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

Macro-demarketing: The key to unlocking unsustainable production and consumption systems?

Drawing on the multi-level perspective of socio-technical change and social practice theory, this paper argues that macrosocial marketing must attend to the challenge of aggregate demand reduction in order to support transition to more sustainable marketing systems. However, reversal of current production and consumption system trajectories is a prodigious challenge. To provide deeper insight into that challenge, an ethnographic case study of a failed plastic bag tax identified the mechanisms reinforcing unsustainable marketing systems. Despite widespread awareness and espoused support, the tax failed to meet policy goals. Embeddedness of plastic bags in two inseparable practices (waste management and household provisioning) gave rise to seven themes: Valuableness, skepticism, subversion, blame, juxtaposition, ubiquity and embeddedness, rights and responsibilities, highlighting the roles of habitus and dominant technological regimes, and the notion of markets as sites of conflict. Mapping the system mechanisms highlighted regulating loops locking in systems behaviors at macro (landscape), meso (regimes of technology and practice) and micro (individual consumer and firm) levels. Building on the idea of demarketing, a process of macrodemarketing is proposed as a multi-level challenge to systems unsustainability. A series of macrosocial marketing interventions is proposed, ranging from electoral and education policy, to incentives for closed loop supply chain innovations. Addressing the limitations of the voluntary individual choice perspective, the study contributes insight into sources of resistance and potential capitulation to systems interventions at multiple levels and among multiple stakeholders

Comparative Performance Between Compressed and Uncompressed Airborne Imagery

The US Army\u27s RDECOM CERDEC Night Vision and Electronic Sensors Directorate (NVESD), Countermine Division is evaluating the compressibility of airborne multi-spectral imagery for mine and minefield detection application. Of particular interest is to assess the highest image data compression rate that can be afforded without the loss of image quality for war fighters in the loop and performance of near real time mine detection algorithm. The JPEG-2000 compression standard is used to perform data compression. Both lossless and lossy compressions are considered. A multi-spectral anomaly detector such as RX (Reed & Xiaoli), which is widely used as a core algorithm baseline in airborne mine and minefield detection on different mine types, minefields, and terrains to identify potential individual targets, is used to compare the mine detection performance. This paper presents the compression scheme and compares detection performance results between compressed and uncompressed imagery for various level of compressions. The compression efficiency is evaluated and its dependence upon different backgrounds and other factors are documented and presented using multi-spectral data

Growth and application of WSe

Tungsten di-selenide (WSe2) belonging to the family of layered transition metal di-chalcogenides (TMDCs) is at present widely used in optoelectronic devices due to their adequate energy band gap suitable for photosensing applications. In the present investigation, WSe2 single crystals are grown by direct vapor transport (DVT) technique in a dual zone horizontal furnace maintaining a temperature difference of 50 K between source zone (SZ) and growth zone (GZ). The crystals thus obtained were thin, shiny and with an average thickness of 30 mm. The surface topography of crystals studied by optical microscope revealed hexagonal spirals on the crystal surface which seemed to arise due to screw dislocation defect. The structural properties of the as grown crystals studied by powder X-ray diffraction (XRD) elucidated good crystallinity, hexagonal structure and confirmed the orientation of crystals along crystallographic c-axis. P-type semiconductor nature of the crystals was affirmed by thermoelectric power (TEP) measurement. Optical and vibrational properties of the grown crystals were studied by UV–Visible, photoluminescence (PL) and Raman spectroscopy. An optical direct band gap of 1.41 eV was determined for the crystals which were micromechanically exfoliated upto few layers. The excitonic mechanism of the grown WSe2 crystal was explained by PL spectroscopy. The results of Raman spectroscopy disclosed A1g and E2g vibrational modes present in the crystals. The current–voltage characteristics of nSnSe/pWSe2 hetero-structure studied using Keithley 2400 SMU showed rectification behavior at low bias voltage in dark and illuminated conditions. The diode parameters like ideality factor and barrier potential were determined to be 2.54 and 0.4 eV, respectively, by following conventional lnI–V method. The photodetection properties of the fabricated device were studied using a Laser source (670 nm) having an intensity of 3 mWcm−2at different bias voltage ranging from 0.3 V to 3 V. Parameters such as responsivity, detectivity and external quantum efficiency (EQE) were calculated to substantiate the excellent detection properties shown by the prepared photodetector using time resolved pulsed photoresponse. Value of responsivity and EQE increased from 42.22 mA W−1 to 533.77 mA W−1 and 7% to 95%, respectively, with increase in bias voltage from 0.3 V to 3 V. Also, detectivity values were found to be of the order of 107 Jones