Pulmonary Glue Embolism: An unusual complication following endoscopic sclerotherapy for gastric varices

A pulmonary glue embolism is an unusual but potentially life-threatening complication following the treatment of variceal bleeding, especially in patients with large varices requiring large volumes of sclerosant. Other contributory factors include the rate of injection and ratio of the constituent components of the sclerosant (i.e. n-butylcyanoacrylate and lipiodol). This condition may be associated with a delayed onset of respiratory compromise. Therefore, a high degree of clinical suspicion is essential in patients with unexplained cardiorespiratory decline during or following endoscopic sclerotherapy. We report a 65-year-old man who was admitted to the Hull Royal Infirmary, Hull, UK, in 2017 with haematemesis and melaena. He subsequently developed acute respiratory distress syndrome secondary to a glue embolism following emergency sclerotherapy for bleeding gastric varices. The aetiology of the embolism was likely a combination of the large size of the gastric varices and the large volume of cyanoacrylate needed. After an endoscopy, the patient underwent transjugular intrahepatic portosystemic shunting twice to control the bleeding, after which he recovered satisfactorily.Keywords: Gastric Varices; Pulmonary Embolism; Sclerotherapy; N-butyl-cyanoacrylate; Lipiodol; Case Report; United Kingdom

On the competitive harvesting of marine resources

The paper is concerned with the optimal harvesting of a marine resource, described by an elliptic equation with Neumann boundary conditions and a nonlinear source term. We first consider a single agent, whose harvesting effort at various locations is described by a positive Radon measure. Necessary conditions for optimality are derived, complementing the existence result proved in [A. Bressan, G. Coclite, and W. Shen, SIAM J. Control Optim., 51 (2013), pp. 1186--1202]. The second part of the paper deals with a competitive scenario, where several groups of fishermen, from different coastal towns and hence with different cost functions, harvest the same marine resource. We prove the existence of a Nash equilibrium, which is characterized in terms of a suitable variational inequality.publishe

Functional generalized additive models

We introduce the functional generalized additive model (FGAM), a novel regression model for association studies between a scalar response and a functional predictor. We model the link-transformed mean response as the integral with respect to t of F{X(t), t} where F(·, ·) is an unknown regression function and X(t) is a functional covariate. Rather than having an additive model in a finite number of principal components as by Müller and Yao (2008), our model incorporates the functional predictor directly and thus our model can be viewed as the natural functional extension of generalized additive models. We estimate F(·, ·) using tensor-product B-splines with roughness penalties. A pointwise quantile transformation of the functional predictor is also considered to ensure each tensor-product B-spline has observed data on its support. The methods are evaluated using simulated data and their predictive performance is compared with other competing scalar-on-function regression alternatives. We illustrate the usefulness of our approach through an application to brain tractography, where X(t) is a signal from diffusion tensor imaging at position, t, along a tract in the brain. In one example, the response is disease-status (case or control) and in a second example, it is the score on a cognitive test. The FGAM is implemented in R in the refund package. There are additional supplementary materials available online. © 2013 American Statistical Association, Institute of Mathematical Statistics, and Interface Foundation of North America

Semiclassical model for calculating fully differential ionization cross sections of the H2_2 molecule

Fully differential cross sections are calculated for the ionization of H$_2$ by fast charged projectiles using a semiclassical model developed previously for the ionization of atoms. The method is tested in case of 4 keV electron and 6 MeV proton projectiles. The obtained results show good agreement with the available experimental data. Interference effects due to the two-center character of the target are also observed and analyzed.Comment: 11 pages, 4 figure

Voltage-programmable liquid optical interface

Recently, there has been intense interest in photonic devices based on microfluidics, including displays and refractive tunable microlenses and optical beamsteerers, that work using the principle of electrowetting. Here, we report a novel approach to optical devices in which static wrinkles are produced at the surface of a thin film of oil as a result of dielectrophoretic forces. We have demonstrated this voltage-programmable surface wrinkling effect in periodic devices with pitch lengths of between 20 and 240 µm and with response times of less than 40 µs. By a careful choice of oils, it is possible to optimize either for high-amplitude sinusoidal wrinkles at micrometre-scale pitches or more complex non-sinusoidal profiles with higher Fourier components at longer pitches. This opens up the possibility of developing rapidly responsive voltage-programmable, polarization-insensitive transmission and reflection diffraction devices and arbitrary surface profile optical devices

Turbulence anisotropy and the SO(3) description

We study strongly turbulent windtunnel flows with controlled anisotropy. Using a recent formalism based on angular momentum and the irreducible representations of the SO(3) rotation group, we attempt to extract this anisotropy from the angular dependence of second-order structure functions. Our instrumentation allows a measurement of both the separation and the angle dependence of the structure function. In axisymmetric turbulence which has a weak anisotropy, this more extended information produces ambiguous results. In more strongly anisotropic shear turbulence, the SO(3) description enables one to find the anisotropy scaling exponent. The key quality of the SO(3) description is that structure functions are a mixture of algebraic functions of the scale with exponents ordered such that the contribution of anisotropies diminishes at small scales. However, we find that in third-order structure functions of homogeneous shear turbulence the anisotropic contribution is always large and of the same order of magnitude as the isotropic part. Our results concern the minimum instrumentation needed to determine the parameters of the SO(3) description, and raise several questions about its ability to describe the angle dependence of high-order structure functions

Time-dependent density functional study of the electronic spectra of oligoacenes in the charge states -1, 0, +1, and +2

We present a systematic theoretical study of the five smallest oligoacenes (naphthalene, anthracene, tetracene, pentacene, and hexacene) in their anionic,neutral, cationic, and dicationic charge states. We used density functional theory (DFT) to obtain the ground-state optimised geometries, and time-dependent DFT (TD-DFT) to evaluate the electronic absorption spectra. Total-energy differences enabled us to evaluate the electron affinities and first and second ionisation energies, the quasiparticle correction to the HOMO-LUMO energy gap and an estimate of the excitonic effects in the neutral molecules. Electronic absorption spectra have been computed by combining two different implementations of TD-DFT: the frequency-space method to study general trends as a function of charge-state and molecular size for the lowest-lying in-plane long-polarised and short-polarised $\pi\to\pi^\star$ electronic transitions, and the real-time propagation scheme to obtain the whole photo-absorption cross-section up to the far-UV. Doubly-ionised PAHs are found to display strong electronic transitions of $\pi\to\pi^\star$ character in the near-IR, visible, and near-UV spectral ranges, like their singly-charged counterparts. While, as expected, the broad plasmon-like structure with its maximum at about 17-18 eV is relatively insensitive to the charge-state of the molecule, a systematic decrease with increasing positive charge of the absorption cross-section between about 6 and about 12 eV is observed for each member of the class.Comment: 38 pages, 11 figures, 7 tables, accepted for publication in Chemical Physic