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Background: Sedation of patients for deep small bowel enteroscopy presents unique challenges and is traditionally provided by anesthesiologists. No study has directly evaluated gastroenterologist-guided, nurse-administered sedation for deep enteroscopy. Further, no comparison exists between gastroenterologist-guided versus anesthesiologist-guided sedation during deep enteroscopy.Aims: To evaluate safety and efficacy of performing deep (spiral) enteroscopy using gastroenterologist-guided sedation and compare outcomes between patients receiving gastroenterologist-guided and anesthesiologist-guided sedation.Methods: This prospective case series contains 91 consecutive patients who underwent deep enteroscopy with spiral Endo-Ease Discovery SB overtube. Of the patients, 64 received gastroenterologist-guided and 27 received anesthesiologist-guided sedation.Results: In the 64 patients receiving gastroenterologist-guided sedation, successful completion occurred in 59 of 64 enteroscopies (92.2%). Mean insertion depth was 231.0+/-85.8 cm beyond the ligament of Treitz. Total procedure time was 39.9+/-15.7 min (diagnostic time 34.7+/-12.3 min; therapy time 5.2+/-8.9 min). Positive findings were noted in 32 cases (50.0%), with therapy performed in 27 cases (42.2%). Six minor complications occurred. Compared to the anesthesiologist-guided sedation group, there was no difference in patient characteristics except mean American Society of Anesthesiologists score (2.5+/-0.5 in gastroenterologist-guided group versus 2.7+/-0.6 in anesthesiologist-guided group; p=0.046) and presence of adhesions (ten in gastroenterologist-guided group and zero in anesthesiologist-guided group; p=0.030). Outcomes for both groups were not significantly different except for shorter times in the gastroenterologist-guided group (39.9+/-15.7 min versus 46.0+/-12.1 min; p=0.047) and more frequent findings in the anesthesiologist-guided group (50.0% vs. 74.1%; p=0.034).Conclusions: Deep enteroscopy using the spiral overtube can be successfully and safely accomplished with gastroenterologist-guided, nurse-administered standard sedation. [ABSTRACT FROM AUTHOR]

The Electron Drift Instrument (EDI) on the Magnetospheric Multiscale (MMS) mission measures the in-situ electric and magnetic fields using the drift of a weak beam of test electrons that, when emitted in certain directions, return to the spacecraft after one or more gyrations. This drift is related to the electric field and, to a lesser extent, the gradient in the magnetic field. Although these two quantities can be determined separately by use of different electron energies, for MMS regions of interest the magnetic field gradient contribution is negligible. As a by-product of the drift determination, the magnetic field strength and constraints on its direction are also determined. The present paper describes the scientific objectives, the experimental method, and the technical realization of the various elements of the instrument on MMS. [ABSTRACT FROM AUTHOR]

The Plasma and Suprathermal Ion Composition (PLASTIC) investigation provides the in situ solar wind and low energy heliospheric ion measurements for the NASA Solar Terrestrial Relations Observatory Mission, which consists of two spacecraft (STEREO-A, STEREO-B). PLASTIC-A and PLASTIC-B are identical. Each PLASTIC is a time-of-flight/energy mass spectrometer designed to determine the elemental composition, ionic charge states, and bulk flow parameters of major solar wind ions in the mass range from hydrogen to iron. PLASTIC has nearly complete angular coverage in the ecliptic plane and an energy range from ∼0.3 to 80 keV/e, from which the distribution functions of suprathermal ions, including those ions created in pick-up and local shock acceleration processes, are also provided. [ABSTRACT FROM AUTHOR]

The Solar Energetic Particle Ionic Charge Analyzer (SEPICA) is the main instrument on the Advanced Composition Explorer (ACE) to determine the ionic charge states of solar and interplanetary energetic particles in the energy range from ≈0.2 MeV nucl−1 to ≈5 MeV charge−1. The charge state of energetic ions contains key information to unravel source temperatures, acceleration, fractionation and transport processes for these particle populations. SEPICA will have the ability to resolve individual charge states and have a substantially larger geometric factor than its predecessor ULEZEQ on ISEE-1 and -3, on which SEPICA is based. To achieve these two requirements at the same time, SEPICA is composed of one high-charge resolution sensor section and two low- charge resolution, but large geometric factor sections. The charge resolution is achieved by the focusing of the incoming ions, through a multi-slit mechanical collimator, deflection in an electrostatic analyzer with a voltage up to 30 kV, and measurement of the impact position in the detector system. To determine the nuclear charge (element) and energy of the incoming ions, the combination of thin-window flow-through proportional counters with isobutane as counter gas and ion-implanted solid state detectors provide for 3 independent ΔE (energy loss) versus E (residual energy) telescopes. The multi-wire proportional counter simultaneously determines the energy loss ΔE and the impact position of the ions. Suppression of background from penetrating cosmic radiation is provided by an anti-coincidence system with a CsI scintillator and Si-photodiodes. The data are compressed and formatted in a data processing unit (S3DPU) that also handles the commanding and various automatted functions of the instrument. The S3DPU is shared with the Solar Wind Ion Charge Spectrometer (SWICS) and the Solar Wind Ion Mass Spectrometer (SWIMS) and thus provides the same services for three of the ACE instruments. It has evolved out of a long family of data processing units for particle spectrometers. [ABSTRACT FROM AUTHOR]