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Scholarship on multimethod case selection in the social sciences has developed rapidly in recent years, but many possibilities remain unexplored. This essay introduces an attractive and advantageous new alternative, involving the selection of extreme cases on the treatment variable, net of the statistical influence of the set of known control variables. Cases that are extreme in this way are those in which the value of the main causal variable is as surprising as possible, and thus, this approach can be referred to as seeking "surprising causes." There are practical advantages to selecting on surprising causes, and there are also advantages in terms of statistical efficiency in facilitating case-study discovery. We first argue for these advantages in general terms and then demonstrate them in an application regarding the dynamics of U.S. labor legislation.

Objective: The objective of this study was to assess the impact of the coronavirus pandemic on gynecology surgical training. Methods: A national cross‐sectional online survey was distributed to all trainees and trainers in the higher specialist training program for obstetrics and gynecology in Ireland. The survey consisted of questions on topics which included: the volume of surgical procedures performed before and since the pandemic, confidence in performing various gynecologic procedures before and since the pandemic and questions regarding the impact of the pandemic on wellbeing and work practices. Results: Trainers and trainees experienced a significant reduction in operative volumes for most procedure types. Analysis showed a significant reduction in the number of minor procedures performed by trainees (z = −2.7, P = 0.007) and a significant reduction in the number of all procedure types performed by trainers (minor procedures z = −3.78, P = <0.001; intermediate procedures z = −4.48, P = < 0.001; major procedures z = −3.69, P = < 0.001). Respondents reported they had less time for research and audit, were less able to attend courses or conferences and worried about the impact of their work on their families. Conclusions: In conclusion, this study has highlighted the current difficulties facing surgical trainees in gynecology because of the COVID‐19 pandemic. These challenges have compounded an already challenging training environment for gynecology trainees. Efforts must be made to continue to provide high‐quality tailored training to ensure the development of the next generation of gynecologic surgeons. Synopsis: A national survey which shows significant challenges with training in gynecology during the coronavirus pandemic. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion To compare the risk profiles, anatomical, and functional outcomes between obese and non‐obese women who experienced obstetric anal sphincter injury (OASI).A retrospective electronic database study was conducted at Cork University Maternity Hospital (CUMH). Women with missing data/repairs conducted outside CUMH were excluded. Participants were categorized into obese (BMI ≥30 kg/m2) and non‐obese (BMI <30 kg/m2) groups. Primary measure was a composite adverse outcome assessed 6 months post‐delivery, including one or more of the following: resting pressure <40 mmHg, squeezing pressure <100 mmHg, defects in the internal and/or external anal sphincter. Statistical analyses were performed using SPSS version 28.Among the 349 women included in the study, 285 (81.7%) had a BMI <30 kg/m2 and 64 (18.3%) had a BMI ≥30 kg/m2. Gestational diabetes was significantly higher in obese women. No significant differences were observed in newborn weight or mode of delivery. The majority of tears were classified as grade 3B in both groups. Attendance rates at the OASI clinic did not differ between the groups. Among those attending, no statistical differences were noted in manometry results, which were reduced in both groups. Rates of internal anal sphincter defects were lower in the obese group (7.0% vs 15.6%, P = 0.15) and external anal sphincter defects were significantly lower in obese women (0% vs 9.1%, P = 0.04). No difference was found in the rates of composite adverse outcomes between the groups.Functional outcomes and manometry results did not differ, but non‐obese women had higher rates of anatomical defects in OASI, requiring further study. [ABSTRACT FROM AUTHOR]