Pediatric Gastrointestinal Endoscopy: European Society of Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) and European Society of Gastrointestinal Endoscopy (ESGE) Guidelines

ABSTRACT: This Guideline refers to infants, children and adolescents aged 0–18 years. The areas covered include: indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileo-colonoscopy; endoscopy for foreign body ingestion; corrosive ingestion and stricture/stenosis endoscopic management; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangio-pancreatography and endoscopic ultrasonography. Percutaneous endoscopic gastrostomy and endoscopy specific to inflammatory bowel disease (IBD) has been dealt with in other Guidelines [1–3] and are therefore not mentioned in this Guideline. Training and ongoing skill maintenance are to be dealt with in an imminent sister publication to this

Pediatric gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) Guideline Executive summary

This Executive summary of the Guideline on pediatric gastrointestinal endoscopy from the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) refers to infants, children, and adolescents aged 0–18 years. The areas covered include: indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileocolonoscopy; endoscopy for foreign body ingestion; endoscopic management of corrosive ingestion and stricture/ stenosis; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangiopancreatography, and endoscopic ultrasonography. Percutaneous endoscopic gastrostomy and endoscopy specific to inflammatory bowel disease (IBD) have been dealt with in other Guidelines and are therefore not mentioned in this Guideline. Training and ongoing skill maintenance will be addressed in an imminent sister publication

First divertor physics studies in Wendelstein 7-X

The Wendelstein 7-X (W7-X) optimized stellarator fusion experiment, which went into operation in 2015, has been operating since 2017 with an un-cooled modular graphite divertor. This allowed first divertor physics studies to be performed at pulse energies up to 80 MJ, as opposed to 4 MJ in the first operation phase, where five inboard limiters were installed instead of a divertor. This, and a number of other upgrades to the device capabilities, allowed extension into regimes of higher plasma density, heating power, and performance overall, e.g. setting a new stellarator world record triple product. The paper focuses on the first physics studies of how the island divertor works. The plasma heat loads arrive to a very high degree on the divertor plates, with only minor heat loads seen on other components, in particular baffle structures built in to aid neutral compression. The strike line shapes and locations change significantly from one magnetic configuration to another, in very much the same way that codes had predicted they would. Strike-line widths are as large as 10 cm, and the wetted areas also large, up to about 1.5 m2, which bodes well for future operation phases. Peak local heat loads onto the divertor were in general benign and project below the 10 MW m−2 limit of the future water-cooled divertor when operated with 10 MW of heating power, with the exception of low-density attached operation in the high-iota configuration. The most notable result was the complete (in all 10 divertor units) heat-flux detachment obtained at high-density operation in hydrogen

Disruption prediction with artificial intelligence techniques in tokamak plasmas

In nuclear fusion reactors, plasmas are heated to very high temperatures of more than 100 million kelvin and, in so-called tokamaks, they are confined by magnetic fields in the shape of a torus. Light nuclei, such as deuterium and tritium, undergo a fusion reaction that releases energy, making fusion a promising option for a sustainable and clean energy source. Tokamak plasmas, however, are prone to disruptions as a result of a sudden collapse of the system terminating the fusion reactions. As disruptions lead to an abrupt loss of confinement, they can cause irreversible damage to present-day fusion devices and are expected to have a more devastating effect in future devices. Disruptions expected in the next-generation tokamak, ITER, for example, could cause electromagnetic forces larger than the weight of an Airbus A380. Furthermore, the thermal loads in such an event could exceed the melting threshold of the most resistant state-of-the-art materials by more than an order of magnitude. To prevent disruptions or at least mitigate their detrimental effects, empirical models obtained with artificial intelligence methods, of which an overview is given here, are commonly employed to predict their occurrence—and ideally give enough time to introduce counteracting measures