Assessment of quality indicators among nurse practitioners performing upper endoscopy.

Background and study aims Limited international data have shown that non-physicians can safely perform upper endoscopy, but no such study has been performed in the United States. Our aim was to assess the quality of outpatient upper endoscopies performed by nurse practitioners (NPs).Patients and methods Retrospective chart review of upper endoscopies performed by 3 NPs between 2010 and 2013 was performed. Comparisons among all NPs performing upper endoscopy and assessment of individual NP performance over time with respect to quality indicators were performed.Results Three NPs performed 333 upper endoscopies (distribution of 166, 44, and 123, respectively). Of the cases, 98.2 %s were successfully completed to the second portion of the duodenum. In most cases, photo-documentation of required anatomical landmarks was performed: GE junction (84.2 %), GE junction in retroflexed view (84.2 %), antrum (82.1 %) and duodenum (80.9 %). Photo-documentation improved with increasing experience. NPs appropriately performed biopsies for specific medical conditions: 10/11 (90.9 %) gastric ulcers were biopsied and 63/66 (95.5) of patients with iron deficiency had duodenal biopsies performed for celiac disease. A physician endoscopist was required during the procedure 22.5 % of the time. Important parameters such as documenting informed consent (100 %) and documenting a discharge plan (99.4 %) in the procedure reports were overwhelming present. There was a single adverse event during the study period.Conclusion In the first US study of NPs performing upper endoscopy, they were able to perform high-quality and safe upper endoscopies. These findings support incorporation of non-physicians alongside physicians to help meet the growing demand for endoscopic services across the United States

Characterization of a Double Mesospheric Bore Over Europe

Observations of a pair of mesospheric bore disturbances that propagated through the nighttime mesosphere over Europe are presented. The observations were made at the Padua Observatory, Asiago (45.9\ub0N, 11.5\ub0E), by the Boston University all-sky imager on 11 March 2013. The bores appeared over the northwest horizon, approximately 30 min apart, and propagated toward the southeast. Using additional satellite and radar data, we present evidence indicating the bores originated in the mesosphere from a single, larger-scale mesospheric disturbance propagating through the mesopause region. Furthermore, the large-scale mesospheric disturbance appeared to be associated with an intense weather disturbance that moved southeastward over the United Kingdom and western Europe during 10 and 11 March

Long-term evolution of the coupled boundary layers (STRATUS) mooring recovery and deployment cruise report NOAA Research Vessel R H Brown • cruise RB-01-08 9 October - 25 October 2001

This report documents the work done on cruise RB-01-08 of the NOAA R/V Ron Brown. This was Leg 2 of R/V Ron Brown’s participation in Eastern Pacific Investigation of Climate (EPIC) 2001, a study of air-sea interaction, the atmosphere, and the upper ocean in the eastern tropical Pacific. The science party included groups from the Woods Hole Oceanographic Institution (WHOI), NOAA Environmental Technology Laboratory (ETL), the University of Washington (UW), the University of California, Santa Barbara (UCSB), and the University Nacional Autonoma de Mexico (UNAM). The work done by these groups is summarized in this report. In addition, the routine underway data collected while aboard R/V Ron Brown is also summarized here.Funding was provided by the National Oceanic and Atmospheric Administration under Grant Numbers NA96GPO429 and NA17RJ1223

Versatile four channel tunable hyperspectral imager for remote sensing

<p>Hyperspectral imaging refers to the measurement of data in a number of contiguous wavelengths. It has increasingly been used in remote sensing to<br> obtain information about a scene in many applications ranging from vegetation analysis to aeronomy. The information obtained from optical methods can<br> be spatial, temporal, spectral, polarimetric or a combination of these. An ideal and versatile instrument is one which can provide information in all four<br> domains at high spectral resolution, and can be used for many applications with minimum modifications. In this work we present our first attempt at<br> building such a hyperspectral imaging system called Liquid Crystal Hyperspectral Imager (LiCHI) which uses Liquid Crystal Fabry-Perot etalons. LiCHI has been built and tested for three applications, viz. auroral imaging, outlier detection and environmental or vegetation analysis. Preliminary<br> measurements and analyses from these tests are presented here. The challenges posed by these applications for the design and performance of the<br> system are discussed here.</p