bluuebunny/crossref_metadata_2025 huggingface dataset:
A Complex Chained P System Based on Evolutionary Mechanism for Image Segmentation
Authors: Liu Xiyu , Wang Lin , Qu Jianhua , Wang Ning
Published: August 2020

A new clustering membrane system using a complex chained P system (CCP) based on evolutionary mechanism is designed, developed, implemented, and tested. The purpose of CCP is to solve clustering problems. In CCP, two kinds of evolution rules in different chained membranes are used to enhance the global search ability. The first kind of evolution rules using traditional and modified particle swarm optimization (PSO) clustering techniques are used to evolve the objects. Another based on differential evolution (DE) is introduced to further improve the global search ability. The communication rules are adopted to accelerate the convergence and avoid prematurity. Under the control of evolution-communication mechanism, the CCP can effectively search for the optimal partitioning and improve the clustering performance with the help of the distributed parallel computing model. This proposed CCP is compared with four existing PSO clustering approaches on eight real-life datasets to verify the validity. The computational results on tested images also clearly show the effectiveness of CCP in solving image segmentation problems.
Research on Multijoint Rock Failure Mechanism Based on Moment Tensor Theory
Authors: Chai J. F.
Published: August 2020

To reveal the influence of the number and location of joints on rock failure mechanism, using Particle Flow Code (PFC) to simulate the calculation of a large amount of acoustic emission data generated during breeding, development, and penetration of rock cracks, the fracture parameters such as the spatial location, rupture azimuth, rupture type, stress state, and moment magnitude of acoustic emission events in various fracture stages of multijoint rock were studied based on the moment tensor theory, the P-T diagram method, and the T-k diagram method. It will be of great importance in the geotechnical engineering field.
Dynamic Multi-Swarm Differential Learning Quantum Bird Swarm Algorithm and Its Application in Random Forest Classification Model
Authors: Zhang Jiangnan , Xia Kewen , He Ziping , Fan Shurui
Published: August 2020

Bird swarm algorithm is one of the swarm intelligence algorithms proposed recently. However, the original bird swarm algorithm has some drawbacks, such as easy to fall into local optimum and slow convergence speed. To overcome these short-comings, a dynamic multi-swarm differential learning quantum bird swarm algorithm which combines three hybrid strategies was established. First, establishing a dynamic multi-swarm bird swarm algorithm and the differential evolution strategy was adopted to enhance the randomness of the foraging behavior’s movement, which can make the bird swarm algorithm have a stronger global exploration capability. Next, quantum behavior was introduced into the bird swarm algorithm for more efficient search solution space. Then, the improved bird swarm algorithm is used to optimize the number of decision trees and the number of predictor variables on the random forest classification model. In the experiment, the 18 benchmark functions, 30 CEC2014 functions, and the 8 UCI datasets are tested to show that the improved algorithm and model are very competitive and outperform the other algorithms and models. Finally, the effective random forest classification model was applied to actual oil logging prediction. As the experimental results show, the three strategies can significantly boost the performance of the bird swarm algorithm and the proposed learning scheme can guarantee a more stable random forest classification model with higher accuracy and efficiency compared to others.
Midregional Proadrenomedullin (MRproADM) Serum Levels in Critically Ill Patients Are Associated with Short-Term and Overall Mortality during a Two-Year Follow-Up
Authors: Buendgens Lukas , Yagmur Eray , Ginsberg Axel , Weiskirchen Ralf , Wirtz Theresa , Jhaisha Samira Abu , Eisert Albrecht , Luedde Tom , Trautwein Christian , Tacke Frank , Koch Alexander
Published: August 2020

Adrenomedullin (ADM) is a peptide with pleiotropic effects in systemic inflammation. Its more stable precursor protein midregional proadrenomedullin (MRproADM) can be measured more reliably compared to ADM. Our objective was to investigate the potential role of MRproADM as a diagnostic and prognostic biomarker in critically ill patients at the intensive care unit (ICU). We therefore measured MRproADM in 203 ICU patients and 66 healthy controls. We found that MRproADM levels are significantly increased in critically ill patients as compared to healthy controls. MRproADM levels are significantly increased in patients with sepsis, but its diagnostic value for identifying sepsis is numerically lower than that of established markers (e.g., interleukin-6, C-reactive protein, and procalcitonin). MRproADM levels are closely correlated to endothelial and organ dysfunction, inflammation, and established clinical scores (APACHE II, SOFA, and SAPS2). MRproADM concentrations correlate with vasopressor use but not fluid balance. Increased MRproADM levels (cut−off>1.4 nmol/L) in critically ill patients are independent predictors of ICU and overall mortality during a follow-up of up to 26 months (OR 3.15 for ICU mortality, 95% CI 1.08-9.20, p=0.036; OR for overall mortality 2.4, 95% CI 1.12-5.34, p=0.026). Our study demonstrates the potential of MRproADM serum levels as a prognostic biomarker in critical illness for ICU mortality and long-term survival during follow-up.
Promotion of Bone Formation by Red Yeast Rice in Experimental Animals: A Systematic Review and Meta‐Analysis
Authors: Wu Bin , Huang Jie-Feng , He Bang-Jian , Huang Chen-Wei , Lu Jian-Hua
Published: August 2020

Objective. To systematically evaluate the effects of red yeast rice (RYR) and its extract on bone formation in experimental animals and to provide reference data for clinical research on the treatment of osteoporosis. Methods. Chinese and English language databases, including Web of Science, PubMed, the Cochrane Library, Elsevier, Google Scholar, SpringerLink, Embase, China National Knowledge Infrastructure (CNKI), Weipu Chinese Sci‐tech periodical full‐text database (VIP), and Wanfang Data Knowledge Service Platform (Wanfang), were searched from their establishment to February 2020 using the following terms: “hongqu,” “red yeast rice,” “Monascus purpureus‐fermented rice,” “bone mineral density,” “osteoblast,” “osteoporosis,” and “animal models.” After excluding nonrelevant articles, Review Manager 5.2 was used to evaluate article quality and to analyze the data. Outcome indicators included bone mineral density (BMD), osteoblast proliferation, and the expression of alkaline phosphatase (ALP). Results. A total of 11 randomized controlled trials were included in the meta‐analysis, all of which were animal studies. Six studies included data on BMD, five on osteoblast proliferation, and six on the expression of ALP. The results of the meta‐analysis showed that RYR can significantly improve BMD (standardized mean difference (SMD) = 3.12, 95% confidence interval (CI) 1.41 to 4.83, P = 0.0003), promote osteoblast proliferation (SMD = 1.64, 95% CI 1.04 to 2.23, P < 0.00001), and increase ALP expression in rats (SMD = 1.25, 95% CI 0.69 to 1.80, P < 0.00001). Conclusions. RYR can promote bone formation in experimental animals and may be useful for the treatment of osteoporosis.
Phenotypic Characterization of Tiger Nuts (Cyperus esculentus L.) from Major Growing Areas in Ghana
Authors: Asare Paul Agu , Kpankpari Roger , Adu Michael Osei , Afutu Emmanuel , Adewumi Adeyinka Saburi
Published: August 2020

Tigernut (Cyperus esculentus Lativum) is an important but understudied and underutilized crop in Ghana. The tubers are highly appreciated for their health benefits and nutritive value. To contribute to the conservation process of tiger nut and identify elite genotypes, this study was conducted to assess phenotypic variability in tiger nut genotypes in Ghana. Sixty-four (64) genotypes were collected from major tiger nut growing areas in Ghana. The genotypes were field-grown and characterized based on phenotypic and yield traits. Similarity coefficient (Bray-Curtis) was between 0.82 and 0.98, indicating low variability in both qualitative and quantitative characters. The cophenetic correlation coefficient was 0.64. The genotypes were mainly brown with only a few black (6) tubers from the central region. Materials collected from parts of the eastern region (Aduamoah) generally recorded the highest tuber weight. Tuber weight depended on plant height and number of tillers. There were high tillering genetic materials among the genotypes. Tubers were categorised as oval (10), ovoid (33), or oblong (15). The genotypes clustered into two groups based on shoot and tuber characteristics, rather than on geographical origin. The low genetic diversity among the genotypes suggested either the possible existence of a network among tiger nut farmers in Ghana in circulating the planting material or some form of seed sorting for uniform and homogenous planting materials has been carried out over the years. Our results point to the imperativeness to expand the genetic base of the tiger nuts to facilitate its improvement in Ghana.
The Predictive Effectiveness of Blood Biochemical Indexes for the Severity of COVID-19
Authors: Zhou Yingchu , Li Bo , Liu Jiyang , Chen Dong
Published: August 2020

Objective. We aimed to explore the predictive effectiveness of blood biochemical indexes for COVID-19 severity. Method. We retrospectively analyzed the clinical data of COVID-19 patients who were cured and discharged from the Public Health Treatment Center of Changsha from January 30, 2020, to February 19, 2020. According to the clinical classification of the disease, the patients were divided into severe and nonsevere groups. General clinical data and underlying medical conditions were recorded through the electronic medical record (EMR) system. Laboratory examination results of the patients during their hospitalization were collected, including the first results for erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), peripheral blood lymphocyte ratio and count, and peripheral blood white blood cell (WBC) count. Univariate and multivariate logistic regression models were used to analyze the predictive effectiveness of blood biochemical indexes and other related factors for COVID-19 severity. Result. In all, 108 COVID-19 patients (median age: 43.9 years (range: 1–75); male patients: 56 (51.85%)) were enrolled, of whom 24 (22.22%) showed severe disease and 84 (77.78%) showed nonsevere disease, and two in 24 patients with severe disease developed into a critically severe type and died. Fever was the most common onset symptom (67.59%), followed by cough (48.15%) and fatigue (37.04%). Comorbidities were important factors affecting the severity of COVID-19, and among the patients with severe disease, the proportion with comorbidities was 70.83%, and the proportion without comorbidities was 29.17%. The intergroup difference was significant P<0.05. In patients with CRP levels (mg/L) of ≤8, >8–≤20, >20–≤40, and >40, the proportions of those with severe and nonsevere disease were 0 to 32, 7 to 19, 6 to 23, and 11 to 10, respectively; the intergroup difference was significant P<0.05. Conclusion. The presence or absence of comorbidities and CRP elevation were independent significant predictors of COVID-19 severity, and hypertension was found as the most common comorbidity in patients with severe disease.
Research on Identification Technology of Explosive Vibration Based on EEMD Energy Entropy and Multiclassification SVM
Authors: Ma Huayuan , Li Xinghua , Liu Qiang , Xingbo Xie , Ji Chong , Zhao Changxiao
Published: August 2020

In this study, the authors introduced energy entropy as a reference feature into the field of blast vibration recognition classification and achieved good results. On the basis of the previous experimental database, 4 kinds of typical vibration signals were selected to form the sample group (building collapse vibration, surface rock blast vibration, underground tunnel blast vibration, and natural gas pipeline explosion vibration). EEMD (ensemble empirical mode decomposition) algorithm was used to calculate the energy entropy of each signal. Taking eigenvector composed of CEE (components of energy entropy) as input, multiclassification SVM algorithm was used for training and prediction. Prediction accuracy was more than 80%. Compared with BP (backpropagation) neural network algorithm, SVM (support vector machine) algorithm has higher training efficiency. The research results can be used in urban vibration monitoring, identify the nature of vibration source in time, and provide technical support for rapid response of emergency rescue.
Image Denoising Using Sparsifying Transform Learning and Weighted Singular Values Minimization
Authors: Zhao Yanwei , Yang Ping , Guan Qiu , Zheng Jianwei , Wang Wanliang
Published: August 2020

In image denoising (IDN) processing, the low-rank property is usually considered as an important image prior. As a convex relaxation approximation of low rank, nuclear norm-based algorithms and their variants have attracted a significant attention. These algorithms can be collectively called image domain-based methods whose common drawback is the requirement of great number of iterations for some acceptable solution. Meanwhile, the sparsity of images in a certain transform domain has also been exploited in image denoising problems. Sparsity transform learning algorithms can achieve extremely fast computations as well as desirable performance. By taking both advantages of image domain and transform domain in a general framework, we propose a sparsifying transform learning and weighted singular values minimization method (STLWSM) for IDN problems. The proposed method can make full use of the preponderance of both domains. For solving the nonconvex cost function, we also present an efficient alternative solution for acceleration. Experimental results show that the proposed STLWSM achieves improvement both visually and quantitatively with a large margin over state-of-the-art approaches based on an alternatively single domain. It also needs much less iteration than all the image domain algorithms.
A Case of Von Hippel–Lindau Disease with Bilateral Pheochromocytoma and Ectopic Hypersecretion of Intact Parathyroid Hormone in an Adolescent Girl
Authors: Belaid Rym , Oueslati Ibtissem , Chihaoui Melika , Yazidi Meriem , Grira Wafa , Chaker Fatma
Published: August 2020

Von Hippel–Lindau disease is an autosomal dominant inherited syndrome predisposing to a variety of highly vascularised tumors in different organs. Although bilateral pheochromocytoma was reported in patients with von Hippel–Lindau disease, the coexistence of primary hyperparathyroidism is not a common condition. We report an observation of a primary hyperparathyroidism secondary to an ectopic secretion of intact parathyroid hormone in a 17-year-old girl with von Hippel–Lindau disease and bilateral pheochromocytoma. She presented with a newly diagnosed diabetes mellitus and a severe arterial hypertension. Blood tests disclosed hypercalcemia with increased intact PTH level. Cervical ultrasound and sestamibi scintigraphy were normal. Twenty-four-hour urinary normetanephrine level was highly elevated pointing to a catecholamine-secreting tumor. The abdominal computed tomography showed bilateral adrenal masses. MIBG scintigraphy exhibited a high accumulation of the tracer in both adrenal tumors. Genetic testing revealed a mutation of the VHL gene. The patient underwent a bilateral adrenalectomy. The postoperative outcome was marked by normalization of blood pressure, blood glucose, calcium, and PTH levels. In our case, the elevation of intact PTH and its spontaneous normalization after surgical treatment of pheochromocytomas confirms its ectopic secretion.
Study on Supporting Structure Performance of Deep Soft Soil Foundation Pit near Sea under Waves, Tides, Vibration, and Unbalanced Loads
Authors: Chen Junsheng , Lin Chen , Liu Shuzhuo , Mo Haihong
Published: August 2020

In addition to the vibration loads caused by offshore structure construction, the offshore foundation pit can also be affected by additional hydraulic loads such as waves, tides, and typhoons, hindering our understanding of the mechanical performance of the foundation pit supporting structure. In order to illuminate this mechanical performance under waves, tides, hammering, and unbalanced loads, this paper analyzed the supporting structure with theoretical and numerical simulations. The results were verified with field monitoring data. Moreover, the influences of loads, including construction vibration loads and unbalanced loads, on structure and soil were discussed. By applying these results to the engineering design, this research could provide a reference for studying mechanical properties of relevant supporting structures and the construction of offshore foundation pits.
A Multifrequency Heterodyne Phase Error Compensation Method for 3D Reconstruction
Authors: Yu Zihao , Liu Jin , Yang Haima , Huang Bo , Jian Yumei
Published: August 2020

In view of the problem of “jumping points” in the phase unwrapping of the multifrequency heterodyne principle, this paper proposes a novel method to improve the multifrequency heterodyne. By solving the root-mean-square error of the original frequency function, it includes the relationship between the error and the adjacent phase in the condition of constrained phase unwrapping, and it compensates phase ±2π of the skip point. To ensure the accuracy of phase unwrapping, the function with a “jump point” after each phase unwrapping and the absolute phase curve of the principal value function are used to establish the threshold judgment model of the least square method, and the initial phase unwrapping of the principal value function with different frequencies is carried out continuously. The simulation analysis of phase compensation with the four-step phase-shifting method shows that the error is reduced to 36% under the set environment. The experimental result of 3D reconstruction by measuring the flatness of the plate shows that the error decreases by 41% after phase compensation compared with before phase compensation. The three-dimensional reconstruction experiment of pitch measurement with a nut shows that the nut after phase compensation is smooth without noise, and the pitch error is 0.033 mm, which verified the method is workable and effective.
Calculation on Bending Stiffness of RC Short Beam Strengthened by CFRP
Authors: Tingyan Wang , Yun Zhou , Junwei Zhang
Published: August 2020

Based on the bending tests of seven reinforced concrete (RC) short beams strengthened with carbon fiber reinforced polymer (CFRP), the bending stiffness curves of the whole process of the short beams strengthened with CFRP were obtained. The variation law of bending stiffness curve of short beam in the whole loading process was analyzed. Based on the reasonable calculation assumption, the calculation method of flexural rigidity of short reinforced concrete beams strengthened with CFRP sheets in the whole loading process was put forward. The comparison between the calculated value and the test value of bending stiffness showed that the calculation method of bending stiffness was reasonable and had high calculation accuracy. This calculation method can be used not only in the calculation of flexural rigidity of short reinforced concrete beams strengthened with CFRP sheets but also in the calculation of flexural rigidity of ordinary short reinforced concrete beams. The calculation method in this paper can provide a theoretical basis for the deformation calculation of reinforced concrete short beams strengthened with CFRP sheets.
Forecasting Disastrous Characteristics of Highway Landslides Using the Material Point Method: A Surcharge‐Induced Perspective
Authors: Wang Jian , Zhang Wei , Xie Chao-yang , Xiao Qian , Zhu Yu-chen , Pan Bo
Published: August 2020

Precisely forecasting the disastrous characteristics of landslides can address the optimized preliminary design of the highway landslide stabilization. In this paper, taking the surcharge‐induced landslides as an example, we developed the models of the material point method (MPM), a novel meshless numerical method, to calculate the large deformation of the highway landslides, with the affordable computing power. After convincing verification of the MPM model to simulate a surcharge‐induced soil landslide, 32 typical postfailure scenarios were analyzed to obtain the highway landslide run‐out processes and disastrous characteristics, such as the sliding distance and speed of the leading edge and sliding body morphology. Moreover, linear regression equations of the maximal sliding distance and speed were deduced after verification, to forecast the reasonable avoiding distance. The maximal sliding distance and speed were found to be negatively linearly correlated with the internal frictional angle and cohesion of the soil, and positively linearly correlated with the surcharge and the slope angle, respectively. Optimized preliminary design, of the highways in the mountainous and hilly areas, can be performed based on those insights.
Malnutrition in Chronic Pancreatitis: Causes, Assessment Methods, and Therapeutic Management
Authors: Madro Agnieszka
Published: August 2020

Purpose. In recent years, more and more emphasis has been placed on early diagnosis and adequate treatment of malnutrition in the course of chronic diseases (CP). One of these diseases is chronic pancreatitis in which malnutrition may develop as a consequence of abdominal pain, vomiting, diarrhea, and alcohol abuse. The aim of this review paper is recognized if we can improve the nutritional status of patients with CP. Methods. This paper is based on systematic literature review according to the PubMed. Results. One of the most important problems is lack of “gold standard” in screening of nutritional status in patients with CP, especially in outpatient clinics. Another problem is preventing malnutrition in these patients and beginning treatment already at significant stages of disease. To prevent malnutrition you must first recognize the causes of malnutrition in CP, adequately assess its severity using one of available questionnaires and then apply the appropriate therapeutic management. At each visit, remember to assess the nutritional status of the patient, including laboratory markers and anthropometric measurements. Patients should be advised to stop smoking and drinking alcohol and to use adequate enzyme supplementation. Conclusion. Patients with CP should be led by a team of gastroenterologist, diabetologist, and psychologist and consulted by a dietitian, specialist of pain treatment, and surgeon.
Experimental Study of Blast‐Induced Vibration Characteristics Based on the Delay‐Time Errors of Detonator
Authors: Wang Ping , Ma Yuanjun , Zhu Yongjian , Zhu Jun
Published: August 2020

The delay‐time of detonators in hole‐by‐hole blasting is generally calculated accurately considering they have great influence on the blasting effect, such as blasting vibration and blasting slungshot. The high‐precision nonel detonator and digital electronic detonator are been commonly used because of their accuracy of delay‐time. However, each detonator has an allowable error range of delay‐time due to the difference in manufacturing process. In the initiation network, the errors of delay‐time often accumulate gradually as the number of detonators increases. Therefore, theoretical delay‐time and actual delay‐time with error in the detonating network were discussed based on the delay‐time errors of detonators. The single‐factor variable method was used to carry out the comparative test in deep hole blasting. The results showed that the particle peak vibration velocity (PPV) was 13.1783 cm/s and 3.4856 cm/s with a drop of 73.55% in comparison with a nonel detonator and digital electronic detonator, which proved that hole‐by‐hole blasting in the high‐precision nonel detonator network was not achieved due to the delay error of detonators. Furthermore, the location distribution map of holes where the same section of detonators might occur was obtained. Finally, the probability of blasting in the same section changes with the number of blast holes was discovered by theoretical analysis, which provided a basis for accurate hole‐by‐hole blasting.
Extracorporeal Cardiopulmonary Resuscitation for Management of Out-of-Hospital Cardiac Arrest in a Patient with Fulminant Myocarditis
Authors: Meyer Alexander J. , Biersmith Michael A. , Mazzaferri Ernest L. , Boudoulas Konstantinos Dean
Published: August 2020

A 68-year-old male with a witnessed out-of-hospital cardiac arrest while jogging who was managed with extracorporeal cardiopulmonary resuscitation (ECPR) is presented. The patient was found to be in refractory ventricular fibrillation by emergency medical service personnel and underwent advanced cardiac life support (ACLS) protocol with placement of an automated chest compression device. He was emergently transported to the cardiac catheterization laboratory. Due to refractory ventricular fibrillation, he was placed on venoarterial extracorporeal membranous oxygenation (VA-ECMO). Coronary angiography at that time showed nonobstructive coronary artery disease. Management with VA-ECMO and other supportive measures were continued for 5 days, after which a cardiac magnetic resonance imaging was performed with findings consistent with acute myocarditis. His condition substantially improved, and he was discharged from the hospital with good neurologic and functional status. Fulminant myocarditis is often fatal, but aggressive supportive measures with novel ECPR protocols may result in recovery, as it happened in this case.
Stability Control of Staged Filling Construction on Soft Subsoil Using Hyperbolic Settlement Prediction Method: A Case Study of a Tidal Flat in China
Authors: Yu Fei , Li Shichang , Dai Zhangjun , Li Jian , Chen Shanxiong
Published: August 2020

An improved method, which combines in situ measured settlement data, hyperbolic method, and deep lateral displacement rate, is presented in this study to predict the consolidation and stability of the ground, which can be used in conducting staged filling construction on soft subsoil. A case history of a highway embankment construction in a tidal flat with thick mucky clay is studied in Xia Pu, China. Preloading with the prefabricated vertical drain method is adopted to accelerate the consolidation of a subgrade. The field behavior of soft ground under filling load is observed through in situ monitoring sensors in four typical sections. The final ground settlement in each stage is determined using the field monitoring data based on the hyperbolic settlement prediction method. For each stage of graded filling load, the ground settlement with a strain consolidation degree of 95% is defined as the standard settlement, and the corresponding settlement time is set as the standard settlement time. The preloading period is estimated according to the standard settlement time. The deep lateral displacement rate of the ground is monitored to control the stability of the foundation and recommended to guide the embankment construction. Results indicate that the presented method can predict the preloading time of graded filling, reduce the frequency of observation, and ensure the consolidation and stability of the ground.
Impact of UAV Delivery on Sustainability and Costs under Traffic Restrictions
Authors: Li Yuyu , Yang Wei , Huang Bo
Published: August 2020

Compared with traditional vehicles delivery, unmanned aerial vehicle (UAV) delivery can reduce energy consumption and greenhouse gas emissions, which benefits environmental sustainability. Besides, UAVs can overcome traffic restrictions, which are the big obstacle in parcel delivery. In reality, there are two kinds of most popular traffic restrictions, vehicle-type restriction, and half-side traffic. We propose a mixed-integer (0-1 linear) green routing model with these two kinds of traffic restrictions for UAVs to exploit the environmental aspects of the use of UAVs in logistics. A genetic algorithm is proposed to efficiently solve the complex routing problem, and an experimental analysis is made to illustrate and validate our model and the algorithm. We found that, under both these two traffic restrictions, UAV delivery can accomplish deliveries that cannot be carried out or are carried out at much higher costs by vehicles only and can always effectively save costs and cut CO2 emissions, which is environmentally friendly. Furthermore, UAV delivery saves more cost and cuts more CO2 emission under the first kind of traffic restriction than that under the second.
Increased QT Dispersion Is Linked to Worse Outcomes in Patients Hospitalized for Out‐of‐Hospital Cardiac Arrest
Authors: Kosmopoulos Marinos , Roukoz Henri , Sebastian Pierre , Kalra Rajat , Goslar Tomaz , Bartos Jason A. , Yannopoulos Demetris , Benditt David G.
Published: August 2020

Background

The incidence and mortality of out‐of‐hospital cardiac arrest (OHCA) remains high, but predicting outcomes is challenging. Being able to better assess prognosis of hospitalized patients after return of spontaneous circulation would enable improved management of survival expectations. In this study, we assessed the predictive value of ECG indexes in hospitalized patients with OHCA.

Methods and Results

PR interval and QT interval corrected by the Bazett formula (QTc) for all leads were calculated from standard 12‐lead ECGs 24 hours after return of spontaneous circulation in 93 patients who were hospitalized following OHCA. PR interval and QT and QTc duration did not differentiate OHCA survivors and nonsurvivors. However, QT and QTc dispersion was significantly increased in patients who died during hospitalization compared with survivors discharged from the hospital (
P
<0.01). Logistic regression indicated a strong association between increased QT dispersion and in‐hospital mortality (
P
<0.0001; area under the curve, 0.8918 for QT dispersion and 0.8673 for QTc dispersion). Multinomial logistic regression indicated that the increase of QTc dispersion correlated with worse Cerebral Performance Category scores at discharge (
P
<0.001; likelihood ratio, 51.42). There was also significant correlation between dispersion measures and serum potassium at the time of measurement and between dispersion measures and cumulative epinephrine administration. No difference existed regarding the number of measurable leads.

Conclusions

Lesser QT and QTc dispersion at 24 hours after return of spontaneous circulation was significantly associated with survival and neurologic status at discharge. Routine evaluation of QT and QTc dispersion during hospitalization following return of spontaneous circulation might improve outcome prognostication for patients hospitalized for OHCA.
Effect of a Triage‐Based Screening Protocol on Diagnosis and Treatment of Acute Coronary Syndrome in a Tanzanian Emergency Department: A Prospective Pre‐Post Study
Authors: Hertz Julian T. , Sakita Francis M. , Kweka Godfrey L. , Bloomfield Gerald S. , Bartlett John A. , Tarimo Tumsifu G. , Temu Gloria , Bettger Janet P. , Thielman Nathan M.
Published: August 2020

Background

Evidence suggests that acute coronary syndrome (ACS) is underdiagnosed in sub‐Saharan Africa. Triage‐based interventions have improved ACS diagnosis and management in high‐income settings but have not been evaluated in sub‐Saharan African emergency departments (EDs). Our objective was to estimate the effect of a triage‐based screening protocol on ACS diagnosis and care in a Tanzanian ED.

Methods and Results

All adults presenting to a Tanzanian ED with chest pain or shortness of breath were prospectively enrolled. Treatments and clinician‐documented diagnoses were observed and recorded. In the preintervention phase (August 2018 through January 2019), ACS testing and treatment were dictated by physician discretion, as per usual care. A triage‐based protocol was then introduced, and in the postintervention phase (January 2019 through October 2019), research assistants performed ECG and point‐of‐care troponin I testing on all patients with chest pain or shortness of breath upon ED arrival. Pre‐post analyses compared ACS care between phases. Of 1020 total participants (339 preintervention phase, 681 postintervention phase), mean (SD) age was 58.9 (19.4) years. Six (1.8%) preintervention participants were diagnosed with ACS, versus 83 (12.2%) postintervention participants (odds ratio [OR], 7.51; 95% CI, 3.52–19.7;
P
<0.001). Among all participants, 3 (0.9%) preintervention participants received aspirin, compared with 50 (7.3%) postintervention participants (OR, 8.45; 95% CI, 3.07–36.13;
P
<0.001).

Conclusions

Introduction of a triage‐based ACS screening protocol in a Tanzanian ED was associated with significant increases in ACS diagnoses and aspirin administration. Additional research is needed to determine the effect of ED‐based interventions on ACS care and clinical end points in sub‐Saharan Africa.
Contesting the Vulgar Hanmai Performance from Kuaishou
Authors: Hou Jiaxi
Published: August 2020

Beyond targeting individuals, online vigilantism can comprise significant collective practices among categories of social groups and therefore profoundly be embedded in reshaping the structures of social positions. By tracing the rise and fall of a specific user-generated music videos, hanmai, and the social media platform facilitating its production and circulation, Kuaishou, this chapter explores how vigilant practices including denunciating, shaming, and humiliating are involved in the transitioning Chinese society’s class stratification process, in particular in the making of distinction between underclass and middle-class identities among younger generations in the digitally-mediated world. After two years of online ethnography, the study first argues that with the new affordable digital technologies, the Chinese underclass youths for the first time attempted to realize a collective underclassness in creating and interacting with hanmai videos, in which class differences were reinforced with rhetoric and affective denunciations. However, these non-vigilante denunciations transformed the underclass into subjects of a larger scale online vigilantism and, later, state-led surveillance. Middle-class Internet users endeavoured to distinguish from the underclass by condemning the aesthetic, moral, and technological vulgarity implied in hanmai videos. The state surveillance also reached the underclass user-generated content in order to pursue a positive rather than vulgar representation of the underclass. The technologically-mediated visibility of Chinese underclass youths in the form of hanmai videos transformed from empowering social recognition to triggering various disciplinary forces both from the middle-class audiences and state power in cooperation with social media platforms.
‘I don’t think that’s very funny’
Authors: Vincent Isabel
Published: August 2020

This chapter focuses on examples of comedy practitioners engaging in behaviour online which was perceived by audiences to be offensive. The offensive actions or jokes in each case led to criticism online which caused audiences to engage in digital vigilantism directed at the comedy practitioners. In each case the reaction from audiences led to a negative effect on the practitioners’ career, though in some cases audiences also rallied around the practitioner in their defence. The primary issue in these cases is that comedy is inherently subjective, and relies on both the audience understanding the joke, and the practitioner being of appropriate agency to make fun of their target. In online spaces such as Twitter or YouTube it can be harder for audiences to differentiate between an individual, and a comedian playing as a fictional version of themselves, and as such there can be confusion regarding intent and agency. This confusion is exacerbated as some claims of intent occur after the publication of a joke and as such it is unclear if they are genuine, or a response to negative reactions from audiences. This chapter discusses the way that the cultural capital of comedy is changing, the responsibility of the practitioner, and the circumstances in which audiences become digital vigilantes.
Criticism of Moral Policing in Russia
Authors: Favarel-Garrigues Gilles
Published: August 2020

Since the beginning of the 2010s, vigilante groups have appeared in the streets and on the Internet in Russia. Acting in the name of civil society, these “activists” (aktivisty) patrol the streets in order to find badly parked vehicles, inspect shops in order to check whether they sell expired products or hunt and trap alleged paedophiles. This paper focuses on public debates about Russian vigilante groups, id est on controversial issues surrounding their activity. It considers who voices the public critique and what exactly is criticized. The discussions encompass issues such as legality and morality of vigilantes’ acts, their retributions, their social usefulness and their efficiency. But do vigilantes care about critique, and how does critique affect their activity? The theoretical framework of this paper is influenced by pragmatic sociology, particularly the analysis of controversies, which emphasizes the role of the audience in public disputes. As a case-study, this paper focuses on a particular group, named Lev Protiv. Founded in 2014 and based in Moscow, this vigilante group presents itself as a “social project”, whose mission is to patrol train and metro stations, commercial areas and public gardens, urging smokers and drinkers to respect the law.
Citizens as Aides or Adversaries?
Authors: Dekker Rianne , Meijer Albert
Published: August 2020

Social media have opened up new sources of information on crime to citizens which facilitates their participation in crime fighting. The labels of “do-it-yourself (DIY) policing” and “digital vigilantism” (or “digilantism”) suggest that a normative line can be drawn between forms of participation that are accepted and unaccepted by law enforcement. This chapter studies how law enforcement authorities set boundaries on what digital contributions of citizens to public security are acceptable. This law enforcement perspective is largely missing in current research into online engagement with public security. Based on a series of round table discussions with approximately 150 European law enforcement practitioners, we were able to study how they discursively define the boundaries between acceptable and unacceptable forms of public engagement in law enforcement. Citizens are considered as aides to police efforts when they engage with cases relating to their local context and when they closely collaborate with law enforcement. When online engagement goes beyond this familiar model of co-production, citizens are more likely to be considered adversaries. This concerns involvement in cases outside of citizens’ own local contexts and when they do not collaborate with law enforcement or only in a later stage in order to be able to claim their own successes. This suggests that discursive boundaries are drawn based on the resemblance with the existing operating paradigm of “community policing”.
The Forgotten Bonds: A Coevolutionary Framework on the Diffusion of Tzu Chi in Four Southeast Asian Countries
Authors: Lee Chengpang
Published: August 2020

The literature on the diffusion of new religion is strongly influenced by the voluntaristic paradigm that highlights the agency of individual migrants. This article examines and compares the diffusion process and outcome of Tzu Chi (Buddhist Compassion Relief Tzu Chi Association) in four Southeast Asian countries—Malaysia, Indonesia, Singapore, and the Philippines—to illustrate the complex relationship between migration, diffusion, critical events, and local conditions. Using a comparative research design and original materials, this article proposes a coevolutionary framework inspired by organization studies on the emergence of novelty. This article argues that the different diffusion processes and diffusion outcomes in the four cases are best explained through looking at network genesis mechanisms. This research contributes to the current studies on the diffusion of religion and scholarly interests in the global Tzu Chi movement.
Administration of 1% topical voriconazole drops was effective and safe in the treatment of refractory otomycosis without tympanic membrane perforation
Authors: Zhang Shoude , Jin Mao , Hu Sunhong , Zhang Yuejiao , Zhou Guojin
Published: August 2020

Background:

Refractory otomycosis is a common condition that is difficult to treat.

Objectives:

This study aimed to evaluate the effectiveness of 1% topical voriconazole drops in the treatment of otomycosis.

Methods:

This retrospective analysis was conducted from November 2017 to November 2019. Patients who had refractory otomycosis without tympanic membrane perforation confirmed by microbial culture and fluorescent staining were included in the study. All patients were treated with 1% topical voriconazole drops hourly at daytime for 2 weeks. Evaluation of effectiveness was conducted 1 month after the completion of topical voriconazole treatment. Before and after topical voriconazole treatment, hearing tests were performed in all patients.

Results:

Fifty-five patients were included in this study. The reasons for refractoriness were resistant recurrence to imidazole drugs (50 cases, 90.9%) and difficulty in cleaning the external auditory canal (5 cases, 9.1%). The most common strain was Aspergillus terreus (50.9%), followed by Aspergillus flavus (29.1%), Aspergillus niger (10.9%), and Aspergillus fumigatus (9.1%). After 2 weeks of treatment with 1% topical voriconazole drops, otomycosis in all patients was resolved. There was no significant change in bone conduction before and after topical voriconazole treatment (paired t-test, P = 0.5023; linear correlation analysis, R2 = 0.98; equation, y = 1.003 x−0.284). Adverse effects, such as blurred vision and phototoxicity, were not observed in any patient.

Conclusions:

Administration of 1% topical voriconazole drops was effective and safe in the treatment of refractory otomycosis without tympanic membrane perforation within 2 weeks.
Idiopathic Subglottic Stenosis during Pregnancy: A Support Group Survey
Authors: McCrary Hilary , Torrecillas Vanessa , Conley Matthew , Anderson Catherine , Smith Marshall
Published: August 2020

Objectives:

(1) To determine how pregnancy affects idiopathic subglottic stenosis (iSGS) symptoms. (2) To determine treatments utilized (including operating room (OR) and in-office procedures) for iSGS before, during, and after pregnancy.

Methods:

A 24-question survey was distributed to an international iSGS support group to assess the patient experience among individuals who have been pregnant with diagnosis of iSGS. Descriptive statistics and chi2 analyses were completed.

Results:

A total of 413 iSGS patients participated; 84.7% (n = 350) of patients were diagnosed prior to menopause. A total of 25.5% patients reported being pregnant when they had airway stenosis; 71.1% of those reported more severe airway symptoms during pregnancy. The proportion of patients that reported requiring ≥1 OR interventions (microlaryngoscopy and bronchoscopy, laser, balloon dilation, or steroid injection) before, during and after pregnancy was the following, respectively: 37.3%, 35.6%, 51.3%. Whereas the proportion of patients that reported requiring ≥1 in-office interventions (awake balloon dilation or steroid injection) before, during and after pregnancy was the following, respectively: 13.6%, 11.8%, 15.8%. Number of pregnancies and age of diagnosis was not related to severity of symptoms or requiring more airway interventions ( P > .05).

Conclusions:

This survey reveals worsening of symptoms during pregnancy, however, this did not lead to increase in operative or clinic interventions to improve airway symptoms during pregnancy. Future avenues for research include optimizing management of airway symptoms during pregnancy to limit OR-based interventions.

Level of evidence:

Level IV
Using a mobile health device to manage severe mental illness in the community: What is the potential and what are the challenges?
Authors: Byrne Simon , Kotze Beth , Ramos Fabio , Casties Achim , Harris Anthony
Published: August 2020

There has been a revolution in the use of mobile health devices for monitoring physical health. There is more recent interest in whether these devices can also be used for monitoring symptoms of mental illness. This paper considers how stress increases risk of mental deterioration and individuals with mental illness are sensitive to the effects of stress. It discusses how an inexpensive mobile health device could be used for detecting physiological signs of stress: deviations in biometrics such as sleep, activity and arousal may reflect a stress response and increased risk of relapse. These biometrics can allow patients to self-monitor and clinicians to detect early warning signs. This paper reviews the measurement of electrodermal activity, actigraphy and heart rate to predict mental deterioration. It considers the advantages of continuous measurement and reviews studies using mobile health devices to monitor stress and psychosis. It describes the potential for using a mobile health device to manage and monitor severe mental illness in young adults. Finally, this paper considers challenges associated with this approach, particularly with regard to correctly interpreting the physiological data and integrating the mobile health device into clinical practice. This paper concludes a mobile health device has the potential to enhance care by improving detection of early warning signs and increasing the connection between clinicians and their patients.
Life Trajectories and Changing Patterns of Marginalization Among the Smiths of Hararge, Ethiopia
Authors: Hinika Mohammed Hassen , Julla Desta Roba
Published: August 2020

Blacksmithing is one of the oldest traditional technologies among the rural communities of Hararge. Smithing has many functions among which its utilitarian role for agriculturalists clearly stands. This article is basically a survey and adopted historical and ethnographic methods. By collecting qualitative data through interview, focus group discussion, observation and document analysis from seven selected waradas of Hararge, the paper aims to investigate the changing patterns in the status of smiths in terms of their social position in Hararge. It concludes that although smiths were accorded a lowly social position and therefore were not yet considered as equals of the dominant agricultural Oromo in Hararge, the dynamics of social interaction over time have improved the social status of smiths. Smiths and other occupational groups like potters and tanners were treated not as equal partners but as marginalized social groups. This was partly due to the underlying socially constructed origin of the occupational groups which put them below agricultural communities in the social hierarchy and considered them as ‘alien’ and ‘remnants’ of an ancient ‘autochthonic’ population.
Organized Labor and Depression in Europe: Making Power Explicit in the Political Economy of Health
Authors: Reynolds Megan M. , Buffel Veerle
Published: August 2020

Despite engagement with the construct of power relations, research on the political economy of health has largely overlooked organized labor as a determinant of well-being. Grounded in the theory of power resources, our study aims to fill this gap by investigating the link between country-level union density and mental health while accounting for the compositional effects of individual-level union membership. We use three waves of the European Social Survey (N = 52,737) and a variation on traditional random-effects models to estimate both the contextual and change effects of labor unions on depressive symptoms. We find that country-level union density is associated with fewer depressive symptoms and that this is true irrespective of union membership. We discuss our findings vis-à-vis the literatures on the political economy of health, power resources, and fundamental causes of disease.