Saturn's near-equatorial ionospheric conductivities from in situ measurements.

Cassini's Grand Finale orbits provided for the first time in-situ measurements of Saturn's topside ionosphere. We present the Pedersen and Hall conductivities of the top near-equatorial dayside ionosphere, derived from the in-situ measurements by the Cassini Radio and Wave Plasma Science Langmuir Probe, the Ion and Neutral Mass Spectrometer and the fluxgate magnetometer. The Pedersen and Hall conductivities are constrained to at least 10-5-10-4 S/m at (or close to) the ionospheric peak, a factor 10-100 higher than estimated previously. We show that this is due to the presence of dusty plasma in the near-equatorial ionosphere. We also show the conductive ionospheric region to be extensive, with thickness of 300-800 km. Furthermore, our results suggest a temporal variation (decrease) of the plasma densities, mean ion masses and consequently the conductivities from orbit 288 to 292.

Systematic review: adrenal insufficiency secondary to swallowed topical corticosteroids in eosinophilic oesophagitis.

BACKGROUND: Swallowed topical corticosteroids are prescribed for eosinophilic oesophagitis (EoE), but there is a theoretical risk of adrenal insufficiency from their use. AIMS: To determine if the use of topical corticosteroids to treat EoE is associated with the development of adrenal insufficiency. METHOD: We conducted a systematic review of the published literature from January 1, 1950 to April 1, 2017 using Pubmed, Embase, Web of Science and Cochrane Central. Studies and meeting abstracts were included that described patients with EoE who received swallowed topical corticosteroids and any investigation for adrenal insufficiency. RESULTS: The search revealed 1610 unique publications, and 17 met inclusion criteria. There were 7 randomised controlled trials (RCTs), 6 prospective observational studies, 3 retrospective observational studies, and 1 case report. Cortisol measurements were performed on 596 individuals with EoE who received topical corticosteroids. Adrenal testing was abnormal, as defined by each study, in 94/596 patients (crude rate of 15.8%). Only 2 studies were considered to have a low risk of bias, being randomised controlled trials that estimated adrenal insufficiency in the active treatment and placebo groups, before and after treatment. None of the seven randomised controlled trials demonstrated statistically significantly different rates of adrenal insufficiency between topical corticosteroid and placebo over treatment intervals of 2-12 weeks. CONCLUSION: Topical corticosteroids were associated with adrenal insufficiency in a minority of patients. Most cases came from uncontrolled observational studies, with widely varying definitions of adrenal insufficiency. Longer follow-up and larger controlled studies are needed to quantify the risk of adrenal insufficiency with maintenance topical corticosteroid therapy in EoE.

Cassini observations of ionospheric plasma in Saturn's magnetotail lobes.

Studies of Saturn's magnetosphere with the Cassini mission have established the importance of Enceladus as the dominant mass source for Saturn's magnetosphere. It is well known that the ionosphere is an important mass source at Earth during periods of intense geomagnetic activity, but lesser attention has been dedicated to study the ionospheric mass source at Saturn. In this paper we describe a case study of data from Saturn's magnetotail, when Cassini was located at ≃ 2200 h Saturn local time at 36 RS from Saturn. During several entries into the magnetotail lobe, tailward flowing cold electrons and a cold ion beam were observed directly adjacent to the plasma sheet and extending deeper into the lobe. The electrons and ions appear to be dispersed, dropping to lower energies with time. The composition of both the plasma sheet and lobe ions show very low fluxes (sometimes zero within measurement error) of water group ions. The magnetic field has a swept-forward configuration which is atypical for this region, and the total magnetic field strength is larger than expected at this distance from the planet. Ultraviolet auroral observations show a dawn brightening, and upstream heliospheric models suggest that the magnetosphere is being compressed by a region of high solar wind ram pressure. We interpret this event as the observation of ionospheric outflow in Saturn's magnetotail. We estimate a number flux between (2.95 ± 0.43) × 109 and (1.43 ± 0.21) × 1010 cm-2 s-1, 1 or about 2 orders of magnitude larger than suggested by steady state MHD models, with a mass source between 1.4 ×102 and 1.1 ×103 kg/s. After considering several configurations for the active atmospheric regions, we consider as most probable the main auroral oval, with associated mass source between 49.7 ±13.4 and 239.8 ±64.8 kg/s for an average auroral oval, and 10 ±4 and 49 ±23 kg/s for the specific auroral oval morphology found during this event. It is not clear how much of this mass is trapped within the magnetosphere and how much is lost to the solar wind.

Quasiperpendicular High Mach Number Shocks.

Shock waves exist throughout the Universe and are fundamental to understanding the nature of collisionless plasmas. Reformation is a process, driven by microphysics, which typically occurs at high Mach number supercritical shocks. While ongoing studies have investigated this process extensively both theoretically and via simulations, their observations remain few and far between. In this Letter we present a study of very high Mach number shocks in a parameter space that has been poorly explored and we identify reformation using in situ magnetic field observations from the Cassini spacecraft at 10 AU. This has given us an insight into quasiperpendicular shocks across 2 orders of magnitude in Alfvén Mach number (M_{A}) which could potentially bridge the gap between modest terrestrial shocks and more exotic astrophysical shocks. For the first time, we show evidence for cyclic reformation controlled by specular ion reflection occurring at the predicted time scale of ~0.3τ_{c}, where τ_{c} is the ion gyroperiod. In addition, we experimentally reveal the relationship between reformation and M_{A} and focus on the magnetic structure of such shocks to further show that for the same M_{A}, a reforming shock exhibits stronger magnetic field amplification than a shock that is not reforming.

Field dipolarization in Saturn's magnetotail with planetward ion flows and energetic particle flow bursts: Evidence of quasi-steady reconnection.

We present a case study of an event from 20 August (day 232) of 2006, when the Cassini spacecraft was sampling the region near 32 RS and 22 h LT in Saturn's magnetotail. Cassini observed a strong northward-to-southward turning of the magnetic field, which is interpreted as the signature of dipolarization of the field as seen by the spacecraft planetward of the reconnection X line. This event was accompanied by very rapid (up to ~1500 km s-1) thermal plasma flow toward the planet. At energies above 28 keV, energetic hydrogen and oxygen ion flow bursts were observed to stream planetward from a reconnection site downtail of the spacecraft. Meanwhile, a strong field-aligned beam of energetic hydrogen was also observed to stream tailward, likely from an ionospheric source. Saturn kilometric radiation emissions were stimulated shortly after the observation of the dipolarization. We discuss the field, plasma, energetic particle, and radio observations in the context of the impact this reconnection event had on global magnetospheric dynamics.

Asymmetries observed in Saturn's magnetopause geometry.

For over 10 years, the Cassini spacecraft has patrolled Saturn's magnetosphere and observed its magnetopause boundary over a wide range of prevailing solar wind and interior plasma conditions. We now have data that enable us to resolve a significant dawn-dusk asymmetry and find that the magnetosphere extends farther from the planet on the dawnside of the planet by 7 ± 1%. In addition, an opposing dawn-dusk asymmetry in the suprathermal plasma pressure adjacent to the magnetopause has been observed. This probably acts to reduce the size asymmetry and may explain the discrepancy between the degree of asymmetry found here and a similar asymmetry found by Kivelson and Jia (2014) using MHD simulations. Finally, these observations sample a wide range of season, allowing the "intrinsic" polar flattening (14 ± 1%) caused by the magnetodisc to be separated from the seasonally induced north-south asymmetry in the magnetopause shape found theoretically (5 ± 1% when the planet's magnetic dipole is tilted away from the Sun by 10-17°).

Internally driven large-scale changes in the size of Saturn's magnetosphere.

Saturn's magnetic field acts as an obstacle to solar wind flow, deflecting plasma around the planet and forming a cavity known as the magnetosphere. The magnetopause defines the boundary between the planetary and solar dominated regimes, and so is strongly influenced by the variable nature of pressure sources both outside and within. Following from Pilkington et al. (2014), crossings of the magnetopause are identified using 7 years of magnetic field and particle data from the Cassini spacecraft and providing unprecedented spatial coverage of the magnetopause boundary. These observations reveal a dynamical interaction where, in addition to the external influence of the solar wind dynamic pressure, internal drivers, and hot plasma dynamics in particular can take almost complete control of the system's dayside shape and size, essentially defying the solar wind conditions. The magnetopause can move by up to 10-15 planetary radii at constant solar wind dynamic pressure, corresponding to relatively "plasma-loaded" or "plasma-depleted" states, defined in terms of the internal suprathermal plasma pressure.

Saturn's dayside ultraviolet auroras: Evidence for morphological dependence on the direction of the upstream interplanetary magnetic field.

We examine a unique data set from seven Hubble Space Telescope (HST) "visits" that imaged Saturn's northern dayside ultraviolet emissions exhibiting usual circumpolar "auroral oval" morphologies, during which Cassini measured the interplanetary magnetic field (IMF) upstream of Saturn's bow shock over intervals of several hours. The auroras generally consist of a dawn arc extending toward noon centered near ∼15° colatitude, together with intermittent patchy forms at ∼10° colatitude and poleward thereof, located between noon and dusk. The dawn arc is a persistent feature, but exhibits variations in position, width, and intensity, which have no clear relationship with the concurrent IMF. However, the patchy postnoon auroras are found to relate to the (suitably lagged and averaged) IMF Bz , being present during all four visits with positive Bz and absent during all three visits with negative Bz . The most continuous such forms occur in the case of strongest positive Bz . These results suggest that the postnoon forms are associated with reconnection and open flux production at Saturn's magnetopause, related to the similarly interpreted bifurcated auroral arc structures previously observed in this local time sector in Cassini Ultraviolet Imaging Spectrograph data, whose details remain unresolved in these HST images. One of the intervals with negative IMF Bz however exhibits a prenoon patch of very high latitude emission extending poleward of the dawn arc to the magnetic/spin pole, suggestive of the occurrence of lobe reconnection. Overall, these data provide evidence of significant IMF dependence in the morphology of Saturn's dayside auroras. KEY POINTS: We examine seven cases of joint HST Saturn auroral images and Cassini IMF dataThe persistent but variable dawn arc shows no obvious IMF dependencePatchy postnoon auroras are present for northward IMF but not for southward IMF.

Cusp observation at Saturn's high-latitude magnetosphere by the Cassini spacecraft.

We report on the first analysis of magnetospheric cusp observations at Saturn by multiple in situ instruments onboard the Cassini spacecraft. Using this we infer the process of reconnection was occurring at Saturn's magnetopause. This agrees with remote observations that showed the associated auroral signatures of reconnection. Cassini crossed the northern cusp around noon local time along a poleward trajectory. The spacecraft observed ion energy-latitude dispersions-a characteristic signature of the terrestrial cusp. This ion dispersion is "stepped," which shows that the reconnection is pulsed. The ion energy-pitch angle dispersions suggest that the field-aligned distance from the cusp to the reconnection site varies between ∼27 and 51 RS . An intensification of lower frequencies of the Saturn kilometric radiation emissions suggests the prior arrival of a solar wind shock front, compressing the magnetosphere and providing more favorable conditions for magnetopause reconnection. KEY POINTS: We observe evidence for reconnection in the cusp plasma at SaturnWe present evidence that the reconnection process can be pulsed at SaturnSaturn's cusp shows similar characteristics to the terrestrial cusp.

Dynamic auroral storms on Saturn as observed by the Hubble Space Telescope.

We present observations of significant dynamics within two UV auroral storms observed on Saturn using the Hubble Space Telescope in April/May 2013. Specifically, we discuss bursts of auroral emission observed at the poleward boundary of a solar wind-induced auroral storm, propagating at ∼330% rigid corotation from near ∼01 h LT toward ∼08 h LT. We suggest that these are indicative of ongoing, bursty reconnection of lobe flux in the magnetotail, providing strong evidence that Saturn's auroral storms are caused by large-scale flux closure. We also discuss the later evolution of a similar storm and show that the emission maps to the trailing region of an energetic neutral atom enhancement. We thus identify the auroral form with the upward field-aligned continuity currents flowing into the associated partial ring current.

Detection of a strongly negative surface potential at Saturn's moon Hyperion.

On 26 September 2005, Cassini conducted its only close targeted flyby of Saturn's small, irregularly shaped moon Hyperion. Approximately 6 min before the closest approach, the electron spectrometer (ELS), part of the Cassini Plasma Spectrometer (CAPS) detected a field-aligned electron population originating from the direction of the moon's surface. Plasma wave activity detected by the Radio and Plasma Wave instrument suggests electron beam activity. A dropout in energetic electrons was observed by both CAPS-ELS and the Magnetospheric Imaging Instrument Low-Energy Magnetospheric Measurement System, indicating that the moon and the spacecraft were magnetically connected when the field-aligned electron population was observed. We show that this constitutes a remote detection of a strongly negative (∼ -200 V) surface potential on Hyperion, consistent with the predicted surface potential in regions near the solar terminator.

Review of exchange processes on Ganymede in view of its planetary protection categorization.

In this paper, we provide a detailed review of Ganymede's characteristics that are germane to any consideration of its planetary protection requirements. Ganymede is the largest moon in our solar system and is the subject of one of the main science objectives of the JUICE mission to the jovian system. We explore the probability of the occurrence of potentially habitable zones within Ganymede at present, including those both within the deep liquid ocean and those in shallow liquid reservoirs. We consider the possible exchange processes between the surface and any putative habitats to set some constraints on the planetary protection approach for this moon. As a conclusion, the "remote" versus "significant" chance of contamination will be discussed, according to our current understanding of this giant icy moon. Based on the different estimates we investigate here, it appears extremely unlikely that material would be exchanged downward through the upper icy layer of Ganymede and, thus, bring material into the ocean over timescales consistent with the survival of microorganisms.

Interposition graft with polytetrafluoroethylene for mesenteric and portal vein reconstruction after pancreaticoduodenectomy.

BACKGROUND: Portal vein-superior mesenteric vein resection is frequently required after surgical resection of tumours of the pancreas head. The ideal graft for portal vein reconstruction (PVR) remains undefined. METHODS: Between May 2000 and July 2007, 28 patients had portal vein-superior mesenteric vein resection and PVR during pancreaticoduodenectomy. Their clinical reports were reviewed retrospectively with specific attention to the methods of PVR and outcomes. RESULTS: Ten patients had PVR with primary anastomosis, seven had PVR with autologous vein, one had a polytetrafluoroethylene (PTFE) patch, one did not have PVR and nine had PVR with a PTFE interposition graft. There was no infection after PTFE grafting. Six patients had PVR thrombosis after surgery: four after primary anastomosis, one after interposition PTFE and one after vein repair. CONCLUSION: PTFE appeared to be an effective and safe option as an interposition graft for portomesenteric venous reconstruction after pancreaticoduodenectomy.

The magnetic memory of Titan's ionized atmosphere.

After 3 years and 31 close flybys of Titan by the Cassini Orbiter, Titan was finally observed in the shocked solar wind, outside of Saturn's magnetosphere. These observations revealed that Titan's flow-induced magnetosphere was populated by "fossil" fields originating from Saturn, to which the satellite was exposed before its excursion through the magnetopause. In addition, strong magnetic shear observed at the edge of Titan's induced magnetosphere suggests that reconnection may have been involved in the replacement of the fossil fields by the interplanetary magnetic field.

The dust halo of Saturn's largest icy moon, Rhea.

Saturn's moon Rhea had been considered massive enough to retain a thin, externally generated atmosphere capable of locally affecting Saturn's magnetosphere. The Cassini spacecraft's in situ observations reveal that energetic electrons are depleted in the moon's vicinity. The absence of a substantial exosphere implies that Rhea's magnetospheric interaction region, rather than being exclusively induced by sputtered gas and its products, likely contains solid material that can absorb magnetospheric particles. Combined observations from several instruments suggest that this material is in the form of grains and boulders up to several decimetres in size and orbits Rhea as an equatorial debris disk. Within this disk may reside denser, discrete rings or arcs of material.

Splenic embolization in liver transplant recipients: early outcomes.

Clinical improvement has been reported following splenic embolization for a wide variety of indications. Improvement following splenic embolization has been described in cirrhotic patients awaiting hepatic transplantation who are not candidates for surgical splenectomy. Occasionally, patients who have undergone hepatic transplantation have conditions that may also benefit from nonsurgical intervention with splenic embolization. Indications include persistent hypersplenism and pancytopenia precluding optimal treatment with antiviral therapy or chemotherapy, risk for persistent gastroesophageal variceal hemorrhage, and splenic artery steal syndrome attenuating hepatic arterial perfusion. Limited data is available on the outcome of splenic embolization in liver transplant recipients. We present the early outcomes of liver transplant recipients who were treated with splenic embolization. A retrospective chart review of all liver transplant recipients who underwent splenic embolization between 1997 and 2006 was performed, under minimal-risk study approval by the institutional review board. Five liver transplant recipients received splenic embolization: 3 for persistent hypersplenism, 1 for increased risk of gastroesophageal variceal hemorrhage, and 1 for splenic artery steal syndrome. The patients with hypersplenism demonstrated hematologic improvement, the patient with gastroesophageal varices did not experience any hemorrhage on follow-up, and the patient with splenic artery steal experienced resolution of the steal phenomenon. Postembolization syndrome was observed but no splenic abscess or death occurred. Mean follow-up was 20.2 months. In conclusion, splenic embolization is a safe and effective nonsurgical alternative for a variety of indications in liver transplant recipients.

Tethys and Dione as sources of outward-flowing plasma in Saturn's magnetosphere.

Rotating at over twice the angular speed of Earth, Saturn imposes a rapid spin on its magnetosphere. As a result, cold, dense plasma is believed to be flung outward from the inner magnetosphere by centrifugal force and replaced by hotter, more tenuous plasma from the outer magnetosphere. The centrifugal interchange of plasmas in rotating magnetospheres was predicted many years ago and was conclusively demonstrated by observations in Jupiter's magnetosphere, which--like that of Saturn (but unlike that of Earth)--is rotationally dominated. Recent observations in Saturn's magnetosphere have revealed narrow injections of hot, tenuous plasma believed to be the inward-moving portion of the centrifugal interchange cycle. Here we report observations of the distribution of the angle between the electron velocity vector and the magnetic field vector ('pitch angle') obtained in the cold, dense plasma adjacent to these inward injection regions. The observed pitch-angle distributions are indicative of outward plasma flow and consistent with centrifugal interchange in Saturn's magnetosphere. Further, we conclude that the observed double-peaked ('butterfly') pitch-angle distributions result from the transport of plasma from regions near the orbits of Dione and Tethys, supporting the idea of distinct plasma tori associated with these moons.

The variable rotation period of the inner region of Saturn's plasma disk.

We show that the plasma and magnetic fields in the inner region of Saturn's plasma disk rotate in synchronism with the time-variable modulation period of Saturn's kilometric radio emission. This relation suggests that the radio modulation has its origins in the inner region of the plasma disk, most likely from a centrifugally driven convective instability and an associated plasma outflow that slowly slips in phase relative to Saturn's internal rotation. The slippage rate is determined by the electrodynamic coupling of the plasma disk to Saturn and by the drag force exerted by its interaction with the Enceladus neutral gas torus.

A regular period for Saturn's magnetic field that may track its internal rotation.

The rotation rate of a planet is one of its fundamental properties. Saturn's rotation, however, is difficult to determine because there is no solid surface from which to time it, and the alternative 'clock'--the magnetic field--is nearly symmetrically aligned with the rotation axis. Radio emissions, thought to provide a proxy measure of the rotation of the magnetic field, have yielded estimates of the rotation period between 10 h 39 min 22 s and 10 h 45 min 45 s (refs 8-10). Because the period determined from radio measurements exhibits large time variations, even on timescales of months, it has been uncertain whether the radio-emission periodicity coincides with the inner rotation rate of the planet. Here we report magnetic field measurements that revealed a time-stationary magnetic signal with a period of 10 h 47 min 6 s +/- 40 s. The signal appears to be stable in period, amplitude and phase over 14 months of observations, pointing to a close connection with the conductive region inside the planet, although its interpretation as the 'true' inner rotation period is still uncertain.

Identification of a dynamic atmosphere at Enceladus with the Cassini magnetometer.

The Cassini magnetometer has detected the interaction of the magnetospheric plasma of Saturn with an atmospheric plume at the icy moon Enceladus. This unanticipated finding, made on a distant flyby, was subsequently confirmed during two follow-on flybys, one very close to Enceladus. The magnetometer data are consistent with local outgassing activity via a plume from the surface of the moon near its south pole, as confirmed by other Cassini instruments.