The RIPASA score is a useful tool to aid in the diagnosis of acute appendicitis in the Irish population. A score of ≥7.5 provides sensitivity and specificity exceeding that previously documented for the Alvarado score in Western populations. WHAT DOES THIS PAPER ADD TO THE LITERATURE?: This is the first study evaluating the utility of the RIPASA score in predicting acute appendicitis in a Western population. At a value of 7.5, a cut-off score suggestive of appendicitis in the Eastern population, RIPASA demonstrated a high-sensitivity, specificity, positive predictive value and diagnostic accuracy in our cohort and was more accurate than the commonly used Alvarado score.
The specificity of Hong Kong’s gentrification trajectory reflects its urban morphology, political institutions, and social and economic structure. While continuously renewing itself economically, much of the city’s inner urban area building stock is old and functionally obsolete, whilst nevertheless providing affordable, well-located housing for lower-income and disadvantaged groups and small-scale commercial clusters. Constrained redevelopment is not the result of economic decline but rather of formidable frictions that make land assembly and vacant possession of buildings difficult. Hong Kong’s executive-led, quasi democratic government articulates with the public ownership of land and its management through the leasehold system, and leads inner-city redevelopment through the Urban Renewal Authority (URA) supported by various institutional and statutory arrangements. (Re)development is favoured because it generates significant state revenue from physical and economic intensification of sites. Although gentrification is not an agenda of the URA, it is a significant outcome of its redevelopment activities.
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