Highly relativistic radiation belt electron acceleration, transport, and loss: Large solar storm events of March and June 2015.

Two of the largest geomagnetic storms of the last decade were witnessed in 2015. On 17 March 2015, a coronal mass ejection-driven event occurred with a Dst (storm time ring current index) value reaching -223 nT. On 22 June 2015 another strong storm (Dst reaching -204 nT) was recorded. These two storms each produced almost total loss of radiation belt high-energy (E ≳ 1 MeV) electron fluxes. Following the dropouts of radiation belt fluxes there were complex and rather remarkable recoveries of the electrons extending up to nearly 10 MeV in kinetic energy. The energized outer zone electrons showed a rich variety of pitch angle features including strong "butterfly" distributions with deep minima in flux at α = 90°. However, despite strong driving of outer zone earthward radial diffusion in these storms, the previously reported "impenetrable barrier" at L ≈ 2.8 was pushed inward, but not significantly breached, and no E ≳ 2.0 MeV electrons were seen to pass through the radiation belt slot region to reach the inner Van Allen zone. Overall, these intense storms show a wealth of novel features of acceleration, transport, and loss that are demonstrated in the present detailed analysis.

An impenetrable barrier to ultrarelativistic electrons in the Van Allen radiation belts.

Early observations indicated that the Earth's Van Allen radiation belts could be separated into an inner zone dominated by high-energy protons and an outer zone dominated by high-energy electrons. Subsequent studies showed that electrons of moderate energy (less than about one megaelectronvolt) often populate both zones, with a deep 'slot' region largely devoid of particles between them. There is a region of dense cold plasma around the Earth known as the plasmasphere, the outer boundary of which is called the plasmapause. The two-belt radiation structure was explained as arising from strong electron interactions with plasmaspheric hiss just inside the plasmapause boundary, with the inner edge of the outer radiation zone corresponding to the minimum plasmapause location. Recent observations have revealed unexpected radiation belt morphology, especially at ultrarelativistic kinetic energies (more than five megaelectronvolts). Here we analyse an extended data set that reveals an exceedingly sharp inner boundary for the ultrarelativistic electrons. Additional, concurrently measured data reveal that this barrier to inward electron radial transport does not arise because of a physical boundary within the Earth's intrinsic magnetic field, and that inward radial diffusion is unlikely to be inhibited by scattering by electromagnetic transmitter wave fields. Rather, we suggest that exceptionally slow natural inward radial diffusion combined with weak, but persistent, wave-particle pitch angle scattering deep inside the Earth's plasmasphere can combine to create an almost impenetrable barrier through which the most energetic Van Allen belt electrons cannot migrate.

Simultaneous ground- and space-based observations of the plasmaspheric plume and reconnection.

Magnetic reconnection is the primary process through which energy couples from the solar wind into Earth's magnetosphere and ionosphere. Conditions both in the incident solar wind and in the magnetosphere are important in determining the efficiency of this energy transfer. In particular, the cold, dense plasmaspheric plume can substantially impact the coupling in the dayside reconnection region. Using ground-based total electron content (TEC) maps and measurements from the THEMIS spacecraft, we investigated simultaneous ionosphere and magnetosphere observations of the plasmaspheric plume and its involvement in an unsteady magnetic reconnection process. The observations show the full circulation pattern of the plasmaspheric plume and validate the connection between signatures of variability in the dense plume and reconnection at the magnetopause as measured in situ and through TEC measurements in the ionosphere.

Ophthalmoscopic contact lenses for transpupillary thermotherapy.

Ophthalmoscopic contact lenses for transpupillary thermotherapy (TTT) must provide effective visualization of retinal treatment sites and transmission of infrared diode laser radiation. Selection and proper use of retinal laser lenses requires knowledge of their lateral magnification, laser beam magnification factor, field of view and resolution. Optical performance is analyzed for Goldmann-type lenses and a series of inverted image lenses of differing magnification. Goldmann lenses have the highest resolution, but inverted image lenses of comparable magnification have 2.5 times or more their field of view. Inverted image lenses of similar magnification can differ in resolution. They require 2-4% more incident laser power to produce the same retinal irradiance as a Goldmann lens, but this difference is small in comparison to other clinical variables. Tilting an ophthalmoscopic contact lens up to 15 degrees causes little distortion in the circularity of the retinal spot formed by a laser beam or difference in retinal irradiance across the spot. Inverted image lenses produce higher anterior segment irradiances than Goldmann-type lenses, but anterior segment injuries are less likely in TTT than conventional visible light, short-pulse retinal photocoagulation because of the comparatively low irradiances used in TTT and the decreased absorption of diode laser infrared radiation in ocular media and melanin.

Retinal laser lenses: magnification, spot size, and field of view.

Proper use of ophthalmoscopic contact lenses for retinal photocoagulation requires knowledge of their comparative magnification, spot size, and field of view. We determined these parameters for four commonly used lenses, using data measured from optical components of the lenses and a commonly used photo-coagulator slit-lamp and spot size changer. A Krieger lens has 8% more working field of view and 29% less magnification than a Goldmann lens. A Panfundoscope lens has 84% more working field of view and 24% less magnification than a Goldmann lens. A Mainster lens has 58% more working field of view and 3% more magnification than a Goldmann lens. For Goldmann, Krieger, Panfundoscope, and Mainster lenses, respectively, retinal spot size is 8%, 53%, 41%, and 5% greater than photo-coagulator spot size settings. The field of view of each lens is increased in myopic and decreased in hyperopic patients. Anterior segment irradiance is higher than retinal irradiance for 1000 microns spot size settings with a Panfundoscope or Mainster lens, and this setting should be avoided, especially in patients with hazy ocular media.

Comparison of transscleral neodymium:YAG cyclophotocoagulation with and without a contact lens in human autopsy eyes.

A contact lens designed to facilitate neodymium:YAG transscleral cyclophotocoagulation was evaluated on human autopsy eyes, and the lesions produced were compared to the lesions produced by similar laser treatments without a lens. Using the thermal mode at 20-msec duration, the variables studied were distance from the corneoscleral limbus (0.5, 1.5, 2.5 mm); energy (2, 4, 6, 8 J); and offset (distance between the focal points of the aiming and therapeutic beams; settings of 5, 7, 8, 9). By gross and light microscopic inspection, the ciliary body lesions produced were similar with or without the lens. A distance between 0.5 and 1.5 mm appears optimal for damaging the pars plicata. Energies of 4 to 8 J produced ciliary epithelial destruction.

Ostomies: the art of pouching.

Excellent ostomy management is the goal for each new ostomate. Nurses are in pivotal positions to assist in selection and use of a variety of ostomy appliances and products. Individuals with ileostomies, transverse colostomies, sigmoid colostomies, or urostomies have unique management needs. Equipment recommendations and pouching procedures are detailed for each ostomy type. Access to proper instruction will enable the new ostomate to remain socially and physically active.

A high-efficiency laser iridotomy-sphincterotomy lens.

A new laser iridotomy-sphincterotomy contact lens, bearing a 103-diopter optical button decentered 2.5 mm, gives the smallest iris focal spot and highest iris energy density practicably obtainable with a single optical glass refracting surface placed upon a thin Goldmann-type contact lens. By increasing iris energy density to a level 7.79 times greater than that from a plano contact lens and 2.92 times greater than that from the Abraham lens, the lens increases the iris burn temperature level above the threshold level for evaporative pyrolysis, even at exposures of 0.01 and 0.02 second, thus facilitating argon laser iridotomy and iris sphincterotomy by the linear incision method. Corneal and retinal energy exposures are greatly reduced. Used with the Nd-YAG laser, the lens increases efficiency for iridotomy and for division of vitreous bands in the anterior chamber.