The Emirates Mars Mission.

The Emirates Mars Mission (EMM) was launched to Mars in the summer of 2020, and is the first interplanetary spacecraft mission undertaken by the United Arab Emirates (UAE). The mission has multiple programmatic and scientific objectives, including the return of scientifically useful information about Mars. Three science instruments on the mission's Hope Probe will make global remote sensing measurements of the Martian atmosphere from a large low-inclination orbit that will advance our understanding of atmospheric variability on daily and seasonal timescales, as well as vertical atmospheric transport and escape. The mission was conceived and developed rapidly starting in 2014, and had aggressive schedule and cost constraints that drove the design and implementation of a new spacecraft bus. A team of Emirati and American engineers worked across two continents to complete a fully functional and tested spacecraft and bring it to the launchpad in the middle of a global pandemic. EMM is being operated from the UAE and the United States (U.S.), and will make its data freely available.

Solar Terrestrial Relations Observatory (STEREO) Observations of Stream Interaction Regions in 2007 - 2016: Relationship with Heliospheric Current Sheets, Solar Cycle Variations, and Dual Observations.

We have conducted a survey of 575 slow-to-fast stream interaction regions (SIRs) using Solar Terrestrial Relations Observatory (STEREO) A and B data, analyzing their properties while extending a Level-3 data product through 2016. Among 518 pristine SIRs, 54% are associated with heliospheric current sheet (HCS) crossings, and 34% are without any HCS crossing. The other 12% of the SIRs often occur in association with magnetic sectors shorter than three days. The SIRs with HCS crossings have slightly slower speeds but higher maximum number densities, magnetic-field strengths, dynamic pressures, and total pressures than the SIRs without an HCS. The iron charge state is higher throughout the SIRs with an HCS than the SIRs without an HCS, by about 1/3 charge unit. In contrast with the comparable phases of Solar Cycle 23, slightly more SIRs and higher recurrence rates are observed in the years 2009 - 2016 of Cycle 24, with a lower HCS association rate, possibly attributed to persistent equatorial coronal holes and more pseudo-streamers in this recent cycle. The solar-wind speed, peak magnetic field, and peak pressures of SIRs are all lower in this cycle, but the weakening is less than for the comparable background solar-wind parameters. Before STEREO-B lost contact in October 2014, 151 SIR pairs were observed by the twin spacecraft. Of the dual observations, the maximum speed is the best correlated of the plasma parameters. We have obtained a sample of plasma-parameter differences analogous to those that would be observed by a mission at Lagrange points 4 or 5. By studying several cases with large discrepancies between the dual observations, we investigate the effects of HCS relative location, tilt of stream interface, and small transients on the SIR properties. To resolve the physical reasons for the variability of SIR structures, mesoscale multi-point observations and time-dependent solar-wind modeling are ultimately required.

Magnetic Clouds: Solar Cycle Dependence, Sources, and Geomagnetic Impacts.

Magnetic clouds (MCs) are transient magnetic structures giving the strongest southward magnetic field (Bz south) in the solar wind. The sheath regions of MCs may also carry a southward magnetic field. The southward magnetic field is responsible for space-weather disturbances. We report a comprehensive analysis of MCs and Bz components in their sheath regions for 1995 to 2017. 85% of 303 MCs contain a south Bz up to 50 nT. Sheath Bz during the 23 years may reach as high as 40 nT. MCs of the strongest magnetic magnitude and Bz south occur in the declining phase of the solar cycle. Bipolar MCs depend on the solar cycle in their polarity, but not in the occurrence frequency. Unipolar MCs show solar-cycle dependence in their occurrence frequency, but not in their polarity. MCs with the highest speeds, the largest total- B magnitudes, and sheath Bz south originate from source regions closer to the solar disk center. About 80% of large Dst storms are caused by MC events. Combinations of a south Bz in the sheath and south-first MCs in close succession have caused the largest storms. The solar-cycle dependence of bipolar MCs is extended to 2017 and now spans 42 years. We find that the bipolar MC Bz polarity solar-cycle dependence is given by MCs that originated from quiescent filaments in decayed active regions and a group of weak MCs of unclear sources, while the polarity of bipolar MCs with active-region flares always has a mixed Bz polarity without solar-cycle dependence and is therefore the least predictable for Bz forecasting. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11207-018-1356-8) contains supplementary material, which is available to authorized users.

Weak, Quiet Magnetic Fields Seen in the Venus Atmosphere.

The existence of a strong internal magnetic field allows probing of the interior through both long term changes of and short period fluctuations in that magnetic field. Venus, while Earth's twin in many ways, lacks such a strong intrinsic magnetic field, but perhaps short period fluctuations can still be used to probe the electrical conductivity of the interior. Toward the end of the Venus Express mission, an aerobraking campaign took the spacecraft below the ionosphere into the very weakly electrically conducting atmosphere. As the spacecraft descended from 150 to 140 km altitude, the magnetic field became weaker on average and less noisy. Below 140 km, the median field strength became steady but the short period fluctuations continued to weaken. The weakness of the fluctuations indicates they might not be useful for electromagnetic sounding of the atmosphere from a high altitude platform such as a plane or balloon, but possibly could be attempted on a lander.

MAVEN observations of the response of Mars to an interplanetary coronal mass ejection.

Coupling between the lower and upper atmosphere, combined with loss of gas from the upper atmosphere to space, likely contributed to the thin, cold, dry atmosphere of modern Mars. To help understand ongoing ion loss to space, the Mars Atmosphere and Volatile Evolution (MAVEN) spacecraft made comprehensive measurements of the Mars upper atmosphere, ionosphere, and interactions with the Sun and solar wind during an interplanetary coronal mass ejection impact in March 2015. Responses include changes in the bow shock and magnetosheath, formation of widespread diffuse aurora, and enhancement of pick-up ions. Observations and models both show an enhancement in escape rate of ions to space during the event. Ion loss during solar events early in Mars history may have been a major contributor to the long-term evolution of the Mars atmosphere.

Early MAVEN Deep Dip campaign reveals thermosphere and ionosphere variability.

The Mars Atmosphere and Volatile Evolution (MAVEN) mission, during the second of its Deep Dip campaigns, made comprehensive measurements of martian thermosphere and ionosphere composition, structure, and variability at altitudes down to ~130 kilometers in the subsolar region. This altitude range contains the diffusively separated upper atmosphere just above the well-mixed atmosphere, the layer of peak extreme ultraviolet heating and primary reservoir for atmospheric escape. In situ measurements of the upper atmosphere reveal previously unmeasured populations of neutral and charged particles, the homopause altitude at approximately 130 kilometers, and an unexpected level of variability both on an orbit-to-orbit basis and within individual orbits. These observations help constrain volatile escape processes controlled by thermosphere and ionosphere structure and variability.

How unprecedented a solar minimum was it?

The end of the last solar cycle was at least 3 years late, and to date, the new solar cycle has seen mainly weaker activity since the onset of the rising phase toward the new solar maximum. The newspapers now even report when auroras are seen in Norway. This paper is an update of our review paper written during the deepest part of the last solar minimum [1]. We update the records of solar activity and its consequent effects on the interplanetary fields and solar wind density. The arrival of solar minimum allows us to use two techniques that predict sunspot maximum from readings obtained at solar minimum. It is clear that the Sun is still behaving strangely compared to the last few solar minima even though we are well beyond the minimum phase of the cycle 23-24 transition.

The loss of ions from Venus through the plasma wake.

Venus, unlike Earth, is an extremely dry planet although both began with similar masses, distances from the Sun, and presumably water inventories. The high deuterium-to-hydrogen ratio in the venusian atmosphere relative to Earth's also indicates that the atmosphere has undergone significantly different evolution over the age of the Solar System. Present-day thermal escape is low for all atmospheric species. However, hydrogen can escape by means of collisions with hot atoms from ionospheric photochemistry, and although the bulk of O and O2 are gravitationally bound, heavy ions have been observed to escape through interaction with the solar wind. Nevertheless, their relative rates of escape, spatial distribution, and composition could not be determined from these previous measurements. Here we report Venus Express measurements showing that the dominant escaping ions are O+, He+ and H+. The escaping ions leave Venus through the plasma sheet (a central portion of the plasma wake) and in a boundary layer of the induced magnetosphere. The escape rate ratios are Q(H+)/Q(O+) = 1.9; Q(He+)/Q(O+) = 0.07. The first of these implies that the escape of H+ and O+, together with the estimated escape of neutral hydrogen and oxygen, currently takes place near the stoichometric ratio corresponding to water.

Plasma acceleration above martian magnetic anomalies.

Auroras are caused by accelerated charged particles precipitating along magnetic field lines into a planetary atmosphere, the auroral brightness being roughly proportional to the precipitating particle energy flux. The Analyzer of Space Plasma and Energetic Atoms experiment on the Mars Express spacecraft has made a detailed study of acceleration processes on the nightside of Mars. We observed accelerated electrons and ions in the deep nightside high-altitude region of Mars that map geographically to interface/cleft regions associated with martian crustal magnetization regions. By integrating electron and ion acceleration energy down to the upper atmosphere, we saw energy fluxes in the range of 1 to 50 milliwatts per square meter per second. These conditions are similar to those producing bright discrete auroras above Earth. Discrete auroras at Mars are therefore expected to be associated with plasma acceleration in diverging magnetic flux tubes above crustal magnetization regions, the auroras being distributed geographically in a complex pattern by the many multipole magnetic field lines extending into space.

Oxygen ions observed near Saturn's A ring.

Ions were detected in the vicinity of Saturn's A ring by the Ion and Neutral Mass Spectrometer (INMS) instrument onboard the Cassini Orbiter during the spacecraft's passage over the rings. The INMS saw signatures of molecular and atomic oxygen ions and of protons, thus demonstrating the existence of an ionosphere associated with the A ring. A likely explanation for these ions is photoionization by solar ultraviolet radiation of neutral O2 molecules associated with a tenuous ring atmosphere. INMS neutral measurements made during the ring encounter are dominated by a background signal.

Solar wind-induced atmospheric erosion at Mars: first results from ASPERA-3 on Mars Express.

The Analyzer of Space Plasma and Energetic Atoms (ASPERA) on board the Mars Express spacecraft found that solar wind plasma and accelerated ionospheric ions may be observed all the way down to the Mars Express pericenter of 270 kilometers above the dayside planetary surface. This is very deep in the ionosphere, implying direct exposure of the martian topside atmosphere to solar wind plasma forcing. The low-altitude penetration of solar wind plasma and the energization of ionospheric plasma may be due to solar wind irregularities or perturbations, to magnetic anomalies at Mars, or both.

Pharmacological management of pain and anxiety during emergency procedures in children.

Painful procedures are frequently required during treatment of children in the emergency department and are very stressful for the children, their parents and healthcare providers. Pharmacological methods to safely provide almost painless local anaesthesia, analgesia and anxiolysis have been increasingly studied in children. With knowledge of these methods, and patience, the emergency care provider can greatly reduce the distress often associated with emergency care of children. Topical local anaesthetics such as LET [lidocaine (lignocaine), epinephrine (adrenaline), tetracaine] or buffered lidocaine injected through the wound with fine needles can almost painlessly anaesthetise lacerations for suturing. Topical creams such as lidocaine/ prilocaine (EMLA) or tetracaine, iontophoresed lidocaine, or buffered lidocaine subcutaneously injected with fine needles can make intravenous catheter placement virtually 'painless'. When anxiety is significant, and mild to moderate analgesia/ anxiolysis/amnesia is needed, nitrous oxide can be administered if the proper delivery devices are available. Alternatively, when intensely painful fracture reduction, burn debridement, or abscess drainage is necessary, well tolerated and effective deep sedation can be achieved with careful use of midazolam and either ketamine or fentanyl.

A randomized clinical trial of continuous-flow nitrous oxide and midazolam for sedation of young children during laceration repair.

STUDY OBJECTIVE: To compare the efficacy and complication profile of oral midazolam therapy and continuous-flow 50% nitrous oxide in alleviating anxiety during laceration repair in children 2 to 6 years old. METHODS: We conducted a prospective, randomized clinical trial using 4 study groups who required laceration repair: (1) children who received standard care alone, which included comforting and topical anesthesia augmented with injected lidocaine if needed; (2) children who received standard care and oral midazolam; (3) children who received standard care and nitrous oxide; and (4) children who received standard care, oral midazolam, and nitrous oxide. Videotapes were blindly scored using the Observational Scale of Behavioral Distress-Revised (OSBD-R) to assess distress during baseline, wound cleaning, lidocaine injecting, suturing, and recovery. Adverse effects were noted during suturing and by parent questionnaires completed 24 hours after suturing and at suture removal. OSBD-R data were analyzed using repeated-measures analysis of variance. Adverse effect data were analyzed using categorical models. RESULTS: Two hundred four subjects were enrolled (midazolam plus nitrous oxide 52, midazolam 51, nitrous oxide 51, standard care 50; mean patient age was 4.1 years; 66% were boys). Mean OSBD-R scores were lower for groups that received nitrous oxide during wound cleaning by 2.2 points (95% confidence interval [CI] 1.1 to 3.2), lidocaine injecting by 2.5 points (95% CI 1.4 to 3.5), and suturing by 2.9 (95% CI 1.8 to 3.9). Adverse effects occurred more frequently, and recovery times were longer for groups that received midazolam. CONCLUSION: For facial suturing in 2- to 6-year-old children, regimens including continuous-flow nitrous oxide were more effective in reducing distress, and had fewer adverse effects and shorter recovery times than midazolam.

Continuous-flow delivery of nitrous oxide and oxygen: a safe and cost-effective technique for inhalation analgesia and sedation of pediatric patients.

Nitrous oxide (N2O) safely and rapidly alleviates the pain and distress of minor procedures in the emergency department (ED). We have found self-administration in children does not consistently achieve acceptable analgesia and sedation. The equipment generally available for ED use is designed for adults and delivers 50% N2O through a demand valve that requires an inspiratory effort of -3 to -5 cm of water to activate gas flow. This is difficult for young children who are crying, have more shallow respirations than adults, or cannot follow instructions. In collaboration with the Departments of Anesthesiology, Dentistry, and Respiratory Therapy, we constructed a continuous-flow system for delivering N2O and oxygen (O2). The following is a description of the components, assembly, and use of a continuous-flow machine that safely and inexpensively delivers N2O and O2 to children.

Spinal epidural abscess in preverbal children: A case report with Currarino triad.

Spinal epidural abscess is rare in preverbal children and leads to permanent neurologic deficits if not treated promptly. Currarino triad (anorectal malformation, sacral bony abnormality and presacral mass) is also rare in children. We report the association of extensive spinal epidural abscess and Currarino triad in a young child.

Etiology of septic arthritis in children: an update for the 1990s.

OBJECTIVE: To establish the etiology of septic arthritis in children after implementation of HIB immunization guidelines. METHODS: A retrospective review of all charts with a discharge diagnosis of septic arthritis (ICD-9: 711) from January 1991 to December 1996 at St. Louis Children's Hospital was conducted. RESULTS: Sixty-four patients (male = 58%) were identified, whose median age was 6.0 years. Twenty-one children (33%) were misdiagnosed on initial presentation. An organism was isolated in 38 (59%) of cases. The predominant organisms were Staphylococcus aureus (10 isolates), Group A Streptococcus (4), Enterobacter species (4), Kingella kingae (3), Neisseria meningitides (3), Streptococcus pneumoniae (2), Neisseria gonorrhoeae (2), Candida (2), Staphylococcus epidermidis (2). The only isolate of Haemophilus influenzae type B was in 1992 in an unimmunized 14 month old. CONCLUSIONS: These data confirm Staphylococcus aureus as a frequent pathogen and suggest that H influenzae type B is no longer the predominant isolate in young children with septic arthritis. In addition, early septic arthritis in children is frequently misdiagnosed on initial evaluation.

The "ouchless emergency department". Getting closer: advances in decreasing distress during painful procedures in the emergency department.

Painful and frightening injuries and illnesses are frequent reasons for children to seek care in an emergency department. Painful therapeutic procedures are often a necessary part of emergency care and are very distressful for the children, their parents, and healthcare providers. Inadequately relieved pain and distress have acute and long-term consequences, yet methods for pain and anxiety reduction during frightening minor and major procedures are often not used because of lack of detailed knowledge of techniques and fear of adverse effects. This article reviews psychologic and pharmacologic means of safe and effective reduction of anxiety and pain during emergency department procedures.