Background: The existing scores for predicting severity of acute pancreatitis (AP) underperform in sensitivity. The existing scores do not predict moderately severe pancreatitis. Methods: We performed a prospective observational study from August 2014 to April 2016 on patients hospitalized at Apollo Hospitals, Chennai, with a clinical diagnosis of AP (as per Atlanta 2012 classification). Three established scoring systems – Complete Ranson's (at 48 h), Acute Physiology and Chronic Health Evaluation (APACHE-II), Bedside Index of Severity in AP (BISAP) and new score BISAP + saturation of oxygen, hematocrit (BISAP + SHO) (packed cell volume [PCV]) and overweight by body mass index [BMI]) were calculated at admission. In BISAP + SHO score 5 points were given as in BISAP and 3 points were added 1 each for low oxygen saturation ≤92%, PCV ≥47% and BMI of ≥23 making BISAP + SHO an 8-point score. The prediction by scores was validated against the actual clinical outcome of severity. Results: Of 102 patients with AP, 34 (33%) patients had organ failure (OF) and in 17 patients (16.5%) it lasted >48 h, classified as severe AP. Remaining 17 were moderately severe AP as OF resolved within <48 h. Cut-off values to predict severe pancreatitis were - Ranson's score - ≥3, APACHE-II - ≥8, BISAP - ≥3, and BISAP + SHO - ≥5. Area under receiver operator curve (AUC) for Ranson's, APACHE-II, BISAP and BISAP + SHO were 0.958, 0.953, 0.899 and 0.989, respectively. With a score 3 or 4, BISAP + SHO predicted moderately severe AP with a sensitivity of 94.12%, specificity 97.6%. Conclusions: The BISAP + SHO (rephrased as BISSHOAP) stratifies AP with better AUC than existing scores and is also able to predict moderately severe pancreatitis in the ER.

Satellite-based positioning field of research is growing rapidly as there is an increase in demand for precise position requirements in various civil and commercial applications. There are many errors that affect the GNSS signals while propagation from satellite to receiver, which eventually induces errors in pseudo-range measurements. In order to assess the receiver characteristics for a specific error condition, the real-time signals may not be appropriate, and it is challenging to perform repeated experiments with the same error condition. The advantage of the GNSS simulator is that users can model the different scenarios for any given location on the globe, which are repeatable at any point of time. The conventional hardware simulators are expensive and have few limitations. In this paper, a reconfigurable hybrid simulator is proposed with some advantages over traditional hardware simulators, such as low cost, reconfigurability, and controllability over fundamental parameters. It can be able to record intermediate stage data, which makes it more suitable for the GNSS research field. The proposed multi-GNSS simulator considered implementing IRNSS-L5, IRNSS-S1, and GPS-L1 band signals. A general-purpose computer can perform the necessary calculations for signal generation. The hybrid simulator can be able to generate the digital I/Q data, which can be stored as I/Q data or can be connected to a general-purpose SDR (Software Defined Radio) for RF signal generation (bladeRF in this case). The I/Q data can be used with the software receiver to analyse the receiver performance concerning the specific error. The generated GNSS signals are validated with software and hardware receivers, and the obtained position is observed as expected.

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