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Background: Lifestyle plays an important role in shaping the gut microbiome. However, its contributions to the oral microbiome remains less clear, due to the confounding effects of geography and methodology in investigations of populations studied to date. Furthermore, while the oral microbiome seems to differ between foraging and industrialized populations, we lack insight into whether transitions to and away from agrarian lifestyles shape the oral microbiota. Given the growing interest in so-called 'vanishing microbiomes' potentially being a risk factor for increased disease prevalence in industrialized populations, it is important that we distinguish lifestyle from geography in the study of microbiomes across populations. Results: Here, we investigate salivary microbiomes of 63 Nepali individuals representing a spectrum of lifestyles: foraging, subsistence farming (individuals that transitioned from foraging to farming within the last 50 years), agriculturalists (individuals that have transitioned to farming for at least 300 years), and industrialists (expatriates that immigrated to the United States within the last 20 years). We characterize the role of lifestyle in microbial diversity, identify microbes that differ between lifestyles, and pinpoint specific lifestyle factors that may be contributing to differences in the microbiomes across populations. Contrary to prevailing views, when geography is controlled for, oral microbiome alpha diversity does not differ significantly across lifestyles. Microbiome composition, however, follows the gradient of lifestyles from foraging through agrarianism to industrialism, supporting the notion that lifestyle indeed plays a role in the oral microbiome. Relative abundances of several individual taxa, including Streptobacillus and an unclassified Porphyromonadaceae genus, also mirror lifestyle. Finally, we identify specific lifestyle factors associated with microbiome composition across the gradient of lifestyles, including smoking and grain source. Conclusion: Our findings demonstrate that by controlling for geography, we can isolate an important role for lifestyle in determining oral microbiome composition. In doing so, we highlight the potential contributions of several lifestyle factors, underlining the importance of carefully examining the oral microbiome across lifestyles to improve our understanding of global microbiomes.

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INTRODUCTION: Nepali-speaking Bhutanese refugees have been subject to one of the largest resettlement programs in the world and experience higher rates of chronic pain when compared to the general population. The purpose of this study was to explore qualitative conceptualisations of chronic pain among a group of Nepali-speaking Bhutanese adults with a refugee background who relocated to rural and regional Australia. METHODS: Participants included 22 individuals (females n=15) with chronic pain, who took part in structured qualitative focus groups exploring their experiences of chronic pain. Data were analysed using thematic analysis and five main themes were developed. RESULTS: The themes were: (1) pain is persistent and creates suffering, (2) pain is subjective and poorly understood, (3) pain is a biomedical problem that needs to be solved, (4) pain is complex and more than a biomedical problem, and (5) coping with pain is multi-faceted.Some participants viewed pain through a predominantly biomedical lens, and some recognised social and psychological factors as contributors to pain. Overwhelmingly, the participants believed pain is complex and multifaceted, requiring active and passive strategies for management, some of which are culturally informed. CONCLUSION: The experiences of resettled Nepali-speaking Bhutanese refugees living with pain are important to elucidate to improve healthcare inequalities among this marginalised group. This research will inform future assessment guidelines and treatment programs for Nepali-speaking Bhutanese adults living with chronic pain.

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TITLE: Translation and validation of Bristol Female lower urinary tract symptoms (BFLUTS) questionnaire for Nepali speaking women Introduction: Bristol female lower urinary tract symptoms questionnaire (BFLUTS) was designed to identify the lower urinary tract symptoms (LUTS) in women. It aids in determining the severity of lower urinary tract symptoms and how they affect sexual function and quality of life.It can be employed in research and therapeutic practice. It is not available in Nepali version. As a result, our goal is to translate and validate the BFLUTS questionnaire in Nepali. METHODS: The BFLUTS questionnaire has been translated into Nepali. From March 1, 2020 to February 28, 2021, 225 Nepalese patients with lower urinary tract symptoms were evaluated using a Nepali version of the BFLUTS questionnaire adapted from the English version. Internal consistency, test-retest reliability, validity, and change responsiveness were all assessed. RESULTS: A total of 225   patients were enrolled in the study. The missing data was less than 2%. The Nepali version of the BFLUTS questionnaire showed good reliability (? = 0.76; ICC= 0.934). Test-retest reliability was assessed with weighted kappa (?) ranging from 0.71 to 0.83.It showed good sensitive to change before and after the treatment. Mean BFLUTS scores correlated strongly with the symptomsof lower urinary tract symptoms reported in the bladder diary with ? ranging from 0.689to 0.859. CONCLUSIONS: The Nepali version of BFLUTS questionnaire is a reliable, valid and consistent for measuring lower urinary tract symptoms and their effect on sexual function and quality of life.

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BACKGROUND: Assessment of the depiction of suicidal behavior in motion pictures would reveal the social representation of suicide that would foster suicide prevention in a country. OBJECTIVES: We aimed to assess how suicidality has been depicted in Nepali movies by scrutinizing their contents against the sociodemographic checklist and WHO media guidelines for suicidal reporting. METHODS: This is a narrative quantitative analysis of suicidal behavior portrayals in the Nepali motion pictures that are publicly and freely accessible. RESULTS: Overall, out of the 573 scrutinized movies, we found ten movies consisting of 11 characters (i.e., the prevalence is 1.75%) showing suicidal behavior. The majority of suicidal behavior was seen in males 6 (54.5%), and the majority of attempters were students 3 (27.3%) or homemakers 2 (18.2%). Suicidal behavior was mostly observed in unmarried people 6 (54.5%). Hanging was the most prevalent method (45.5%), and home (36.4%) and public places (36.4%) were equally the most frequent places of attempt. The consequential risk factors for the attempts were found to be marital problems/premarital affairs (50%), followed by unfulfilled demand/conflict (30%). While all 11 items depicted the method and place of the attempt, two also depicted the complete scene of the attempt. One item used language that normalized suicide as a constructive solution to the problem. None of the pictures publicized any mental health messages or educated the public about suicide prevention. CONCLUSIONS: The minimal adherence of the Nepali motion pictures on the depictions of suicidality with WHO media guidelines indicates urgent need to create awareness among the Nepali film fraternity.

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Nepali Sign Language (NSL) is used by the Nepali-speaking community in Nepal and in Indian states such as Sikkim, the hilly region of North Bengal, some parts of Uttarakhand, Meghalaya, and Assam. It consists of the International Manual Alphabet (A-Z), Nepali consonants, vowels, conjunct letters, and numbers represented in the form of one-handed fingerspelling or Nepali manual alphabet. The standard gestures for NSL have been published by the Nepal National Federation of the Deaf & Hard of Hearing (NFDH). To learn Nepali Sign Language, the first step is to understand its alphabet set. The use of technology can help ease the learning process. One of the application areas of computer vision is translating sign language gestures to either text or audio to facilitate communication. This is an open research area. However, NSL translation is one of the less explored research areas because there is no dataset available to work on for NSL. This paper introduces the Nepali Sign Language Dataset (NSL23), which is the first of its kind and includes vowels and consonants of the Nepali Sign Language alphabet. The dataset consists of .mov videos performed by 14 volunteers who have demonstrated 36 consonant signs and 13 vowel signs either in one full video or character by character. The dataset has been prepared under various conditions, including normal lighting, dark lighting conditions, prepared environments, unprepared environments, and real-world environments. The volunteers who performed the NSL gesture have been classified as 9 beginners who are using NSL for the first time and 5 experts who have been using NSL for 5 to 25 years. NSL23 contains 630 total videos representing 1205 gestures. The dataset can be used to train machine learning models to classify the alphabet set of NSL and further develop a sign language translator.

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INTRODUCTION: The burden of chronic viral hepatitis (CVH) in the UK Nepali population is unknown. We aimed to determine knowledge of liver disease (LD) and prevalence of CVH in this community. METHODS: This was a mixed method (qualitative and quantitative) study guided by a multidisciplinary stakeholder group. Focus groups (FG) led by Nepali community leaders explored LD knowledge. Thereafter, a prospective community-based cohort study utilising dried-blood spot testing was conducted. Thematic analysis explored FG data with categorical data analysed with Excel and R Studio. RESULTS: FG data showed a lack of LD knowledge, with conflict between the roles of traditional and modern practices; 1,005 participants (525 male, 480 female) were tested for CVH, with a mean age of 63 years (range:19-86). Rates of CVH infection were low: 0.3% had current hepatitis B, with no active hepatitis C. DISCUSSION: Key drivers for enthusiastic participation were development of peer support networks and advisory groups to disseminate information, including hepatitis B vaccine recommendations.

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While many studies have found an association between childhood emotional abuse and alcohol use disorders (AUD) during adulthood, underlying psychological mechanisms linking the two remain inadequately understood. Drawing on the developmental psychopathology perspective, this study examined the relationship between childhood emotional abuse and AUD during adulthood with a national sample of women in Nepal (N = 1,100, M age = 37.73), focusing on the mediating role of borderline personality traits. Mediation analyses were performed using the Karlson-Holm-Breen (KHB) method and bootstrapping confidence intervals. Results indicated that Nepali women's borderline personality traits significantly mediated the relationship between childhood emotional abuse and AUD. Hence, emotional abuse in childhood increases the risk for AUD during adulthood for Nepali women by increasing the risk of borderline personality traits. Findings underscore the necessity of continued emphasis on developing and implementing early interventions for childhood emotional abuse and therapeutic interventions for borderline personality traits in reducing AUD among vulnerable women in Nepal.

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Members of the Nepali-speaking Bhutanese refugee community had resettled in the United States beginning in 2008 after previously being settled in United Nations (UN) refugee camps in Nepal. Due to the recency of their resettlement, there has been little research regarding diabetes in the Nepali-speaking Bhutanese American community. This study sought to identify the prevalence of diabetes in Nepali-speaking Bhutanese Americans living in the Greater Harrisburg Area and whether this community was at a higher risk of developing diabetes due to changes in diet and physical activity lifestyle behaviors. This study was conducted using an anonymous online survey. Anyone over the age of 18 and a self-identified member of the Nepali-speaking Bhutanese American community living in the Greater Harrisburg Area was included, regardless of their diabetes status. This study excluded individuals under the age of 18, those found outside the limits of the targeted region, and those who do not self-identify as members of the Nepali-speaking Bhutanese American community. Through this survey, data regarding demographics (age and gender), length of stay in the US, diabetes status (present or absent), consumption of rice (increased or decreased post-resettlement), and physical activity status (increased or decreased post-resettlement) were collected. The current prevalence of diabetes in this population was compared against the one reported by the CDC before migration and against the prevalence of diabetes in the general population of the United States of America (USA). The association between rice consumption, physical activity, and diabetes was analyzed using the odds ratio. The survey yielded responses from 81 participants. Results showed a 2.29 times higher prevalence of diabetes in the Bhutanese-speaking Nepali population of the Greater Harrisburg Area, Pennsylvania, compared to the general population of the USA. Results indicated a 37 times higher prevalence of diabetes after resettlement in the USA compared to the population's self-reported prevalence before the resettlement. The data showed that increased rice consumption or decreased physical activity alone did not significantly increase the risk of developing diabetes. However, the combination of decreased physical activity and increased rice consumption significantly increased the risk of diabetes, with an odds ratio of 5.94 (CI: 1.27 to 27.56, p-value: 0.01). The higher prevalence of diabetes in this community justifies diabetes education around causes, symptoms, treatments, and preventative healthcare methods. Greater awareness of the issue among the members of this community, as well as their healthcare providers, paves the way for future studies to identify all possible risk factors for diabetes in this community. Once risk factors are identified, early interventions and screening tools can be implemented to mitigate the onset of disease in this population in the future.

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Migrants in Japan often face difficulties accessing healthcare due to language barriers, lack of information, shortage of interpreters, amongst other barriers. With an increase in the number of foreigners in Japan, it is also expected that health and safety concerns for migrants will rise during times of crisis or disaster. The purpose of this article is to present recommendations from Nepali migrants themselves about various actions that stakeholders or policymakers could take to improve healthcare access during future disasters, emergencies, or crises in Japan. Recommendations from Nepali migrants in this study include mobilization of Nepali healthcare professionals, self-preparedness, a disaster information centre by the embassy, Nepali hotline services, telehealth services, and mutual help. By working together and leveraging available resources, it is possible to ensure that migrants are not left behind in the face of disasters and emergencies. Further research is required to determine the most effective ways to improve healthcare access for migrants in Japan during disasters, crises, or emergencies.

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BACKGROUND: Objective mobility measurement of Nepali prosthesis users is lacking. OBJECTIVE: The objective of this study was to cross-culturally adapt, translate and evaluate construct validity of the Prosthetic Limb Users Survey of Mobility (PLUS-M™/Nepali-12 Short Form (SF)) instrument in lower limb prosthesis users residing in Nepal. METHODOLOGY: Two forward translations, review and reconciliation, back translation, expert review, developer review to create the PLUS-M™/Nepali-12SF. Psychometric testing for internal consistency, test-retest reliability and construct validity against the Two-Minute Walk Test (2MWT) and Amputee Mobility Predictor with Prosthesis (AMPPRO) were performed on sixty-six lower limb prosthesis users. FINDINGS: The majority of populations were with transtibial amputation 45 (68%), with transfemoral amputation 15 (23%), with knee disarticulation 5 (7.5%) and with syme's amputation 1 (1.5%). The most common cause of amputation among the population was trauma and the least was tumor. Chronbach's alpha for the PLUS-M™/Nepali-12SF was 0.90, mean T-Score was 52.90, test-retest intraclass correlation coefficient (ICC) was 0.94 (95% confidence interval 0.90-0.96). Construct validity with the 2MWT was good (r = 0.62, p< 0.001) and moderately positive with the AMPPRO (r = 0.57, p< 0.001). CONCLUSION: Our research evidenced that the PLUS-M™/Nepali-12SF had excellent reproducibility. The significance of this work is that it may allow for the measurement of mobility in austere locations of Nepal.

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Elder abuse and neglect (EAN) are serious health and human rights issues. Less is known about EAN in refugee communities. University researchers and leaders of a refugee services nonprofit partnered to conduct an exploratory community engaged study on EAN risks in two refugee communities in North Carolina. A convenience sample of 17 Nepali-speaking Bhutanese and 13 Congolese self-identified older adults filled short surveys and participated in Focus Group Discussions (FGDs). Descriptive survey findings showed EAN risk, isolation, economic insecurity, and family dependency, more among Congolese. FGDs yielded no reports of EAN, but showed dependence on family, and difficulties with language, transportation, and economic insecurity in both groups. These factors indicate individual and contextual vulnerabilities for EAN in these communities. An EAN awareness event was conducted for participants by a family violence nonprofit. Refugee older adults need culturally appropriate coordinated services including EAN information, English classes, job skills, income, and transportation.

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BACKGROUND: The AO Spine Patient Reported Outcome Spine Trauma has been validated in English and Dutch language, however, there is an absence of a translated and validated version in Nepali language. The purpose of this study was to translate the AO Spine Patient Reported Outcome Spine Trauma into Nepali and adapt cross-culturally as outlined by established guidelines, as well as test its psychometric properties among Nepali speaking spine trauma patients. METHODS: Patients were recruited from two Nepali centers as a cross-sectional multicenter validation study. The English version of AO Spine Patient Reported Outcome Spine Trauma was translated and cross-culturally adapted into Nepali language following international guidelines. Next to AO Spine Patient Reported Outcome Spine Trauma also the EQ-5D-3L was filled out by the patients for concurrent validity. Descriptive statistics were used to analyze the patient characteristics. Assessment of measurement properties included content validity (floor and ceiling effects), internal consistency (Cronbach's ? and item total-correlation coefficients) and test-retest reliability by the Bland-Altman plot and Intraclass Correlation Coefficients. Spearman correlation tests were performed within the items and in correlation to EQ-5D-3L. RESULTS: Sixty two spine trauma patients completed the instrument with a mean time of 6.8 minutes. The translated version showed good content validity with no floor and ceiling effects. The internal consistency was excellent with a Cronbach's ? of 0.95. The Spearman correlations within the AO Spine Patient Reported Outcome Spine Trauma items were 0.07 - 0.65 and the test-retest analysis showed excellent results with an Intraclass Correlation Coefficients value of 0.95 (CI 0.93 - 0.97). Inverse correlation was observed between Nepali AO Spine PROST with EQ-5D-3L components. CONCLUSIONS: The Nepali version of AO Spine Patient Reported Outcome Spine Trauma demonstrated excellent validity and reliability results for measuring patient-reported outcomes of spine trauma patients.

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Vaccination saves lives and can be an effective strategy for preventing the spread of the COVID-19, but negative attitudes towards vaccines lead to vaccine hesitancy. This study aimed to explore the factors influencing the uptake of the COVID-19 vaccine in the Nepali community in the United Kingdom (UK). This qualitative study included in-depth interviews with 20 people from Nepal living in the UK. Interviews were conducted by a native-Nepali speaker and all interviews were audio-recorded, transcribed, and translated into English before being analysed thematically. Our study found that attitudes towards COVID-19 are generally positive. Nine overlapping themes around barriers to COVID-19 vaccination were identified: (a) rumours and mis/disinformation; (b) prefer home remedies and yoga; (c) religion restriction; (d) concern towards vaccine eligibility; (e) difficulty with online vaccine booking system; (f) doubts of vaccine effectiveness after changing the second dose timeline; (g) lack of confidence in the vaccine; (h) past bad experience with the influenza vaccine; and (i) worried about side-effects. Understanding barriers to the uptake of the COVID-19 vaccine can help in the design of better targeted interventions. Public health messages including favourable policy should be tailored to address those barriers and make this vaccination programme more viable and acceptable to the ethnic minority communities in the UK.

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INTRODUCTION: Bhutanese refugees may exhibit psychological distress (PD), post-traumatic stress (PTS), and suicidal ideation (SI), but little is known about predictors of these mental health problems. PURPOSE: To examine rates and predictors of PD, PTS, and SI among Bhutanese refugees. METHODS: Cross-sectional correlational study of 209 Bhutanese refugees in Midwestern United States. Data were collected using the Hopkins Symptom Checklist/Nepali version and Refugee Health Screener-15/PTS subscale and then analyzed using simultaneous multiple regression. RESULTS: Rates of PD, PTS, and SI were 18.7%, 8.1%, and 7.7%, respectively. Significant predictors of PD were a history of mental health treatment (p<.001) and fewer years of schooling (p = .032). Predictors of PTS were history of mental health treatment (p<.001), female gender (p = .016), fewer years of schooling (p = .012), and being single/previously married (p = .004). PTS predicted SI (ρ<.001). DISCUSSION: Health providers should routinely assess Bhutanese refugees' mental health status for timely further assessment and treatment.

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This practice note reports on the work of the Namaste Community Health Partnership, an academic-community partnership established to address health disparities in a metro-area Bhutanese-Nepali refugee community in the western United States. Partners worked together to develop, implement, and evaluate a culturally-tailored health promotion program where Bhutanese-Nepali individuals led weekly walking groups and shared health promotion information and behavior change tools with community participants. The program was implemented with approximately 70 community members across two metro-area neighborhoods and two adult day care centers serving elders. Evaluation strategies included documenting walk attendance, tracking engagement with health promotion goals, and focus group discussions with program participants. Once enrolled, most participants consistently attended walks and achieved weekly goals-some even increased walking frequency beyond program requirements. Participants provided positive feedback about having a community leader and reported learning new information and enjoying participating with other community members. Challenges and lessons learned included difficulties engaging younger adults from the community, concerns about signing research consent forms, cultural norms discouraging the distribution of individual research participation incentives, variability across groups in preferences for program activities, and barriers to administering survey-based evaluation instruments. This academic-community partnership built capacity in the local Bhutanese-Nepali community, produced culturally relevant health programming, and trained and employed community members as health educators and physical activity leaders. The program resulting from this work has the potential to improve health knowledge and chronic disease prevention practices and ultimately reduce health disparities in an underserved refugee community.

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BACKGROUND: Bhutanese refugees' mental problems are relatively high. The Hopkins Symptom Checklist-25 (HSCL-25) has been used widely in examining refugees' mental health, but its psychometric properties in Nepali version is unknown. PURPOSE: To examine psychometric properties of the HSCL-25/Nepali version. METHODS: Bhutanese refugees (n = 209) responded to demographic questionnaire, the HSCL-25/Nepali, and the Refugee Health Survey-15. Exploratory factor analysis (EFA), convergent validity, and internal consistency were performed. RESULTS: After three rounds of EFA, item 14 was deleted resulting in HSCL-24/Nepali with good construct validity and excellent internal consistency (α = .94). CONCLUSIONS: The HSCL-24/Nepali version is reliable and valid and can be used to culturally, appropriately assess psychological distress of Bhutanese refugees as it omits item 14 that captures individual's sexual interest.

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Introduction: Speech production is the most unique task performed by a human. The speech signals consist of strings of vowels and consonants. Vowels are differentiated based on acoustic characteristics. Methodology: A total of 50 Nepali students, 25 males and 25 females of the age range 18 to 25 years with no history of voice disorders, flu, neurological disorders, speech, language impairment, and respiratory dysfunction were included in the study. Sustained phonation of five short vowels /a/, /i/, /o/, /u/ and /e/ were used in order to measure the acoustic variables. PRAAT software was used to extract the acoustic parameter of voice; mean pitch, Jitter, RAP, PPQ 5, Shimmer, and APQ 11. Result: Mean and SD was calculated using SPSS. Mann-Whitney test revealed there was a highly significant difference in all the parameters taken for the study among males and females. However, the females had greater F0, jitter, RAP, PPQ5, shimmer, APQ11 than the males. Conclusion: Before implementing these norms in clinical set up we must consider that these values are developed for the adults whose L1 is Nepali language and the software used for the establishment of norms was Praat.

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Hearing handicap inventory for adult- screening version (HHIA-S) is one of the widely used questionnaire for assessing hearing handicap among adult population over the short period of time. This questionnaire has been translated in many languages worldwide including Indian, Sweden, and Spanish. However, there is lack of such questionnaire in Nepali language. Hence, this study is aimed at developing and standardizing the HHIA-S questionnaire in Nepali language. The English version of the HHIA-S was translated to the Nepali language using the translation-back-translation method. Further, it was given to 10 native Nepali speakers for content validation. The final HHIA-S Nepali version was then administered to 70 normal native Nepali speakers and 50 hearing impaired Nepali speaker. The responses were analyzed, and Cronbach's alpha was calculated to measure the internal consistency of the questionnaire. Results showed that the HHIA-S Nepali version has a Cronbach's alpha score of 0.94 for normal hearing group and 0.93 for hearing impaired group, which is considered good reliability. The HHIA-S Nepali version developed in this study is found to be valid and reliable. Hence, it can be used as a screening tool for assessing hearing handicap among Nepali population. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-022-03082-5.

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There are estimated over 8 million Nepali migrants spread across various countries around the globe. Though the majority of them enjoy good health in general, a large proportion of them suffer from non-communicable diseases, mental health issues and communicable diseases. Telemedicine services, which are organized by Non-Resident Nepali Association (NRNA), have been proven to be effective in addressing some of the health and medical needs of the migrant Nepali workers. The purpose of this study is to assess the use of tele-health services among Nepali migrant population and examine the limitations. During the pandemic period from March 2020 through August 2021, Nepali in different countries utilized telehealth services. Mental health issues, chronic diseases, skin diseases were the most common ailments people sought telehealth services for. Many of them sought for urgent medical consultations related to Covid-19 symptoms and ailments. Digital gap, lack of cross-border regulations and unwillingness to utilize telemedicine were the challenges the service faced in the optimal utilization of such services. Training and education, use of easy Apps and subsidies from the government would help in the long-term use and sustainability of telehealth services amongst the Nepali migrants.

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OBJECTIVES: To evaluate an association between preoperative Nepali pain catastrophizing scale (N-PCS) scores and postoperative pain intensity and total opioid consumption. METHODS: In this prospective cohort study we enrolled 135 patients with an American Society of Anaesthesiologists physical status I or II, aged between 18 and 65 years, and scheduled for surgery for lower-extremity fracture under spinal anaesthesia. Maximum postoperative pain reported during the 24 h was classified into two groups, no-mild pain group (Numeric rating scale [NRS] scores 1-3) and a moderate-severe pain group (NRS 4-10). The Pearson's correlation coefficient was used to compare the association between the baseline N-PCS scores and outcome variables, i.e., the maximum NRS pain score and the total tramadol consumption within the first 24 h after surgery. Logistic regression models were used to identify the predictors for the intensity of postoperative pain. RESULTS: As four patients violated the protocol, the data of 131 patients were analyzed. Mean N-PCS scores reported by the moderate-severe pain group was 27.39 ± 9.50 compared to 18.64 ± 10 mean N-PCS scores by the no-mild pain group (p < 0.001). Preoperative PCS scores correlated positively with postoperative pain intensity (r = 0.43, [95% CI 0.28-0.56], p < 0.001) and total tramadol consumption (r = 0.36, [95% CI 0.20-0.50], p < 0.001). Preoperative pain catastrophizing was associated with postoperative moderate-severe pain (odds ratio, 1.08 [95% confidence interval, 1.02-1.15], p = 0.006) after adjusting for gender, ethnicity and preoperative anxiety. CONCLUSION: Patients who reported higher pain catastrophizing preoperatively were at increased risk of experiencing moderate-severe postoperative pain. CLINICAL TRIAL REGISTRATION: www.clinicaltrials.gov Identifier: NCT03758560.

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