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

Microwave-Promoted Catalyst- and Solvent-Free Aza-Diels–Alder Reaction of Aldimines with 6-[2-(Dimethylamino)vinyl]-1,3-dimethyluracil

A microwave-promoted aza-Diels–Alder reaction between 6-[2-(dimethylamino)­vinyl]-1,3-dimethyluracil and aldimines has been developed for the construction of dihydropyrido­[4,3-<i>d</i>]­pyrimidines. Urea is effectively employed as an environmentally benign source of ammonia in the absence of any catalyst or solvent. The key step in the reaction is in situ generation and trapping of the reactive aldimine formed from urea and aldehyde by the diene system of the uracil. The reaction is clean, and excellent yields are obtained in a matter of a few minutes

Air-Stable Surface-Passivated Perovskite Quantum Dots for Ultra-Robust, Single- and Two-Photon-Induced Amplified Spontaneous Emission

We demonstrate ultra-air- and photostable CsPbBr₃ quantum dots (QDs) by using an inorganic–organic hybrid ion pair as the capping ligand. This passivation approach to perovskite QDs yields high photoluminescence quantum yield with unprecedented operational stability in ambient conditions (60 ± 5% lab humidity) and high pump fluences, thus overcoming one of the greatest challenges impeding the development of perovskite-based applications. Due to the robustness of passivated perovskite QDs, we were able to induce ultrastable amplified spontaneous emission (ASE) in solution processed QD films not only through one photon but also through two-photon absorption processes. The latter has not been observed before in the family of perovskite materials. More importantly, passivated perovskite QD films showed remarkable photostability under continuous pulsed laser excitation in ambient conditions for at least 34 h (corresponds to 1.2 × 10⁸ laser shots), substantially exceeding the stability of other colloidal QD systems in which ASE has been observed

Perovskite Nanocrystals as a Color Converter for Visible Light Communication

Visible light communication (VLC) is an emerging technology that uses light-emitting diodes (LEDs) or laser diodes for simultaneous illumination and data communication. This technology is envisioned to be a major part of the solution to the current bottlenecks in data and wireless communication. However, the conventional lighting phosphors that are typically integrated with LEDs have limited modulation bandwidth and thus cannot provide the bandwidth required to realize the potential of VLC. In this work, we present a promising light converter for VLC by designing solution-processed CsPbBr₃ perovskite nanocrystals (NCs) with a conventional red phosphor. The fabricated CsPbBr₃ NC phosphor-based white light converter exhibits an unprecedented modulation bandwidth of 491 MHz, which is ∼40 times greater than that of conventional phosphors, and the capability to transmit a high data rate of up to 2 Gbit/s. Moreover, this perovskite-enhanced white light source combines ultrafast response characteristics with a high color rendering index of 89 and a correlated color temperature of 3236 K, thereby enabling dual VLC and solid-state lighting functionalities

Surface Restructuring of Hybrid Perovskite Crystals

Hybrid perovskite crystals have emerged as an important class of semiconductors because of their remarkable performance in optoelectronics devices. The interface structure and chemistry of these crystals are key determinants of the device’s performance. Unfortunately, little is known about the intrinsic properties of the surfaces of perovskite materials because extrinsic effects, such as complex microstructures, processing conditions, and hydration under ambient conditions, are thought to cause resistive losses and high leakage current in solar cells. We reveal the intrinsic structural and optoelectronic properties of both pristinely cleaved and aged surfaces of single crystals. We identify surface restructuring on the aged surfaces (visualized on the atomic-scale by scanning tunneling microscopy) that lead to compositional and optical bandgap changes as well as degradation of carrier dynamics, photocurrent, and solar cell device performance. The insights reported herein clarify the key variables involved in the performance of perovskite-based solar cells and fabrication of high-quality surface single crystals, thus paving the way toward their future exploitation in highly efficient solar cells