Continuity of the value function for deterministic optimal impulse control with terminal state constraint

Deterministic optimal impulse control problem with terminal state constraint is considered. Due to the appearance of the terminal state constraint, the value function might be discontinuous in general. The main contribution of this paper is the introduction of an intrinsic condition under which the value function is proved to be continuous. Then by a Bellman dynamic programming principle, the corresponding Hamilton-Jacobi-Bellman type quasi-variational inequality (QVI, for short) is derived. The value function is proved to be a viscosity solution to such a QVI. The issue of whether the value function is characterized as the unique viscosity solution to this QVI is carefully addressed and the answer is left open challengingly.

229 CX3CR1 in exhausted CD8 T cell states

BackgroundCancer has chronic antigen exposure that results in a suppressed CD8 T cell state termed exhaustion. An outcome of anti PD-1 blockade therapy is the expansion of early exhausted CD8+ T cells into a terminally differentiated exhausted state. The reversal of this transcriptionally plastic yet epigenetically fixed state of CD8 T cell exhaustion has the potential to increase responses to anti PD-1 therapy.MethodsCX3CR1 is a marker of CD8 T cell activation, effector function however less is known about the contribution of CX3CR1 in CD8 T cell exhaustion. We identified three distinct subsets of CD8+ tumor infiltrating lymphocytes (TILs) based on high, mid, and negative CX3CR1 expression in a mouse model of colon carcinoma.ResultsThe CX3CR1 high CD8+ T cells are more exhausted with higher PD1+TIM3+ expression compared to CX3CR1 mid and CX3CR1 negative cells thereby representing the terminal state of CD8 T cell exhaustion. Moreover, CX3CR1 high CD8 T cells increase following anti PD-1 blockade, and their abundance is associated with a positive response to anti PD-1.ConclusionsWe identify a consequence of CX3CR1 in terminal T cell exhaustion, and our work can offer strategies to increase responses to anti PD-1.Ethics ApprovalAnimal experiments were performed as per the IACUC regulations at the Dana Farber cancer Institute, and the MD Anderson Cancer Center

Underwater Robot Manipulator Control

This paper deals with the problem of bringing the end effector (grip center) of an underwater vehicle anthropomorphic manipulator to a predetermined position in a given time using the terminal state method. A dynamic model with the account of joint drives dynamics is formulated on the basis of obtained kinematic model constructed by using the Denavit-Hartenberg method (DH model). The DH model is used in a terminal nonlinear criterion that displays estimate of the proximity of the effector's orientation and position to the specified values. The dynamic model is adapted for effective application of the author's terminal state method (TSM) so that it forms a system of differential equations for the rotation angles of manipulator links around the longitudinal and transverse axes, having only desired TSM-controls in the right parts. The converted model provides simplifications of controls calculation by eliminating the numerical solution of special differential equations, that is needed in the case of using in TSM nonlinear dynamic models in general form. The found TSM-controls are further used in expressions for control actions on joints electric drives obtained on the basis of electric drives dynamic models. Unknown drives parameters as functions of links rotation angles or other unknown factors, are proposed to be determined experimentally. Such two-step procedure allowed to get drive control in the form of algebraic and transcendental expressions. Finally, by applying the developed software, simulation results of the manipulator end effector moving to the specified positions on the edge of the working area are presented. The resulting error (without accounting measurement error) does not exceed 2 centimeters at the 1.2 meters distance by arm reaching maximum of length ability. The work was performed under the Federal program of developing a robotic device for underwater research in shallow depths (up to 10 meters).

Medical ethics in relationship with moribund patient

The continuous changes in the basic values of modern society are based on transformations in the field of intellectual communication, an avalanche-like increase in the volume of new knowledge, the emergence of new medical technology, and a sharp increase in attention to human rights. These processes exacerbate deontological problems, which are most difficult to manifest when a doctor comes into contact with a dying patient. Purpose of the study. To improve the quality of medical care for a patient in a terminal state. Research results. For most people, death is associated with severe physical and spiritual suffering. The doctor can alleviate this suffering only with a deep understanding of the phenomenon of death, both from scientific and religious positions. The article analyzes the philosophical foundations of medical ethics, knowledge of which is necessary for a doctor when communicating with a dying patient. The modern understanding of death as a natural event necessary to support the development of living nature is given. It is shown that our society has not yet developed the principles of the culture of death. In connection with the development of modern medical technologies, it became necessary to search for new criteria for death. The modern legal and moral interpretation of the human right to death with dignity is considered. The difficulty of communicating information about a fatal diagnosis to a patient is noted: when a bitter truth is possible, and when a “holy” lie is needed. The proposition is put forward that the complexity and contradictory nature of the problem of euthanasia is solved by providing the terminal patient with high-quality palliative care. Conclusion. Despite all the wonderful judgments about the necessity and importance of death in the development of mankind, the tragedy of personal death cannot be removed even by the most optimistic philosophy. However, a doctor, armed with modern knowledge, possessing modern deontological methods, endowed with high moral qualities, can significantly reduce the level of feeling of this tragedy. Death is an important stage in a person's life, the confidence of all living people that their terminal period will be provided with proper care and attention, will greatly improve the quality and the entire period of a person's life.

Constrained stochastic predictive control of linear systems with uncertain communication

This paper proposes a scheme of model predictive control for single-loop networked control system (NCS) with probabilistically modeled communication channel and disturbances. Uncertainties of the communication network are projected onto a tailored probability for the satisfaction of state and input constraints. The proposed receding horizon control scheme uses a probabilistic terminal state and set to establish a balance between control performance and state probability distribution, while satisfying the given constraints. In addition to describing the control approach, its properties are discussed, and it is illustrated by an example.

Nursing care in palliative care in pediatric oncology

This research has as general theme "Nursing care in palliative care in pediatric oncology", an approach that needs to be further discussed due to the need to prepare nursing professionals working in the pediatric sector with cancer patients who are terminally. Thus, an informative text was produced with information based on authors who have already conducted research on this theme, with a qualitative approach, because this is a Bibliographic research. To guide this research, the general objective was to identify the knowledge and reactions of nursing professionals in pediatric cancer care and as specific objectives to identify the perceptions and feelings that permeate pediatric nursing practice in relation to cancer, treatment, and its implications and to know the care/care activities aimed at children hospitalized in the pediatric oncology sector. It is concluded that the courses directed to nursing need to offer disciplines that prepare these professionals to deal with pediatric patients who are in terminal state, preparing them to comfort the family in the face of the failure of the treatments that the patient underwent.

Symmetric Control Systems

The paper focuses on the properties of symmetric control systems, whose distinctive feature is that the solution of the optimal control problem for an object, the mathematical model of which belongs to the class of symmetric control systems, leads to the solution of two problems. The first optimal control problem is the initial one; the result of its solution is a function that ensures the optimal movement of the object from the initial state to the terminal one. In the second problem, the terminal state is the initial state, and the initial state is the terminal state. The complexity of the problem being solved is due to the increase in dimension when the models of all objects of the group are included in the mathematical model of the object, as well as the emerging dynamic phase constraints. The presence of phase constraints in some cases leads to the target functional having several local extrema. A theorem is proved that under certain conditions the functional is not unimodal when controlling a group of objects belonging to the class of symmetric systems. A numerical example of solving the optimal control problem with phase constraints by the Adam gradient method and the evolutionary particle swarm method is given. In the example, a group of two symmetrical objects is used as a control object

Peg solitaire on graphs with large maximum degree

In 2011, Beeler and Hoilman introduced the peg solitaire on graphs. The peg solitaire on a connected graph is a one-player combinatorial game starting with exactly one hole in a vertex and pegs in all other vertices and removing all pegs but exactly one by a sequence of jumps; for a path [Formula: see text], if there are pegs in [Formula: see text] and [Formula: see text] and exists a hole in [Formula: see text], then [Formula: see text] can jump over [Formula: see text] into [Formula: see text], and after that, the peg in [Formula: see text] is removed. A problem of interest in the game is to characterize solvable (respectively, freely solvable) graphs, where a graph is solvable (respectively, freely solvable) if for some (respectively, any) vertex [Formula: see text], starting with a hole [Formula: see text], a terminal state consisting of a single peg can be obtained from the starting state by a sequence of jumps. In this paper, we consider the peg solitaire on graphs with large maximum degree. In particular, we show the necessary and sufficient condition for a graph with large maximum degree to be solvable in terms of the number of pendant vertices adjacent to a vertex of maximum degree. It is a notable point that this paper deals with a question of Beeler and Walvoort whether a non-solvable condition of trees can be extended to other graphs.

Perspectives of solution to the problem of persistent intra-abdominal hemorrhage at the prehospital stage

A post-hoc analysis of 338 casualties demonstrating persistent intra-abdominal hemorrhage has been carried out, the proportion of this group being 16.5% in overall casualty structure or 64% in the group of casualties with abdominal injuries. Lethal outcome rate in the studied group was 13%, the complication rate was 53.2%. Traumatic shock was found in 86% of casualties, the greatest proportion was accounted for by the first and second degree (59.1%). Lethality rate in the case of the third degree traumatic shock and terminal state was 34.4%. Injured parenchymal organs and abdominal major vessels showed the greatest blood loss 2348 250 ml. The time of arrival of casualties with persistent intra-abdominal hemorrhage to the advanced trauma management stage or definitive surgical care stage was virtually similar amounting to 2.6 0.4 hr. Injuries to hollow organs (34.1%) were most commonly found, injuries to parenchymal organs (24.9%) occurred less frequently, the rate of combination of injuries to abdominal internal organs was approximately the same (24.9%). Major vessels injuries were diagnosed only in one casualty (0.3%), while those combined with internal organs injuries in 37(11%)of casualties. As regards favorable prognosis this group was considered to be the least perspective owing to high rate of hemorrhage and inability to achieve effective hemostasis at the prehospital stage. Thus, persistent hemorrhage was not profuse, and the majority of casualties (88.7%) should be considered as perspective recipients to achieve temporary hemostasis at the prehospital stage. It is this approach based on the principles of early pathogenetic management that could reduce the rate of complications and lethality in casualties with persistent intra-abdominal hemorrhage.

Agonal Factors Distort Gene-Expression Patterns in Human Postmortem Brains

Agonal factors, the conditions that occur just prior to death, can impact the molecular quality of postmortem brains, influencing gene expression results. Our study used gene expression data of 262 samples from ROSMAP with the detailed terminal state recorded for each donor, such as fever, infection, and unconsciousness. Fever and infection were the primary contributors to brain gene expression changes, brain cell-type-specific gene expression, and cell proportion changes. Furthermore, we also found that previous studies of gene expression in postmortem brains were confounded by agonal factors. Therefore, correction for agonal factors is important in the step of data preprocessing. Our analyses revealed fever and infection contributing to gene expression changes in postmortem brains and emphasized the necessity of study designs that document and account for agonal factors.