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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]

Abstract: Lagrangian formulation has traditionally been introduced for solids under large deformation. Earth-moving operations on the other hand, involve excessive material deformation and damage that cannot be modeled by the Lagrangian formulation. In this paper, a Semi-Lagrangian reproducing kernel (RK) formulation is introduced for modeling earth-moving operations. von Neumann stability analyses of Lagrangian and Semi-Lagrangian Reproducing Kernel (RK) formulations are first performed. The analysis results show that Semi-Lagrangian weak form integrated by a direct nodal integration (DNI), resembling Smoothed Particle Hydrodynamics (SPH), leads to a tensile instability that is inconsistent with the material stability. On the contrary, Semi-Lagrangian RK weak form integrated using the stabilized conforming nodal integration (SCNI) exhibits consistent numerical stability and material stability. The stable time steps for Lagrangian and Semi-Lagrangian RK formulations using central difference are also estimated and an enhanced stability is observed when the weak forms are integrated by SCNI compared to that using DNI or one-point Gauss quadrature. Earth moving simulation is performed to demonstrate the applicability of the proposed Semi-Lagrangian RK formulations to excessive material deformation and fragment problems. [Copyright &y& Elsevier]

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 Very Energetic Radiation Imaging Telescope Array System (VERITAS) is the major next generation imaging atmospheric Cherenkov γ-ray telescope in the western hemisphere and will be located in southern Arizona nearby Kitt Peak National Observatory. The VERITAS observatory will provide unprecedented sensitivity to photon energies between 50 GeV and 50 TeV. The first stage is an array of four telescopes to be fully operational in early 2006, with an expansion to seven telescopes envisioned for 2008. The construction of a prototype telescope is underway, for which first light is expected in Fall 2003. The technical concept is outlined and a progress report is given. [Copyright &y& Elsevier]

The Very Energetic Radiation Imaging Telescope Array System (VERITAS) represents an important step forward in the study of extreme astrophysical processes in the universe. It combines the power of the atmospheric Cherenkov imaging technique using a large optical reflector with the power of stereoscopic observatories using arrays of separated telescopes looking at the same shower. The seven identical telescopes in VERITAS, each of aperture 10 m, will be deployed in a filled hexagonal pattern of side 80 m; each telescope will have a camera consisting of 499 pixels with a field of view of 3.5°. VERITAS will substantially increase the catalog of very high energy (E>100 GeV) γ-ray sources and greatly improve measurements of established sources. [Copyright &y& Elsevier]

ABSTRACT The close relation between ground-based TeV observations and satellite borne γ-ray measurements has been important for the understanding of blazars. The observations which involve the TeV component in blazar studies are reviewed. [ABSTRACT FROM AUTHOR]