Clinical Characteristics of H1N1 Influenza A-Associated Mild Encephalopathy with Reversible Splenial Lesion: 4 Pediatric Cases

Objective Mild encephalopathy with reversible splenial lesion(MERS)is associated with a variety of infections and anti-epileptic drug withdrawal.Here we report the clinical characteristics of H1N1 influenza A-associated MERS based on our experience of four pediatric cases.Methods A detailed retrospective analysis of four patients with H1N1 influenza A-associated MERS was performed at Guangzhou Women and Children’s Medical Center.Results All patients exhibited mild influenza-like illness and seizures.Three patients presented with a new-onset seizure with fever after 5 years of age.75%patients had altered mental status.For all four patients,influenza A(H1N1)viral RNA was detected in throat swab specimens at least twice.Brain magnetic resonance images revealed similar ovoid lesions in the corpus callosum,mainly in the splenium and for one patient in the splenium and genu of the corpus callosum.Only one patient had an abnormal electroencephalogram tracing.Cells and protein in the cerebrospinal fluid were normal in all patients.All patients received oseltamivir and one patient received intravenous immunoglobulin.As a result,all patients fully recovered after 2 months and showed no neurologic sequelae at discharge.Conclusion This case series provides insight towards clinical features of H1N1 influenza A-associated MERS.

Heuristic algorithm based on the principle of minimum total potential energy(HAPE):a new algorithm for nesting problems

We present a new algorithm for nesting problems.Many equally spaced points are set on a sheet,and a piece is moved to one of the points and rotated by an angle.Both the point and the rotation angle constitute the packing attitude of the piece.We propose a new algorithm named HAPE(Heuristic Algorithm based on the principle of minimum total Potential Energy) to find the optimal packing attitude at which the piece has the lowest center of gravity.In addition,a new technique for polygon overlap testing is proposed which avoids the time-consuming calculation of no-fit-polygon(NFP).The detailed implementation of HAPE is presented and two computational experiments are described.The first experiment is based on a real industrial problem and the second on 11 published benchmark problems.Using a hill-climbing(HC) search method,the proposed algorithm performs well in comparison with other published solutions.