Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Opere infrastrutturali e perequazione urbanistica: la variante alla via Emilia Est nel comune di Modena

L\u2019ipotesi di una modalit\ue0 applicativa della perequazione urbanistica al progetto di un nuovo asse infrastrutturale in variante alla Via Emilia Est viene analizzata considerando il processo virtuoso che essa potrebbe innescare in termini di valorizzazione territoriale dell\u2019area interessata, congiuntamente al finanziamento dell\u2019opera stessa ed alla realizzazione di opere di riqualificazione e salvaguardia ambientale, in questa ed in altre aree della citt\ue0

Polypodium phyllitidis L. (Polypodiaceaea): a fern with a high sucrose content

A partir del extracto metanólico de Polypodium phyllitidis L (Polypodiaceae) se obtuvo un precipitado sumamente abundante que se comprobó se trataba de sacarosa, lo que determinó su cuantificación por cromatografía gaseosa dado su posible valor económico.An abundant precipitate was obtained from the methanolic extract of Polypodium phyllitidis L. (Polypodiaceae), which was identified as sucrose and quantified by gas chromatography due to its possible economic irnportance.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Pengaruh Kecemasan Siswa Terhadap Hasil Belajar Matematika Pada Materi Trigonometri

Salah satu hal yang dapat mempengaruhi hasil belajar adalah faktor internal siswa, yaitu kecemasan. Kecemasan merupakan gejala normal yang diduga merupakan salah satu faktor penghambat belajar dan dapat mempengaruhi kemampuan seseorang dalam mengingat, memecahkan masalah, berkonsentrasi, dan membentuk ide. Penelitian ini bertujuan untuk mengetahui pengaruh kecemasan siswa terhadap hasil belajar matematika pada materi trigonometri. Metode penelitian yang digunakan adalah kuantitatif eksperimen dengan teknik analisis data menggunakan regresi linier sederhana. Data dikumpulkan melalui angket dan lembar tes hasil belajar. Sampel penelitian terdiri dari kelas X IPS MA Al-Bukhary sebanyak 24 siswa. Dengan metode regresi linier sederhana berbantuan SPSS diperoleh nilai signifikansi sebesar 0,005 &lt; 0,05 yang berarti &nbsp;ditolak dan &nbsp;diterima atau dengan kata lain dapat dikatakan bahwa terdapat pengaruh yang signifikan antara kecemasan siswa terhadap hasil belajar matematika pada materi trigonometri dengan besar pengaruh yaitu 30,2%. Adapun persamaan regresi linier yang diperoleh adalah &nbsp;dimana koefisien regresi bernilai negatif, yang berarti kecemasan berpengaruh negatif terhadap hasil belajar matematika siswa pada materi trigonometri. Semakin tinggi kecemasan siswa maka semakin rendah hasil belajar matematika siswa, begitu pula sebaliknya semakin rendah kecemasan siswa maka semakin tinggi hasil belajar matematika siswa

Polypodium phyllitidis L. (Polypodiaceaea): a fern with a high sucrose content

A partir del extracto metanólico de Polypodium phyllitidis L (Polypodiaceae) se obtuvo un precipitado sumamente abundante que se comprobó se trataba de sacarosa, lo que determinó su cuantificación por cromatografía gaseosa dado su posible valor económico.An abundant precipitate was obtained from the methanolic extract of Polypodium phyllitidis L. (Polypodiaceae), which was identified as sucrose and quantified by gas chromatography due to its possible economic irnportance.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Valorizzazione del territorio e finanziamento di opere pubbliche: la variante alla via Emilia est nel comune di Modena

Il dibattito disciplinare degli ultimi anni ha focalizzato la propria attenzione sui limiti dell\u2019efficacia della pianificazione, evidenziando la necessit\ue0 di governare l\u2019evoluzione di sistemi urbani sempre pi\uf9 complessi attraverso strumenti flessibili; in questo contesto, il mutamento del modello di sviluppo urbano, dall\u2019espansione alla trasformazione, unitamente alla diffusione delle istanze ecologiche, porta la pianificazione ad orientarsi alla valorizzazione ed alla conservazione delle risorse economiche, sociali ed ambientali delle citt\ue0. A queste esigenze risponde la soluzione perequativa, che, oltre a perseguire l\u2019equit\ue0 sociale e l\u2019efficienza delle trasformazioni, assicura la tutela ecologica delle trasformazioni urbanistiche. Oggetto del presente studio \ue8 l\u2019esplicitazione di una modalit\ue0 applicativa della perequazione urbanistica attraverso l\u2019approfondimento di un caso che consiste nella valorizzazione di un\u2019area situata nel comune di Modena in prossimit\ue0 della Via Emilia Est, congiunta alla realizzazione di una nuova infrastruttura a servizio dell\u2019area stessa e dell\u2019intera citt\ue0