BACKGROUND: Acute appendicitis is the most common surgical condition presented in emergency departments worldwide. Clinical scoring systems, such as the Alvarado and modified Alvarado scoring systems, were developed with the goal of reducing the negative appendectomy rate to 5%-10%. The Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system was established in 2008 specifi cally for Asian populations. The aim of this study was to compare the modifi ed Alvarado with the RIPASA scoring system in Kuwait population. METHODS:This study included 180 patients who underwent appendectomies and were documented as having "acute appendicitis" or "abdominal pain" in the operating theatre logbook (unit B) from November 2014 to March 2016. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, predicted negative appendectomy and receiver operating characteristic (ROC) curve of the modified Alvarado and RIPASA scoring systems were derived using SPSS statistical software. RESULTS:A total of 136 patients were included in this study according to our criteria. The cut-off threshold point of the modifi ed Alvarado score was set at 7.0, which yielded a sensitivity of 82.8% and a specifi city of 56%. The PPV was 89.3% and the NPV was 42.4%. The cut-off threshold point of the RIPASA score was set at 7.5, which yielded a 94.5% sensitivity and an 88% specifi city. The PPV was 97.2% and the NPV was 78.5%. The predicted negative appendectomy rates were 10.7% and 2.2% for the modifi ed Alvarado and RIPASA scoring systems, respectively. The negative appendectomy rate decreased signifi cantly, from 18.4% to 10.7% for the modifi ed Alvarado, and to 2.2% for the RIPASA scoring system, which was a signifi cant difference (P<0.001) for both scoring systems.CONCLUSION: Based on the results of this study, the RIPASA score is a simple scoring system with better sensitivity and specifi city than the modifi ed Alvarado scoring system in Asian populations. It consists of 14 clinical parameters that can be obtained from a good patient history, clinical examination and laboratory investigations. The RIPASA scoring system is more accurate and specific than the modifi ed Alvarado scoring system for Kuwait population.

Twisted carbazoles and shallow dihedral angles provide a defence against dimer formation that adversely affects OLED performance.

Age-related effects were studied in 14 younger (M = 34 years) and 14 (M = 47 years) older healthy participants. Event-related potential (ERP) recording was done using a 256-channel EEG system. Results indicated that ERP is affected by advanced age. There was a significant difference in P200 mean latency between the younger participants and older participants for the target (low-probability) stimuli, but no such significance was evident for the P200 mean latency during the presentation of the standard (high-probability) stimuli. As for the P200 mean peak amplitude, the results for the target (low-probability) stimuli did show a significant difference between the two age groups, while the results for the standard (high-probability) stimuli did not show any significant difference between the two age groups. The results of this study are explained in light of aging effects on attentional recruitment and frontal lobe intactness.

We conducted an event-related potential (ERP) study using a 256-channel dense sensor array electroencephalography (EEG) system to examine how, and if the P200 neurophysiological signal is sexually dimorphic. We had two groups of participants: females (n= 15, mean age = 40.6 years old) and males (n = 15, mean age = 39.0 years old). ERPs from all participants were recorded while the participants performed an oddball task. Results showed that males on average had a significantly larger P200 peak amplitude and a significantly shorter P200 latency period. These results indicate that the P200 ERP is affected by sex. Therefore, suggesting that sex differences exist on an electrophysiological level, which may aid in better understanding of sex-biased biological influences, behaviors, neuropsychiatric disorders, and general brain function.

Spinal Cord Injury (SCI) causes interruption along the severed axonal tract(s) resulting in complete or partial loss of sensation and motor function. SCI can cause tetraplegia or paraplegia. Both these conditions can have lifelong excessive medical costs, as well as can reduce life expectancy. Preclinical research showed that Photobiomodulation therapy (PBMT), also known as Low-level laser (light) therapy (LLLT), possesses reparative and regenerative capabilities that have the potential to be used as a complimentary or supplementary SCI therapy. Despite the promising effects of PBMT, there are still no standardized irradiation parameters (i.e. different wavelengths, power, fluence, irradiance, beam type, beam diameters, and irradiation time) and there is also a lack of standardized experimental protocol(s), which makes it difficult to compare different studies. It is, nonetheless, essential to standardize such irradiation parameters in order to provide better PBMTs. The aim of this study, therefore, is to evaluate the delivery of light in a 3D voxelated SCI rat model for PBMT using different irradiation parameters (wavelengths: 660, 810, and 980 nm; beam types: Gaussian and Flat beam; and beam diameters: 0.04-1.2 cm) using Monte Carlo simulation. This study also aids in providing standardization for preclinical research for PBMT, which will eventually translate into clinical standardization upon clinical research studies and results.

Artificial intelligence (AI) pertains to the ability of computers or computercontrolled machines to perform activities that demand the cognitive function and performance level of the human brain. The use of AI in medicine and health care is growing rapidly, significantly impacting areas such as medical diagnostics, drug development, treatment personalization, supportive health services, genomics, and public health management. AI offers several advantages; however, its rampant rise in health care also raises concerns regarding legal liability, ethics, and data privacy. Technological singularity (TS) is a hypothetical future point in time when AI will surpass human intelligence. If it occurs, TS in health care would imply the replacement of human medical practitioners with AIguided robots and peripheral systems. Considering the pace at which technological advances are taking place in the arena of AI, and the pace at which AI is being integrated with health care systems, it is not be unreasonable to believe that TS in health care might occur in the near future and that AI-enabled services will profoundly augment the capabilities of doctors, if not completely replace them. There is a need to understand the associated challenges so that we may better prepare the health care system and society to embrace such a change-if it happens.

Light propagation in a fibrous anisotropic scattering medium is quite different from that in an isotropic medium. Both the anisotropic diffuse equation (ADE) and the continuous time random walk (CTRW) theory predict that the equi-intensity profiles of the surface reflectance have an elliptical shape in a fibrous turbid medium. In this study, we simulated the spatially resolved surface reflectance in a fibrous sample using a Monte Carlo model. A parametric equation was used to quantitatively characterize the geometric profiles of the reflectance patterns. The results indicated that the equi-intensity profiles of surface reflectance had elliptical shapes only when evaluated at distances far away from the incident point. The length ratio of the two orthogonal axes of the ellipse was not affected by the sample optical properties when the ratio of reduced scattering coefficients along the two axes is the same. But the relationship between the aforementioned two ratios was different from the predication of ADE theory. Only for fibers of small sizes did the fitted axes ratios approach the values predicted from the ADE theory.

Optical diffuse reflectance in fibrous tissues depends on measurement angles in relation to fiber orientation. In this study, path-length resolved optical reflectance was measured in tendon and skeletal muscle samples using a low-coherence Mach-Zehnder interferometer. The results show that the angular dependency in reflectance was eliminated in tendon tissue when representing reflectance as a function of mean path-length. Our analysis indicated that this observation can be understood in the frame work of anisotropic diffuse theory. However the same phenomenon was not observed in muscles, suggesting involvement of additional scattering mechanisms.