Survival of homogenous fragmentation processes with killing

We consider a homogeneous fragmentation process with killing at an exponential barrier. With the help of two families of martingales we analyse the decay of the largest fragment for parameter values that allow for survival. In this respect the present paper is also concerned with the probability of extinction of the killed process

Unrecognized hand ischemia after intraarterial drug injection: successful management of a "near miss" event

<p>Abstract</p> <p>Background</p> <p>Complications arising from accidental intraarterial drug injections have been described in the past. However, given the multitude of injected substances and complex pathophysiology, guidelines regarding diagnosis and management of patients with intraarterial injections remain vague. As such it remains unclear, when to expect limb ischemia and whether and for how long to monitor patients after intraarterial injections.</p> <p>Case report</p> <p>We present the case of a "near miss event" in an i.v. drug abuser presenting to the emergency department 3 hours after injection of water dissolved zolpidem (Ambien™) tablets into the right ulnar artery. Chief complaint was forearm pain. Clinical examination at the time revealed no concern for limb ischemia and patient was discharged. The patient returned unplanned 18 hours after injection with an ischemic right hand. Angiography revealed no flow in the distal ulnar artery and minimal flow in the palmar arch. Emergent intraarterial thrombolysis with Urokinase was performed and restored hand perfusion. Clinical follow-up 3 months after injury showed full recovery with regular recapillarisation and normal Allen test.</p> <p>Conclusion</p> <p>This case report highlights the need to rigorously monitor patients with suspected intraarterial injections for potential delayed onset of limb ischemia. This is to our knowledge the first described case report of a successful revascularization after prolonged ischemia with delayed onset after zolpidem injection. We recommend close monitoring of these patients for at least 24 hours in addition to starting prophylactic anticoagulation.</p

Assessment of energy loss across aortic valves using accelerated CMR multi-point flow measurements

ISSN:1097-6647ISSN:1532-429

Horizontal Wavenumber Spectra Across the Middle Atmosphere From Airborne Lidar Observations During the 2019 Southern Hemispheric SSW

Horizontal wavenumber spectra across the middle atmosphere are investigated based on density measurements with the Airborne Lidar for Middle Atmosphere research (ALIMA) in the vicinity of the Southern Andes, the Drake passage and the Antarctic peninsula in September 2019. The probed horizontal scales range from 2000 to 25 km. Spectral slopes are close to k−5/3 in the stratosphere and get shallower for horizontal wavelengths <200 km in the mesosphere. The spectral slopes are shown to be statistically robust with the presented number of flight legs despite the unknown orientation of true wave vectors relative to the flight track using synthetic data and a Monte Carlo approach. The largest spectral amplitudes are found over the ocean rather than over topography. The 2019 sudden stratospheric warming caused a critical level for MWs and a reduction of spectral amplitudes at horizontal wavelengths of about 200 km in the mesosphere

Anthracycline-Induced Cardiotoxicity: Cardiac Monitoring by Continuous Wave-Doppler Ultrasound Cardiac Output Monitoring and Correlation to Echocardiography

Background: Anthracyclines are agents with a well-known cardiotoxicity. The study sought to evaluate the hemodynamic response to an anthracycline using real-time continuous-wave (CW)-Doppler ultrasound cardiac output monitoring (USCOM) and echocardiography in combination with serum biomarkers. Methods: 50 patients (26 male, 24 female, median age 59 years) suffering from various types of cancer received an anthracycline-based regimen. Patients' responses were measured at different time points (T0 prior to infusion, T1 6 h post infusion, T2 after 1 day, T3 after 7 days, and T4 after 3 months) with CW-Doppler ultrasound (T0-T4) and echocardiography (T1, T4) for hemodynamic parameters such as stroke volume (SV; SVUSCOM ml) and ejection fraction (EF; EFechocardiography%) and with NT-pro-BNP and hs-Troponin T (T0-T4). Results: During the 3-month observation period, the relative decrease in the EF determined by echocardiography was -2.1% (Delta T0-T4, T0 71 +/- 7.8%, T4 69.5 +/- 7%, p = 0.04), whereas the decrease in SV observed using CW-Doppler was -6.5% (Delta T0-T4, T0 54 +/- 19.2 ml, T4 50.5 +/- 20.6 ml, p = 0.14). The kinetics for serum biomarkers were inversely correlated. Conclusions: Combining real-time CW-Doppler USCOM and serum biomarkers is feasible for monitoring the immediate and chronic hemodynamic changes during an anthracycline-based regimen; the results obtained were comparable to those from echocardiography