One Case of Primary Thrombocythemia with Concealed Hypokalemia Complicated by Acute Myocardial Infarction

Medical history summary: Male, 47 years old, was admitted to the hospital due to “dizziness accompanied by chest tightness and pain for more than 8 days”. One week ago, the patient experienced chest tightness, chest pain accompanied by profuse sweating for 3 hours and underwent emergency percutaneous coronary intervention (PCI) at a local hospital. The procedure revealed left main stem occlusion with subsequent left main stem to left anterior descending artery percutaneous transluminal coronary angioplasty (PTCA). After the procedure, the patient experienced hemodynamic instability, recurrent ventricular fibrillation, and critical condition, thus transferred to our hospital for further treatment. Symptoms and signs: The patient is in a comatose state, unresponsive to stimuli, with bilateral dilated pupils measuring 2.0 mm, exhibiting reduced sensitivity to light reflex, and recurrent fever. Coarse breath sounds can be heard in both lungs, with audible moist rales. Irregular breathing pattern is observed, and heart sounds vary in intensity. No pathological murmurs are auscultated in any valve auscultation area. Diagnostic methods: Coronary angiography results at the local hospital showed complete occlusion of the left main stem, and left main stem to left anterior descending artery percutaneous transluminal coronary angioplasty (PTCA) was performed. However, the distal guidewire did not pass through. After admission, blood tests showed a Troponin T level of 1.44 ng/ml and a Myoglobin level of 312 ng/ml. The platelet count was 1390 × 109/L. Von Willebrand factor (vWF) activity was measured at 201.9%. Bone marrow aspiration biopsy showed active bone marrow proliferation and platelet clustering. The peripheral blood smear also showed platelet clustering. JAK-2 gene testing was positive, confirming the diagnosis of primary thrombocytosis. Treatment methods: The patient is assisted with mechanical ventilation and intra-aortic balloon counterpulsation to improve coronary blood flow. Electrolyte levels are closely monitored, especially maintaining plasma potassium levels between 4.0 and 4.5 mmol/l. Hydroxyurea 500 mg is administered for platelet reduction. Anticoagulants and antiplatelet agents are used rationally to prevent further infarction or bleeding. Antiarrhythmic, lipid-lowering, gastroprotective, hepatoprotective, and heart failure treatment are also provided. Clinical outcome: The family members chose to withdraw treatment and signed for discharge due to a combination of reasons, including economic constraints and uncertainty about the prognosis due to the long disease course. Acute myocardial infarction has gradually become one of the leading causes of death in our country. As a “green channel” disease, corresponding diagnostic and treatment protocols have been established in China, and significant progress has been made in emergency care. There are strict regulations for the time taken from the catheterization lab to the cardiac intensive care unit, and standardized treatments are provided to patients once they enter the intensive care unit. Research results show that the incidence of acute myocardial infarction in patients with primary thrombocythemia within 10 years is 9.4%. This type of disease is rare and difficult to cure, posing significant challenges to medical and nursing professionals. In order to benefit future patients, we have documented individual cases of treatment and nursing care for these patients. The research results show that these patients exhibit resistance to traditional oral anticoagulant drugs and require alternative anticoagulants. Additionally, there are significant differences in serum and plasma potassium levels among patients. Therefore, when making clinical diagnoses, it is necessary to carefully distinguish between the two. Particularly, nursing personnel should possess dialectical thinking when supplementing potassium levels in patients in order to reduce the incidence of malignant arrhythmias and mortality rates.

Application of geophysical methods in fine detection of urban concealed karst:A case study of Wuhan City,China

The construction of modern livable cities faces challenges in karst areas,including ground collapse and engineering problems.Wuhan,with a population of 13.74×10^(6) and approximately 1161 km^(2)of soluble rocks in the urban area of 8569.15 km^(2),predominantly consists of concealed karst areas where occasional ground collapse events occur,posing significant threats to underground engineering projects.To address these challenges,a comprehensive geological survey was conducted in Wuhan,focusing on major karstrelated issues.Geophysical methods offer advantages over drilling in detecting concealed karst areas due to their efficiency,non-destructiveness,and flexibility.This paper reviewed the karst geological characteristics in Wuhan and the geophysical exploration methods for karst,selected eight effective geophysical methods for field experimentation,evaluated their suitability,and proposed method combinations for different karst scenarios.The results show that different geophysical methods have varying applicability for karst detection in Wuhan,and combining multiple methods enhances detection effectiveness.The specific recommendations for method combinations provided in this study serve as a valuable reference for karst detection in Wuhan.

An error resilient scheme for H.264 video coding based on distortion estimated mode decision and nearest neighbor error concealment

Although H.264 video coding standard provides several error resilience tools, the damage caused by error propagation may still be tremendous. This work is aimed at developing a robust and standard-compliant error resilient coding scheme for H.264and uses techniques of mode decision, data hiding, and error concealment to reduce the damage from error propagation. This paper proposes a system with two error resilience techniques that can improve the robustness of H.264 in noisy channels. The first technique is Nearest Neighbor motion compensated Error Concealment (NNEC) that chooses the nearest neighbors in the reference frames for error concealment. The second technique is Distortion Estimated Mode Decision (DEMD) that selects an optimal mode based on stochastically distorted frames. Observed simulation results showed that the rate-distortion performances of the proposed algorithms are better than those of the compared algorithms.

Frame loss error concealment for SVC

Scalable video coding (SVC), as the Scalable Extension of H.264/AVC, is an ongoing international video coding standard designed for network adaptive or device adaptive applications and also offers high coding efficiency. However, packet losses often occur over unreliable networks even for base layer of SVC and have severe impact on the playback quality of compressed video. Until now, no literature has discussed error concealment support for standard SVC bit-stream. In this paper, we provide robust and effective error concealment techniques for SVC with spatial scalability. Experimental results showed that the proposed methods provide substantial improvement, both subjectively and objectively, without a significant complexity overhead.

Error concealment in pixel based Wyner-Ziv video coding

In the Wyner-Ziv(WZ) video coding paradigm, a virtual correlation channel is assumed between the quantized source and the side information(SI) at the decoder, and channel coding is applied to achieve compression. In this paper, errors caused by the virtual correlation channel are addressed and an error concealment approach is proposed for pixel-based WZ video coding. In the approach, errors after decoding are classified into two types. Type 1 errors are caused by residual bit errors after channel decoding, while type 2 errors are due to low quality of SI in part of a frame which causes SI not lying within the quantization bin of a decoded quantized pixel value. Two separate strategies are respectively designed to detect and conceal the two types of errors. Simulations are carried out and results are presented to demonstrate the effectiveness of the proposed approach.

Analysis and application of error concealment tools in AVS-M decoder

Audio Video coding Standard (AVS) is the latest audio and video coding standard of China. AVS Part 7 (also known as AVS-M) targets mobility applications where error concealment is of great importance. This paper first briefly introduces the general concept of error concealment. Then two error concealment schemes are proposed and implemented on AVS-M decoder under different test conditions. Simulation results of the schemes and suggestions on how to use these tools are also provided.

Content-adaptive robust error concealment for packet-lossy H.264 video streaming

In this paper, we present a spatio-temporal post-processing error concealment (EC) algorithm designed initially for a H.264 video-streaming scheme over packet-lossy networks. It aims at optimizing the subjective quality of the restored video under the constraints of low delay and computational complexity, which are critical to real-time applications and portable devices having limited resources. Specifically, it takes into consideration the physical property of motion field in order to achieve more meaningful perceptual video quality, in addition to the improved objective PSNR. Further, a simple bilinear spatial interpolation approach is combined with the improved boundary-match (B-M) based temporal EC approach according to texture and motion activity analysis. Finally, we propose a low complexity temporal EC method based on motion vector interpolation as a replacement of the B-M based approach in the scheme under low-computation requirement, or as a complement to further improve the scheme's performance in applications having enough computation resources. Extensive experiments demonstrated that the proposal features not only better reconstruction, objectively and subjectively, than JM benchmark, but also robustness to different video sequences.

Temporal Shape Error Concealment for Video Objects

A novel temporal shape error concealment technique is proposed, which can he used in the context of object-based video coding schemes. In order to reduce the effect of the shape variations of a video object, the curvature scale space （CSS） technique is adopted to extract features, and then these features are used for boundary matching between the current frame and the previous frame. Because the temporal, spatial and sta- tistical video contour information are all considered, the proposed method can find the optimal matching, which is used to replace the damaged contours. The simulation results show that the proposed algorithm achieves better subjective, objective qualities and higher efficiency than those previously developed methods.

A NOVEL TEMPORAL ERROR CONCEALMENT METHOD BASED ON FUZZY REASONING FOR H.264

In this paper,a fuzzy reasoning based temporal error concealment method is proposed. The basic temporal error concealment is implemented by estimating Motion Vector (MV) of the lost MacroBlock (MB) from its neighboring MVs. Which MV is the most proper one is evaluated by some criteria. Generally,two criteria are widely used,namely Side Match Distortion (SMD) and Sum of Absolute Difference (SAD) of corresponding MV. However,each criterion could only partly describe the status of lost block. To accomplish the judgement more accurately,the two measures are considered together. Thus a refined measure based on fuzzy reasoning is adopted to balance the effects of SMD and SAD. Terms SMD and SAD are regarded as fuzzy input and the term ‘similarity’ as output to complete fuzzy reasoning. Result of fuzzy reasoning represents how the tested MV is similar to the original one. And k-means clustering technique is performed to define the membership function of input fuzzy sets adaptively. According to the experimental results,the concealment based on new measure achieves better performance.

A MODIFIED EDGE-ORIENTED SPATIAL INTERPOLATION ALGORITHM FOR CONSECUTIVE BLOCKS ERROR CONCEALMENT

This paper proposes a low-complexity spatial-domain Error Concealment (EC) algorithm for recovering consecutive blocks error in still images or Intra-coded (I) frames of video sequences. The proposed algorithm works with the following steps. Firstly the Sobel operator is performed on the top and bottom adjacent pixels to detect the most likely edge direction of current block area. After that one-Dimensional (1D) matching is used on the available block boundaries. Displacement between edge direction candidate and most likely edge direction is taken into consideration as an important factor to improve stability of 1D boundary matching. Then the corrupted pixels are recovered by linear weighting interpolation along the estimated edge direction. Finally the interpolated values are merged to get last recovered picture. Simulation results demonstrate that the proposed algorithms obtain good subjective quality and higher Peak Signal-to-Noise Ratio (PSNR) than the methods in literatures for most images.

SPATIAL ERROR CONCEALMENT BASED ON MOJETTE TRANSFORM

This letter presents a novel spatial error concealment algorithm for the H.264 video coding. The error concealment algorithm is based on directional interpolation. Mojette transform is used to estimate the orientation features of the damaged blocks,and the image is interpolated in the appro-priate directions. The proposed method is compared with bilinear interpolation algorithm in the ref-erence implementation of H.264 and all directional interpolation. Experimental results prove that the proposed algorithm has better subjective and objective image reconstruction quality.

Reawakened Sexual Interest: The Result of Surgical Correction of Concealed Penis

Concealed penis (CP) is a developmental anomaly in which the penis is hidden in the skin of the abdomen, thigh or scrotum. As a result of this, the penis appears shortened in length. It was first described by Keyes Jr. E.L. in 1919. It can be associated with voiding problem and in adults, sexual issues, among others. Objective: To show that surgery can reverse celibacy induced by CP and highlight the need for an interdisciplinary approach to correction of this anomaly. Patient and Method: A thirty-one-year male patient who had a surgical release of his buried penis by two surgeons in 2019 in a private hospital. The case note was reviewed, the data obtained analyzed and the results including photographs, were presented. The patient was followed up. Result: A 10 cm length of penis and a hundred percent (100%) take of sheet of split skin graft used to resurface the denuded penis were achieved using combined spinal and epidural anesthesia. The patient, his mother and the surgeons were satisfied with the outcome. Consequently, he resolved to marry a wife after all. Conclusion: Concealed penis can now be regarded as a known cause of celibacy and surgical correction can reverse the celibate state.

Temporal Error Concealment Technique for MPEG-4 Video Streams

有关在 MPEG-4 录像广泛地采用的 inter4v 模式，为 MPEG-4 录像序列的一个新时间的错误隐匿计划被建议，它能有选择地插入内推为失踪的宏块(MB ) 的一或四运动向量(MV ) 根据编码模式的估计的 MB。建议计划的性能与有以不同小点错误率的多重严峻的序列的存在计划相比。试验性的结果证明建议算法能掩盖为不同小点误差率消费更多的时间传动误差比 0 MV 和平均 MV 方法更高效地引起的缺陷。由匹配的选择运动向量(SMVM ) 获得了算法，这有可接受的图象质量到近，当拿操作的周期的不到一半时。建议隐匿计划对低复杂性 videoreal 时间实现合适。

Network-aware perceptual error concealment method for H.264 video with side information

In order to improve the video quality of transmission with data loss,a spatial and temporal error concealment method was proposed,which considered both the state information of the network and the perceptual weight of the video content.The proposed method dynamically changed the reliability weight of the neighboring macroblock,which was used to conceal the lost macroblocks according to the packet loss rate of the current channel state.The perceptual weight map was utilized as side information to do weighted pixel interpolation and side-match based motion compensation for spatial and temporal error concealment,respectively.And the perceptual weight of the neighboring macroblocks was adaptively modified according to the perceptual weight of the lost macroblocks.Compared with the method used in H.264 joint model,experiment results show that the proposed method performs well both in subjective video quality and objective video quality,and increases the average peak signal-to-noise ratio(PSNR) of the whole frame by about 0.4 dB when the video bitstreams are transmitted with packets loss.

基于断层量化隐伏型煤矿基岩含水层水化学空间演化机制研究

地质构造是控制地下水化学场形成的关键因子,但由于其类型、性质和组合方式存在较大差异,致使定量表征地质构造对含水层水化学空间演化是个难点问题,亟待解决。本文以典型隐伏型煤田——淮北煤田袁店一矿的二叠系主采煤层砂岩裂隙含水层(简称“煤系”)和石炭系太原组灰岩岩溶裂隙含水层(简称“太灰”)为研究对象,基于主成分分析和离子比例分析,阐明控制含水层水化学空间演化的关键因素,利用断层复杂系数量化地质构造对地下含水层水-岩作用的影响,揭示袁店一矿水化学空间演化机制。研究结果表明,袁店一矿煤系主要水-岩作用为阳离子交替吸附与脱硫酸,太灰主要水-岩作用为碳酸盐溶解与黄铁矿氧化。袁店一矿东部断层复杂系数平均值为0.56,中部为0.61,西部为0.71。随着断层复杂系数平均值的增加,断层愈发育,煤系在袁店一矿主要水-岩作用阳离子交替吸附与脱硫酸有向非碳酸盐溶解转变的趋势;太灰在袁店一矿主要水-岩作用碳酸盐溶解与黄铁矿氧化有进一步增强的趋势。研究成果为研究华北隐伏型煤田地下水化学演化的构造控制机制提供了新思路,奠定了良好的理论基础。

双层带钢板暗支撑装配整体式混凝土剪力墙抗震性能研究

为研究带钢板暗支撑装配整体式混凝土剪力墙的抗震性能,设计制作1片双层带钢板暗支撑装配整体式混凝土剪力墙和1片双层带钢板暗支撑现浇混凝土剪力墙,其中装配整体式剪力墙内置钢板暗支撑在墙身与基础梁和上下墙身水平连接节点处采用双面角焊缝连接以适应施工时的安装尺寸冗余度要求。对试件进行低周反复加载试验,结果表明:采用双面角焊缝连接预制墙身内置钢板暗支撑可以适应较大的施工冗余度,并且保证暗支撑传力的可靠性;装配整体式剪力墙具有和现浇剪力墙等同的水平承载力、刚度退化水平和耗能能力;2个构件均为弯曲破坏,但装配整体式剪力墙在一层墙体后浇带与预制墙身接缝处也产生塑性铰。

被遮蔽的从属性:“互联网+劳动关系”的关键内核及其协调策略--以外卖骑手作为观察对象

围绕外卖骑手与互联网平台之间能否形成劳动法意义上的劳动关系,存在着否定性意见、肯定性意见、观望性意见三种差异化观点。从实然状态来看,在表象上,互联网平台与专送骑手和众包骑手之间均不存在或难以存在从属性。从应然状态来看,一方面,外卖骑手不仅仅在现实世界中的流通环节提供送餐行为,更在与之平行的虚拟世界或数字世界的生产环节中生产具有价值的数据,另一方面,人的逻辑和算法逻辑的冲突,背后的“从属性”实像被互联网及技术所遮蔽和掩盖,由此亟待揭开互联网平台与外卖骑手之间的“隐蔽从属性”并适用劳动法调整。但即使立法层面采纳“隐蔽从属性”的观点和理由,确认互联网平台与外卖骑手之间存在劳动关系,也依旧需要对劳动法进行一个相当程度甚至颠覆性的改造和重塑。同时,辅之严禁“最严算法”、适用“算法取中”、实现“算法透明”、发挥“算法伦理”,以充分塑造“新”的劳动秩序。

文野之别:现代伦理何以可能成为人类文明之道

现代伦理在人类世俗化生活世界中以普遍的人性、自然法、个体自由、科学理性和公益与私益的权利为基础,才真正表达了现代人道义实存的方式,从而成为普遍文明的方向。但无论人文主义运动、宗教改革运动还是启蒙运动,都在弘扬一种道义,从而将这种特殊道义上升为“唯一”伦理基础,在成为“定言命令”进程中也同时导致了文化的野蛮化甚至普遍的战争,这是伦理善的一种自身隐匿性。伦理的文野之别,是善的规范有效性与自身隐匿性不可避免地造成的现象。如何解决这一矛盾,是伦理学史为人类文明发展提出的严峻问题。

论掩饰、隐瞒犯罪所得、犯罪所得收益罪的入罪边界

掩隐罪的适用在全链条打击电诈犯罪过程中发挥着重要作用,司法适用率激增。罪刑法定原则要求掩隐罪有明确的入罪边界,以便准确区分罪与非罪、此罪与彼罪。经由实质解释可知,掩隐罪的保护法益包含司法识别与司法追缴二重构造。根据该二重构造可将掩隐罪的客观行为类型化,并据此合理划定掩隐罪中“其他方法”的边界,以及为主观明知的认定归纳出清晰的判断规则。共同犯罪的本质是团体性。掩隐罪与上游犯罪共犯的区分标准在于,双方之间是否形成了能够期待协同互助且具有一定拘束力的意思联络。

网络传销犯罪行为的司法实践现状及认定研究

互联网时代,信息技术的迅猛发展为传销犯罪行为滋生营造了更为隐蔽化、虚拟化的网络空间。网络传销犯罪行为具有隐蔽性极强、执法难度大;行为专业化、极具迷惑性;犯罪成本低、涉案地域广;手段复杂化、识别难度大等基本特征,据此从司法实践层面入手进行网络传销犯罪行为规制十分必要。当前网络传销犯罪行为司法实践存在组织层级认定标准尚待明确、共犯形态认定存在不确定性、针对骗取行为刑法界看法不一、犯罪重合性影响罪数处理结果等若干问题,文章从犯罪故意,明确违法性认知对象;共犯认定,明晰网络传销共犯法律责任;明确界限,科学划分网络传销犯罪和合法经验;罪数认定,规避司法适用存在的错误等方面提出有效实践路径。