There are few detailed investigations of neurologic complications in severe acute respiratory syndrome coronavirus 2 infection. We describe 3 patients with laboratory-confirmed coronavirus disease ...who had encephalopathy and encephalitis develop. Neuroimaging showed nonenhancing unilateral, bilateral, and midline changes not readily attributable to vascular causes. All 3 patients had increased cerebrospinal fluid (CSF) levels of anti-S1 IgM. One patient who died also had increased levels of anti-envelope protein IgM. CSF analysis also showed markedly increased levels of interleukin (IL)-6, IL-8, and IL-10, but severe acute respiratory syndrome coronavirus 2 was not identified in any CSF sample. These changes provide evidence of CSF periinfectious/postinfectious inflammatory changes during coronavirus disease with neurologic complications.
The problem of deriving decision-making policies, subject to some formal specification of behavior, has been well-studied in the control synthesis, reinforcement learning, and planning communities. ...Such problems are typically framed in the context of a non-deterministic decision process, the non-determinism of which is optimally resolved by the computed policy. In this paper, we explore the derivation of such policies in Markov decision processes (MDPs) subject to two types of formal specifications. First, we consider steady-state specifications that reason about the infinite-frequency behavior of the resulting agent. This behavior corresponds to the frequency with which an agent visits each state as it follows its decision-making policy indefinitely. Second, we examine the infinite-trace behavior of the agent by imposing Linear Temporal Logic (LTL) constraints on the behavior induced by the resulting policy. We present an algorithm to find a deterministic policy satisfying LTL and steady-state constraints by characterizing the solutions as an integer linear program (ILP) and experimentally evaluate our approach. In our experimental results section, we evaluate the proposed ILP using MDPs with stochastic and deterministic transitions.
El artículo explora los discursos que combinan imaginarios sobre masculinidady modernidad movilizados desde las élites intelectuales peruanas en la transición al siglo XX. El texto se basa en la ...revisión en detalle de algunos casos--revistas culturales, homenajes fúnebres y piezas literarias--que ilustran estas representaciones. El artículo evidencia un intento de las élites por posicionar al Perú dentro de los países civilizados y como parte de los avances de la modernidad occidental. Para ello, se trató de proyectar la imagen de un país compuesto por hombres viriles, enérgicos y de elevada racionalidad. Por un lado, se trató de exaltar el carácter heroico--en clave de masculinidad hegemónica--de figuras civiles y militares para contrarrestar el desencanto tras la derrota militar en la Guerra del Pacífico. Asimismo, el posterior entusiasmo durante la República Aristocrática se ancló en las posibilidades de transformación del país hacia un sujeto ideal más blanco, masculino y civilizado.
Despite the value of family-centered care (FCC) in intensive care units (ICUs), this approach is rarely a reality in this context. This article aims to increase the likelihood that ICU-based care ...incorporates best practices for FCC. Consistent with this goal, this article begins by overviewing FCC and its merits and challenges in ICUs. It then offers a systemic framework for conceptualizing FCC in this challenging environment, as such a model can help guide the implementation of this invaluable approach. This systemic framework combined with previous guidelines for FCC in the ICU are used to inform the series of recommended best practices for FCC in the ICU that balance the needs and realities of patients, families, and the interprofessional healthcare team. These best practices reflect an integration of the existing literature and previously published guidelines as well as our experiences as healthcare providers, family members, and patients. We encourage healthcare leaders and interprofessional ICU healthcare teams to adopt these best practices and modify them for the specific healthcare needs of the patients they serve and their families.
Clostridium subterminale is an anaerobic spore-forming bacterium rarely isolated in human infections. This case study presents a necrotizing C. subterminale infection stemming from a dental abscess ...that progressed into sepsis, a small pericardial effusion, moderate bilateral pulmonary effusions, and multiple organ dysfunction syndrome. The management of the infection, along with other relevant cases is discussed.
El presente artículo analiza la manera en que la educación sirve como mecanismo de reproducción de clase y, con ello, de producción de cuadros para las élites. En términos analíticos, se enmarca en ...los estudios sobre clases sociales y sus formas de reproducción mediadas por la escuela. Para ello, se emplea una aproximación cualitativa que combina entrevistas en profundidad con un mapeo de actores de las principales empresas del país. Sostenemos que además de soportes familiares, académicos y sociales, el paso por colegios de prestigio constituye una garantía para su reproducción social. Estas instituciones no solo sirven como mecanismo de cierre social, sino que también otorgan ventajas simbólicas, culturales y sociales que se traducen en beneficios a lo largo de su trayectoria laboral.
Objective
To report our initial experience using an adult‐template MAP in drug‐resistant focal epilepsy in five children with apparently normal MRI.
Methods
Patients selected were highly suspicious ...of harboring focal structural lesions and had negative brain MRI studies. MAP was performed using a locally obtained adult database as a template. Results were reviewed by two neuroradiologists. Pertinence of MAP‐positive areas was confirmed by the focal epileptic hypothesis or by pathology when possible (J Neuroradiol, 39, 2012, 87). Visual analysis was performed using Mango Software. MRI studies were reanalyzed at the workstation with knowledge of the clinical suspicion to confirm or discard the possibility of FCD.
Results
Five patients aged 19‐48 months were studied, all with initial 3T MRI studies interpreted as normal. All had focal epileptic hypothesis with coherence of clinical seizure characterization and electroencephalographic findings. In two patients, histology showed type 1 FCD. Due to the age of our subjects, the junction map always highlighted the subcortical white matter in relationship to maturity differences. FCD was identified as asymmetric U‐shaped highlighted regions in the junction map.
Significance
FCD is the most frequent pathology reported in pediatric epilepsy surgery series (Epileptic Disord, 18, 2016, 240). Significant number of FCDs may be overlooked on MRIs, reducing the odds of seizure freedom after surgery (Epilepsy Res, 89, 2010, 310). MAP is an image postprocessing method for enhanced visualization of FCD; however, when using an adult template in developing brains, normal subcortical regions may be highlighted as pathological. Creating a pediatric template is difficult, due to the need for general anesthesia to acquire the MRI database. Here, we were able to show that MAP identified FCDs as asymmetric “U‐” shaped highlighted regions in the junction maps of all five patients, which may indicate that obtaining childhood databases for this purpose may not be necessary and that adult ones suffice for diagnosis of FCD.
In this paper, we discuss the problems of finding minimum stopping sets and trapping sets in Tanner graphs, using integer linear programming. These problems are important for establishing reliable ...communication across noisy channels. Indeed, stopping sets and trapping sets correspond to combinatorial structures in information-theoretic codes, which lead to errors in decoding once a message is received. In particular, these sets correspond to variables that are not eventually corrected by the decoder, thus causing failures in decoding when using iterative algorithms. We present integer linear programs (ILPs) for finding stopping sets and several trapping set variants. Furthermore, we prove that two of these trapping set problem variants are NP-hard for the first time. Additionally, we analyze these variants from the parameterized perspective. Finally, we model stopping set and trapping set problems as Integer Linear Programs (ILPs). The effectiveness of our approach is demonstrated by finding stopping sets of size up to 48 in the (4896,2474) Margulis code. This compares favorably to the current state-of-the-art, which finds stopping sets of size up to 26. For the trapping set problems, we show for which cases an ILP produces solutions efficiently and for which cases it performs poorly. The proposed approach is applicable to codes represented by regular and irregular graphs alike.1
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