Characteristics of Suspected COVID-19 Discharged Emergency Department Patients Who Returned During the First Wave.

INTRODUCTION: Limited information exists on patients with suspected coronavirus disease 2019 (COVID-19) who return to the emergency department (ED) during the first wave. In this study we aimed to identify predictors of ED return within 72 hours for patients with suspected COVID-19. METHODS: Incorporating data from 14 EDs within an integrated healthcare network in the New York metropolitan region from March 2-April 27, 2020, we analyzed this data on predictors for a return ED visit-including demographics, comorbidities, vital signs, and laboratory results. RESULTS: In total, 18,599 patients were included in the study. The median age was 46 years old [interquartile range 34-58]), 50.74% were female, and 49.26% were male. Overall, 532 (2.86%) returned to the ED within 72 hours, and 95.49% were admitted at the return visit. Of those tested for COVID-19, 59.24% (4704/7941) tested positive. Patients with chief complaints of "fever" or "flu" or a history of diabetes or renal disease were more likely to return at 72 hours. Risk of return increased with persistently abnormal temperature (odds ratio [OR] 2.43, 95% CI 1.8-3.2), respiratory rate (2.17, 95% CI 1.6-3.0), and chest radiograph (OR 2.54, 95% CI 2.0-3.2). Abnormally high neutrophil counts, low platelet counts, high bicarbonate values, and high aspartate aminotransferase levels were associated with a higher rate of return. Risk of return decreased when discharged on antibiotics (OR 0.12, 95% CI 0.0-0.3) or corticosteroids (OR 0.12, 95% CI 0.0-0.9). CONCLUSION: The low overall return rate of patients during the first COVID-19 wave indicates that physicians' clinical decision-making successfully identified those acceptable for discharge.

Non-linear global optimization via parameterization and inverse function approximation: an artificial neural networks approach.

In this article, a novel technique for non-linear global optimization is presented. The main goal is to find the optimal global solution of non-linear problems avoiding sub-optimal local solutions or inflection points. The proposed technique is based on a two steps concept: properly keep decreasing the value of the objective function, and calculating the corresponding independent variables by approximating its inverse function. The decreasing process can continue even after reaching local minima and, in general, the algorithm stops when converging to solutions near the global minimum. The implementation of the proposed technique by conventional numerical methods may require a considerable computational effort on the approximation of the inverse function. Thus, here a novel Artificial Neural Network (ANN) approach is implemented to reduce the computational requirements of the proposed optimization technique. This approach is successfully tested on some highly non-linear functions possessing several local minima. The results obtained demonstrate that the proposed approach compares favorably over some current conventional numerical (Matlab functions) methods, and other non-conventional (Evolutionary Algorithms, Simulated Annealing) optimization methods.

A radial basis function network approach for the computation of inverse continuous time variant functions.

This Paper presents an efficient approach for the fast computation of inverse continuous time variant functions with the proper use of Radial Basis Function Networks (RBFNs). The approach is based on implementing RBFNs for computing inverse continuous time variant functions via an overall damped least squares solution that includes a novel null space vector for singularities prevention. The singularities avoidance null space vector is derived from developing a sufficiency condition for singularities prevention that conduces to establish some characterizing matrices and an associated performance index.

Diálogo en espiral: dilema de la sociedad contemporanea

Este Diálogo en espiral se ocupa de problemas fundamentales de una sociaedad que trata aceleradamente de modernizarse, pero que se halla sumida en un serio conflicto de identidad colectiva.

Democratización y modernización del Estado en Bolivia / Democratization and modernization of the State in Bolivia

Tras estudiar las políticas estatales y las repuestas de los actores sociales y políticas, este ensayo planteará los escenarios posibles y expondrá algunas reflexiones finales que ponen énfasis en el distanciamiento que se está produciendo entre el proceso real de democratización y la "salida óptima de la crisis" tal como fue esbozada en el documento básico del proyecto sobre "Ciencias sociales, crisis y requerimientos de nuevos paradigmas en la relación Estado/Sociedad/economía"

Teoría como reflexion critica

Contiene: Problemas metodológicos de la dialéctica y el análisis marxista del estado capitalista: contradicciones y límites - Ideología y crítica de las ideologías: la alternativa teorica de la escuela de Frankfurt - Racionalismo crítico y marxismo: la crítica de Karl Popper - Discurso y constitución de lo social: critica del enfoque discursivo de Laclau - Las paradojas e insuficiencias de la modernización y democratización - La construcción de la democracia frente a la tradición cultural y política en América Latina - Reflexiones sobre la constitución política de los sujetos sociales en América Latina