82. The difficulty parameter ranged from -4.14 to 0.42. The discrimination parameter ranged from 0.41 to 1.89. The items regarding drug-drug/drug-food interactions were able to differentiate knowledge about oral anticoagulation with greater accuracy. WHAT IS NEW AND CONCLUSION This study is the first that uses this methodology to evaluate the knowledge on oral anticoagulation therapy with warfarin. The evaluation using item response theory showed that the Brazilian version of the Oral Anticoagulation Knowledge Test is suitable for assessing the patient's knowledge of oral anticoagulation with warfarin. Thus, our findings confirmed the utility of this instrument and provided an essential point of reference for the structuring of health education activities that ensure the individualization of educational interventions in patients on warfarin. © 2020 John Wiley & Sons Ltd.Several studies for the clinical validity of circulating tumor cells (CTCs) in metastatic breast cancer were conducted showing that it is a prognostic biomarker of overall survival. In this work, we consider an individual patient data meta-analysis for nonmetastatic breast cancer to assess the discrimination of CTCs regarding the risk of death. Data are collected in several centers and present correlated failure times for subjects of the same center. However, although the covariate-specific time-dependent receiver operating characteristic (ROC) curve has been widely used for assessing the performance of a biomarker, there is no methodology yet that can handle this specific setting with clustered censored failure times. We propose an estimator for the covariate-specific time-dependent ROC curves and area under the ROC curve when clustered failure times are detected. We discuss the assumptions under which the estimators are consistent and their interpretations. We assume a shared frailty model for modeling the effect of the covariates and the biomarker on the outcome in order to account for the cluster effect. A simulation study was conducted and it shows negligible bias for the proposed estimator and a nonparametric one based on inverse probability censoring weighting, while a semiparametric estimator, ignoring the clustering, is markedly biased. Finally, in our application to breast cancer data, the estimation of the covariate-specific area under the curves illustrates that the CTCs discriminate better patients with inflammatory tumor than patients with noninflammatory tumor, with respect to their risk of death. © 2020 John Wiley & Sons, Ltd.The aim of this study was to access whether microsurgical subinguinal varicocelectomy (MSV) with testicular delivery has a better therapeutic effect than MSV without testicular delivery, including semen quality, serum testosterone (T) level and International Index of Erectile Function (IIEF)-5 score in infertility male patients with varicocele. In this prospective study, 181 patients were included and they chose the treatment by themselves. A total of 114 patients who received MSV without testicular delivery (TD) and 67 patients who received MSV with TD were followed-up 6 months after the operation. Semen parameters, serum T level and IIEF-5 scores were recorded before and 6 months after the operation. Results showed that MSV with or without TD could improve semen quality, serum T level and IIEF-5 score. For semen quality 6 months after the operation, there was no significant difference between patients received MSV with or without TD. But in patients with varicocele of grade III, MSV without testicular delivery improved the sperm concentration and motility more. And patients received MSV without TD have a higher T level 6 months after the operation, especially in patients ≤27 years. MSV with TD is not superior to that without, but this should be verified in more samples and a better designed randomised controlled study in the future. © 2020 Blackwell Verlag GmbH.The objective of this article is to study the impact of weather on the damage caused by fire incidents across the United States. The article uses two sets of big data--fire incidents data from the National Fire Incident Reporting System (NFIRS) and weather data from the National Oceanic and Atmospheric Administration (NOAA)-to obtain a single comprehensive data set for prediction and analysis of fire risk. In the article, the loss is referred to as "Total Percent Loss," a metric that is calculated based on the content and property loss incurred by an owner over the total value of content and property. Gradient boosting tree (GBT), a machine learning algorithm, is implemented on the processed data to predict the losses due to fire incidents. An R2 value of 0.933 and mean squared error (MSE) of 124.641 out of 10,000 signify the extent of high predictive accuracy obtained by implementing the GBT model. In addition to this, an excellent predictive performance demonstrated by the GBT model is further validated by a strong fitting between the predicted loss and the actual loss for the test data set, with an R2 value of 0.97. While analyzing the influence of each input variable on the output, it is observed that the state in which a fire incident takes place plays a major role in determining fire risk. This article provides useful insights to fire managers and researchers in the form of a detailed framework of big data and predictive analytics for effective management of fire risk. © 2020 Society for Risk Analysis.AIMS To assess the prevalence of catheter-associated meatal pressure injury in acute hospitalized males, to determine risk factors for its formation and to propose a grading system for meatal pressure injury severity. METHODS In this cross-sectional study, we screened all adult males concurrently hospitalized at a tertiary medical center for indwelling urethral catheters and for meatal pressure injury. We proposed a system to grade meatal pressure injury severity and used logistic-regression modeling to calculate odds ratios (ORs) of possible risk factors. RESULTS A number of 168/751 (22.4%) hospitalized males with indwelling urethral catheters were included. Median age was 70.5 (inter-quartile range [IQR] 57.0-80.3) years, median time from catheterization 5.5 (IQR 2-11) days. A total of 61 (36%) had meatal pressure injury, as early as the first day after catheterization.  https://www.selleckchem.com/products/shr0302.html  Grade III injuries ( less then 2 cm ulcer) developed in 22 (13%) patients, earliest noted on the second catheter day, and grade IV injuries (≥2 cm) in 7 (4%) patients, as early as 5 days post catheterization.