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Super-refractory status epilepticus (SE) is a stage of refractory SE characterized by unresponsiveness to initial anesthetic therapy. It is a new concept that has been the focus of recent basic and therapeutic work, and is defined as "SE that continues or recurs 24 hours or more after the onset of anesthesia, including those cases in which SE recurs on the reduction or withdrawl of anesthesia." It is encountered typically, but not exclusively, in two quite distinctive clinical situations: (1) in patients with severe acute brain injury, and (2) in patients with no history of epilepsy in whom status epilepticus develops out of the blue with no overt cause. There are a variety of treatments used, almost entirely based on open observational studies or case reports. Therapy includes anesthesia, antiepileptic drug therapy, hypothermia and ICU therapy, other medical, immunological, and physical therapies. In this review, the range of possible therapies is outlined and an approach to therapy is discussed.
Super-refractory status epilepticus is defined as status epilepticus that continues or recurs 24 h or more after the onset of anaesthetic therapy, including those cases where status epilepticus recurs on the reduction or withdrawal of anaesthesia. It is an uncommon but important clinical problem with high mortality and morbidity rates. This article reviews the treatment approaches. There are no controlled or randomized studies, and so therapy has to be based on clinical reports and opinion. The published world literature on the following treatments was critically evaluated: anaesthetic agents, anti-epileptic drugs, magnesium infusion, pyridoxine, steroids and immunotherapy, ketogenic diet, hypothermia, emergency resective neurosurgery and multiple subpial transection, transcranial magnetic stimulation, vagal nerve stimulation, deep brain stimulation, electroconvulsive therapy, drainage of the cerebrospinal fluid and other older drug therapies. The importance of treating the identifying cause is stressed. A protocol and flowchart for managing super-refractory status epilepticus is suggested. In view of the small number of published reports, there is an urgent need for the establishment of a database of outcomes of individual therapies.
We lost super host status because we had to cancel one reservation early last year, when calendar syncing across systems failed briefly. We accepted a booking in AIRBNB and immediately after accepting a booking in VRBO, because the calendar in AIRBNB still showed as available. We realized within an hour or two, and notified the AIRBNB guest, as her reservation had been booked second. She was appreciative that we'd notified quickly. We otherwise had terrific scores as super hosts, and have maintained those scores continuously since that cancellation, but we're still sitting here without super host status since March or April, 2017. When we called to alert AIRBNB regarding this unusual situation, we were told that we'd lose super host status, and that's that. More recently, we've heard from other hosts that they were able to get exceptions for a circumstance such as this. When scores are impeccable, why would this policy be so stringent that a single lapse of this nature would not be exempted? Losing super host status definitely affected our bookings. What gives? Have others had this experience?
Fred, with all due respect, a quarter is not a year, and a lapse for an instant due to a tech glitch that might even have been an AIRBNB issue really doesn't seem to justify a year down. But my question is this -- Why do some people get exceptions, while others do not? What I hear is that it depends on who receives the call at AIRBNB. This is troubling. A year without super host status results in significant loss of traction -- This should not be an arbitrary and capricious decision -- sometimes a penalty, sometimes not?
I looked at your listings: you do not seem to have Instant Booking on, so it is not like the AirBnB system accepted a booking where there was a conflict. You received an AirBnB reservation request and you actually approved it manually even though you had already received a confirmed booking from VRBO for that same listing for overlapping dates. This is not just "a lapse for an instant due to a tech glitch". It was a mistake you made.
There are guidelines, and the difference is whether the customer service representative feels your situation fits the guidelines. For a host cancellation, the guidelines would be the "Extenuating Circumstance" exceptions for cancellation.
invite arguments or suppression. Take the challenge approach somewhere else. I simply would like to know if others have been exempted this penalty and in what circumstances. It isn't clear to me that 'extenuating circumstances' applies in the context of this cancellation metric question, but perhaps it broadly applies to all issues -- that's just not clear from policy docs. Of course we accepted the reservation -- I made that plain in my post. I did not mask or mislead.
I only come here to help; if you felt AirBnB's decisions were being arbitrary, I wanted to understand the thinking. Other hosts may feel the decisions are unfair, or unjustified; but "arbitrary" means something specific, and I had not heard many people say that.
I had hoped to receive a response from you earlier, because I was scheduled to attend the AirBnB Global Q&A session this morning to hear the CEO Brian Chesky speak. My understanding was there would be a chance for us to ask our own questions at the end, and if I could understand your perspective on the issue, perhaps I could get some clarity from the actual people who run the various programs. I did get to speak briefly with the people in charge of the SuperHost program and the local Community Organizers, but I didn't get to address your issue because I really didn't have a good understanding of your position.
Honestly, we've been syncing calendars for years and have only had this problem the one time. I think it was because the two reservations came in at precisely the same time and the Airbnb calendar had not yet updated.
I had a client who cancelled within 24 hours so not my fault at all and this was last april, but lost it for a year. but i still had good booking for last year .people look as the remarks from your clients first i think , so good thing too.
I am in the middle of the same situation at the moment. For some reason dates that I had blocked 4 months ago on another calendar were unblocked on airbnb. Not sure how that happened. I also discovered that airbnb had blocked my other calendar for 96 days. Anyway, I am equally as frustrated and upset because I work so diligently on my vacation rentals.
I wasn't very articulate in my last post. I'm upset that I've lost superhost status after JUST getting it. I responded to the guest immediately and explained the situation. I too think it's unfair to be penalized so drastically if you are in good standing on everything else and simply make a mistake. I think that a more fair system would listen to a host who corrected the mistake immediately and doesn't have a history of cancellation. Honestly I want to take my properties off of Airbnb because I find the system at Homeaway easier to use. Also, every single time I call Homeaway for assistance, I get to talk to someone within minutes. So Gail and Beth, my response is yes, I've had a similar experience and I'm sorry. It's a shame that after all of your hard work you were penalized so drastically.
I had the same thing happen because one of the landlords I work for failed to communicate with me regarding a stay in one of the properties. The cancellation was six months ahead of time. I now lost Superhost status for a year and not happy at all. This seems draconian and they simply show zero mercy for a single occurance. This is poor customer service.
Your superhost status will still apply to your profile and won't be affected just because you will be the host of a new listing. As guests stay in your new place reviews they leave will show on the page for the listing and on your profile page as happens now.
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This retrospective observational cohort study enrolled patients with SRSE admitted to the neurology department between January 2007 and December 2019 at the National Cheng Kung University Hospital. This study obtained ethical approval for research with human participants from the Institutional Review Board, National Cheng Kung University Hospital (IRB No: B-ER-107-106). Waiver of informed consent was granted by the Institutional Review Board of National Cheng Kung University Hospital. All procedures were performed in accordance with the relevant guidelines and regulations.
Time courses of anesthetics used in patients with SRSE. (a) Time courses of anesthetics used in patients of the mortality group following their hospital admission. (b) Time courses of anesthetics used in surviving patients with SRSE. (c) Overlapping durations of the combined use of two or more anesthetics comparing survival and mortality groups. (d) Overlapping durations of the combined use of three anesthetics comparing survival and mortality groups. Gray bars indicate the total duration of hospital stay for each patient. Anesthetics are labeled in different colors and presented chronologically for the hospital stay. SRSE super-refractory status epilepticus.
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