PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Optical Optimization of Tandem Solar Cells: A Systematic Review for Enhanced Power Conversion

Tandem solar cells (TSCs) perform a better adaptation of the incident photons in different-energy-level bandgap materials, and overcome the Shockley–Queisser limit, but they require advanced control over the management of light for optimum performance. Nanomaterials and nanostructures offer a vastly improved control over the management of light. Through different optimization techniques, researchers can gain valuable insights regarding the optimization of various parameters of nano-optical designs. Over the past years, the number of studies on this topic has been continuously increasing. The present study reviews various current state-of-the-art optical designs, and provides an overview of the optimization techniques and numerical modeling of TSCs. This paper collected and analyzed different studies published within the years 2015–2022, using systematic literature review techniques, such as specific protocol screening and a search strategy. Seven different optical designs were extracted, along with their advanced local and global optimization methods, which offer a solution to the optical limitations of TSCs

Polymer Dispersion Effects on Drag, Heat Transfer, and Mass Transfer in Non-Newtonian Based Nanofluids

This article explores the influence of polymers on the boundary layer flow, heat transfer, and mass transfer control of non-Newtonian-based nanofluids flowing past a stretching surface. The mathematical model incorporates the Oldroyd-B model to analyze the effects of polymers, while the Powell–Eyring and Reiner–Philippoff viscosity models are employed to study the behavior of non-Newtonian fluids. The dispersion model is adopted to account for nanofluid characteristics. Appropriate transformations yield governing equations with similar forms, which are solved numerically to investigate the impact of polymer inclusion on skin friction, Nusselt number, and Sherwood number. The study’s findings reveal that the addition of polymers to the non-Newtonian-based nanofluids leads to a reduction in heat and mass transport while enhancing skin drag. Detailed analysis of these effects sheds light on the underlying physical mechanisms

A RANDOMIZED OPEN LABEL CLINICAL TRIAL OF SAFOOF-E-MOHAZZIL IN THE MANAGEMENT OF FART-E-TADASSUM-FID-DAM (PRIMARY HYPERLIPIDAEMIA)

Hyperlipidaemia is a highly atherogenic lipid metabolic disorder characterized by abnormally elevated levels of circulating Cholesterol or Triglycerides in the blood. It results either from increase in synthesis or decrease in degradation of lipoproteins, which transport Cholesterol &amp; Triglycerides, 6,7. According to Unani system of medicine there is no such description of Hyperlipidaemia found, but Abu SahalMaseehi had given the concept of dosoomat-e-khoon24. The Hippocrate, Rofas, Galen, Razes and Avicenna described the obesity (Saman-e-mufrit), which is due to the excessive phlegm (Khilt-e-Balgham). Their observation of etiological factors, presentation, complications, pathophysiology and non-pharmacological management are in close similarity to hyperlipidaemia.The corner stones of Cholesterol reduction are lifestyle modification, dietary interventions and pharmacological interventions (statins, resins, fibrates, niacins, ezetimibe etc)1,2,3,4. But all these lipid lowering agents are known to cause intolerable adverse effects and there is also a possibility of hypolipoproteinemia42,43. All these factors needs a search of the drugs which are effective, safer, having fewer side effects, cost effective and are available freely.Thus selection of test drug Safoof-e-Mohazzil (Compound of Unani Formulation) is supported by unani and some scientific literatures, which claim that it has lipolytic activity, it reduces blood pressure markedly, it works on diseases of heart, and it opens the blockage and reduces the viscosity of all humours.The present study was designed as a open labeling trial in successive patients with primary Hyperlipidaemia diagnosed on presentation, history and investigations. Thirty diagnosed patients of age between 20-60 years. Who belongs to inclusion criteria were registered, treated with Safoof-e-Mohazzil(Unani Compound) 05gm/day respectively for 90 days, and follow-up planned prior of trial, 45th day and at the end of trial. . After Intervention, most of the subjective parameters improved significantly, On objective parameters, improvement is very significant. All the biochemical parameters P=0.001. This result suggesting the effect of test drug is not only effective in lowering the Total Cholesterol, Triglyceride or LDLc but increment on HDLc, lowering of BMI and WHR. The HDL Cholesterols considered as good Cholesterols and lowering of BMI and WHR so this is also beneficial effect of test drug

Flood susceptibility modeling in the urban watershed of Guwahati using improved metaheuristic-based ensemble machine learning algorithms

The urban watershed of Guwahati is a highly flood-prone region and the fastest growing city situated on the bank of the Brahmaputra River. Therefore, this study aims to the urban flood susceptibility mapping of Guwahati city using metaheuristic optimization algorithms integrated with random forest (RF) machine learning algorithm. Further, the receiver operating characteristic (ROC) and multiple error measurements were applied to analyze the performances of the models used. The result showed that about one-third of the area of Guwahati city is under the high and very high flood risk while nearly 50% area comes under low and very low flood risk. The value of the area under curve (AUC) of ROC was above 0.80 for all the integrated models applied. However, the RF-bee colony (BCO) and the RF-based ant colony (ACO) are the two best flood susceptibility models that performed better in the analysis. The methodology adopted in the study is cost and time effective and can be used for the flood susceptibility modeling in other parts of the world. Further, the findings of this study can useful in the flood mitigation and planning process

In Situ Synthesis of Crystalline MoS₂@ZIF-67 Nanocomposite for the Efficient Removal of Methyl Orange Dye from Aqueous Media

The zeolitic imidazolate framework-67 (ZIF-67) adsorbent and its composites are known to effectively remove organic dyes from aqueous environments. Here, we report a unique crystalline MoS2@ZIF-67 nanocomposite adsorbent for the efficient removal of methyl orange (MO) dye from an aqueous medium. In situ synthetic techniques were used to fabricate a well-crystalline MoS2@ZIF-67 nanocomposite, which was then discovered to be a superior adsorbent to its constituents. The successful synthesis of the nanocomposite was confirmed using XRD, EDX, FTIR, and SEM. The MoS2@ZIF-67 nanocomposite exhibited faster adsorption kinetics and higher dye removal efficiency compared with its constituents. The adsorption kinetic data matched well with the pseudo-second-order model, which signifies that the MO adsorption on the nanocomposite is a chemically driven process. The Langmuir model successfully illustrated the MO dye adsorption on the nanocomposite through comparing the real data with adsorption isotherm models. However, it appears that the Freundlich adsorption isotherm model was also in competition with the Langmuir model. According to the acquired thermodynamics parameters, the adsorption of MO on the MoS2@ZIF-67 nanocomposite surface was determined to be spontaneous and exothermic. The findings of this research open an avenue for using the MoS2@ZIF-67 nanocomposite to efficiently remove organic dyes from wastewater efflux

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to &lt; 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of &amp; GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P &lt; 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo