The Infrared Array Camera (IRAC) is one of three focal plane instruments in the Spitzer Space Telescope. IRAC is a four-channel camera that obtains simultaneous broad-band images at 3.6, 4.5, 5.8, and 8.0 µm. Two nearly adjacent 5.2×5.2 arcmin fields of view in the focal plane are viewed by the four channels in pairs (3.6 and 5.8 µm; 4.5 and 8 µm). All four detector arrays in the camera are 256×256 pixels in size, with the two shorter wavelength channels using InSb and the two longer wavelength channels using Si:As IBC detectors. IRAC is a powerful survey instrument because of its high sensitivity, large field of view, and four-color imaging. This paper summarizes the in-flight scientific, technical, and operational performance of IRAC.

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Objective: The aim of this study was to develop and externally validate the first evidence-based guidelines on minimally invasive pancreas resection (MIPR) before and during the International Evidence-based Guidelines on Minimally Invasive Pancreas Resection (IG-MIPR) meeting in Miami (March 2019). Summary Background Data: MIPR has seen rapid development in the past decade. Promising outcomes have been reported by early adopters from high-volume centers. Subsequently, multicenter series as well as randomized controlled trials were reported; however, guidelines for clinical practice were lacking. Methods: The Scottisch Intercollegiate Guidelines Network (SIGN) methodology was used, incorporating these 4 items: systematic reviews using PubMed, Embase, and Cochrane databases to answer clinical questions, whenever possible in PICO style, the GRADE approach for assessment of the quality of evidence, the Delphi method for establishing consensus on the developed recommendations, and the AGREE-II instrument for the assessment of guideline quality and external validation. The current guidelines are cosponsored by the International Hepato-Pancreato-Biliary Association, the Americas Hepato-Pancreato-Biliary Association, the Asian-Pacific Hepato-Pancreato-Biliary Association, the European-African Hepato-Pancreato-Biliary Association, the European Association for Endoscopic Surgery, Pancreas Club, the Society of American Gastrointestinal and Endoscopic Surgery, the Society for Surgery of the Alimentary Tract, and the Society of Surgical Oncology. Results: After screening 16,069 titles, 694 studies were reviewed, and 291 were included. The final 28 recommendations covered 6 topics; laparoscopic and robotic distal pancreatectomy, central pancreatectomy, pancreatoduodenectomy, as well as patient selection, training, learning curve, and minimal annual center volume required to obtain optimal outcomes and patient safety. Conclusion: The IG-MIPR using SIGN methodology give guidance to surgeons, hospital administrators, patients, and medical societies on the use and outcome of MIPR as well as the approach to be taken regarding this challenging type of surgery.

LPD provides similar short-term outcomes and long-term survival to OPD in the treatment of PDAC.

Ips typographus populations were analysed by enzyme electrophoresis and by sequence analysis in order to quantify the degree of population differentiation. Enzyme electrophoresis showed a high gene flow among all European populations. Analysis of single loci showed that aspartate aminotransferase‐2 (Aat‐2) clustered the Scandinavian populations apart from the other populations whereas other enzyme loci showed no significant pattern. Analysis of mitochondrial DNA revealed eight haplotypes. The populations from Italy, Croatia and Belgium were the most polymorphic. Two haplotypes (I and II) were found in the majority of Central European populations. In the northern populations only one haplotype (I) was found. The Russian and Lithuanian populations had a particular haplotype (IV) that was not found in any of the other populations. In view of these data it is suggested that the population structure of I. typographus has been influenced by events which took place during and after the last ice age. Populations were forced into refugial areas in the south and in the area north of Moscow along with the host tree, Picea abies. P. abies had four refugial areas: the Apennine Alps, the Dinaric Alps, the Carpathian Alps and Kostroma, an area north of Moscow. With amelioration of the temperature, beetles spread after P. abies. According to the data presented here, I. typographus migrated from the Apennine and/or Dinaric Alps to the north. Whilst there is evidence for high gene flow among populations, bottleneck effects can still be detected in the north and also in the east. Beetles from the refugial area north of Moscow did not spread to Scandinavia or to the west like the host tree.

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The scenarios identified by the high-risk FRS zone represent challenging anastomoses associated with markedly elevated rates of fistula. Externalized stents and omission of prophylactic octreotide, in the setting of intraperitoneal drainage and pancreaticojejunostomy reconstruction, provides optimal outcomes.

Summary Clostridium difficile colitis (CDC) remains a serious and common complication after liver transplantation (LT). Four hundred and sixty‐seven consecutive LTs in 402 individuals were performed between 1998 and 2001 at our center. Standard immunosuppression consisted of tacrolimus, mycophenolate, and steroids. CD toxins A and B were detected by using a rapid immunoassay or enzyme immunoassay. CDC was diagnosed in 32 patients (5–1999 days post‐LT), with 93.8% (30/32) of patients developing CDC during the first year post‐LT; three individuals had CDC more than 3 years post‐LT, one of which also had early CDC. All patients presented with abdominal pain and watery diarrhea. Patients who developed CDC within 1‐year post‐LT were significantly more likely to have a hemorrhagic, biliary, or infectious complication. Patients who developed CDC within 28 days post‐LT had a significantly higher model end‐stage liver disease score. Treatment consisted of fluid and electrolyte replacement and metronidazole and no patients developed toxic megacolon, required colonic resection, or died from CDC. CDC represents a potentially severe complication following LT. Most cases occur early post‐LT. Development of a hemorrhagic, biliary, or infectious complication is associated with the development of CDC.