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

Caracterização morfológica e dissimilaridade genética entre variedades crioulas de melão Morphological characterization and genetic dissimilarity in melon landraces

Variedades crioulas de melão (Cucumis melo) são cultivadas no Sul do Brasil para consumo familiar e também para comercialização dos frutos. No entanto, existe uma carência de trabalhos relativos a sua caracterização. Este trabalho teve por objetivo caracterizar e avaliar a variabilidade genética de variedades crioulas de melão do Sul do Brasil mantidos no Banco Ativo de Germoplasma de Cucurbitáceas da Embrapa Clima Temperado. Foram caracterizados 14 acessos utilizando 26 descritores morfológicos de fruto. Os dados foram analisados pelos métodos de agrupamento de Tocher e hierárquico UPGMA. Os métodos de agrupamento foram parcialmente concordantes. O acesso C88 possui características distintas, ficando isolado dos demais, pois é o único entre todos os avaliados que apresenta formato piriforme e sem gomos, cor de epicarpo creme, cor de polpa branca e ruptura profunda no fruto. Existe grande variabilidade genética, para caracteres de frutos, nas variedades crioulas de melão conservadas nesse Banco Ativo de Germoplasma, com potencial para uso no melhoramento genético, destacando-se o acesso C71 por possuir sabor adocicado e polpa de cor laranja e o C72, por apresentar elevados valores de peso de fruto e espessura de polpa.<br>Melon landraces (Cucumis melo) are cultivated in South of Brazil for family consumption and also for marketing fruits. However, there is a lack of works related to characterization of these landraces. The objective of this work was to characterize and evaluate genetic variability of melon landraces from South of Brazil which are maintained in the Cucurbitaceae Genebank at Embrapa Clima Temperado, trough morphological characterization. Fourteen accessions were characterized in 26 morphological fruit descriptors. Data were analyzed by Tocher grouping method and UPGMA hierarchical. The two methods agreed partially. The accession C88 has unique characteristics, being isolated when compared to the other accessions, it is the only one among all evaluated with pyriform shape and fruit ribs absent, cream skin color, white flesh color and deep groove in the fruit. There is great genetic variability for fruit traits in the melon landraces from South of Brazil maintained in this Gene Bank, with potential use in plant breeding, with an emphasis on the accession C71 due to its sweet taste and orange pulp and the C72 due to its high values for fruit weight and flesh thickness

The CMS Collaboration

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Transverse-momentum and pseudorapidity distributions of charged hadrons in pp collisions at square root of s = 7 TeV.

Charged-hadron transverse-momentum and pseudorapidity distributions in proton-proton collisions at square root of s = 7  TeV are measured with the inner tracking system of the CMS detector at the LHC. The charged-hadron yield is obtained by counting the number of reconstructed hits, hit pairs, and fully reconstructed charged-particle tracks. The combination of the three methods gives a charged-particle multiplicity per unit of pseudorapidity dN(ch)/dη|(|η|&lt;0.5) = 5.78 ± 0.01(stat) ± 0.23(syst) for non-single-diffractive events, higher than predicted by commonly used models. The relative increase in charged-particle multiplicity from square root of s = 0.9 to 7 TeV is [66.1 ± 1.0(stat) ± 4.2(syst)]%. The mean transverse momentum is measured to be 0.545 ± 0.005(stat) ± 0.015(syst)  GeV/c. The results are compared with similar measurements at lower energies