification effect on flood risk as temperature increases from 1.5 to 3.0°C. Our findings emphasize the urgency of limiting greenhouse gas emission to adapt to future flood hazards under global climate change. Key Points: We project future daily streamflow by a cascade model chain in 11,528 catchments across the globeWe evaluate shifts in future global flood risk with a copula‐based framework under different warming levelsGlobal warming from 1.5 to 3.0°C has a significant impact on flood intensification, with an amplification effect on flood peak and duration [ABSTRACT FROM AUTHOR]

Objective: To determine if caregivers would be able to successfully perform in home lung ultrasounds on their children without direct supervision after undergoing a basic tutorial that would allow for expert interpretation. Methods: A prospective exploratory single‐center cohort study was conducted on patients (0–18 years) presenting to a pediatric emergency department with a respiratory complaint or COVID‐related illness. Caregivers underwent a brief hands‐on session and were instructed to scan the lungs daily for 7 days. Images were assessed using a modified POCUS IQ score. Descriptive statistics were used to describe the data and bivariate analysis was used to compare groups. Results: Eighteen patients were enrolled; the average age of the parent scanner was 31.9 years and 78% were female. Of all participants, 77.8% scanned on day one. Parents were able to successfully perform some part of the daily scan session for an average of 3.8 out of 7 days. The average POCUS IQ score overall was 6.7 (out of 12). Conclusion: Our study demonstrates the feasibility and acceptability of caregiver ability to obtain adequate lung ultrasound images, at home under no guidance, using the Butterfly iQ probe. Further studies are needed to investigate the accessibility of ultra‐portable ultrasound and the ability to integrate with the at‐home hospital model, specifically in the pediatric population. [ABSTRACT FROM AUTHOR]

Background and Aim: Though emergency medical services (EMS) respond to all types of emergency calls, they do not always result in the patient being transported to the hospital. This study aimed to explore the determinants influencing emergency call‐response‐based conveyance decisions in a Middle Eastern ambulance service. Methods: This retrospective quantitative analysis of 93,712 emergency calls to the Hamad Medical Corporation Ambulance Service (HMCAS) between January 1 and May 31, 2023, obtained from the HMCAS electronic system, was analyzed to determine pertinent variables. Sociodemographic, emergency dispatch‐related, clinical, and miscellaneous predictors were analyzed. Descriptive, bivariate, ridge logistic regression, and combination analyses were evaluated. Results: 23.95% (N = 21,194) and 76.05% (N = 67,285) resulted in patient nontransport and transportation, respectively. Sociodemographic analysis revealed that males predominantly activated EMS resources, and 60% of males (n = 12,687) were not transported, whilst 65% of females (n = 44,053) were transported. South Asians represented a significant proportion of the transported patients (36%, n = 24,007). "Home" emerged as the primary emergency location (56%, n = 37,725). Bivariate analysis revealed significant associations across several variables, though multicollinearity was identified as a challenge. Ridge regression analysis underscored the role of certain predictors, such as missing provisional diagnoses, in transportation decisions. The upset plot shows that hypertension and diabetes mellitus were the most common combinations in both groups. Conclusions: This study highlights the nuanced complexities governing conveyance decisions. By unveiling patterns such as male predominance, which reflects Qatar's expatriate population, and specific temporal EMS activity peaks, this study accentuates the importance of holistic patient assessment that transcends medical histories. [ABSTRACT FROM AUTHOR]

Due to the low frequency and the changes in diagnostic techniques and terminology during the last few years, only little clinical information is available on splenic stromal sarcoma (SSS). This multi‐institutional study aimed at gathering clinical cases of SSS in dogs and investigates their clinical behaviour, as well as analyse possible clinicopathological prognostic factors, including the use of adjuvant therapy. Dogs with a histologically confirmed SSS that underwent splenectomy were retrospectively included. To be included in the study, either FFPE tissue blocks or multiple tissue sections had to be available for histopathologic and immunohistochemical revision. Clinical and pathological variables, along with adjuvant therapy data, were collected. Cumulative incidence of metastatic disease was analysed through univariate and bivariate analyses. The impact of adjuvant chemotherapy on metastasis incidence and survival was assessed, considering an estimated propensity score. A total of 32 dogs were included. Among them, 22 developed metastases with an incidence of 37.5%, 59.38%, and 65.94% at 6, 12, and 24 months, respectively. Univariate analysis identified mitotic count, total scoring, and necrosis as prognostic factors. In bivariate analysis, mitotic count remained prognostic. The administration of adjuvant chemotherapy did not have an impact on metastasis incidence or survival time. The study found that dogs with SSSs are at high risk of metastasis, although a small subgroup may experience longer survival after splenectomy. Mitotic count was the only variable having a reliable prognostic impact. Adjuvant chemotherapy did not appear to decrease the incidence of metastasis or prolong survival in these dogs. [ABSTRACT FROM AUTHOR]

Objective: To assess the feasibility and relevancy of a systematic data collection process in characterizing factors influencing research acceptability through women during pregnancy and early postpartum. Methods: A pilot prospective observational crossover unicentric study was conducted in Est France. All the women (except language barrier and intensive care transfer) were called upon to complete a survey (33 questions). The primary endpoints were the participation rate and the completeness of the information. The secondary endpoint was the participants' sociodemographic background and preferences regarding research (bivariate analysis, P value <0.20). Results: Within the research period (February 23–March 8, 114 childbirths), 105 women fitting the criteria were called upon for the survey. The participation rate and completeness were high. The participation rate was 93% with six lost to follow‐up, and one refusal. The global filling rate was 95%. We highlighted two plausible variables of interests for research participation: women age older (P value 0.119) and level of education (P value 0.176). A sufficient cooling‐off period, the commitment of women's health providers, and the possibility to accede research results might favor women's involvement. Acceptability would appear to be decreasing when the protocol implied fetal or neonatal data collection (compared to maternal data), unless research led to a better therapeutic option. Conclusion: The data collection process is highly feasible and provide consistent data. Larger‐scale output obtention should enhance the conception and rollout of projects, first by calculating sample size based on potentials for recruitments adjusted to populations, characteristics and second by fitting the experimental design to women's expectations. Synopsis: The pilot study aims to contextualize perinatal research results, facilitate research implementation and promote evidence‐based medicine and midwifery. [ABSTRACT FROM AUTHOR]

Background: Mixed reality (MR), a form of virtual reality (VR), provides an immersive and interactive experience for the user. Given VR's benefits in patients undergoing needle insertion procedures, MR's usability, impact on anxiety, and safety were evaluated in the blood donation setting. Study Design and Methods: Whole blood donors ≥18 years old (yo) were enrolled at two blood centers and provided a MR headset with independently developed software to wear during blood donation. Pre‐ and post‐donation questionnaires were conducted, and reaction data were reviewed. A post‐study questionnaire was also completed by staff who assisted donors with MR. Descriptive statistics, bivariate analyses, and multinomial logistic regression were performed, and p values determined statistical significance between variables. Results: A total of 282 donors completed the study. 84% wanted to try MR because it seemed fun/different/cool/interesting, and most staff (69%) and donors (68%) found MR easy to use. Baseline subjective anxiety, reported by 50.3% (more often in females, first‐time donors, and donors <20 yo), was reduced by MR in 68.4% of donors, and there was a 3.6 times higher odds of anxiety reduction with MR. 54% of donors with baseline anxiety would use MR again with the highest future interest in young donors. Donor reactions while using MR were mild and included pre‐faint reactions and hematomas. Conclusion: This study demonstrates the potential of MR in reducing donor anxiety, its feasibility during blood donation, and its safety in blood donors. MR is an innovative technology that holds promise to increase donor engagement, satisfaction, and retention. [ABSTRACT FROM AUTHOR]

Background: Emerging literature suggests that LGBTQ+ cancer survivors are more likely to experience financial burden than non‐LGBTQ+ survivors. However, LGBTQ+ cancer survivors experience with cost‐coping behaviors such as crowdfunding is understudied. Methods: We aimed to assess LGBTQ+ inequity in cancer crowdfunding by combining community‐engaged and technology‐based methods. Crowdfunding campaigns were web‐scraped from GoFundMe and classified as cancer‐related and LGBTQ+ or non‐LGBTQ+ using term dictionaries. Bivariate analyses and generalized linear models were used to assess differential effects in total goal amount raised by LGBTQ+ status. Stratified models were run by online reach and LGBTQ+ inclusivity of state policy. Results: A total of N = 188,342 active cancer‐related crowdfunding campaigns were web‐scraped from GoFundMe in November 2022, of which N = 535 were LGBTQ+ and ranged from 2014 to 2022. In multivariable models of recent campaigns (2019–2022), LGBTQ+ campaigns raised $1608 (95% CI: −2139, −1077) less than non‐LGBTQ+ campaigns. LGBTQ+ campaigns with low (26–45 donors), moderate (46–87 donors), and high (88–240 donors) online reach raised on average $1152 (95% CI: −$1589, −$716), $1050 (95% CI: −$1737, −$364), and $2655 (95% CI: −$4312, −$998) less than non‐LGBTQ+ campaigns respectively. When stratified by LGBTQ+ inclusivity of state level policy states with anti‐LGBTQ+ policy/lacking equitable policy raised on average $1910 (95% CI: −2640, −1182) less than non‐LGBTQ+ campaigns from the same states. Conclusions and Relevance: Our findings revealed LGBTQ+ inequity in cancer‐related crowdfunding, suggesting that LGBTQ+ cancer survivors may be less able to address financial burden via crowdfunding in comparison to non‐LGBTQ+ cancer survivors—potentially widening existing economic inequities. [ABSTRACT FROM AUTHOR]

Background and Aims: Through reduced natural selection, measured with Biological State Index (Ibs), modern medicine enables most people to survive well beyond the reproductive lifespan leading to deleterious gene accumulation in population. This study explored the role of reduced natural selection in increasing cardiovascular disease (CVD) incidence worldwide. Methods: Country‐specific estimates of CVD incidence and the index of reduced natural selection were captured for analysis of their correlation. Aging, affluence, obesity prevalence, and urbanization were considered as the potential confounders in the analyses. Results: Worldwide, Ibs was significantly correlated with CVD incidence in the bivariate correlation analyses. This relationship remains when the contributing effects from aging, affluence, obesity prevalence, and urbanization are removed in partial correlation model. Multiple linear regression (enter) shows that Ibs is a significant predictor of CVD incidence. Stepwise multiple linear regression selects Ibs as the variable having the second greatest influence on CVD incidence after ageing. Ibs showed a significantly greater correlation with CVD incidence in low‐ and middle‐income countries (LMICs) than in high‐income countries. Conclusion: Worldwide, through reducing natural selection, the side effects of healthcare services may have been partially contributing to the increase of CVD incidence worldwide with special regard to LMICs. [ABSTRACT FROM AUTHOR]

Background: To evaluate factors affecting length of stay (LOS) after choledochal cyst resection in paediatric patients. Methods: This was a retrospective study on patients operated between 2004 and 2021. Associations between clinical factors and LOS were evaluated by bivariate analysis, multiple regression, and equivalence test. Results: Sixty-two patients were included. Twenty-four underwent hepaticoduodenostomy as biliary reconstruction. Five suffered from major complications. The median (25th–75th percentile) operation time was 279 (182–378) min. Median LOS, time to enteral feeding, and time to abdominal drain removal were 8(6–10), 2(1–3), and 5(4–7) days, respectively. Seven factors were found significantly associated with a shorter LOS in bivariate analysis and were included in multiple regression. It revealed that early abdominal drain removal (p < 0.001), early enteral feeding (p = 0.042), and the absence of major complications (p < 0.001) were significantly associated with shorter LOS. Equivalence test suggested that age and preoperative cholangitis had no practical effect on LOS. Conclusions: Early enteral feeding, early drain removal, and avoidance of major complications are associated with a shorter LOS. [ABSTRACT FROM AUTHOR]

This study proposed a framework to evaluate multivariate return periods of hurricanes using event‐based frequency analysis techniques. The applicability of the proposed framework was demonstrated using point‐based and spatial analyses on a recent catastrophic event, Hurricane Ian. Univariate, bivariate, and trivariate frequency analyses were performed by applying generalized extreme value distribution and copula on annual maximum series of flood volume, peak discharge, total rainfall depth, maximum wind speed, wave height and storm surge. As a result of point‐based analyses, return periods of Hurricane Ian was investigated by using our framework; univariate return periods were estimated from 39.2 to 60.2 years, bivariate from 824.1 to 1,592.6 years, and trivariate from 332.1 to 1,722.9 years for the Daytona‐St. Augustine Basin. In the Florida Bay‐Florida Keys Basin, univariate return periods were calculated from 7.5 to 32.9 years, bivariate from 36.5 to 114.9 years, and trivariate from 25.0 to 214.8 years. Using the spatial analyses, we were able to generate the return period map of Hurricane Ian across Florida. Based on bivariate frequency analyses, 18% of hydrologic unit code 8 (HUC8) basins had an average return period of more than 30 years. Sources of uncertainty, due to the scarcity of analysis data, stationarity assumption and impact of other weather systems such as strong frontal passages, were also discussed. Despite these limitations, our framework and results will be valuable in disaster response and recovery. Key Points: We introduced a new framework for evaluating multivariate return periods of hurricane events through event‐based frequency analysesUsing this framework, we estimated the univariate, bivariate, and trivariate return periods of Hurricane IanA return period map was produced using the framework to identify the HUC8 basins affected by Hurricane Ian [ABSTRACT FROM AUTHOR]

Univariate data has been the focus of optimal design for generalized linear models. It is common practice to conduct experiments with multiple dependent responses that are modelled using regression techniques. To design the experiment for all these responses, one needs a multivariate distribution supporting a previously chosen data model. The T‐optimal criterion is used to discriminate between two competing models. The designs that are optimal for discrimination between two models may be unsuitable for describe the quality of predictions for test data. G‐optimal criterion overcomes this restriction by minimizing the maximum variance of the predicted values. The design of experiments with dependent bivariate binary data is a topic we discuss in this paper. For dependent bivariate binary data, a technique for deriving TG‐optimal experimental designs using Copula is shown. The new compound TG‐criterion satisfy the dual aim to selecting the true model and minimizing the maximum prediction variance. The equivalence theorem is demonstrated and proved for the new compound criterion. A numerical example is presented to show the properties of the new compound criterion for bivariate binary setting and its value in meeting the dual aims. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the three symptom indicators of scalp seborrheic dermatitis (SSD), namely scalp flaking, maximum erythema area, and pruritus, to develop a "16‐point scale," to explore its relationship with the severity of SSD, and verify the reliability of the 16‐point scale. Method: A dermatologist evaluated patients with SSD using a 16‐point scale, and statistically analyzed the collected data with the help of SPSS 26.0 software. The measurement data are expressed as (mean ± SD), and the intergroup comparison was done using a non‐parametric test. We performed the correlation analysis using the bivariate correlation analysis method, and the relationship among non‐normal distribution data variables were analyzed using Spearman's correlation coefficient. p < 0.05 indicated that the difference was statistically significant. Results: The total score of the "16‐point scale" strongly correlated with the severity of disease, where scalp flaking had the strongest correlation. As compared with a single score, the correlation of the total score with the severity of disease was higher. The scoring range for mild patients was (0, 5], that for moderate patients was (5, 9], and that for severe patients was (9, 16]. Conclusion: A "16‐point scale", consisting of items for adherent scalp flaking (0–10), maximum erythema area (0–3), and pruritus (0–3), was used to score the patients with SSD, and the total score was strongly correlated with and differentiated the severity of SSD. Recommended evaluation criteria: a total score of 0–5 points indicates mild SSD, 6–9 points indicates moderate SSD, 10–16 points indicates severe SSD. These criteria can help to standardize disease diagnosis and treatment, and efficacy assessment. [ABSTRACT FROM AUTHOR]

Introduction: One of the main adverse outcomes following Holmium laser enucleation of the prostate (HoLEP) is the development of transient de novo urinary incontinence (UI). We aimed to evaluate the correlation of multiple risk factors to UI rates post‐HoLEP. Methods: A review of prospectively maintained 7 year database for HoLEP patients in a single center was performed. UI data at 6 week, 3 month, and 1 year follow‐up intervals were assessed with bivariate and multivariate analysis of multiple potential risk factors. Results: The study included 666 patients with median (IQR) age of 72 (66–78) years old and median (IQR) preoperative prostate volume of 89 (68–126) gm. UI was seen in 287 (43%), 100 (15%) and 26 (5.8%) at 6 week, 3 month, and 1 year follow up occasions respectively. At 6 weeks follow up, UI type was stress, urge and mixed in 121 (18.16%), 118 (17.72) and 48 (7.21%) patients respectively. Using a multivariate regression analysis, obesity and pre‐operative UI were associated with postoperative UI rate at both 6 week (p =.0065,.031) and 3 month (p =.0261,.044) follow up encounters respectively. Also, larger specimen weight was another predictor for 6 week UI (p =.0399) while higher frailty score was a predictor for UI at 3 month occasion (p =.041). Conclusion: Patients with preoperative UI, obesity, frailty, and large prostate volume are at higher risk of short‐term UI post‐HoLEP up to 3 months. Patients with one or more of these risk factors should be counseled regarding the higher risk of UI. [ABSTRACT FROM AUTHOR]

Gauging dental graduates' perceptions of their university training and of how it prepares them for professional practice is useful in measuring the quality and adequacy of the curriculum to which they were exposed. Objectives: This study aimed to evaluate the perceptions of dental graduates' educational environment as well as preparedness to practice, and how these two components are correlated. Methods: A self‐administered, validated questionnaire, developed from previous studies, was distributed to dental graduates of a public Malaysian university (n = 178, response rate = 60%) via online and postal surveys. Bivariate analyses were carried out using Spearman's rank‐order correlation (Spearman's Rho, significance level p <.01) to determine the correlation between (1) Global Preparedness Score and Global DREEM Score, (2) domains of DREEM Inventory and perceived preparedness, and (3) domains of perceived preparedness and DREEM Score. Results: The Global Preparedness Score was 191.52, with more than 90% of respondents feeling well prepared in the "General Patient Management," "Drug and Emergency Management" and "Practice Management" domains. The Global DREEM Score was 148.99/200, interpreted as "more positive than negative." The DREEM Inventory domains with the highest and lowest scores were "Students' Academic Self‐Perception" (78.03%) and "Students' Social Self‐Perception" (71.86%), respectively. A moderate positive correlation was found between Global Preparedness Score and Global DREEM Score (p <.01). In addition, moderate to large positive correlations were noted between perceived preparedness and "Student Perception of Learning," "Student Perception of Atmosphere" and "Student Academic Self‐Perception" (p <.01). Moderate positive correlations were also found between the DREEM Score and most domains of perceived preparedness (p <.01). Conclusions: The majority of graduates were well prepared to perform in most areas of clinical practice and perceived their overall educational environment as positive. In particular, those who viewed the educational environment in a positive light were also found to possess a good level of preparedness. [ABSTRACT FROM AUTHOR]

Objective: Emotional competence (EC) describes one's general ability to perceive, express, process, and regulate their own emotions as well as those of others. In the clinical context of parent–child interactions, the specific ability to perceive, express and regulate a child's emotions is conceptually covered by the Emotional Availability Scales (EAS). We aim to examine theoretical and empirical overlaps between EC (Rindermann) and emotional availability (EA; Biringen) for theoretical, diagnostic, and therapeutic reasons. Methods: Parents of a clinically referred sample of preschool‐aged children (55 dyads) filled out a self‐report questionnaire (ECQ), and certified and blinded raters applied the EAS via observations. In a novel approach, the EC was additionally estimated with independent ratings made by two further observers. All dyads were coded on 10‐min video‐recorded parent–child interactions during free play. Results: In bivariate and multivariate analyses, EC scores from observational ratings were strongly associated with independently rated clinical emotional availability scores. EC scores from self‐reports were moderately associated with emotional availability scores. A post hoc power analysis estimated β error probabilities. Conclusions: EC may represent an important personal precondition to an emotionally available parent. As such, we discuss implications for early risk factor assessments for child development and highlight new prevention approaches, new diagnostic options, and refined treatment goals. Limitations included the sample size, assessment, and the influence of study design on results. [ABSTRACT FROM AUTHOR]

Background and purpose: Measuring health‐related quality of life (QOL) is vital for understanding the disease impact, but the complex relationship between clinical parameters and QOL remains unclear. The objective was to determine the demographic and clinical factors that influence the QOL in adults with inherited and acquired myopathies. Methods: The study was of cross‐sectional design. Detailed demographic and clinical details were collected. Patients answered Neuro‐QOL and Patient‐Reported Outcomes Measurement Information System short‐form questionnaires. Results: Data was collected from 100 consecutive in‐person patient visits. Mean age of the cohort was 49.5 ± 20.1 (18–85) years, and the majority were male (53, 53%). Bivariate analysis between the various demographic and clinical features with the QOL scales revealed single simple question (SSQ), handgrip strength, Medical Research Council (MRC) sum score, female gender, and age to be nonuniformly associated with the QOL scales. There was no difference between inherited and acquired myopathies for any of the QOL scores, except for the poorer lower limb function domain in inherited myopathies (36.7 ± 7.3 vs. 40.9 ± 11.2, p = 0.049). Linear regression models revealed lower SSQ, lower handgrip strength, and lower MRC sum score to independently predict poor QOL. Conclusions: Handgrip strength and SSQ serve as novel predictors of QOL in myopathies. Handgrip strength has a significant impact on physical, mental, and social domains and deserves special attention with respect to rehabilitation. SSQ correlates well with QOL and can be employed as a quick and global assessment of a patient's well‐being. Differences in QOL scores between patients with inherited and acquired myopathies were minimal. [ABSTRACT FROM AUTHOR]

We introduce a bivariate bidimensional mixed‐effects regression model, motivated by the analysis of CO2$$ {\mathrm{CO}}_2 $$ emission levels and growth on OECD countries from 1990 to 2018. The model is able to capture heterogeneity across countries and allows for a full association structure among outcomes, assuming a discrete distribution for the random terms with a possibly different number of support points in each univariate profile. We test the behavior of the proposed approach via a simulation study, considering several factors such as the number of observed units, times, and levels of heterogeneity in the data. Empirically, we define an extended version of the STIRPAT model where all model parameters, and not only the mean, vary according to a regression model. Our empirical findings provide evidence of heterogeneous behaviors across countries and suggest the need of a flexible approach to properly reflect the heterogeneity in both the emission levels and the growth processes. [ABSTRACT FROM AUTHOR]

To design a phase III study with a final endpoint and calculate the required sample size for the desired probability of success, we need a good estimate of the treatment effect on the endpoint. It is prudent to fully utilize all available information including the historical and phase II information of the treatment as well as external data of the other treatments. It is not uncommon that a phase II study may use a surrogate endpoint as the primary endpoint and has no or limited data for the final endpoint. On the other hand, external information from the other studies for the other treatments on the surrogate and final endpoints may be available to establish a relationship between the treatment effects on the two endpoints. Through this relationship, making full use of the surrogate information may enhance the estimate of the treatment effect on the final endpoint. In this research, we propose a bivariate Bayesian analysis approach to comprehensively deal with the problem. A dynamic borrowing approach is considered to regulate the amount of historical data and surrogate information borrowing based on the level of consistency. A much simpler frequentist method is also discussed. Simulations are conducted to compare the performances of different approaches. An example is used to illustrate the applications of the methods. [ABSTRACT FROM AUTHOR]

Background: Coaching has been shown to decrease physician burnout; however, coachee outcomes have been the focus. We report the impact of coaching on women-identifying surgeons who participated as coaches in a 9-month virtual program. Methods: A coaching program was implemented in the Association of Women Surgeons (AWS) to determine the effects of coaching on well-being and burnout from 2018 to 2020. AWS members volunteered and completed training in professional development coaching. Pre- and post-study measures were assessed, and bivariate analysis performed based on burnout and professional fulfillment score. Results: Seventy-five coaches participated; 57 completed both pre- and post-study surveys. There were no significant changes in burnout or professional fulfillment including the Positive Emotion, Engagement, Relationship, Meaning, and Accomplishment scale, hardiness, self-valuation, coping, gratitude, or intolerance of uncertainty scores from baseline to post-survey. On bivariate analysis, hardiness was associated with lower burnout throughout the duration of the program. Coaches with lower burnout at the end of the program met with their coachee more frequently than coaches with higher burnout [mean (SD) 3.95(2.16) versus 2.35(2.13) p = 0.0099]. Discussion: Burnout and professional fulfillment demonstrated no change in women surgeons who participated as professional development coaches. Those with lower burnout and higher professional fulfillment at the end of the program were found to have higher hardiness, which may be worth future investigation. Conclusions: Acquisition of coaching skills did not directly improve well-being in faculty who participated in a resident coaching program. Future studies would benefit from control groups and exploration of qualitative benefits of coaching. [ABSTRACT FROM AUTHOR]

Introduction: Around half of Australian students aged 16–17 are estimated to have drunk alcohol in the past month, with 11% drinking at 'risky' levels. This study investigated: (i) how many Australian adolescents aged 16–17 had parental permission to drink at home in 2016/17 and whether prevalence differed by adolescent sex; (ii) whether adolescents allowed to drink at home had drunk more recently and were drinking greater quantities; (iii) if adolescents allowed to drink at home experienced more alcohol‐related harms; and (iv) if parental drinking patterns were associated with permitting adolescents to drink at home. Methods: Data from Wave 7 of the Longitudinal Study of Australian Children were used. Descriptive and bivariate analyses addressed Aims i–iii. Nested multivariable logistic regression models addressed aim iv. Results: In 2016/17, 28% of Australian adolescents aged 16–17 were allowed to drink alcohol at home. More adolescents with permission had drunk alcohol in the past month (77% vs. 63% of those without permission). There was no difference in quantity of alcohol consumed in the past week between groups. More adolescents allowed to drink at home had experienced alcohol‐related harm compared to those without permission (23% vs. 17%). In multivariable analyses, alcohol consumption by primary parents was associated with an increased likelihood of allowing adolescents to drink at home. Discussions and Conclusions: In order to reduce adolescent alcohol use and associated harms, parents should avoid permitting alcohol use among adolescents at home. Frequent (twice or more/week) primary parental alcohol consumption was especially associated with greater odds of allowing adolescents to drink at home. [ABSTRACT FROM AUTHOR]

Background: Plantar warts are benign, epidermal neoformations, viral, and easily transmitted. Although 30% of these warts disappear spontaneously, the American Association of Dermatology recommends treatment if they cause pain or bleeding. Objectives: The aim of this study was to determine the efficacy of Dermojet® infiltration using a solution composed of equal parts of 0.9% saline and 2% mepivacaine in the treatment of plantar warts, and to identify the type of necrosis achieved at 7–10 days after the infiltration (M1 sample) and at 15–17 days (M2 sample). Method: In this analytical prospective observational study, 102 histories were reviewed by the same researcher. The patients were treated with this technique at four private podiatry clinics. Results: A total of 61.8% of the patients were male. The patients' mean age was 26.6 ± 14.10 years. A total percentage of 78.4% of the patients achieved complete elimination of the lesion by the second evaluation and after a single infiltration. Bivariate analysis revealed a significant inverse relationship between treatment efficacy and a history of previous disease (p < 0.001) and the period of evolution of the lesion (p < 0.001; 95% CI [0.78–7.91]). Multivariate linear regression analysis revealed an association with the number of evaluation sessions (p < 0.001) and with previous illnesses (p = 0.014). A total percentage of 82.35% presented partial necrosis in the M1 sample and 76.92% had complete necrosis in the M2 sample. Conclusions: In 78.4% of the patients considered, the plantar warts treated disappeared after a single infiltration. The variables associated with treatment efficacy were the number of follow‐up visits and the existence of associated diseases. [ABSTRACT FROM AUTHOR]

Background: The prevalence of low back pain (LBP) and its associated risk factors, including physical function, are not fully clarified among health, medical, and welfare facility professionals and workers. Furthermore, issues related to the prevention of LBP are not completely understood. Objective: To investigate the prevalence of LBP and associated risk factors, including physical function, in professionals and workers in health, medical, and welfare facilities. Design: Cross‐sectional study. Setting: Physical examinations for LBP were conducted, and data were collected at health, medical, and welfare facilities in Japan. Participants: A total of 1085 health, medical, and welfare facility professionals and workers participated in the study. Main Outcome Measures: Prevalence was calculated based on the presence or absence of symptoms of LBP at the time of survey. Then, bivariate analysis was conducted to examine the relationship between LBP and age, gender, occupation, history of treatment for LBP, passive straight leg raising (SLR) angle, and abdominal muscle strength. Furthermore, multivariate analysis was performed to examine the relationship between LBP and the six risk factors. Results: The prevalence of LBP was high (74.8%). Bivariate analysis showed a significantly higher percentage of nursing professionals (46.2%) in the LBP group (p <.001). The association between LBP and the risk factors in multivariate analysis was as follows: history of treatment for LBP (odds ratio [OR] = 3.92, 95% confidence interval [CI] 2.63–5.84, p <.001), nursing professionals as occupation (OR = 2.12, 95% CI 1.55–2.90, p <.001), passive SLR angle (OR = 2.06, 95% CI 1.24–3.42, p =.005), abdominal muscle strength (OR = 1.61, 95% CI 1.07–2.41, p =.021), and gender (OR = 1.52, 95% CI 1.08–2.14, p =.015). Conclusion: In the future, it will be necessary to take preventive measures for risk factors and to follow up longitudinally on the prevalence of LBP and on workers with indicated risk factors. [ABSTRACT FROM AUTHOR]

While food allergy prevalence has been studied at the national level, we know little of food allergy prevalence or perceptions of prevalence/management at the local level. This paper uses Waterloo Region as a case study to 1) document self‐reported individual and household food allergy and sensitivity prevalence at the local level; 2) investigate perceptions of food allergy prevalence; and 3) explore perceived confidence in anaphylaxis management. Survey data were collected from January to March 2019. Respondents (n = 500) self‐reported individual and household food allergy and sensitivity, estimated the percentage of Canadians with food allergy, and were queried about their knowledge of food allergy management. Prevalence estimates were weighted to the structure of the 2016 Canadian Census, and univariate and bivariate analysis were conducted. Prevalence of self‐reported food allergy was 12.1% (95%CI, 8.8%‐15.3%), and prevalence of self‐reported food sensitivity was 26.3% (95%CI, 21.9%‐30.7%). When asked to estimate the percentage of Canadians with food allergy, the mean perceived percentage was 35.1% (SD = 22.96). Self‐reported prevalence of food allergy appears higher in Waterloo Region, and the estimated percentage of Canadians with food allergy is inflated. Understanding prevalence and perceptions at the local level is important for targeted allocation of public health resources to ensure safe spaces for individuals with food allergy. Key Messages: Compared to national prevalence estimates, individual self‐reported prevalence of food allergy appears higher in Waterloo Region.The estimated percentage of Canadians with food allergy is almost four times the actual self‐reported prevalence of food allergy in Canada.Inflated perception of food allergy prevalence has implications for local‐level food allergy management, to ensure safe public spaces for individuals affected by food allergy. [ABSTRACT FROM AUTHOR]

Background: Although barriers to trial accrual are well‐reported, few studies have explored trial eligibility and trial offers as potential drivers of disparities in cancer clinical trial enrollment. Methods: We identified patients with gastrointestinal (GI) or head/neck (HN) malignancies who were seen as new patients at the University of Michigan Health Rogel Cancer Center in 2016. By exhaustive review of the electronic medical record, we assessed the primary outcomes: (1) eligibility for, (2) documented offer of, and (3) enrollment in a clinical trial. All 41 of the clinical trials available to these patients were considered. Independent variables included clinical and non‐clinical patient‐related factors. We assessed associations between these variables and the primary outcomes using multivariable regression. Results: Of 1446 patients, 43% were female, 15% were over age 75, 6% were Black. 305 (21%) patients were eligible for a clinical trial. Among eligible patients, 154 (50%) had documentation of a trial offer and 90 (30%) enrolled. Among the GI cohort, bivariate analyses demonstrated that older age was associated with decreased trial eligibility. Bivariate analyses also demonstrated that Black race was associated with increased trial offer. After adjustment, patients 75 or older were less likely to be eligible for a clinical trial in the GI cohort; however, we found no significant associations between race and any of the outcomes after adjustment. Among eligible GI patients, we found no significant associations between non‐clinical factors and enrollment. Among the HN cohort, bivariate analyses demonstrated that female sex, older age, Black race, and unpartnered marital status were associated with decreased likelihood of trial offer; however, we found no significant associations between race, age, and marital status and any of the outcomes after adjustment. We found no significant associations between non‐clinical factors and eligibility after adjustment; however, women were less likely to be offered and to enroll in a clinical trial in the HN cohort. Conclusion: Factors associated with eligibility, documented offer, and enrollment differed between disease site cohorts at our institution. Future work is needed to ensure the equitable inclusion of women and elderly patients in clinical trials. A thorough review assessing the clinical trial eligibility of individual cancer patients seen at an academic center demonstrates that only 21% of patients were eligible for any trials, and only half of these eligible patients had documented evidence of clinical trial offer. Specific demographic groups were less likely to receive a trial offer. Interventions in the clinical encounter are needed to improve recognition of trial eligibility and facilitate trial offer if we hope to improve accrual to cancer clinical trials. [ABSTRACT FROM AUTHOR]

Aims: There are several options for treating anal incontinence (AI), with limited success rate in long‐term follow‐up. Patients' selection is important to avoid unnecessary investigations and therapies. The aim of this review is to assess the utility of pelvic floor investigations to predict success from conservative treatment in AI. Methods: Baseline demographics, severity scores, and pelvic floor investigations of 490 patients with AI symptoms were retrospectively reviewed. Patient‐reported outcomes were used to define success of conservative treatment. Results: Bivariate analysis showed that gender, St Mark's incontinence score, Bowel continence and quality of life domains of International Consultation on Incontinence Modular Questionnaire–Bowel symptoms score, Bristol stool chart, anal squeeze pressure, enterocoele, leak of contrast at rest, and dyssynergia in defecography were associated with patient's outcomes from conservative treatment (p < 0.05). Multivariate analysis showed that only the Bowel continence score was an independent predictor of patient's success with treatment. Conclusions: Pelvic floor investigations are of limited value to predict success of conservative treatment and they should be reserved for patients who fail noninvasive management and might require surgical intervention. [ABSTRACT FROM AUTHOR]

Background: Hypofibrinogenemia is an important risk factor for poor outcomes in children with severe bleeding. There is a paucity of data on the impact of cryoprecipitate transfusion on outcomes in pediatric patients with life‐threatening hemorrhage (LTH). Study Design and Methods: This secondary analysis of a multicenter prospective observational study of children with LTH investigated subjects who were categorized by receipt of cryoprecipitate during their resuscitation and according to the etiology of their bleeding: trauma, operative, and medical. Bivariate analysis was performed to identify variables associated with 6‐h, 24‐h, and 28‐day mortality. Cox Hazard regression models were generated to adjust for potential confounders. Results: Cryoprecipitate was transfused to 33.9% (152/449) of children during LTH. The median (Interquartile range) time to cryoprecipitate administration was 108 (47–212) minutes. Children in the cryoprecipitate group were younger, more often female, with higher BMI and pre‐LTH PRISM score and lower platelet counts. After adjusting for PRISM score, bleeding etiology, age, sex, RBC volume, platelet volume, antifibrinolytic use and cardiac arrest, cryoprecipitate administration was independently associated with lower 6‐h mortality, Hazard Ratio (95% CI), 0.41 (0.19–0.89), (p = 0.02) and 24‐h mortality, Hazard Ratio (95% CI), 0.46 (0.24–0.89), (p = 0.02). Conclusion: Cryoprecipitate transfusion to children with LTH was associated with reduced early mortality. A prospective randomized trial is needed to determine if cryoprecipitate can improve outcomes in children with LTH. [ABSTRACT FROM AUTHOR]

Talking to others about experiences of sexual assault can facilitate recovery. The present study explored associations between assault characteristics, attitudes, coping strategies, social support, and the college women's disclosure of adolescent sexual victimization (N = 134), as well as sexual victimization over a 7‐month interim during college (N = 67). A sample of first‐year college women completed pencil and paper assessments of sexual victimization, assault characteristics, tendency to disclose, self‐concealment, attributions of blame, likelihood to report sexual victimization, social support., and coping strategies. A series of bivariate and multivariate analyses examined predictors of sexual assault disclosure. Whereas acknowledgment of the sexual assault as victimization predicted disclosure of adolescent sexual assault, less acquaintance with the perpetrator and strong social attachments predicted disclosure of sexual assault occurring during women's first year of college. Data suggest that the factors that influence disclosure of sexual assault may vary across periods of adolescent and young adult development. [ABSTRACT FROM AUTHOR]

Despite the relatively high frequency of Achilles ruptures, there is no general consensus on the optimal treatment method. A general trend toward more patients being treated nonoperatively has emerged recently with the advent of functional rehabilitation. However, much of the recent data on this subject has been highly variable. This systematic review focused on Achilles tendon rupture (ATR) treatment outcomes, with a focus on rerupture and complication rates. This systematic review specifically focused on articles regarding ATR treatment that also included rerupture and complication rates. Treatments were divided into three categories: open minimally invasive, open standard, and nonoperative. Bivariate analyses were performed to compare complication and rerupture rates among pairs of treatment options, as well as between early weight bearing versus immobilization. There was significantly higher complications for minimally invasive compared to nonoperative treatment (risk ratio [RR] = 4.4154; p < 0.05), lower complication rates for minimally invasive compared to open treatment (RR = 0.3231; p < 0.05), and higher complications for open standard compared to nonoperative treatment (RR = 5.6350; p < 0.001). There were significantly lower rerupture rates in minimally invasive compared to nonoperative treatment (RR = 0.4085; p < 0.001), a significantly lower rerupture rate in nonoperative treatment compared to open treatment (RR = 0.2282; p < 0.001), and no significant difference in rerupture rates when comparing minimally invasive to open standard treatment. We found that operative treatment is associated with fewer reruptures and more complications than a nonoperative approach. Minimally invasive surgery appears to be associated with a lower rate of complications than open operative treatment. [ABSTRACT FROM AUTHOR]

We propose a novel flexible bivariate conditional Poisson (BCP) INteger‐valued Generalized AutoRegressive Conditional Heteroscedastic (INGARCH) model for correlated count time series data. Our proposed BCP‐INGARCH model is mathematically tractable and has as the main advantage over existing bivariate INGARCH models its ability to capture a broad range (both negative and positive) of contemporaneous cross‐correlation, which is a non‐trivial advancement. Properties of stationarity and ergodicity for the BCP‐INGARCH process are developed. Estimation of the parameters is performed through conditional maximum likelihood (CML), and the finite‐sample behavior of the estimators is investigated through simulation studies. Asymptotic properties of the CML estimators are derived. Hypothesis testing methods for the presence of contemporaneous correlation between the time series are presented and evaluated. A Granger causality test is also addressed. We apply our methodology to monthly counts of hepatitis cases in two nearby Brazilian cities, which are highly cross‐correlated. The data analysis demonstrates the importance of considering a bivariate model allowing for a wide range of contemporaneous correlation in real‐life applications. [ABSTRACT FROM AUTHOR]

In this study, we measured Rwandan men's engagement in HIV services based on the UNAIDS 90‐90‐90 targets and assessed factors associated with linkage to HIV services. We analyzed the Rwanda Population‐based HIV Impact Assessment (RPHIA) data for 15‐ to 64‐year‐old males. We conducted bivariate analysis to assess the distribution and association of sociodemographic characteristics with UNAIDS 90‐90‐90 targets. We adjusted multivariable models to understand the effect measurement of associated factors and determine the factors that best predict the achievement of UNAIDS 90‐90‐90. Of 13 780 males aged 15–64 years who participated in the RPHIA and consented to the blood draw and HIV testing, 302 had a positive HIV result, while 301 had valid responses to all variables analyzed in this paper and were included in the analysis. We found that age group was an explanatory and predictive factor for achievement of UNAIDS 90‐90‐90. Younger men living with HIV (MLHIV) are less likely to have achieved UNAIDS 90‐90‐90 compared to MLHIV 50–64 years old: adjusted odds ratio (aOR) for MLHIV aged 15–34 years was 0.21 (0.08–0.53) and aOR for MLHIV aged 35–49 years was 0.77 (0.36–1.66). To close the UNAIDS 90‐90‐90 gap in Rwanda, innovative service delivery strategies are needed to support young MLHIV to reach 90‐90‐90. [ABSTRACT FROM AUTHOR]

Background and Aim: Inguinal hernia is the most common defect of the abdominal wall in 75% and their treatment consists of surgical repair. The technique of choice is laparoscopic because of its overall benefits. However, when this is not available, open approaches may be a viable option. Currently, the most commonly used open techniques are Lichtenstein and Nyhus. However, there are few medium‐ or long‐term studies that have compared outcomes between these two techniques. Methods: This is a retrospective comparative study that included patients undergoing open inguinal hernia correction with mesh, using Lichtenstein open hernioplasty versus Nyhus preperitoneal hernioplasty, in two tertiary referral centers in Bogota, Colombia, during a period of 2 years. A bivariate analysis was performed to compare groups, according to the complications presented between the two techniques. Results: A total of 193 patients were included, of whom 53.36% were men and 112 (58.03%) were approached with the Nyhus technique versus 81 patients with the Lichtenstein technique. Nonabsorbable suture fixation was performed in 100% of patients. Among the main complications, seroma (5.18%), pain (4.14%), bleeding (2.07%), recurrence (10.88%), and reoperation (0.51%) were observed, of which only recurrence showed a statistically significant difference, which is lower in the Nyhus approach (3.57% vs. 20.67%; p < 0.001). No patients died. Conclusions: Both Nyhus and Lichtenstein hernioplasty techniques were shown to cause a low incidence of postoperative complications, with significantly lower recurrence using the Nyhus technique up to 1 year postoperatively. Key points: It was found that in the Colombian population with inguinal hernia, using the Nyhus technique generates significantly less recurrence at 1 year, compared to the Lichtenstein technique.Both Nyhus and Lichtenstein hernioplasty techniques were shown to cause a low incidence of postoperative complications.In the Colombian population, there was a high incidence of inguinal hernia in women, compared to the literature. [ABSTRACT FROM AUTHOR]