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.

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.

The Analysis Method of Time Reversal for Defect Diagnosis of Concealed Structure

In this paper, a new method of time reversal for defect diagnosis of concealed structure has been proposed based on the detecting technique of structure acoustic wave and the theory of time reversal. The time reversal recurrence formula for detecting the acoustic wave speed constitution of concealed structures with bilevel asynchronous test has been established. The wave speed constitution can be reconstructed in 2 D graticule form by means of this method. The result of model test shows the method is valid.

Technique of Error Concealment for Block-Based Image Coding Using Genetic Algorithm

Since real world communication channels are not error free, the coded data transmitted on them may be corrupted, and block based image coding systems are vulnerable to transmission impairment. So the best neighborhood match method using genetic algorithm is used to conceal the error blocks. Experimental results show that the searching space can be greatly reduced by using genetic algorithm compared with exhaustive searching method, and good image quality is achieved. The peak signal noise ratios(PSNRs) of the restored images are increased greatly.

Shielding Effectiveness of Rural Concealed Communication Cable of Asymmetric/Symmetric Slots with Different Shapes

With the rural concealed communication cable as the study object, the shielding effectiveness of different slot shapes was analyzed by using LBEM （linear boundary element method）. The engineering example results showed that for twocore shielded cable, the coupling capacitance of trapezoid slots （asymmetric and symmetric） changed the most, followed by rectangular slots （asymmetric and symmetric）, and the changes of wedge slots were the smallest, but the change tenden- cies were consistent. In addition, with the increase of slot width of different slots, the coupling capacitance of tow-cored shielded cable showed small change.

A New Method Searching for Concealed Mineral Resources: Geogas Prospecting Based on Nuclear Analysis and Accumulation Sampling

Geogas prospecting is a new method in the search for deep and/or concealed mineral deposits.The probing depth of the method comes to 300-500 m below the surface. The method, based on nuclear aualysis and accumulation sampling, has matured and become useful method of geogas prospecting, through authors' studies more than 10 years. The study of the mechanism for geogas prospecting has also been progressed. It bas been revealed that the geogas matter is in the form of nano-scale particles of the ores by the observation of scanning electron microscope (SEM). This paper summarizes the feature of the geogas anomaly, and describes its forming mechanism. A new example using geogas prospecting is given.

An attribute recognition model for safe thickness assessment between concealed karst cave and tunnel

An attribute recognition model for safe thickness assessment between a concealed karst cave and a tunnel is established based on the attribute mathematic theory.The model can be applied to carrying out risk classification of the safe thickness between a concealed karst cave and a tunnel and to guarantee construction’s safety in tunnel engineering.Firstly,the assessment indicators and classification standard of safe thickness between a concealed karst cave and a tunnel are studied based on the perturbation method.Then some attribute measurement functions are constructed to compute the attribute measurement of each single index and synthetic attribute measurement.Finally,the identification and classification of risk assessment of safe thickness between a concealed karst cave and a tunnel are recognized by the confidence criterion.The results of two engineering application show that the evaluation results agree well with the site situations in construction.The results provide a good guidance for the tunnel construction.

Frame erasure concealment in wideband speech coding based on large hidden Markov model

Frame erasure concealment is studied to solve the problem of rapid speech quality reduction due to the loss of speech parameters during speech transmission. A large hidden Markov model is applied to model the immittance spectral frequency （ISF） parameters in AMR-WB codec to optimally estimate the lost ISFs based on the minimum mean square error （MMSE） rule. The estimated ISFs are weighted with the ones of their previous neighbors to smooth the speech, resulting in the actual concealed ISF vectors. They are used instead of the lost ISFs in the speech synthesis on the receiver. Comparison is made between the speech concealed by this algorithm and by Annex I of G. 722. 2 specification, and simulation shows that the proposed concealment algorithm can lead to better performance in terms of frequency-weighted spectral distortion and signal-to-noise ratio compared to the baseline method, with an increase of 2.41 dB in signal-to-noise ratio （SNR） and a reduction of 0. 885 dB in frequency-weighted spectral distortion.

Collapse mode of rock mass induced by a concealed karst cave above a deep cavity

Reliable prediction of the potential collapse region of rock mass is a key challenge for deep underground cavity excavation, especially if a concealed karst cave is located above the excavated cavity. Because of the effect of the blast vibration, a possible collapse would occur at a certain region between the concealed karst cave and the excavated cavity. This paper aims to study the roof collapse of a deep buried cavity induced by a concealed karst cave base on a two-dimensional failure mechanism by using upper bound theorem. The failure mechanism is constituted by arbitrary curves which is similar to the collapse observed in an actual cavity excavation. The shape and range of the collapse block is determined by virtual work equation in conjunction with variational approach. The results obtained by the presented approach are approximate with the numerical results provided by finite difference code, which indicates that the proposed method in this work is valid.

Research on seismic performance of shear walls with concrete filled steel tube columns and concealed steel trusses

In order to further improve the seismic performance of RC shear walls, a new composite shear wall with concrete filled steel tube （CFT） columns and concealed steel trusses is proposed. This new shear wall is a double composite shear wall; the first composite being the use of three different force systems, CFT, steel truss and shear wall, and the second the use of two different materials, steel and concrete. Three 1/5 scaled experimental specimens： a traditional RC shear wall, a shear wall with CFT columns, and a shear wall with CFT columns and concealed steel trusses, were tested under cyclic loading and the seismic performance indices of the shear walls were comparatively analyzed. Based on the data from these experiments, a thorough elastic-plastic finite element analysis and parametric analysis of the new shear walls were carried out using ABAQUS software. The finite element results of deformation, stress distribution, and the evolution of cracks in each phase were compared with the experimental results and showed good agreement. A mechanical model was also established for calculating the load-carrying capacity of the new composite shear walls. The results show that this new type of shear wall has improved seismic performance over the other two types of shear wails tested.

Quantitative analysis of geological ore-controlling factors and stereoscopic quantitative prediction of concealed ore bodies

To address the issues for assessing and prospecting the replaceable resource of crisis mines, a geological ore-controlling field model and a mineralization distribution field model were proposed from the viewpoint of field analysis. By dint of solving the field models through transferring the continuous models into the discrete ones, the relationship between the geological ore-controlling effect field and the mineralization distribution field was analyzed, and the quantitative and located parameters were extracted for describing the geological factors controlling mineralization enrichment. The method was applied to the 3-dimensional localization and quantitative prediction for concealed ore bodies in the depths and margins of the Daehang mine in Guangxi, China, and the 3-dimensional distribution models of mineralization indexes and ore-controlling factors such as magmatic rocks, strata, faults, lithology and folds were built. With the methods of statistical analysis and the non-linear programming, the quantitative index set of the geological ore-controlling factors was obtained. In addition, the stereoscopic located and quantitative prediction models were set up by exploring the relationship between the mineralization indexes and the geological ore-controlling factors. So far, some concealed ore bodies with the resource volume of a medium-sized mineral deposit are found in the deep parts of the Dachang Mine by means of the deep prospecting drills following the prediction results, from which the effectiveness of the predication models and results is proved.

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.

Element analysis method of concealed explosive based on TNA

The detection technology of concealed bulk explosives is related to social security and national defense construction and has important research significance. In this paper, an element analysis method of concealed explosives based on thermal neutron analysis is proposed.This method could provide better reconstruction precision for hydrogen, carbon, and nitrogen ratios, making it possible to discriminate explosives from other compounds with the same elements but different proportions, as well as to identify the types of concealed bulk explosives. In this paper, the basic principles and mathematical model of this method are first introduced, and the calculation formula of the element number ratio(the ratio between the nucleus numbers of two different elements) of the concealed explosive is deduced. Second, a numerical simulation platform of this method was established based on the Monte Carlo JMCT code. By calibrating the absorption efficiencies of the explosive device to c rays, the element number ratios of a concealed explosive model under the irradiation of thermal neutrons were reconstructed from the neutron capture prompt c-ray spectrum. The reconstruction values were in good agreement with the actual values,which shows that this method has a high reconstruction precision of the element number ratio for concealed explosives. Lastly, it was demonstrated using the simulation study that this method can discriminate explosives,drugs, and common materials, with the capability of determining the existence of concealed bulk explosives and identifying explosive types.

Holocene Floral and Faunal Remains Revealed Concealed Neotectonic Disturbance (Saria Tal, Kumaun Himalaya, India)

Palynological and paleontological investigations supported by the radiocarbon dates of the lacustrine sediments of two profiles from the temperate lake Saria Tal, in Naini Tal District, Kumaun Himalaya, have revealed the presence of a concealed fold at the region. The profile from bore cores represents the upper part of the Late Holocene and the profile from exposed sections from the Middle Holocene to the over middle part of the Late Holocene. The data generated from different investigations have uniformly indicated that the former profile represents normal superposition, while the latter represents the reverse order. The contemporary pollen as well as molluscan zones of both profiles are situated at different elevations but consist of similar bioremains - indicating continuation of the same strata in two profiles. The presence of reverse order of superposition, continuation of the same strata in two profiles at different elevations, and the orientation of biozones, have indicated that the revealed folding is of syncline type. The present study has also given an idea about the origin of this lake.

concealed代数的grothendieck群的生成关系

考虑concealed代数grothendieck群的生成关系,给出了concealed代数grothendieck群的生成关系群的一个基.

Application of Optically Stimulated Luminescence Technique in Exploring a Concealed Sandstone-type Uranium Deposit

Identifying ore-induced geochemical anomalies at the surface that indicate concealed deposits in buried areas remains a significant challenge in geochemical exploration. In this study, in order to trace the source of the geochemical anomalies, systematic luminescence intensity analyses were conducted on quartz grains from the Quaternary regolith at the Hadatu sandstone-type uranium deposit in the Erenhot Basin. The optically stimulated luminescence(OSL) ages were much older than the depositional ages of the Quaternary regolith. Moreover, quartz OSL ages were closely related to both borehole grades and sampling depths. Thus, the abnormal mineral OSL ages from near-surface sediments were ultimately controlled by the sandstone-type uranium deposits. This is identical to the rapid changes of quartz OSL ages(0.063 ka/cm) and equivalent doses(0.19 Gy/cm) with depths in a given sampling site. The instantaneous soil radon concentration was positively correlated with the quartz OSL apparent age, indicating their ore-induced origin and, as a result, their effectiveness in the exploration of concealed uranium deposits. Other parameters, including mobile-state uranium and;Po contents, were poorly correlated with quartz OSL ages and therefore should only be used with caution for geochemical exploration. This is the first time an attempt has been made to discriminate the ore-induced sources for different surface anomaly parameters, including instantaneous soil radon, mobile-state uranium and;Po contents for concealed sandstonetype uranium deposits.

Application of Tectono Geochemical Study in Deep Concealed Ore Body Exploration--As the Huize Super-Large Lead-Zinc Deposit an exemple

1 Geological Background of Minerlization or Geologic Setting The northeast of Yunnan1 Pb-Zn-Ag-Ge polymetallic ore district is an important part of the southwestern margin of the Yangtze block Sichuan-Yunnan-Guizhou

Identification of the Concealed Structures in the Beiya Area of Western Yunnan

The interpretation of regional gravity and magnetic data, especially the extracted information about concealed targets and structures, provide important evidence for geological structure research, oil-gas resource assessment, mineral potential forecast and prospective area delineation. Several interpretation methods have been proposed to determine structural boundary, including vertical derivative, horizontal first-order derivative, total horizontal derivative, total gradient modulus, tilt derivative, and theta graph, and each have their advantages and disadvantages. This study used the tilt derivate method to obtain bouguer gravity anomalies in the Beya area, as shown in Fig. 1a.

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.