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

Management systems: soil cover and compaction, longitudinal distribution, and yield of soybean crop

The way the soil is managed can influence its structuring and, consequently, crop yield. Thus, this study aimed to evaluate the effect caused by the management systems plowing followed by two intermediate harrowing operations, intermediate harrowing, chiseling, chiseling followed by intermediate harrowing, cross chiseling followed by intermediate harrowing, and non-tillage on soil and agronomic attributes of the soybean crop. A randomized block design with four replications was used. The percentage of soil cover, soil resistance to penetration, number of plants per meter, longitudinal distribution of seedlings, and soybean yield were evaluated. The data were submitted to analysis of variance by the Tukey test at 5% probability, and use of geostatistics for soil resistance to penetration. The system without soil tillage provides the best straw preservation but affects the longitudinal distribution of soybean seedlings. The use of intermediate harrowing for managing crop residues or soil tillage leads to the greatest compaction problems. Chiseling is efficient in maintaining compaction values below critical values up to a depth of 0.20 m when working at 0.35 m. Soil yield is not affected by soil management systems when the pluviometric regime is adequate to crop requirements394490497COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPE

Sensory analysis of specialty coffee from different environmental conditions in the region of Matas de Minas, Minas Gerais, Brazil.

Specialty coffees can be differentiated in various ways, including the environmental conditions in which they are produced and the sensory composition of the drink. This study aimed to evaluate the effect of altitude, slope exposure and fruit color on the sensory attributes of cafes of the region of Matas de Minas. Sampling points were georeferenced in four altitude ranges ( 825 m, 825 950 m) of the coffee crop; two fruit colors of var. Catuaí (yellowand red); and two slope exposures (North-facing and South-facing). Coffee fruit at the cherry stage were processed andsubmitted to sensory analysis. The sensory attributes evaluated were overall perception, clean cup, balance, aftertaste, sweetness, acidity , body and flavor, which made up the final score. The scores were examined by ANOVA and means werecompared by the Tukey test (p < 0.05). From the sensory standpoint, coffee fruits of both colors are similar, as well as the cof fees from both slope exposures when these factors were analyzed separately . However , at higher altitudes, Y ellow Catuaí produces coffees with better sensory quality . Similarly , coffees from North-facing slopes, at higher altitudes produce better quality cup. The altitude is the main factor that interferes with coffee quality in the area. All factors together contribute tothe final quality of the beverage produced in the region of Matas de Minas.201

Satisfação no trabalho: um estudo entre os funcionários dos hotéis de João Pessoa Satisfaction in working: a study on the hotel employees in João Pessoa

Este estudo teve como objetivo verificar o nível de satisfação no trabalho, entre os funcionários dos hotéis de João Pessoa, tendo como referencial a teoria dos dois fatores de Frederick Herzberg. Dos 456 funcionários nos 14 hotéis com capacidade a partir de 70 leitos, foram estudados 69, provenientes dos hotéis da praia e dos hotéis centrais. Os dados foram coletados mediante um questionário e, em seguida, após a análise chegou-se à conclusão de que os funcionários estão satisfeitos no trabalho.<br>This study aims to verify the level of satisfaction at work among the hotel employees in João Pessoa and it based on Frederick Herzberg&#8217;s two factory theory. It was taken a sample of 69 subjects out of 456 employees of the 14 beach and downtown hotels with a minimum capacity of 70 bedrooms. Those employees were given a questionnaire in order to get all the needed data. The conclusions drawn from the analysis was that the employees are satisfied with their jobs