Development and Implementation of a Multicenter Registry for Resuscitation-Focused Transesophageal Echocardiography.

STUDY OBJECTIVE: To evaluate the clinical effect, safety, and clinical outcomes of focused transesophageal echocardiography (TEE) in the evaluation of critically ill patients in the emergency department (ED) and ICUs. METHODS: We established a prospective, multicenter, observational registry involving adult critically ill patients in whom focused TEE was performed for evaluation of out-of-hospital cardiac arrest (OHCA), inhospital cardiac arrest, evaluation of undifferentiated shock, hemodynamic monitoring, and/or procedural guidance in the ED, ICU, or operating room setting. The primary objective of the current investigation was to evaluate the clinical influence and safety of focused, point-of-care TEE in critically ill patients. Data elements included patient and procedure characteristics, laboratory values, timing of interventions, clinical outcomes, and TEE video images. RESULTS: A total of 1,045 focused TEE studies were collected among 916 patients from 28 hospitals, including 585 (64%) intraarrest and postarrest OHCA and inhospital cardiac arrest, 267 (29%) initial evaluation of undifferentiated shock, 101 (11%) procedural guidance, and 92 (10%) hemodynamic monitoring. TEE changed management in 85% of patients with undifferentiated shock, 71% of patients with inhospital cardiac arrest, and 62% of patients with OHCA. There were no reported esophageal perforations or oropharyngeal injuries, and other procedural complications were rare. CONCLUSIONS: A prospective, multicenter, and multidisciplinary TEE registry was successfully implemented, and demonstrated that focused TEE is safe and clinically impactful across multiple critical care applications. Further studies from this research network will accelerate the development of outcome-oriented research and knowledge translation on the use of TEE in emergency and critical care settings.

Resuscitative transesophageal echocardiography in emergency departments in the United States and Canada: A cross-sectional survey.

INTRODUCTION: Over the past two decades, transesophageal echocardiography (TEE) has been used with increasing frequency to evaluate critically ill patients outside of traditional settings. The purpose of this study was to characterize the number of programs, users, practice characteristics, training and competency requirements and barriers for the current use of resuscitative transesophageal echocardiography (TEE) in Emergency Departments (EDs) in the United States and Canada. METHODS: A closed internet-based, cross-sectional, point-prevalence survey was administered via email to 120 program directors of emergency ultrasound fellowships (EUSF) and 43 physicians from EDs without EUSF from the United States and Canada. RESULTS: Ninety-eight percent of surveyed participants responded. Twenty percent of respondents reported having active resuscitative TEE programs. The majority of participating hospitals (70%) were academic centers with residency programs. A total of 33 programs reported using resuscitative TEE in their ED and of those, 82% were programs with EUSF. Most programs performing TEE (79%) had less than five attending physicians performing TEE. Evaluation of patients during resuscitation from cardiac arrest (100%) and post-arrest care (76%) are the two most frequent indications for TEE in the ED. The most common core elements of resuscitative TEE protocols used are: assessment of left ventricular (LV) systolic function (97%), assessment of right ventricular (RV) function (88%), evaluation of pericardial effusion / tamponade (52%). All programs reported using formal didactics in their training programs, 94% reported using high-fidelity simulation, and 79% live scanning of patients. Financial concerns were the most common barrier use of TEE in the ED (58%), followed by maintenance of equipment (30%), and credentialing/privileges (30%). CONCLUSIONS: This study provides a snapshot of the practice of resuscitative TEE in EDs in the United States and Canada revealing the existence of 33 programs using this emerging modality in the care of critically ill patients.

Impact of C-reactive Protein on Anticoagulation Monitoring in Extracorporeal Membrane Oxygenation.

OBJECTIVE: To evaluate the impact of inflammation on anticoagulation monitoring for patients supported with extracorporeal membrane oxygenation (ECMO). DESIGN: Prospective single-center cohort study. SETTING: University-affiliated tertiary care academic medical center. PARTICIPANTS: Adult venovenous and venoarterial ECMO patients anticoagulated with heparin/ MEASUREMENTS AND MAIN RESULTS: C-Reactive protein (CRP) was used as a surrogate for overall inflammation. The relationship between CRP and the partial thromboplastin time (PTT, seconds) was evaluated using a CRP-insensitive PTT assay (PTT-CRP) in addition to measurement using a routine PTT assay. Data from 30 patients anticoagulated with heparin over 371 ECMO days was included. CRP levels (mg/dL) were significantly elevated (median, 17.2; interquartile range [IQR], 9.2-26.1) and 93% of patients had a CRP of ≥5. The median PTT (median 58.9; IQR, 46.9-73.3) was prolonged by 11.3 seconds compared with simultaneously measured PTT-CRP (median, 47.6; IQR, 40.1-55.5; p < 0.001). The difference between PTT and PTT-CRP generally increased with CRP elevation from 2.7 for a CRP of <5.0 to 13.0 for a CRP between 5 and 10, 17.7 for a CRP between 10 and 15, and 15.1 for a CRP of >15 (p < 0.001). In a subgroup of patients, heparin was transitioned to argatroban, and a similar effect was observed (median PTT, 62.1 seconds [IQR, 53.0-78.5 seconds] vs median PTT-CRP, 47.6 seconds [IQR, 41.3-57.7 seconds]; p < 0.001). CONCLUSIONS: Elevations in CRP are common during ECMO and can falsely prolong PTT measured by commonly used assays. The discrepancy due to CRP-interference is important clinically given narrow PTT targets and may contribute to hematological complications.

Discrete and broadband electron acceleration in Jupiter's powerful aurora.

The most intense auroral emissions from Earth's polar regions, called discrete for their sharply defined spatial configurations, are generated by a process involving coherent acceleration of electrons by slowly evolving, powerful electric fields directed along the magnetic field lines that connect Earth's space environment to its polar regions. In contrast, Earth's less intense auroras are generally caused by wave scattering of magnetically trapped populations of hot electrons (in the case of diffuse aurora) or by the turbulent or stochastic downward acceleration of electrons along magnetic field lines by waves during transitory periods (in the case of broadband or Alfvénic aurora). Jupiter's relatively steady main aurora has a power density that is so much larger than Earth's that it has been taken for granted that it must be generated primarily by the discrete auroral process. However, preliminary in situ measurements of Jupiter's auroral regions yielded no evidence of such a process. Here we report observations of distinct, high-energy, downward, discrete electron acceleration in Jupiter's auroral polar regions. We also infer upward magnetic-field-aligned electric potentials of up to 400 kiloelectronvolts, an order of magnitude larger than the largest potentials observed at Earth. Despite the magnitude of these upward electric potentials and the expectations from observations at Earth, the downward energy flux from discrete acceleration is less at Jupiter than that caused by broadband or stochastic processes, with broadband and stochastic characteristics that are substantially different from those at Earth.

Juno's Close Encounter With Ganymede-An Overview.

The Juno spacecraft has been in orbit around Jupiter since 2016. Two flybys of Ganymede were executed in 2021, opportunities realized by evolution of Juno's polar orbit over the intervening 5 years. The geometry of the close flyby just prior to the 34th perijove pass by Jupiter brought the spacecraft inside Ganymede's unique magnetosphere. Juno's payload, designed to study Jupiter's magnetosphere, had ample dynamic range to study Ganymede's magnetosphere. The Juno radio system was used both for gravity measurements and for study of Ganymede's ionosphere. Remote sensing of Ganymede returned new results on geology, surface composition, and thermal properties of the surface and subsurface.

Juno Plasma Wave Observations at Ganymede.

The Juno Waves instrument measured plasma waves associated with Ganymede's magnetosphere during its flyby on 7 June, day 158, 2021. Three distinct regions were identified including a wake, and nightside and dayside regions in the magnetosphere distinguished by their electron densities and associated variability. The magnetosphere includes electron cyclotron harmonic emissions including a band at the upper hybrid frequency, as well as whistler-mode chorus and hiss. These waves likely interact with energetic electrons in Ganymede's magnetosphere by pitch angle scattering and/or accelerating the electrons. The wake is accentuated by low-frequency turbulence and electrostatic solitary waves. Radio emissions observed before and after the flyby likely have their source in Ganymede's magnetosphere.

Closed Fluxtubes and Dispersive Proton Conics at Jupiter's Polar Cap.

Two distinct proton populations are observed over Jupiter's southern polar cap: a ∼1 keV core population and ∼1-300 keV dispersive conic population at 6-7 RJ planetocentric distance. We find the 1 keV core protons are likely the seed population for the higher-energy dispersive conics, which are accelerated from a distance of ∼3-5 RJ. Transient wave-particle heating in a "pressure-cooker" process is likely responsible for this proton acceleration. The plasma characteristics and composition during this period show Jupiter's polar-most field lines can be topologically closed, with conjugate magnetic footpoints connected to both hemispheres. Finally, these observations demonstrate energetic protons can be accelerated into Jupiter's magnetotail via wave-particle coupling.

Similarities in extracorporeal membrane oxygenation management across intensive care unit types in the United States: An analysis of the Extracorporeal Life Support Organization Registry.

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) use in the United States occurs often in cardiothoracic ICUs (CTICU). It is unknown how it varies across ICU types. METHODS: We identified 10 893 ECMO runs from the Extracorporeal Life Support Organization (ELSO) Registry across 2018 and 2019. Primary outcome was ECMO case volume by ICU type (CTICU vs. non-CTICU). Adjusting for pre-ECMO characteristics and case mix, secondary outcomes were on-ECMO physiologic variables by ICU location stratified by support type. RESULTS: CTICU ECMO occurred in 65.1% and 55.1% (2018 and 2019) of total runs. A minority of total runs related to cardiac surgery procedures (CTICU: 21.7% [2018], 18% [2019]; non-CTICU: 11.2% [2018], 13% [2019]). After multivariate adjustment, non-CTICU ECMO for cardiac support associated with lower 4- and 24-h circuit flow (3.9 liters per minute [LPM] vs. 4.1 LPM, p < 0.0001; 4.1 LPM vs. 4.3 LPM, p < 0.0001); for respiratory support, lower on-ECMO mean fraction of inspired oxygen ([Fi O2 ], 67% vs. 69%, p = 0.02) and lower respiratory rate (14 vs. 15, p < 0.0001); and, for extracorporeal cardiopulmonary resuscitation (ECPR), lower ECMO flow rates at 24 h (3.5 LPM vs. 3.7 LPM, p = 0.01). CONCLUSIONS: ECMO mostly remains in CTICUs though a minority is associated with cardiac surgery. Statistically significant but clinically minor differences in on-ECMO metrics were observed across ICU types.

Real-time acoustic observations in the Canadian Arctic Archipelago.

The main sources of noise in the Arctic Ocean are naturally occurring, rather than related to human activities. Sustained acoustic monitoring at high latitudes provides quantitative measures of changes in the sound field attributable to evolving human activity or shifting environmental conditions. A 12-month ambient sound time series (September 2018 to August 2019) recorded and transmitted from a real-time monitoring station near Gascoyne Inlet, Nunavut is presented. During this time, sound levels in the band 16-6400 Hz ranged between 10 and 135 dB re 1 µPa2/Hz. The average monthly sound levels follow seasonal ice variations with a dependence on the timing of ice melt and freeze-up and with higher frequencies varying more strongly than the lower frequencies. Ambient sound levels are higher in the summer during open water and quietest in the winter during periods of pack ice and shore fast ice. An autocorrelation of monthly noise levels over the ice freeze-up and complete cover periods reveal a ∼24 h periodic trend in noise power at high frequencies (>1000 Hz) caused by tidally driven surface currents in combination with increased ice block collisions or increased stress in the shore fast sea ice.

Comprehensive analysis utilizing flow cytometry and immunohistochemistry reveals inflammatory changes in local endometrial and systemic dendritic cell populations in endometriosis.

STUDY QUESTION: What are the detailed endometrial tissue specific and systemic dendritic cell (DC) subset disturbances in endometriosis? SUMMARY ANSWER: This study confirms myeloid DC (mDC) and plasmacytoid DC subsets are readily identified in endometrial tissue and shows both endometrial and circulating differences in DC populations in women with endometriosis, with disease stage-specific relationships evident locally in the endometrium. WHAT IS KNOWN ALREADY: Immune factors in the uterus, the peritoneal environment and systemically are implicated in the pathogenesis and progression of both endometriosis and infertility. While there is some evidence that endometrial DC populations are altered in endometriosis, DC subset involvement in both the endometrium and peripheral blood have not been comprehensively investigated so the functional consequences have been unknown. STUDY DESIGN, SIZE, DURATION: This prospective cross-sectional cohort study compares circulating and endometrial DC populations in women of reproductive age with and without endometriosis (n = 55 and 30, respectively), wherein each participant donated samples at a single time point. Study participants were surveyed for menstrual cycle phase, American Society for Reproductive Medicine (ASRM) endometriosis disease stage and fertility status (where possible). PARTICIPANTS/MATERIALS, SETTING, METHODS: Peripheral blood samples were processed into mononuclear cells for analysis by flow cytometry, and endometrial samples were analysed by immunohistochemistry and dissociated into single-cell suspension for flow cytometry. MAIN RESULTS AND THE ROLE OF CHANCE: In the endometrium of women with endometriosis, IRF-8+ cells were increased during the proliferative phase (P = 0.014), total DC proportions increased in the secretory phase (P = 0.038) and normal menstrual cyclical fluctuations in CD1c+ and IRF-8+ cells blunted; indicative of a consistently inflammatory tissue environment. The inflammatory changes in CD141+ and IRF-8+ populations in the endometrium of women with endometriosis were particularly evident in more advanced ASRM stages of the disease (respective P-values 0.032 and 0.045). There was also evidence of systemic inflammation in women with endometriosis, with increased circulating CD141+ mDC proportions (overall P = 0.040, secretory phase P = 0.021). LARGE SCALE DATA: N/A. LIMITATIONS, REASONS FOR CAUTION: As is common in this type of study, one of the main limitations was small sample numbers, particularly during the menstrual phase of the cycle. WIDER IMPLICATIONS OF THE FINDINGS: Further phenotyping of local and circulating immune cell subtypes is critical to improving understanding of endometriosis pathogenesis and immune contributions to infertility associated with the disease. STUDY FUNDING/COMPETING INTEREST(S): This research was financially supported by a Sydney Medical School and Balnaves Foundation Kick Start Grant and the Department of Obstetrics, Gynaecology and Neonatology at The University of Sydney. The authors have no conflicts of interest to declare.

Typical achondroplasia secondary to a unique insertional variant of FGFR3 with in vitro demonstration of its effect on FGFR3 function.

We describe an individual in whom clinical and radiographic features are typical for achondroplasia, but in whom the common variants of FGFR3 that result in achondroplasia are absent. Whole exome sequencing demonstrated a novel, de novo 6 base pair tandem duplication in FGFR3 that results in the insertion of Ser-Phe after position Leu324. in vitro studies showed that this variant results in aberrant dimerization, excessive spontaneous phosphorylation of FGFR3 dimers and excessive, ligand-independent tyrosine kinase activity. Together, these data suggest that this variant leads to constitutive disulfide bond-mediated dimerization, and that this, surprisingly, occurs to an extent similar to the neonatal lethal thanatophoric dysplasia type I Ser249Cys variant.

Evaluation and Management of the Physiologically Difficult Airway: Consensus Recommendations From Society for Airway Management.

Multiple international airway societies have created guidelines for the management of the difficult airway. In critically ill patients, there are physiologic derangements beyond inadequate airway protection or hypoxemia. These risk factors contribute to the "physiologically difficult airway" and are associated with complications including cardiac arrest and death. Importantly, they are largely absent from international guidelines. Thus, we created management recommendations for the physiologically difficult airway to provide practical guidance for intubation in the critically ill. Through multiple rounds of in-person and telephone conferences, a multidisciplinary working group of 12 airway specialists (Society for Airway Management's Special Projects Committee) over a time period of 3 years (2016-2019) reviewed airway physiology topics in a modified Delphi fashion. Consensus agreement with the following recommendations among working group members was generally high with 80% of statements showing agreement within a 10% range on a sliding scale from 0% to 100%. We limited the scope of this analysis to reflect the resources and systems of care available to out-of-operating room adult airway providers. These recommendations reflect the practical application of physiologic principles to airway management available during the analysis time period.

Factors affecting test reproducibility among laboratories.

Reproducibility is the ability of an assay to provide consistent results (when testing the same samples) in different laboratories. The validation of a new diagnostic assay should include specific assessment of assay reproducibility to determine the degree to which results are unaffected by minor changes in experimental conditions. Ideally, assessment of reproducibility involves the testing of identical samples in multiple laboratories by multiple analysts using the same method, reagents and controls, albeit with different equipment. Such an assessment will provide estimates of the precision and accuracy of an assay across laboratories. In reality, although the reproducibility of an assay is often assessed by multiple laboratories testing identical samples, the reagents, controls and testing platforms used, while similar, are usually not the same. Thus, reproducibility testing permits the assessment of variability resulting from different testing platforms, reagent supplies and operators. The determination of minor versus major variations in test conditions that may be anticipated in multi-laboratory use is part of the assessment at this stage of validation. Once validated, there are ongoing monitoring requirements to assess the performance characteristics and ensure they are consistently maintained. The use of quality assurance programmes is required, as this offers continued monitoring of assay performance by measuring the precision and accuracy of results for well-characterised samples and controls. Tests recommended by the World Organisation for Animal Health as fit for purpose are widely used internationally and need to have satisfactory reproducibility.

La reproductibilité d'un test désigne son aptitude à fournir des résultats constants (en testant les mêmes échantillons) lors d'analyses effectuées par différents laboratoires. Toute validation d'un nouvel essai diagnostique doit inclure une étape spécifique d'évaluation de la reproductibilité de l'essai, visant à vérifier jusqu'à quel point les résultats du test demeurent inchangés en cas de légères variations dans les conditions de réalisation de l'essai. Idéalement, l'évaluation de la reproductibilité consiste à soumettre des échantillons identiques à une même méthode d'essai réalisée dans plusieurs laboratoires par des analystes à chaque fois différents et en utilisant les mêmes réactifs et contrôles, mais avec des équipements différents. Une telle évaluation fournit une estimation de la précision et de l'exactitude d'un essai conduit par plusieurs laboratoires. Dans la pratique, si la reproductibilité d'un essai est souvent évaluée par des laboratoires différents à partir d'échantillons similaires, les réactifs, les contrôles et les plateformes d'essai ne sont généralement pas les mêmes d'un laboratoire à l'autre, bien qu'étant similaires. Les essais de reproductibilité permettent ainsi d'évaluer la variabilité induite par l'utilisation de plateformes de test et de réactifs différents par des opérateurs eux-mêmes différents. La détermination du caractère mineur ou substantiel des variations des conditions d'essai susceptibles d'être anticipées dans un cadre d'utilisation impliquant de nombreux laboratoires fait partie de l'évaluation à ce stade de la validation. Une fois la validation faite, des exigences de contrôle continu sont requises afin d'évaluer les caractéristiques de performances et de veiller à leur maintien dans le temps. Les laboratoires doivent se doter d'un programme d'assurance qualité qui garantisse le suivi continu des performances des essais à travers une mesure de la précision et de l'exactitude des résultats à partir d'échantillons et de contrôles bien caractérisés. Les tests dont l'aptitude à l'emploi selon l'objectif prévu a été établie et qui de ce fait sont recommandés par l'Organisation mondiale de la santé animale ont vocation à être utilisés dans le monde entier ; il est donc important qu'ils soient suffisamment reproductibles.

Se entiende por "reproducibilidad" el conjunto de características que permiten que un ensayo depare resultados uniformes al ser aplicado a las mismas muestras en laboratorios distintos. El proceso de validación de una prueba de diagnóstico debe incluir una evaluación específica de su reproducibilidad, a fin de determinar en qué medida los resultados se mantienen inalterados ante cambios menores de las condiciones experimentales. Lo idóneo para evaluar la reproducibilidad es que, en múltiples laboratorios, múltiples analistas sometan a prueba muestras idénticas empleando idénticos métodos, reactivos y controles, pero distinto equipo de laboratorio. Semejante evaluación permitirá estimar la precisión y exactitud que ofrece un ensayo en diferentes laboratorios. En realidad, aunque en la evaluación de la reproducibilidad de un ensayo intervienen a menudo múltiples laboratorios que analizan muestras idénticas, los reactivos, controles y dispositivos de prueba utilizados, aún siendo parecidos, no suelen los mismos. La realización de pruebas de reproducibilidad permite pues determinar la variabilidad que introducen distintos dispositivos de prueba, suministros de reactivos y técnicos de laboratorio. Así, la determinación de las variaciones menores frente a las variaciones importantes de las condiciones experimentales que cabe prever cuando múltiples laboratorios emplean un ensayo forma parte de la evaluación en esta fase del proceso de validación. Una vez validado un ensayo, hay una serie de requisitos de seguimiento continuo que sirven para evaluar las características de rendimiento y garantizar que se mantengan estables en el tiempo. Para ello es necesario utilizar programas de garantía de calidad, que ofrecen la posibilidad de hacer un seguimiento continuo del rendimiento de un ensayo cuantificando la precisión y exactitud de los resultados obtenidos con muestras y controles bien caracterizados. Las pruebas que la Organización Mundial de Sanidad Animal recomienda por considerarlas adaptadas a su finalidad, de uso muy extendido a escala internacional, deben presentar un nivel satisfactorio de reproducibilidad.

The value of virtual biobanks for transparency purposes with respect to reagents and samples used during test development and validation.

Biobanks represent a valuable resource in many areas of biomedical research and development. They function as repositories for well-documented and well-characterised biological material that can be used as the basis for this work. Virtual biobanks amplify the availability of this resource by linking multiple biobanks via a single interface. Test development and validation is an essential process that helps to provide confidence in diagnostic test results and, by extension, the disease and health status of animal populations demonstrated by such results. The quality of the development and validation pathway can be enhanced by the use of well-characterised material for standards and validation panels. Virtual biobanks represent a powerful mechanism for enhancing access to such material, and allow other parties to both have greater confidence in the work done, and to be able to repeat it themselves, as required.

Les biobanques constituent une ressource précieuse dans un grand nombre de domaines de la recherche et du développement biomédicaux. Elles servent d'archives destinées au stockage de matériels biologiques suffisamment documentés et caractérisés pour être utilisés comme éléments de base dans ces domaines. Les biobanques virtuelles opèrent comme multiplicateurs des ressources disponibles en reliant plusieurs biobanques sur une même interface. La mise au point et la validation des tests constituent un processus essentiel qui contribue à asseoir la confiance dans les résultats d'un test et, par voie de conséquence, dans le statut sanitaire d'une population animale tel qu'il ressort de ces résultats. La qualité du processus de développement et de validation peut être améliorée en faisant appel à des matériels bien caractérisés en tant que panels de référence et de validation. Les biobanques virtuelles sont un mécanisme puissant pour améliorer l'accès à ce type de matériels et permettent à d'autres intervenants d'avoir une plus grande confiance dans les travaux réalisés, et de pouvoir eux-mêmes les répéter, si besoin.

Los biobancos constituyen un recurso muy útil en numerosas vertientes de la labor de investigación y desarrollo (I+D) en biomedicina. Estos bancos funcionan como repositorios de material biológico bien descrito y caracterizado que cabe utilizar como base de dicha labor. Los biobancos virtuales, al vincular entre sí múltiples biobancos por medio de una única interfaz, ponen este recurso al alcance de muchos más usuarios. La creación y validación de pruebas analíticas es un proceso esencial, que ayuda a ofrecer confianza en los resultados de una prueba de diagnóstico y, por extensión, en la condición sanitaria de las poblaciones animales que dichos resultados indican. Es posible conferir mayor calidad al procedimiento de creación y validación utilizando muestras biológicas bien caracterizadas como material de referencia y para establecer paneles de validación. Los biobancos virtuales, amén de constituir un potente mecanismo para mejorar el acceso a material biológico, infunden a terceras partes mayor confianza en la labor realizada y permiten a estas partes replicar por sí mismas el proceso de ser necesario.

Discovery of ONO-8590580: A novel, potent and selective GABAA α5 negative allosteric modulator for the treatment of cognitive disorders.

The identification and SAR development of a series of negative allosteric modulators of the GABAA α5 receptor is described. This novel series of compounds was optimised to provide analogues with high GABAA α5 binding affinity, high α5 negative allosteric modulatory activity, good functional subtype selectivity and low microsomal turnover, culminating in identification of ONO-8590580.

High-Energy (>10 MeV) Oxygen and Sulfur Ions Observed at Jupiter From Pulse Width Measurements of the JEDI Sensors.

The Jovian polar regions produce X-rays that are characteristic of very energetic oxygen and sulfur that become highly charged on precipitating into Jupiter's upper atmosphere. Juno has traversed the polar regions above where these energetic ions are expected to be precipitating revealing a complex composition and energy structure. Energetic ions are likely to drive the characteristic X-rays observed at Jupiter (Haggerty et al., 2017, https://doi.org/10.1002/2017GL072866; Houston et al., 2018, https://doi.org/10.1002/2017JA024872; Kharchenko et al., 2006, https://doi.org/10.1029/2006GL026039). Motivated by the science of X-ray generation, we describe here Juno Jupiter Energetic Particle Detector Instrument (JEDI) measurements of ions above 1 MeV and demonstrate the capability of measuring oxygen and sulfur ions with energies up to 100 MeV. We detail the process of retrieving ion fluxes from pulse width data on instruments like JEDI (called "puck's"; Clark, Cohen, et al., 2016, https://doi.org/10.1002/2017GL074366; Clark, Mauk, et al., 2016, https://doi.org/10.1002/2015JA022257; Mauk et al., 2013, https://doi.org/10.1007/s11214-013-0025-3) as well as details on retrieving very energetic particles (>20 MeV) above which the pulse width also saturates.

Jovian Injections Observed at High Latitude.

The polar orbit of Juno at Jupiter provides a unique opportunity to observe high-latitude energetic particle injections. We measure energy-dispersed impulsive injections of protons and electrons. Ion injection signatures are just as prevalent as electron signatures, contrary to previous equatorial observations. Included are previously unreported observations of high-energy banded structures believed to be remnants of much earlier injections, where the particles have had time to disperse around Jupiter. A model fit of the injections used to estimate timing fits the shape of the proton signatures better than it does the electron shapes, suggesting that electrons and protons are different in their abilities to escape the injection region. We present ultaviolet observations of Jupiter's aurora and discuss the relationship between auroral injection features and in situ injection events. We find, unexpectedly, that the presence of in situ particle injections does not necessarily result in auroral injection signatures.

Energetic Oxygen and Sulfur Charge States in the Outer Jovian Magnetosphere: Insights From the Cassini Jupiter Flyby.

On 10 January 2001, Cassini briefly entered into the magnetosphere of Jupiter, en route to Saturn. During this excursion into the Jovian magnetosphere, the Cassini Magnetosphere Imaging Instrument/Charge-Energy-Mass Spectrometer detected oxygen and sulfur ions. While Charge-Energy-Mass Spectrometer can distinguish between oxygen and sulfur charge states directly, only 95.9 ± 2.9 keV/e ions were sampled during this interval, allowing for a long time integration of the tenuous outer magnetospheric (~200 RJ) plasma at one energy. For this brief interval for the 95.9 keV/e ions, 96% of oxygen ions were O+, with the other 4% as O2+, while 25% of the energetic sulfur ions were S+, 42% S2+, and 33% S3+. The S2+/O+ flux ratio was observed to be 0.35 (±0.06 Poisson error).

Comparing Electron Energetics and UV Brightness in Jupiter's Northern Polar Region During Juno Perijove 5.

We compare electron and UV observations mapping to the same location in Jupiter's northern polar region, poleward of the main aurora, during Juno perijove 5. Simultaneous peaks in UV brightness and electron energy flux are identified when observations map to the same location at the same time. The downward energy flux during these simultaneous observations was not sufficient to generate the observed UV brightness; the upward energy flux was. We propose that the primary acceleration region is below Juno's altitude, from which the more intense upward electrons originate. For the complete interval, the UV brightness peaked at ~240 kilorayleigh (kR); the downward and upward energy fluxes peaked at 60 and 700 mW/m2, respectively. Increased downward energy fluxes are associated with increased contributions from tens of keV electrons. These observations provide evidence that bidirectional electron beams with broad energy distributions can produce tens to hundreds of kilorayleigh polar UV emissions.

Suppression of Electron Thermal Conduction by Whistler Turbulence in a Sustained Thermal Gradient.

The dynamics of weakly magnetized collisionless plasmas in the presence of an imposed temperature gradient along an ambient magnetic field is explored with particle-in-cell simulations and modeling. Two thermal reservoirs at different temperatures drive an electron heat flux that destabilizes off-angle whistler-type modes. The whistlers grow to large amplitude, δB/B_{0}≃1, and resonantly scatter the electrons, significantly reducing the heat flux. Surprisingly, the resulting steady-state heat flux is largely independent of the thermal gradient. The rate of thermal conduction is instead controlled by the finite propagation speed of the whistlers, which act as mobile scattering centers that convect the thermal energy of the hot reservoir. The results are relevant to thermal transport in high-ß astrophysical plasmas such as hot accretion flows and the intracluster medium of galaxy clusters.