In Flight Performance of the Far Ultraviolet Instrument (FUV) on ICON.

The NASA Ionospheric Connection Explorer (ICON) was launched in October 2019 and has been observing the upper atmosphere and ionosphere to understand the sources of their strong variability, to understand the energy and momentum transfer, and to determine how the solar wind and magnetospheric effects modify the internally-driven atmosphere-space system. The Far Ultraviolet Instrument (FUV) supports these goals by observing the ultraviolet airglow in day and night, determining the atmospheric and ionospheric composition and density distribution. Based on the combination of ground calibration and flight data, this paper describes how major instrument parameters have been verified or refined since launch, how science data are collected, and how the instrument has performed over the first 3 years of the science mission. It also provides a brief summary of science results obtained so far.

Neutral Composition Information in ICON EUV Dayglow Observations.

Since the earliest space-based observations of Earth's atmosphere, ultraviolet (UV) airglow has proven a useful resource for remote sensing of the ionosphere and thermosphere. The NASA Ionospheric Connection Explorer (ICON) spacecraft, whose mission is to explore the connections between ionosphere and thermosphere utilizes UV airglow in the typical way: an extreme-UV (EUV) spectrometer uses dayglow between 54 and 88 nm to measure the density of O+, and a far-UV spectrograph uses the O 135.6 nm doublet and N2 Lyman-Birge-Hopfield band dayglow to measure the column ratio of O to N2 in the upper thermosphere. Two EUV emission features, O+ 61.6 and 83.4 nm, are used for the O+ retrieval; however, many other features are captured along the EUV instrument's spectral dimension. In this study, we examine the other dayglow features observed by ICON EUV and demonstrate that it measures a nitrogen feature around 87.8 nm which can be used to observe the neutral thermosphere.

First results from the retrieved column O/N2 ratio from the Ionospheric Connection Explorer (ICON): Evidence of the impacts of nonmigrating tides.

In near-Earth space, variations in thermospheric composition have important implications for thermosphere-ionosphere coupling. The ratio of O to N2 is often measured using far-UV airglow observations. Taking such airglow observations from space, looking below the Earth's limb allows for the total column of O and N2 in the ionosphere to be determined. While these observations have enabled many previous studies, determining the impact of non-migrating tides on thermospheric composition has proved difficult, owing to a small contamination of the signal by recombination of ionospheric O+. New ICON observations of far UV are presented here, and their general characteristics are shown. Using these, along with other observations and a global circulation model we show that during the morning hours and at latitudes away from the peak of the equatorial ionospheric anomaly, the impact of non-migrating tides on thermospheric composition can be observed. During March - April 2020, the column O/N2 ratio was seen to vary by 3 - 4 % of the zonal mean. By comparing the amplitude of the variation observed with that in the model, both the utility of these observations and a pathway to enable future studies is shown.

The Thermospheric Column O/N2 Ratio.

More than 2 decades ago, D. J. Strickland and colleagues proposed use of the O/N2 column number density ratio as a new geophysical quantity to interpret thermospheric processes recorded in far ultraviolet (FUV) images of the Earth. This concept has enabled multiple advances in understanding the global behavior of Earth's thermosphere. Nevertheless, confusion remains about the conceptual meaning of the column density ratio, and in the application of this integral quantity. This is so even though it is now a key thermospheric measurement made by current and planned far ultraviolet remote sensing missions in pursuit of new understanding of thermospheric processes and variability. The intent here is to review the historical context of the O/N2 column density ratio, clarify its physical meaning, and resolve misunderstandings evident in the literature. Simple examples elucidate its original derivation for extracting column O/N2 ratios from measurements of the OI 135.6 nm/N2 Lyman-Birge-Hopfield (LBH) emission based on an algorithmic synthesis of model precomputations. These are organized in the form of a table lookup of column density ratio as a function of observed radiance ratios. To accommodate generalized solar-geophysical and viewing conditions, the table required to specify the number of needed parameters becomes large. Proposed as an alternative is a simplified, first principles approach to obtaining the column density ratio from the emission ratio. This new methodology is now being applied successfully to FUV measurements made from onboard the Ionospheric CONnection satellite and will be applied retrospectively to the Global Ultraviolet Imager data.

Sensorimotor and body perception assessments of nonspecific chronic low back pain: a cross-sectional study.

BACKGROUND: Low back pain (LBP) is one of the most common musculoskeletal disorders, causing significant personal and social burden. Current research is focused on the processes of the central nervous system (particularly the sensorimotor system) and body perception, with a view to developing new and more efficient ways to treat chronic low back pain (CLBP). Several clinical tests have been suggested that might have the ability to detect alterations in the sensorimotor system. These include back-photo assessment (BPA), two-point discrimination (TPD), and the movement control tests (MCT). The aim of this study was to determine whether the simple clinical tests of BPA, TPD or MCT are able to discriminate between nonspecific CLBP subjects with altered body perception and healthy controls. METHODS: A cross-sectional study was conducted. At one point in time, 30 subjects with CLBP and 30 healthy controls were investigated through using BPA, TPD and MCT on the lower back. Correlations among the main covariates and odds ratios for group differences were calculated. RESULTS: MCT showed an odds ratio for the presence of CLBP of 1.92, with a statistically significant p-value (0.049) and 95%CI. The TPD and BPA tests were unable to determine significant differences between the groups. CONCLUSIONS: Of the three tests investigated, MCT was found to be the only suitable assessment to discriminate between nonspecific CLBP subjects and healthy controls. The MCT can be recommended as a simple clinical tool to detect alterations in the sensorimotor system of nonspecific CLBP subjects. This could facilitate the development of tailored management strategies for this challenging LBP subgroup. However, further research is necessary to elucidate the potential of all the tests to detect alterations in the sensorimotor system of CLBP subjects. TRIAL REGISTRATION: No trial registration was needed as the study contains no intervention. The study was approved by the Swiss Ethics Commission of Northwest and Central Switzerland (EKNZ) reference number 2015-243.

Bone and joint infections of the hand.

BACKGROUND: Little guidance is currently available for standardized diagnostic protocols and therapeutic recommendations for bone and joint infections (BJIs) of the hand. OBJECTIVES: To summarize the available data in the scientific English-language literature on the diagnosis and treatment of native BJIs of the hand. To illustrate these concepts from a narrative point of view in areas where there is lack of evidence. SOURCES: We performed a systematic PubMed and Internet search of studies that investigated hand BJIs in adult patients. CONTENT: Few studies have systematically investigated and validated diagnostic concepts, classifications or surgical treatment protocols. Most concepts derive from traditional intra-institutional experience, expert opinions and extrapolations from infections in large joints and long bones. Similarly, there is no uniformly accepted infection definition of BJIs of the hand. The best-documented literature is available for microbiological findings and antibiotic treatment duration in uncomplicated native joint arthritis of the fingers. Retrospective studies and one prospective randomized trial suggest that post-surgical targeted antibiotic therapy of 2 weeks results in a microbiological cure rate of ≥88%. IMPLICATIONS: Studies on diagnostic workup and infection definition and classification are urgently needed to compare inter-institutional outcome results and generate guidelines for the best patient care. For uncomplicated pyogenic arthritis of native joints, current evidence suggests that a 2-week course of antibiotic therapy following surgery cures the infection.

[Treatment options for scaphoid nonunion advanced collapse]. / Behandlungsoptionen beim karpalen Kollaps nach Skaphoidfraktur.

Untreated scaphoid nonunion as a rule results in subsequent scaphoid nonunion advanced collapse (SNAC) wrist. While reconstructive treatment of the scaphoid in association with resection of the styloid process of the radius is still promising in stage I SNAC wrist, salvage procedures are available for higher degrees of SNAC wrist to reduce pain and to preserve the function of the wrist. Denervation, proximal row carpectomy and partial wrist fusion maintain wrist mobility. Total wrist arthrodesis and total wrist arthroplasty are salvage procedures in cases of panarthritis or failed motion-preserving procedures.

Daytime O/N2 Retrieval Algorithm for the Ionospheric Connection Explorer (ICON).

The NASA Ionospheric Connection Explorer Far-Ultraviolet spectrometer, ICON FUV, will measure altitude profiles of the daytime far-ultraviolet (FUV) OI 135.6 nm and N2 Lyman-Birge-Hopfield (LBH) band emissions that are used to determine thermospheric density profiles and state parameters related to thermospheric composition; specifically the thermospheric column O/N2 ratio (symbolized as ΣO/N2). This paper describes the algorithm concept that has been adapted and updated from one previously applied with success to limb data from the Global Ultraviolet Imager (GUVI) on the NASA Thermosphere Ionosphere Mesosphere Energetics and Dynamics (TIMED) mission. We also describe the requirements that are imposed on the ICON FUV to measure ΣO/N2 over any 500-km sample in daytime with a precision of better than 8.7%. We present results from orbit-simulation testing that demonstrates that the ICON FUV and our thermospheric composition retrieval algorithm can meet these requirements and provide the measurements necessary to address ICON science objectives.

Wild boar and infectious diseases: evaluation of the current risk to human and domestic animal health in Switzerland: A review.

INTRODUCTION: The Eurasian wild boar is widely distributed in Europe and hunting bags reveal a massive increase in the population. Since wild boar and domestic pigs are susceptible to the same pathogens and can infect each other, free-ranging wild boar populations are increasingly considered to be a threat to the pig industry. Switzerland has an outstanding veterinary health situation due to its official free-of-disease status for many diseases, and the role that wildlife could play as a source of infection for domestic animals is of particular concern. This article provides an overview of the current knowledge on wild boar health in Switzerland and discusses the health risk to domestic animals and humans currently posed by wild boar. It places the data in the context of the situation in neighbouring countries. The risk currently posed by wild boar within Switzerland is largely limited to swine brucellosis. The major threat coming from abroad originates from the expansion of African swine fever. To prevent pathogen introduction and transmission between wild boar and domestic pigs, it is essential to pursue efforts in 4 areas: disease surveillance in domestic pigs, biosecurity on pig farms, disease surveillance in wild boar, and sustainable wild boar management.

INTRODUCTION: Le Sanglier est très répandu en Europe et les statistiques de chasse indiquent que sa population est en forte augmentation. Puisque le Sanglier et le Porc domestique sont sensibles aux mêmes agents pathogènes et qu'une infection réciproque est possible, les sangliers sont de plus en plus considérés comme une menace pour la production porcine. La Suisse est officiellement indemne de diverses maladies infectieuses et jouit d'un bon statut Sanitaire vétérinaire. C'est pourquoi on s'inquiète que les animaux sauvages puissent représenter une source d'infection pour les animaux domestiques. Le présent article résume les connaissances actuelles sur la santé des sangliers en Suisse, compare la situation avec celle des pays voisins et discute des risques sanitaires pour l'Homme et les animaux domestiques. Le risque sanitaire actuellement posé par le Sanglier au sein de la Suisse est largement limité à la brucellose porcine. La menace principale venant de l'étranger provient de l'expansion de la peste porcine africaine. Afin de prévenir l'introduction de pathogènes et leur transmission entre les sangliers et les porcs domestiques, il est essentiel de poursuivre les efforts dans 4 domaines: la surveillance des maladies chez les porcs domestiques, la biosécurité dans les élevages porcins, la surveillance des maladies chez les sangliers et la gestion raisonnable des sangliers.

Piscine mycobacteriosis - Involvement of bacterial species and reflection in pathology.

INTRODUCTION: Piscine mycobacteriosis is a lethal disease with zoonotic potential, found worldwide in both fresh and marine fish. More than 20 strains of Mycobacterium spp. are known to persist in fish so far, but the pathogenicity is currently unknown for most of them. However, M. marinum is reported as one of the most pathogenic agents for fish and is involved in zoonotic cases. We examined 47 different cases from two zoological gardens, where fish tuberculosis was identified or previously suspected during the last ten years. We collected PCR and sequencing data, which were then compared to previously collected clinical data and pathology. The clinical signs caused by Mycobacterium spp. were similar in all the cases, except for cases infected by M. marinum, which lacked the presence of skin lesions. Lesions seen in histology caused by M. marinum tended to be more acute and severe compared lesions caused by other Mycobacterium spp. The majority of M. marinum cases have been reported within marine fish. In contrast to previous studies we detected this species to be the predominant bacteria present within freshwater fish. Interestingly, we detected M. holsaticum in one of the seawater systems used in this project, being the first report of this Mycobacterium species shown to be present in a fish.

INTRODUCTION: La mycobactériose du poisson est une maladie létale avec un potentiel zoonotique qui se trouve dans le monde entier chez les poissons d'eau douce et marins. Plus de 20 souches de Mycobacterium spp. sont à ce jour connues chez les poissons, mais la pathogénicité est actuellement inconnue pour la plupart d'entre elles. Cependant, M. marinum est signalé comme l'un des agents les plus pathogènes pour les poissons et il est impliqué dans des cas de zoonoses. Nous avons examiné 47 cas différents provenant de deux jardins zoologiques où la tuberculose du poisson a été identifiée ou suspectée au cours des dix dernières années. Nous avons recueilli des données de PCR et de séquençage qui ont ensuite été comparées aux données cliniques et à la pathologie précédemment collectées. Les signes cliniques causés par Mycobacterium spp. étaient similaires dans tous les cas, à l'exception des cas infectés par M. marinum, chez lesquels manquaient les lésions cutanées. Les lésions histologiques observées dans les infections par M. marinum tendaient à être plus aiguës et graves comparées aux lésions provoquées par d'autres espèces de Mycobacterium spp. La majorité des cas de M. marinum ont été documentés chez des poissons marins. Contrairement aux études précédentes, nous avons constaté que cette espèce était la principale bactérie présente chez les poissons d'eau douce. Fait intéressant, nous avons détecté M. holsaticum dans l'un des systèmes d'eau de mer examinés dans ce projet, ce qui est le premier cas confirmé de la présence de cette espèce de Mycobacterium chez un poisson.

[Injuries of ligaments and tendons of foot and ankle : What every radiologist should know]. / Band- und Sehnenverletzungen an Fuß und Sprunggelenk : Was jeder Radiologe wissen sollte.

Injuries of the ligaments and tendons of the ankle and foot are among the most common musculoskeletal injuries. A correct and precise description of the pathology and possible accompanying injuries is essential for treatment planning by trauma and orthopedic surgeons. While X­ray is used to exclude fractures, ultrasound is a very useful tool to assess the ligaments and tendons. For the radiologist, magnetic resonance imaging (MRI) is invaluable regarding the correct assessment of (partial) ruptures, as well as for evaluating accompanying injuries. The aim of the present overview is to provide the most relevant facts for radiologists regarding injuries of ligaments and tendons of the ankle and foot. A description of expected MRI findings and possible pitfalls are presented. For each ligament complex or tendon, we review the anatomy, followed by relevant facts on biomechanics and typical findings in case of injury. The lateral and medial ligament complex, syndesmosis, spring ligament complex, and the Lisfranc ligament are shown in detail. The Achilles tendon and the peroneal tendons are also discussed.

The Ionospheric Connection Explorer Mission: Mission Goals and Design.

The Ionospheric Connection Explorer, or ICON, is a new NASA Explorer mission that will explore the boundary between Earth and space to understand the physical connection between our world and our space environment. This connection is made in the ionosphere, which has long been known to exhibit variability associated with the sun and solar wind. However, it has been recognized in the 21st century that equally significant changes in ionospheric conditions are apparently associated with energy and momentum propagating upward from our own atmosphere. ICON's goal is to weigh the competing impacts of these two drivers as they influence our space environment. Here we describe the specific science objectives that address this goal, as well as the means by which they will be achieved. The instruments selected, the overall performance requirements of the science payload and the operational requirements are also described. ICON's development began in 2013 and the mission is on track for launch in 2017. ICON is developed and managed by the Space Sciences Laboratory at the University of California, Berkeley, with key contributions from several partner institutions.

Inferring Nighttime Ionospheric Parameters With the Far Ultraviolet Imager Onboard the Ionospheric Connection Explorer.

The Ionospheric Connection Explorer (ICON) Far Ultraviolet (FUV) imager, ICON FUV, will measure altitude profiles of OI 135.6 nm emissions to infer nighttime ionospheric parameters. Accurate estimation of the ionospheric state requires the development of a comprehensive radiative transfer model from first principles to quantify the effects of physical processes on the production and transport of the 135.6 nm photons in the ionosphere including the mutual neutralization contribution as well as the effect of resonant scattering by atomic oxygen and pure absorption by oxygen molecules. This forward model is then used in conjunction with a constrained optimization algorithm to invert the anticipated ICON FUV line-of-sight integrated measurements. In this paper, we describe the connection between ICON FUV measurements and the nighttime ionosphere, along with the approach to inverting the measured emission profiles to derive the associated O+ profiles from 150-450 km in the nighttime ionosphere that directly reflect the electron density in the F-region of the ionosphere.

Intra-Abdominal Cooling System Limits Ischemia-Reperfusion Injury During Robot-Assisted Renal Transplantation.

Robot-assisted kidney transplantation is feasible; however, concerns have been raised about possible increases in warm ischemia times. We describe a novel intra-abdominal cooling system to continuously cool the kidney during the procedure. Porcine kidneys were procured by standard open technique. Groups were as follows: Robotic renal transplantation with (n = 11) and without (n = 6) continuous intra-abdominal cooling and conventional open technique with intermittent 4°C saline cooling (n = 6). Renal cortex temperature, magnetic resonance imaging, and histology were analyzed. Robotic renal transplantation required a longer anastomosis time, either with or without the cooling system, compared to the open approach (70.4 ± 17.7 min and 74.0 ± 21.5 min vs. 48.7 ± 11.2 min, p-values < 0.05). The temperature was lower in the robotic group with cooling system compared to the open approach group (6.5 ± 3.1°C vs. 22.5 ± 6.5°C; p = 0.001) or compared to the robotic group without the cooling system (28.7 ± 3.3°C; p < 0.001). Magnetic resonance imaging parenchymal heterogeneities and histologic ischemia-reperfusion lesions were more severe in the robotic group without cooling than in the cooled (open and robotic) groups. Robot-assisted kidney transplantation prolongs the warm ischemia time of the donor kidney. We developed a novel intra-abdominal cooling system that suppresses the noncontrolled rewarming of donor kidneys during the transplant procedure and prevents ischemia-reperfusion injuries.

Assessment of UV spectrophotometry for determination of plasmid DNA concentration in vector preparations for human gene therapy products.

The European Pharmacopoeia (Ph. Eur.) general chapter 5.14. Gene transfer medicinal products for human use suggests the use of absorbance measurements at 260 nm to determine the DNA concentration of plasmid vectors used for the preparation of gene therapy products for human use. An international collaborative study was organised by the European Directorate for the Quality of Medicines & HealthCare (EDQM) to confirm the suitability of UV spectrophotometry for the quantification of plasmid vectors used in gene therapy (GT). Three Official Medicine Control Laboratories (OMCLs of the European OMCL Network) and members of the OMCL Working Group for GT products took part in the study, in which various types of spectrophotometers were assessed using common test samples. Results of the study demonstrated that UV spectrophotometry can be considered suitable for the quantification of plasmid DNA in GT products regardless of the instrument used.

Beyond the Coral Triangle: high genetic diversity and near panmixia in Singapore's populations of the broadcast spawning sea star Protoreaster nodosus.

The Coral Triangle is widely considered the most important centre of marine biodiversity in Asia while areas on its periphery such as the South China Sea, have received much less interest. Here, we demonstrate that a small population of the knobbly sea star Protoreaster nodosus in Singapore has similarly high levels of genetic diversity as comparable Indonesian populations from the Coral Triangle. The high genetic diversity of this population is remarkable because it is maintained despite decades of continued anthropogenic disturbance. We postulate that it is probably due to broadcast spawning which is likely to maintain high levels of population connectivity. To test this, we analysed 6140 genome-wide single nucleotide polymorphism (SNP) loci for Singapore's populations and demonstrate a pattern of near panmixia. We here document a second case of high genetic diversity and low genetic structure for a broadcast spawner in Singapore, which suggests that such species have high resilience against anthropogenic disturbances. The study demonstrates the feasibility and power of using genome-wide SNPs for connectivity studies of marine invertebrates without a sequenced genome.

[Acute scaphoid fractures : Management under consideration of the new S3-level guideline]. / Die frische Skaphoidfraktur : Management unter Berücksichtigung der neuen S3-Leitlinie.

BACKGROUND: Scaphoid fractures represent the most common carpal fractures and are often problematic and frequently lead to nonunion with osteoarthritis and collapse of the wrist. The reasons for the nonunion are manifold. Therefore, the main goal of diagnosis and therapy of acute fractures is to achieve bony union and to restore the anatomic shape of the scaphoid. In the long run, only this can preserve the normal function of the wrist. METHODOLOGY: The given recommendations are based on the new S3-level guideline of the AWMF (Association of the Scientific Medical Societies). This guideline was established with involvement of all relevant medical societies based on a comprehensive and systematic review of the literature and after a process of formal consent. The focus of the guideline is recommendations regarding diagnosis and therapy of acute scaphoid fractures. MAIN STATEMENTS: After careful clinical examination consequent imaging must be performed, starting with X­rays in three standard projections. Computed tomography is indispensable for proof of a fracture and for therapy planning. The classification of Herbert and Krimmer is based on the CT under special consideration of instability and displacement of the fracture. Thus, indication for operative and non-operative treatment is mainly CT-dependent. Non-operative treatment may be indicated only for stable fractures (type A). However, operative treatment is strongly recommended for all unstable fractures (type B). For fixation, double-threaded headless screws are preferred. The operative technique depends on the fracture morphology. CONCLUSION: Diagnosis and therapy of acute scaphoid fractures are primarily aimed at the prevention of nonunion and arthritic carpal collapse with painful impairment of the wrist function. To achieve this, the S3-level guideline contains explicit recommendations.

Granule size distributions after twin-screw granulation - Do not forget the feeding systems.

The aim of this study was to investigate the influence of qualitatively different powder feeder performances on resulting granule size distributions after twin-screw granulation of a highly drug loaded, hydrophobic mixture and a mannitol powder. It was shown that powder feeder related problems usually cannot be identified by trusting in the values given by the feeder. Therefore, a newly developed model for the evaluation of the performance of powder feeders was introduced and it was tried to connect this model to residence time distributions in twin-screw granulation processes. The influence of feeder performances on resulting granule size distributions varied, depending on the applied screw configuration and the used powder. Regarding the hydrophobic and highly drug loaded formulation, which was granulated at an L/S-ratio of 0.5, a pure conveying screw and a medium kneading configuration, consisting of 60° kneading blocks were negatively influenced by poor feeder settings. For optimal settings more narrow distributions could be obtained. For an extensive kneading configuration good and poor settings resulted in mono-modal granule size distributions but were differing in the overall size. Mannitol, a model substance for a liquid sensitive formulation was granulated at an L/S-ratio of 0.075. It was even more important to maintain optimal feeding as mannitol was highly affected by poor feeder performances. Even an extensive kneading configuration could not level the errors in powder feeder performance, resulting in qualitatively different granule size distributions. The results of this study demonstrate the importance of detailed knowledge about applied feeding systems to gain optimal performance in twin-screw granulation.

Implantation of a denaturated cellulose adhesion barrier after plate osteosynthesis of finger proximal phalangeal fractures: results of a randomized controlled trial.

Adhesions after osteosynthesis of finger proximal phalangeal fractures often cause stiffness. To minimize adhesions, the use of an adhesion barrier has been proposed. The results until now have not been convincing. The aim of this prospective randomized trial was to evaluate the use of an adhesion barrier. The trial included any isolated, closed proximal phalangeal fracture needing plate osteosynthesis. The patients were randomized into two groups: with or without application of the adhesion barrier. The outcomes we measured were finger ranges of motion and DASH score at 6 weeks and 6 months post-operatively. A total of 42 patients (42 fingers) entered the study; 37 completed the study. The key baseline characteristics were comparable. At 6 weeks there was a trend favouring the adhesion barrier that disappeared at 6 months. Overall the results do not support the use of this device.

English language version of the S3-consensus guidelines on chronic pancreatitis: Definition, aetiology, diagnostic examinations, medical, endoscopic and surgical management of chronic pancreatitis.

Chronic pancreatitis is a disease of the pancreas in which recurrent inflammatory episodes result in replacement of pancreatic parenchyma by fibrous connective tissue. This fibrotic reorganization of the pancreas leads to a progressive exocrine and endocrine pancreatic insufficiency. In addition, characteristic complications arise, such as pseudocysts, pancreatic duct obstructions, duodenal obstruction, vascular complications, obstruction of the bile ducts, malnutrition and pain syndrome. Pain presents as the main symptom of patients with chronic pancreatitis. Chronic pancreatitis is a risk factor for pancreatic carcinoma. Chronic pancreatitis significantly reduces the quality of life and the life expectancy of affected patients. These guidelines were researched and compiled by 74 representatives from 11 learned societies and their intention is to serve evidence-based professional training as well as continuing education. On this basis they shall improve the medical care of affected patients in both the inpatient and outpatient sector. Chronic pancreatitis requires an adequate diagnostic workup and systematic management, given its severity, frequency, chronicity, and negative impact on the quality of life and life expectancy.