The history of biological warfare

Human experimentation, modern nightmares and lone madmen in the twentieth centur

Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. Methods: This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. Results: A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. Conclusions: The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low. © 2018 The Author(s)

Possible Atmospheric Diversity of Low Mass Exoplanets – Some Central Aspects

Exoplanetary science continues to excite and surprise with its rich diversity. We discuss here some key aspects potentially influencing the range of exoplanetary terrestrial-type atmospheres which could exist in nature. We are motivated by newly emerging observations, refined approaches to address data degeneracies, improved theories for key processes affecting atmospheric evolution and a new generation of atmospheric models which couple physical processes from the deep interior through to the exosphere and consider the planetary-star system as a whole. Using the Solar System as our guide we first summarize the main processes which sculpt atmospheric evolution then discuss their potential interactions in the context of exoplanetary environments. We summarize key uncertainties and consider a diverse range of atmospheric compositions discussing their potential occurrence in an exoplanetary context