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

Desires and taboos : Sexual relationships between coaches and athletes

Coach–athlete sexual relationships constitute ethical, behavioral, social, and emotional quandaries that are rarely addressed openly. Most of the current body of research in this area focuses on coaches’ sexual harassment and abuse of children and female athletes. In the present article, we discuss legal coach–athlete sexual relationships and adopt a coach perspective. As dual relationships, coach–athlete sexual relationships blur the boundaries between professional roles circumscribed (usually) by ethical codes of conduct and private spheres of love and desire. We explore the problems associated with the limitations of dichotomous right/wrong ethical decision making and discuss additional ways to understand these relationships, accounting for coaches’ and athletes’ well-being, performance, gendered sexual agency, power, ethical dilemmas, sport policy, and legal implications. Our discussion raises questions about how to open up dialogue and transparency regarding coach–athlete sexual relationships and how to facilitate functional, healthy coach–athlete relationships. Finally, we provide implications for future research that include legal and consensual coach–athlete sexual relationships and advocate transparency, open discussion, and coach education about coach–athlete sexual relationship dilemmas

RNA Nanotechnology

Cite this entry as: Yaradoddi J.S. et al. (2019) RNA Nanotechnology. In: Martínez L., Kharissova O., Kharisov B. (eds) Handbook of Ecomaterials. Springer, Cham Publisher Name: Springer, Cham DOI: https://doi.org/10.1007/978-3-319-68255-6_193 Print ISBN: 978-3-319-68254-9 Online ISBN: 978-3-319-68255-6 First Online: 14 February 2019DNA, RNA, and proteins are seemed to be immensely substantial tools for nanobiotechnological applications; this is since their exceptional biochemical properties and role. Particularly RNA is categorized over comparatively high-temperature stability, varied organizational pliability, and their performance in natural circumstances. Above properties made, RNA, a valued constituent for bionanotechnology processes and usefulness, especially RNA nanotechnology, could synthesize complex molecules using simple molecules through de nova nanostructures having exceptional utility by the strategy, integration, and manipulations of most predominant processes which are usually based on different RNA structures and because of their vital biochemical properties. The current chapter emphasis on the basic principles inspires the normal design of RNA nanostructures, pronounces the important methods that are used in constructing nanoparticles’ self-assemblages, and further describes the associated challenges and excelled opportunities of RNA nanotechnology in near future.Peer reviewe