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

MONOLITHICALLY INTEGRATED SQW LASER AND HBT LASER DRIVER VIA SELECTIVE OMVPE REGROWTH

An AlGaAs/GaAs Npn HBT laser driver circuit and a pseudomorphic InGaAs/GaAs/AlGaAs graded index SQW laser have been laterally integrated to maintain surface planarity using selective OMVPE regrowth of the HBT. The self-aligned HBT's exhibit a dc current gain of 30 and an f(t) (f(max)) of 45 (60) GHz. The 980 nm lasers exhibit room temperature threshold current densities as low as 420 (320) A/cm2 for CW (pulsed) operation. The cavities measuring 40 (7) x 500 mum2 and have less than 1 (2) of series resistance. SPICE simulations of the integrated driver indicate operating speeds over 10 Gb/s are possible.5779179

Qualidade de vida em mulheres submetidas à mastectomia comparada com aquelas que se submeteram à cirurgia conservadora: uma revisão de literatura Quality of life of women recovering from breast cancer after being subjected to mastectomies compared with those who had conservative surgery: a review of the literature

Este estudo revisa a literatura sobre a qualidade de vida (QV) de mulheres com câncer de mama submetidas à mastectomia comparadas àquelas que realizaram cirurgia conservadora. A seleção final resultou em oito ensaios clínicos randomizados. Os estudos foram comparados quanto ao momento em que a QV foi avaliada, se durante ou após o tratamento, quanto aos instrumentos que mensuraram a QV, e quanto à metodologia e resultados. Os resultados de quatro estudos apontam para maior impacto negativo na QV em mulheres mastectomizadas; outros quatro estudos não evidenciam diferenças na QV entre os grupos que passaram pelos dois tipos de intervenção. Medidas objetivas de QV poderão ajudar a identificar situações potencialmente difíceis da vida diária e auxiliar no planejamento de ações de promoção da saúde de mulheres que passaram por cirurgia para câncer de mama.<br>This study reviews the literature on the quality of life (QoL) of women with breast cancer who have been subjected to mastectomy, compared with those who had conservative surgery. Eight random controlled trials were selected. The studies were compared with respect to the moment quality of life was assessed (whether during or after treatment for breast cancer), the measurement tools of quality of life used, and also the methodology and results achieved. The results of four studies suggest a stronger negative impact in the QoL of mastectomized women; the other four studies showed no difference between the groups in terms of QoL. Objective measurements of quality of life may help identify potentially critical situations of daily life and assist in planning actions to promote health among women who have been subjected to breast cancer surgery

GridPP: development of the UK computing Grid for particle physics

The GridPP Collaboration is building a UK computing Grid for particle physics, as part of the international effort towards computing for the Large Hadron Collider. The project, funded by the UK Particle Physics and Astronomy Research Council (PPARC), began in September 2001 and completed its first phase 3 years later. GridPP is a collaboration of approximately 100 researchers in 19 UK university particle physics groups, the Council for the Central Laboratory of the Research Councils and CERN, reflecting the strategic importance of the project. In collaboration with other European and US efforts, the first phase of the project demonstrated the feasibility of developing, deploying and operating a Grid-based computing system to meet the UK needs of the Large Hadron Collider experiments. This note describes the work undertaken to achieve this goal