Combined pulmonary fibrosis and emphysema (CPFE) is a recently recognized syndrome that, as its name indicates, involves the existence of both interstitial lung fibrosis and emphysema in one individual, and is often accompanied by pulmonary hypertension. This debilitating, progressive condition is most often encountered in males with an extensive smoking history, and is presented by dyspnea, preserved lung volumes, and contrastingly impaired gas exchange capacity. The diagnosis of the disease is based on computed tomography imaging, demonstrating the coexistence of emphysema and interstitial fibrosis in the lungs, which might be of various types and extents, in different areas of the lung and several relative positions to each other. CPFE bears high mortality and to date, specific and efficient treatment options do not exist. In this review, we will summarize current knowledge about the clinical attributes and manifestations of CPFE. Moreover, we will focus on pathophysiological and pathohistological lung phenomena and suspected etiological factors of this disease. Finally, since there is a paucity of preclinical research performed for this particular lung pathology, we will review existing animal studies and provide suggestions for the development of additional in vivo models of CPFE syndrome. Combined pulmonary fibrosis and emphysema (CPFE) represents an increasingly recognized, progressive lung pathophysiology. The disease is associated with strong male predominance, a lack of specific treatment options and poor prognosis. The complex pathology of this condition involves emphysematous destruction of lung parenchyma, diffuse interstitial fibrosis, changes in the composition of lung immune cells, increased production of immunomodulatory factors and the prominent remodeling of pulmonary vasculature. Such an existence of obstructive and restrictive changes in the same lungs results in unexpectedly preserved lung volumes, while in contrast gas exchange is impaired. Although the numerous preceding studies noted the coexistence of emphysema and fibrosis in the same lungs and unique physiological consequences of such an occurrence ,2,3,4, iCPFE is a computed tomography (CT)-defined syndrome that encompasses concurrent emphysema and interstitial pulmonary fibrosis. The syndrome is characterized by normal spirometry, impaired gas exchange, a high prevalence of pulmonary hypertension and poor survival. The vast majority of CPFE patients are males and ex- or current heavy smokers, with representation significantly higher compared to idiopathic pulmonary fibrosis (IPF) ,7,8,9. AThe prevalence of CPFE in the general population is not known, but it has been estimated that 3.1% of asymptomatic male smokers have this condition . In pati1), more airflow obstruction and severely depressed carbon monoxide diffusion capacity (DLCO) and a carbon monoxide transfer coefficient (KCO) [1 and FEV1/FVC, less hyperinflation and lower DLCO [CO being the dominant pulmonary function test pattern, followed by restriction and obstruction patterns [CO is the only abnormal finding in pulmonary function tests, due to the counterbalance between the restrictive effects of pulmonary fibrosis and the hyperinflation caused by emphysematous lesions [Long before CPFE was recognized as a separate pathology with unique pathophysiologic features, it had been noticed that the presence of concurrent emphysema in IPF patients can result in atypical, misleading pulmonary function tests ,4,29. Sint (KCO) ,20,23,30nt (KCO) . Converswer DLCO ,6. Similpatterns . In othe lesions ,18,32.Blood gas analysis in CPFE patients resembles that seen in IPF patients, with resting and exercise hypoxemia, while hypercapnia rarely occurs, unlike the situation seen in severe COPD .Regarding the dynamics of lung function parameters, the annual decrease in FEV1/FVC% is significantly higher in CPFE patients compared to those with IPF, but lower than that seen in COPD patients. On the other hand, the annual decrease in DLCO in CPFE patients was comparable to that observed in IPF, but significantly more pronounced than in patients suffering from COPD ,30,34.CPFE was originally individualized as a CT-defined syndrome, with unique clinical and pathophysiologic features. The diagnosis requires the presence of emphysema and interstitial pulmonary fibrosis, but a wide variety of possible appearances in chest high-resolution CT (HRCT) has been described ,6.emphysema lesions of the upper zones distant to fibrotic lesions of the bases;progressive transition with diffuse emphysema (centrilobular and/or bullous) and zone of transition between bullae and honeycombing;paraseptal emphysema with predominant subpleural bullae of enlarging size at the bases.Inclusion criteria used by Cottin and colleagues required upper-zone predominance of emphysema, which, in regard to the relationship with reticular opacities, usually followed one of the three HRCT patterns ,35:emphyCO, presumably because of the destruction of capillary beds in areas of isolated emphysema and the consequent reduction in blood volume within the lungs [Although this requirement for the upper zone predominance limited confounding effects of emphysema, which are discussed in a further text, the current literature acknowledges that emphysema may be present in other areas of the lung, admixed with fibrosis or replaced by large cysts ,36. In fhe lungs .In a cohort reported by Cottin et al., centrilobular emphysema was present in the vast majority of cases and additionally, paraseptal emphysema was particularly frequent in this population (93%) . Other sWhen it comes to the minimal extent of emphysema needed for the CPFE diagnosis, the original definition did not require any, but many subsequent studies imposed the minimum thresholds of lung volume affected by emphysematous changes, such as ≥5%, 10% or even 15% . The ATSThe presence of diffuse parenchymal lung disease with fibrosis is a prerequisite for CPFE diagnosis, but a minimal extent of such changes has rarely been defined . InteresIn a study by Cottin et al., the most commonly observed fibrotic changes in chest HRCT scans were honeycombing 95%), reticular opacities (87%) and traction bronchiectasis 69%). The cases with prominent ground-glass opacities were excluded, but some ground-glass opacities were nevertheless present in more than half of patients, while micronodules and airspace consolidation were rare %, reticu. Taken t9%. The cFinally, when discussing the radiologic appearance of fibrotic changes in CPFE, one is bound to mention the confounding effects of emphysema. These include, for example, the honeycomb cyst-like appearance of emphysema in HRCT scans, in cases when it surrounds ground-glass opacities in NSIP or when it is combined with smoke-induced localized fibrotic changes in septal walls, discussed in a further text ,48,49.CPFE was originally defined based on clinical, physiologic and HRCT features , and diaHistorically, emphysema is defined as the permanent enlargement of airspaces beyond the terminal bronchioles, accompanied by the destruction of alveolar walls, without obvious gross fibrosis . AlthougAs stated before, paraseptal emphysema often coexists with the centrilobular form in CPFE patients ,51. The Fibrotic changes in CPFE, although a prerequisite for a diagnosis, represent the most confusing aspect of the pathology, complicated by unclear classification and terminology. Wright and colleagues  attempteBased on the relatively modest number of biopsy findings from CPFE lungs that have so far been described, diffuse fibrotic changes present in this pathology most often have a UIP pattern, characterized by the patchy fibrosis, honeycombing and presence of fibroblast foci ,43,49,52Apart from UIP and UIP-like patterns , NSIP, DIP as well as unclassifiable interstitial pneumonia have been encountered in histological specimens from CPFE patients ,40,52,53Another scenario, clinically and pathologically very different from the abovementioned diffuse fibrosing interstitial pneumonia, has been classified by Wright as localized fibrosis that is part of emphysema or related to respiratory bronchiolitis (RB), or both .In this class belongs occult interstitial fibrosis, which Katzenstein and colleagues described as a common occurrence in lobectomy samples from smokers  and termAuthors as well as others ,49,54 acGiven the high prevalence of pulmonary hypertension (PH) in CPFE patients , it is nThe extent of pulmonary vascular alterations in emphysematous and fibrous parts of CPFE lungs is comparable to that observed in pathologically changed areas of COPD and IPF lungs, respectively . In addiWith regard to the profiles of inflammatory cells in bronchoalveolar lavage (BAL), CPFE pathology seems indistinguishable from IPF. The differential cell pattern in BAL fluid from CPFE patients is characterized by a reduced proportion of macrophages compared to the healthy lungs, increased neutrophils and occasionally elevated lymphocytes and eosinophils ,22,63. SCO [However, an investigation of cytokine profiles in BAL fluid by Tasaka et al. revealed that levels of chemokine (C-X-C motif) ligand (CXCL)-5 and CXCL-8 are significantly elevated in CPFE patients compared to those with fibrosis alone. Additionally, the study suggested that levels of CXCL-8 correlate with neutrophil accumulation in the alveolar space and impairment of DLCO . The autCO ,65. InteCO .1CYFRA 21-) in the blood of CPFE patients were the same as in those with emphysema and significantly reduced compared to IPF pathology [Several studies investigated the presence of different ILD biomarkers in CPFE and their usefulness in differentiating between this pathology and IPF. The previously mentioned study by Tasaka and colleagues found that the presence of emphysema in patients with fibrosis is associated with decreased levels of lactate dehydrogenase (LDH) and increased C-reactive protein (CRP) in serum, whereas there were no significant differences in the amount of ILD biomarkers’ surfactant protein (SP)-D and Krebs von den Lungen (KL)-6 . Cornwelathology . Curiousathology . These cathology .Intriguingly, some of the changes that would be expected based on animal studies have never been found. For example, levels of transforming growth factor (TGF)-β in CPFE patients did not differ significantly from those measured in either the blood or BAL of emphysema and IPF patients, although there was a significant increase in IPF compared to the emphysema group ,66. SimiClinically, most relevant comorbidities in CPFE are PH and lung cancer . PH, curNumerous studies suggested a higher prevalence of lung cancer in CPFE compared to IPF alone, and this was corroborated by a few recent meta-analyses ,75, althPathological mechanisms involved in the development and progression of CPFE are insufficiently understood. The coexistence of these two smoking-related pathologies might be occurring accidentally, by fibrosis being superimposed on emphysematous lungs or vice versa ,53. HoweCottin et al. coined the term CPFE based on the observations made in a cohort of 61 patients, all of whom were current or former cigarette smokers. Since then, smoking remained the best-documented risk factor for the development of this syndrome. Numerous reports indicate that CPFE patients are almost exclusively former or current heavy smokers, with a more extensive smoking history and greater mean smoking pack years compared to those suffering from IPF ,19,72,80Apart from smoking, other environmental and occupational exposures have been recognized as the risk factors for developing co-existing fibrotic and emphysematous changes, independently or together with smoking. Interestingly, in a cohort consisting mainly of non-smoking female patients chronically exposed to indoor biomass-burning smoke, pathological lung changes included emphysema, but also reticulonodular, honeycombing and ground-glass opacities . In accoInvestigations in patients with CTD-ILD, such as SSc-associated ILD (SSc-ILD) and rheumatoid arthritis-associated ILD (RA-ILD), demonstrated that CPFE may also be observed in an etiologic context different than an exposure to cigarette smoke . SeveralWhile in the “idiopathic” forms of CPFE the pathophysiological mechanisms remain elusive, in the case of CTD, it is believed that mechanisms intrinsic to the disease itself, such as autoimmunity and inflammation, are in play . Indeed,Some cases of CPFE may also have a genetic component. Multiple genetic variants, especially in the genes coding for components of the telomere maintenance system and surfactant metabolism, are associated with a higher susceptibility to emphysema and/or fibrosis in carrying individuals or families. In addition, studies in animal models which we describe in a further text, have provided several candidate genes and signaling pathways potentially involved in the pathogenesis of CPFE, but their relevance for the human disease remains to be investigated.Replicative senescence due to telomere shortening is an interesting topic with regard to the pathogenesis of CPFE. Accelerated telomere attrition and mutations in the components of telomerase have been associated with higher susceptibility for IPF ,117,118.Mutations in gene encoding surfactant protein C (SP-C) have been previously described as a frequent cause of familial interstitial pneumonia ,130,131.TGF-β signaling plays a prominent role in tissue repair, a process whose deregulation is a common denominator for emphysema and fibrosis . In rodeApart from mutations affecting components of the telomerase complex, surfactant metabolism and TGF-β signaling, CPFE has been associated with a mutation in the gene encoding the receptor for advanced glycation end-products (RAGE), previously associated with other lung diseases, including COPD and IPF . ProlidaNumerous studies investigated pathological changes caused by the combination of cigarette smoke exposure and bleomycin injury in mice and reported a palette of different outcomes, ranging from severe (exclusive) emphysema phenotype to aggravated interstitial fibrosis, including even the protective effects of smoke exposure against fibrosis development. Such variability can be attributed to the different experimental designs, with single versus repetitive applications and assorted dosages of bleomycin, diverse smoking regimens of variable duration as well as several possible sequences of these injuries . Thus, iFor example, when 28 days-long nose-only exposure of rats to cigarette smoke (4 h/day) is initiated together with single intratracheal instillation of (2.5 mg/kg) bleomycin, the resulting lung pathology is the interstitial fibrosis, similar in appearance but more severe compared to that observed in the bleomycin-only group. Of note, this relatively short exposure to smoke only did not produce emphysematous changes either alone or in combination with bleomycin . SimilarIn contrast, an old report from Takada et al. describes the situation where a single intratracheal dose of bleomycin (5 mg/kg) given to hamsters in the middle of a 2-month long smoke exposure period induced emphysematous changes in this animal model . HoweverRecently, Cass and colleagues reported that alterations in pulmonary macrophage populations, induced by 15 weeks of cigarette smoke exposure , prevented fibrotic changes following intratracheal bleomycin instillation .Finally, one of the possible pathological outcomes from the challenge of rodent lungs with cigarette smoke and bleomycin is combined pulmonary fibrosis and emphysema. Kulshrestha and colleagues exposed rats to smoke for up to three months (four cigarettes during 1 h per day), in combination with one intratracheal bleomycin instillation (7 U/kg) at the beginning of the 7th week and induced heterogeneous parenchymal remodeling with alternating areas of emphysema and fibrosis . In accoNevertheless, the examples given above effectively illustrate the vast variability between smoke exposure regimens used in preclinical research ,169, whiTo the best of our knowledge, the combination of smoke with other fibrosis-inducing substances such as amiodarone, silica or asbestos, has not been described in the literature.To date, several genetic modifications in animal models have been found to produce varying degrees of emphysema and fibrosis . PerhapsFurthermore, overexpression of platelet-derived growth factor (PDGF)-B in the lung results in emphysematous lesions, focal fibrosis and lung inflammation. However, this transgenic line does not appear to be a suitable model for CPFE, since the airspace enlargement likely results from developmental abnormalities, and there is a significant phenotype variation among the individual mice from the same lineage .Another transgenic mouse line reported to develop both emphysematous and fibrotic lesions is characterized by inducible overexpression of interleukin (IL)-13 in a lung-specific manner . HoweverSimilarly, the absence of SP-C leads to a phenotype consisting of emphysema, monocytic infiltration, epithelial cell dysplasia and areas of interstitial thickening with increased α-smooth muscle actin expression and intensive trichrome staining . Taken t−/−) mice with polyethylene glycol-modified ADA that allowed them to live normally until week 24, and then gradually reducing supplementation to allow the accumulation of excess extracellular adenosine and consequent lung injury. Such a protocol resulted in airspace enlargement, reduced arterial oxygenation, macrophage accumulation, deposition of collagen, marked remodeling of pulmonary vessels and PH [Finally, Collum and colleagues recently reported a model replicating the most important hallmarks of CPFE pathology, namely emphysema, pulmonary fibrosis and PH. Their experimental setup included supplementing adenosine deaminase-deficient  as a measure of fibrosis extent, and age [Finally, as stated earlier, the presence of lung cancer and PH is associated with poor prognosis ,192,196. and age ,53,197.CPFE is an increasingly recognized syndrome, with unique pathophysiological features and a wide variety of radiologic and histologic appearances. The disease is debilitating, progressive and still untreatable. Further preclinical studies and clinical trials are needed to elucidate pathophysiological mechanisms and improve the management of CPFE.


The extant literature has accumulated enormous knowledge on personality prediction from digital records on social networking sites . However, little is known about how short video selfies reflect their owner’s personality and how people judge others’ personalities from short video selfies. Taking short video selfies is very popular today; many people are willing to share their short video selfies with others. Based on the lens model theory, it is expected that one’s personality is associated with short video selfies. By analyzing 177 Chinese TikTok (Douyin in China) users’ short video selfies and their Big Five personalities, it showed that specific cues in short video selfies related to agreeableness, conscientiousness, neuroticism, and openness. But only extraversion could be predicted by short video selfies accurately. This study is the first to reveal personality-related cues in short video selfies and has practical implications for both short video platforms and their users. Personality could be captured from not only individuals’ environments  are reviewed below. Moreover, people in different levels of demographic variables  might differentially use social applications e.g.,  and prioResearch has shown a connection between self-reported personality and photos based on different photographs, such as standard photographs and spontaneous photographs e.g., . For exaPrior research has provided robust evidence on the relationship between selfies posted on social media and the Big Five personalities . SeveralMoreover, prior research has tried to explore the relationship between videos and personality. For example, Compared to photos and selfies, short video selfies could provide unique cues that may reflect people’s personalities. One of the motivations for shooting and submitting short videos is recording and sharing . As the Prior research suggested that demographic variables  of uploaders could influence the relationship between personality expression and selfies on social networking sites e.g., . On the According to a survey of TikTok (Douyin in China) in 2018 , TikTok The lens model helped define and learn interpersonal judgment  and was a) connected the self-report personality with the personality judgment, with a stronger correlation indicating more accuracy. Cue validity (re) is the degree of association between cues (ye) and self-report personality (Ye), with a stronger correlation suggesting better validity. Cue utilization (rs) is the link between cues (ys) and the judgment of personality (Ys), and a strong correlation indicates that the cue is more utilized when forming personality judgments. Cue sensitivity (G) is the correlation between cue validity (re) and cue utilization (rs), with a higher correlation indicating that cues could reflect the given personality well. We will adopt this model to examine how personality is expressed in short videos and what given cues people could use to judge one’s personality from the short videos.Accuracy .Participants were collected through an online survey platform.All participants completed a two-part online survey, were informed about the study, and provided informed written consent. The first part comprises the Big Five personality scale ; Eyes looking at the camera ; Emotional unchanged ; Smile ; Face visibility ; The whole body; Camera height ; Photoshop editing ; and Alone . Moreover, we added cues that are unique for short video selfies. First, users can choose their performances or real lives to share with others through the short video platform. Thus, we added the code of “acting” . Second, people could control the shooting time and switch camera angles freely when taking short video selfies. Thus, the code of “shooting from the same angle”  was used in the study. Third, similar to photoshop editing, users could edit their short video selfies. For example, users could add some special effects that the apps provided freely and present subtitles to embellish their short video selfies. Therefore, the codes of “video effects”  and “subtitle”  were added to the cues. Forth, users could take short video selfies with the help of their surroundings and tools. Thus, the codes of “situational cues”  and “tools”  were used. Finally, short video selfies contain not only selfies, but also background music. Users could add a period of background music to their short videos freely or choose the original sound as background for short videos. According to interactionist theories of music, the musical environments that people select could reflect their psychological traits  was adopted as a cue to capture users’ personalities. Consequently, the study contained a total of 17 cues: Selfie; Acting; Camera in front; Shooting from the same angle; Eyes looking at the camera; Emotional unchanged; Smile; Face visibility; The whole body; Camera height; Video effects; Photoshop editing; Subtitle; Background music; Situational cues; Tools; and Alone.Then, we observed the online videos of all participants and identified which of these videos were selfies . To code the short video selfies, we first selected photos/selfies-coding that are appropriate for coding short video selfies from past researches, because short video selfies were similar to photo selfies e.g., . Combinil traits . TherefoTwo independent raters were chosen to code the cues. We adopted zero-acquaintance personality judgment following prior studies e.g., , which mα = 0.60), openness (Cronbach’s α = 0.61), neuroticism (Cronbach’s α = 0.66), agreeableness (Cronbach’s α = 0.65), and conscientiousness (Cronbach’s α = 0.34). The participants rated each item on a five-point scale ranging from 1 = strongly disagree to 5 = strongly agree.Personality was measured by the Big Five personality scale . On the other hand, we used aggregated observer accuracy  to measure the accuracy of observers’ personality judgment. However, the reliability of aggregated observers’ ratings on personality in a single analysis  might be boosted because of aggregation , the correlation between self-report and observer1’s rating on extraversion , and the correlation between self-report and observer2’s rating on extraversion  are significant, which means that observers could accurately predict extraversion based on short video selfie cues. And we found that the other four dimensions  did not obtain significant correlations.As shown in regation . Thus, tr = 0.70, p < 0.01), indicating that observers used valid cues to generate accurate judgment of extraversion. The other four dimensions  did not obtain significant vector correlations.Following prior research , 2015, tr = 0.22, 0.26, 0.16, 0.17, p < 0.05), while neuroticism was not related to selfies , indicating that people with high extraversion, agreeableness consciousness, and openness are likely to post their short video selfies on TikTok. Extraversion, consciousness, and openness were positively associated with acting , suggesting that people with high extraversion, consciousness, and openness are likely to perform on short video platforms. Extraversion was related to situational cues , suggesting that people in high extroversion are shooting selfies in special situations, such as working situations. Agreeableness was positively connected with the smile , which is consistent with the prior research , suggesting neurotic individuals tend to upload original selfies to short video platforms. Openness was negatively related to shooting from the same angle and tools , while positively associated with camera height , indicating that people with high openness are likely to shoot videos in different angles and above head, and less to use tools in their videos.Cue validity was assessed through the correlation between participants’ self-report personality and cues in short video selfies after controlling age and gender see . The proresearch . Neurotir = 0.30, 0.22, 0.18, p < 0.05), which is consistent with the characteristics of extraversion. People with high extroversion tend to be more sociable and high-performance , suggesting that people with high extraversion are less likely to use tools in short videos. Agreeableness ratings were positively related to smile and photoshop editing  and negatively related to face visibility , indicating that observers considered that agreeable individuals might hide their part of the face to present their value of social affiliation , suggesting that conscientious individuals are likely to convey their authentic selves to others. And ratings of conscientiousness were positively connected to subtitles , indicating that observers considered that conscientious individuals do more work in their video to convey their hardworking  while negatively associated with acting and the whole body in the video , suggesting that neurotic individuals tend to concern their impression management edit their short videos and upload their selfies to present an ideal self  and subtitles , suggesting that people with high openness are likely to post their short video selfies on social media and add subtitles in short video selfies.Cue utilization was assessed by connecting short video selfie cues to observers’ ratings of personality after controlling age and gender See . Ratingsformance . The resiliation . Ratingsdworking . Neurotieal self . Opennesindirect effect size = 0.02, SE = 0.02, 95%CI = ). Second, the results showed that acting was positively related to self-reported and other-rating extraversion. In the present study, controlling for gender and age, the total effect of self-report extraversion on other-rating extraversion was significant , the direct effect of self-report extraversion on other-rating extraversion was significant , and the indirect effect of self-report extraversion on other-rating extraversion through acting was significant . The result suggested that the acting partly mediated the self-other report extraversion. The pattern of results was identical without controlling for gender and age. Specifically, without controlling for gender and age, the indirect effect of self-report extraversion on other-rating extraversion through acting was still significant .Based on the correlation results, we tested the mediating role of the short video selfie cues in self-other report agreeableness and extraversion using SPSS ; Model 4r = 0.20, p < 0.01), suggesting that compared to men, women are more likely to post their short video selfies on social media, which is consistent with prior studies , shooting from the same angle , eyes looking at the camera , smile , video effects , and photoshop editing , suggesting that compared to men, women are more likely to shoot short videos from the one angle, smile in the videos, and keep looking at the camera in front, which is consistent with prior study  and background music , suggesting that compared to men, women are more likely to present a part of the body such as head and less likely to use the background music in short video selfies. Regarding the relation between short video selfies cues and age, the results showed that age was negatively correlated with video effects , suggesting that older are less likely to use video effects to modify their videos and present original images to others.The correlation between short video selfies cues and gender and age are present in  studies . Regardior study . Furtheror study . Moreover = −0.10, p > 0.05), camera in front and neuroticism , tools, and extraversion ] became insignificant, and 11 (78.5%) out of 14 correlations remained statistically significant, without controlling age and gender, suggesting that observers’ personality judgment mainly relied on short video selfie cues rather than the stereotypes of gender and age.Moreover, prior studies have evidenced that there are stereotypes in observer judgments of personality e.g., . Thus, tThe current study explored the relationship between personality and social media use by testing personality expression and perception in short video selfies, a new form of self-portrait in social media. Through the lens model, a few short video selfie cues were identified in personality expression and perception. For example, extroverts prefer to post selfies and act on short video platforms, and people with high agreeableness prefer smiling in short video selfies. Specifically, acting mediated the self-report extraversion and other-rating extraversion. Moreover, regarding accuracy and sensitivity, the study found similar results to previous studies on photos and selfies . In shorThe findings of this study have important theoretical implications. First, the results contribute to the literature on personality expression on social networking sites. The study reveals that short video selfies contain valid personality-related cues, expanding prior findings that people’s digital footprints on social media could reveal their personality traits . MoreoveOur research has several vital practical implications. On the one hand, with the growing number of short video selfies, it is meaningful to understand how short video selfies reflect personality. Prior studies have demonstrated that personality could be an important antecedent of job performance , health The present study has several limitations which need to be addressed in the future. First, we recruited users only from TikTok. Future research needs to examine whether our findings can be generalized to other short video platforms such as Kuaishou and WeSee. Second, prior research has examined the relationship between personality with the different elements of music, such as music genres, acoustic features, psychological attributes, and lyrics . HoweverShort video selfies play an essential role in daily life. The study tested personality expression and perception in short video selfies through the lens model. Some particular short video selfie cues, such as acting, in revealing one’s personality traits were identified. Moreover, the results further indicate the relationship between the preference for short video selfies and demographic variables . Theoretically, these findings expand the field of personality expression and perception on social networking sites and increase our understanding of personality expression and perception through the lens model. Practically, a few commercial applications could improve their recommender system by learning personality, thus promoting users’ experience.The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.The studies involving human participants were reviewed and approved by Ethical Committee of Philosophy School at Wuhan University. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.ZD: methodology, investigation, formal analysis, writing–original draft, and writing—review and editing. TX: conceptualization, investigation, formal analysis, and writing—review and editing. All authors contributed to the article and approved the submitted version.This study is part of a large-scale project entitled “Constructing the ‘circle of friends’ in global media from the perspective of intercultural communication,” funded by the MOE (Ministry of Education of China) Social Science Research Institute Grants (Project No. 22JJD860013).The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Increasing the adoption of digital care tools, including video visits, is a long-term goal for the US Department of Veterans Affairs (VA). While previous work has highlighted patient-specific barriers to the use of video visits, few have examined how clinicians view such barriers and how they have overcome them during the rapid uptake of web-based care.This study sought input from providers, given their role as critical participants in video visit implementation, to qualitatively describe successful strategies providers used to adapt their practices to a web-based care setting.We conducted interviews with 28 VA providers (physicians and nurse practitioners) from 4 specialties that represent diverse clinical services: primary care (n=11), cardiology (n=7), palliative care (n=5), and spinal cord injury (n=5). All interviews were audio recorded and transcribed, and transcripts were reviewed and coded according to an iteratively created codebook. To identify themes, codes were grouped together into categories, and participant comments were reviewed for repetition and emphasis on specific points. Finally, themes were mapped to Expert Recommendations for Implementing Change (ERIC) strategies to identify evidence-based opportunities to support video visit uptake in the VA.Interviewees were mostly female , with an average age of 49 years and with 2-20 years of experience working in the VA across 16 unique VA facilities. Most providers  worked in urban facilities. Many interviewees  had some experience with video visits prior to the COVID-19 pandemic, though a majority  had conducted fewer than 50 video visits in the quarter prior to recruitment. We identified four primary themes related to how providers adapt their practices to a web-based care setting: (1) peer-based learning and support improved providers’ perceived value of and confidence in video visits, (2) providers developed new and refined existing communication and clinical skills to optimize video visits, (3) providers saw opportunities to revisit and refine team roles to optimize the value of video visits for their care teams, and (4) implementing and sustaining web-based care requires institutional and organizational support. We identified several ERIC implementation strategies to support the use of video visits across the individual-, clinic-, and system-levels that correspond to these themes: (1) individual-level strategies include the development of educational materials and conducting education meetings, (2) clinic-level strategies include identifying champions and revising workflows and professional roles, and (3) system-level strategies include altering incentive structures, preparing implementation blueprints, developing and implementing tools for quality monitoring, and involving executive leadership to encourage adoption.This work highlights strategies to support video visits that align with established ERIC implementation constructs, which can be used by health care systems to improve video visit implementation. The Department of Veterans Affairs (VA) health care system comprises 170 medical centers and more than 1000 community-based outpatient clinics across the United States. The VA manages over 9 million enrolled veterans, 30% of whom reside in rural regions . The COVWhile a variety of benefits to video visits have been reported for both patients  conducted interviews with providers. Interviews took place between December 2020 and June 2021 over Microsoft Teams . Based on a review of existing literature as well as engagement with prior web-based care projects conducted at the VA, the research team identified provider perspectives as a noticeable gap. A semistructured interview guide was created, featuring exploratory questions meant to elicit providers’ overall experiences with video care, challenges, facilitators, and recommendations for optimizing web-based care delivery  framework, an implementation science framework that summarizes evidence-based implementation strategies that have been demonstrated to enhance the adoption, implementation, scale-up (or spread), and sustainment of a program or practice ,38. The This work was conducted as part of a VA–funded evaluation that was designated as nonresearch by the VA’s Office of Rural Health and was exempt from institutional review board and research and development committee review.Twenty-six physicians and 2 nurse practitioners agreed to participate. Providers described numerous strategies that they used or felt would be helpful to overcome barriers when implementing video visits. These are described in four themes: (1) peer-based learning and support improved providers’ perceived value of and confidence in video visits, (2) providers developed new and refined existing communication and clinical skills to optimize video visits, (3) providers saw opportunities to revisit and refine team roles to optimize the value of video visits for their care teams, and (4) implementing web-based care initiatives requires institutional and organizational support. In addition to collating overarching themes, we mapped individual-, clinic-, and system-level challenges and recommendations to the ERIC implementation framework in order to identify implementation strategies for further testing and research.Providers described how early in the pandemic, they and their colleagues sought guidance and training on how to provide effective video-based care. Due to a lack of evidence or guidance around video visit implementation and use, providers often relied on peer-to-peer knowledge to overcome initial barriers or challenges. A primary care provider details this perspective and highlights examples of specific peer-to-peer learning strategies used at their facility:We do …. interactive sessions where we go through cases together and do breakout sessions so that the trainees can also practice with each other, simulating both being the patient and provider, trying to get through each—like the majority of [body] systems in terms of doing a physical exam primarily.P1Providers noted that the sharing of best practices encouraged providers who were initially ambivalent about offering video visits to try offering more video care. A palliative care provider described how daily huddles helped support and facilitate video visits:A lot of the providers who are not used to telehealth, the telehealth team had offered what they call a noon huddle. So that brought all the providers who are really interested in learning more about how to manage, how to navigate, and you would literally get a day-to-day tutorial and new development of what is being provided through the tele or virtual.P26Huddles and other similar peer-based learning strategies demonstrate how peer support played a role in facilitating the adoption of video-based care among providers. Through these interactions, providers described how they were able to troubleshoot challenging clinical scenarios and patient needs, which increased their comfort with video-based care.There was broad agreement among providers that optimizing the provider-patient interaction over video required learning the technical aspects of the video visit and adapting communication and physical examination skills. Providers acknowledged that due to the technical challenges that video visits presented, it was important to allow for additional time and patience with patients. They also noted that adjusting their communication strategies to account for the video format facilitated successful visits, as this palliative care provider illustrates:So, when I’m talking about [clinical concerns] virtually, I am frequently pausing, checking in, referencing the patient by their first name to make sure that they're involved, kind of slowly checking in for caregivers to participate in the conversation. So, a lot of this requires a lot more intentionality; whereas, in person I might just use eye contact just with that person or I’d touch them on the shoulder and see how they're feeling. There are a lot of different ways to check in on emotion when using nonverbal communication.P28Providers also described how they adapted their history-taking skills to ensure that necessary patient information was collected. For example, a cardiologist shared how video-based visits prompted them to approach patient interviews in a slightly different way than they would for a face-to-face visit, noting:[Video visits have] prompted me to revisit just basic history-taking skills as well. You have to get a little bit creative about how you ask questions when you're trying to get to the bottom of whether this patient is really [experiencing a heart failure exacerbation].P21Providers described the important roles all members of their clinical team play in improving video visit success and highlighted opportunities for other staff members to be involved. They noted how facilitating a sense of shared responsibility for video visits helped encourage more successful video visits. For example, 1 primary care provider explained:I think the more we can involve each member of the care team and that everybody feels like they have a responsibility in ensuring … video literacy among patients, the more success we'll have over the long-term, because it pays it forward for everybody else.P5This provider noted the importance of ensuring video literacy among patients, which other providers similarly characterized as critical for successful implementation of video visits. Having other members of the clinical team assist patients with technology, particularly first-time users, was described as a major facilitator of video-based care success and uptake. Doing so helped alleviate the burden on the clinical team. Elaborating on this point, 1 provider explained how dedicated telehealth technicians helped patients become comfortable with video visits:When we're talking about doing a video visit with a patient for the first time, having somebody here that can show them, “This is how you do it” and do a practice call with them before they leave the building. We have our telehealth technicians do practice calls with them or attempt to reach out if I've scheduled a [video visit].P18Providers advocated for the development of standard operating procedures that provide patients technical support while minimizing disruptions to visits.Though acquiring new technical skills was necessary to succeed at video visits, providers nevertheless maintained that patients’ technical challenges often become a burden they must overcome. They acknowledged that troubleshooting during a video visit is necessary but felt that providers should not assume a technical support role. They suggested that reimagining existing roles or adopting new roles would better support patients’ technical needs, as a cardiologist explains below:And what we're really trying to do is create a sharp divide between a provider being a health care provider and them being a technician. I think that the more that we can carve out technical stuff for people who wear that designated hat, I think that would be better…P22Furthermore, providers noted how nursing staff could play an active role in a patient’s video visit, for example, by gathering information, fostering connection, and collecting vitals:By having the LVN meet them first in the  room, talk about any vitals that they’ve taken at home, or their meds just like in the clinic, and then when she’s got all the information she needs, having the provider come in. I join the room and I hear my LVN, and the Veterans are laughing and talking, and talking about that social kind of things that you would normally do in a face-to-face visit. And my Veterans seem to be very happy with this format.P3While providers and other clinical team members play an important role in ensuring the success of video visits, participants also recounted how critical organizational initiatives and support are to implementation and sustainment. Providers noted that when leadership celebrated the success of video visits, it encouraged providers to invest in training and use. They also maintained that clear organization-wide policies and guidelines regarding the use of video visits to provide high-quality care can support growth.Providers also identified opportunities to enhance video visits by reimagining how health care visits can better incorporate technology. Patient-generated data may inform health care decisions; for example, by including data from a patient’s remote monitoring device, a provider may learn more about a patient’s overall health and well-being.They also described the opportunity to involve multiple providers in a visit to coordinate and guide clinical care, as this palliative care provider explains:[There is] more opportunity for combined visits between different specialties, so ways to coordinate visits. For example, to have joint visits with oncology and palliative care is something we do quite frequently in person… And so that something that’s kind of lost virtually.P28The previous example underscores the need for institutional support for the technical infrastructure that supports these types of combined visits.Finally, providers emphasized that for video visits to sustain momentum, organizations and leadership must continue to actively promote the value of video visits for their patients and ensure that video technology is accessible and user friendly. One provider summarized this point of view, stating,That's why virtual care or telemedicine is so important…. It shouldn't be the Veteran's responsibility to have to struggle to get to the VA. We should make [the VA system] as user friendly as possible, and this is 1 of the mechanisms that allows us to do that.P10ERIC implementation strategies are well-known, evidence-based practices that help facilitate the implementation and uptake of interventions. Within each of the 4 identified themes, the interview data highlighted several challenges and recommendations for improving video visit implementation. To further enhance the applicability of our findings, we mapped the challenges and recommendations embedded within each of the identified themes and related strategies to a variety of individual, clinic, and system-level ERIC implementation strategies . Our finThis work sought to identify strategies that support VA providers in using video visits effectively. Our findings suggest that the success of video visits relies on the complex coordination of the provider, care team, and organizational factors. As the VA shifts out of the early adoption phase of telehealth and into the long-term maintenance phase, there are new opportunities to support this evolving web-based care landscape. For example, video visits have primarily been used to replicate in-person visits, but there are opportunities to optimize visits for both patients and providers for long-term sustainment. More specifically, not all actions comprising a typical in-person visit must take place synchronously while a physician is conducting a video visit; for example, a patient’s chief complaints, vitals, and screening information can be collected in advance. Hence, engaging patients and clinical staff with new digital modalities to collect and share data has the potential to enhance video visits and should be an organizational priority.Partnerships with medical organizations and societies in the United States and abroad to develop and refine evidence-based guidelines for optimizing the video visit experience are important mechanisms for moving forward with these strategies. While a few medical associations have released clinical guidelines for telehealth practices, there is still a need to support evidence in the field on optimizing video visit care -43.Our work connecting provider-identified challenges and opportunities with video visits to ERIC implementation strategies yields several helpful insights. First, current training modules may need to be further refined to support education needs at the individual and clinical levels. Our findings also highlight the needs at the organizational level to reexamine the implementation of video visits, including using an implementation blueprint to support health care facilities, clinics, and providers in successful adoption. By promoting adaptability, the local needs of clinics, providers, and patients can be addressed, and funding for innovation encourages stakeholders to take an active role in improving video visit implementation. Organizations will need to potentially redesign the video visit clinic workflow, including revising staff roles, to support sustainment. Informed by the framework in Building long-term infrastructure for technology capacity while preserving patient privacy and security remains a top priority to support video visits. The lack of equitable broadband connectivity in many regions of the United States remains an important technical issue for video visit implementation . ContinuThere are several limitations to this work. First, our study focused on providers with previous experience using video-based technologies. This decision may impart some selection bias in our findings, as themes may have differed had we included those with less experience in video-based care. Providers with limited experience using video care likely confront a different set of barriers and challenges; understanding their perspectives and experiences with video care is needed to create a fuller account of both the challenges and facilitators of successful video visits.Second, we only interviewed physicians and nurse practitioners and did not obtain feedback from other clinical team members , whose buy-in is necessary for role expansion associated with video-based care promotion. A teamwork approach to web-based care, where technical challenges and troubleshooting with patients are performed by nonclinician members of the care team, could be studied to facilitate video-based care uptake. While this study only focused on provider-based strategies to increase the use of video-based care, we recognize that incorporating and building on patient-focused engagement strategies are also necessary. Though we focused on provider experiences with video care, patients and their engagement with web-based technologies clearly play a role in the “success” of video visits. Furthermore, our interviews are unable to assess the impact of web-based care modalities on patient outcomes. Third, we conducted our interviews during an early period of the COVID-19 pandemic, when many providers were still becoming accustomed to using web-based care. Finally, this study was conducted in the VA, a highly integrated health care system that had an established web-based care infrastructure prior to the pandemic. Providers employed in other health care systems may confront a different set of challenges and barriers, and therefore strategies that work in this setting may have less applicability in others.This work summarizes the strategies that providers adopted and identified as important to successfully implement video visits in the VA. Future work should examine the concurrence of the provider experience with executive, program office, and patient perspectives. Additionally, further testing and trialability of these suggested strategies, along with evaluation of their impact on video visit usage and provider satisfaction, would enable the refinement of implementation strategies. Additional research that examines health outcomes associated with web-based care would further support the uptake of these modalities. Ultimately, this would increase their ability to support and facilitate the large-scale implementation and sustainment of video-based care at the VA and other large health care organizations.


Anomaly detection in video surveillance is a highly developed subject that is attracting increased attention from the research community. There is great demand for intelligent systems with the capacity to automatically detect anomalous events in streaming videos. Due to this, a wide variety of approaches have been proposed to build an effective model that would ensure public security. There has been a variety of surveys of anomaly detection, such as of network anomaly detection, financial fraud detection, human behavioral analysis, and many more. Deep learning has been successfully applied to many aspects of computer vision. In particular, the strong growth of generative models means that these are the main techniques used in the proposed methods. This paper aims to provide a comprehensive review of the deep learning-based techniques used in the field of video anomaly detection. Specifically, deep learning-based approaches have been categorized into different methods by their objectives and learning metrics. Additionally, preprocessing and feature engineering techniques are discussed thoroughly for the vision-based domain. This paper also describes the benchmark databases used in training and detecting abnormal human behavior. Finally, the common challenges in video surveillance are discussed, to offer some possible solutions and directions for future research. With today’s increasing demand for security, especially in public places such as airports, train stations, supermarkets, schools, and crowded street, surveillance cameras are used for monitoring daily activities and detecting abnormal events. This task focuses on the localization of anomalies using both temporal and partial information in videos. Anomalies can be defined as events deviating from normal behavior , e.g., fAnomaly detection in video has a wide range of applications, such as for traffic accident detection, criminal activity detection, and illegal activity detection. In addition, detecting anomalous items or abandoned objects, such as guns or knifes, is necessary in sensitive areas.Anomaly detection has become an active area of research in recent years. With the purpose of trying to conduct an automated process for detecting abnormal events, many methods have been proposed. The essential idea is to first learn normal patterns from training videos, then extract representations of normal cases. If any events deviate from these representations, an abnormal event can be detected. However, there are still a lot challenges in video surveillance and human activity recognition. These difficulties are related to the feature extraction stage, where occlusion, overlapping, cluttered backgrounds, sensor noise, low illumination, and dynamic background changes may impact a system’s performance . It is qA comprehensive review of vision-based human activity recognition for video surveillance.A description of popular databases used in anomaly detection.Analysis of data processing and feature engineering for deep learning models.Discussion of recent deep learning models, along with their advantages and disadvantages.Identifying existing challenges and future research for anomaly detection in video surveillance.This survey explores the current deep learning methods that have been used in video surveillance. In particular, it focuses on the understanding of abnormal human behaviors, since the identification and recognition of actions is key for an intelligent video system. This survey’s scope encompasses vision-based approaches, since this is becoming a popular trend in action recognition. The significant contributions of this survey are as follows:video surveillance, deep learning activity recognition, human action representation, abnormal behavior detection. The references from these papers were extracted, validated, and added to the survey. After that, research relevant to video surveillance was also included. Finally, the general structure and representative methods were provided in detail, to give an insight into each learning model.In order to prepare for the survey, an essential step was to search and filter recent papers on video surveillance using deep learning techniques for understanding human activities. The research papers were download using relevant index terms, such as The organization of this survey is as follows: In Human action recognition (HAR) is a fundamental problem in computer vision and has been studied for a long time. The purpose of HAR is to identify the action taking place in a video, in order to understand and produce an analysis of specific events. A video’s spatial and temporal information plays an important role in HAR, to correctly identify human actions and classify the video. The detection of abnormal behavior in video surveillance is basically used to ensure security in both indoor and outdoor locations, such as in airports and train stations. Abnormal human action recognition (AbHAR) can be considered a particular problem in HAR. The problem with AbHAR in videos is that it can vary widely, and there is no single approach to solving all problem cases. The common approaches to AbHAR rely on feature extraction from image sequences. These features are built for the tasks of object detection, pose estimation, and finding the dense trajectories that are useful in HAR.AbHAR is used in video surveillance for monitoring behavior and people’s activities, with the purpose of ensuring security and giving instructions. This requires a certain general background in many video processing domains. Video surveillance includes the implementation of knowledge of feature extraction, scene understanding, object tracking, object identification, and model generation. Specifically, the feature extraction step needs to be addressed carefully, since it has a great impact on the whole system. Traditional machine learning algorithms have achieved remarkable results in AbHAR, based on learning shallow features from video data. Methods such as random forest (RF) , BayesiaAnomaly detection in video surveillance has been studied for decades. The topic has attracted much attention from the research community, due to its varied applications. A vast amount of methods have been proposed for both traditional and deep learning approaches to AbHAR. In order to keep track of all available studies, thorough surveys are of considerable interest. In 1997 and 1999, there were reviews ,16 on huIn 2013, a survey was performed of vision-based HAR  summarizA survey  in 2018 A survey of network anomaly detection  was perfAnomaly detection has been extensively studied in many fields, especially in computer vision, for the purpose of learning and understanding activity recognition. This task can become very challenging, due to the complexity of real-world situations. There are infinite abnormal events, and it is impossible to gather all kinds. Fortunately, many databases have been developed to help the scientist and researcher with this task. These databases were mainly acquired in the visible spectrum, so they are sensitive to occlusion and illumination changes. In this section, we briefly introduce some popular databases that researchers are currently using for detecting behavioral anomalies. We arrange the databases in chronological order, from the oldest to the newest database. For each database, we summarize information of the release year, type of database , details of the sensor used , description of anomalous activities, and sample images.-Walk: One subject walking along the road.-Run: One subject running along the road.-Bend: One subject bending his/her body while walking.-Jump: One subject jumping along the road.-Crouch: One subject crouching once while walking along the road.-Faint: One subject falling down on the ground while walking along the road.-Wander: One subject wandering around.-Punching a car: One subject punching a car.Single person action:-Rob: One subject robing another one.-Fight: Two subjects fighting with each other.-Follow: One subject following another till the end.-Follow and gather: One subject following another and then walking together with the other to the end.-Meet and part: Two subjects meeting each other and then departing.-Meet and gather: Two subjects meeting each other and then walking together till the end.-Overtake: One subject overtaking another.Interaction:The CASIA Action database  was releIn order to capture the videos, three noncalibrated cameras were used simultaneously from different viewing angles, which were a horizontal view, angled view, and top-down view. These videos were encoded at a frame rate of 25 FPS and were compressed with the huffyuv codec in avi format. The original spatial resolution of the video frames was reduced to 320 × 240. Each video lasts from 5 s to 30 s, due to the different kind of action. The subway database was introduced by Adam et al. in their 2008 paper . This isThe UMN database was released in 2009 and first described in the paper titled “Abnormal crowd behavior detection using social force model” by R. Mehran et al. . The vidThe database has a total of 11 short videos, which are aggregated into one long video of 4 min 17 s with 7739 frames. The small videos begin with normal behavior, then change to abnormal. There is one scenario for the indoor scene and two outdoors. All the videos have the same frame rate of 30 FPS and were recorded at a resolution of 640 × 480 using a static camera. The ground truth is a temporal annotation. Traffic–Train: This video records daily activity on a train. This is a very challenging video, since the lighting conditions change drastically and there is camera jitter. The video includes 19,218 frames of RGB image with a resolution of 288 × 386 and a frame rate of 25 FPS. The anomalous event is the movement of a passenger.Belleview: This video includes cars moving through an intersection. Video is recorded in grayscale format at a resolution of 320 × 240, with a frame rate of 10 FPS, and it has 2918 frames in total. The anomalous event is cars entering the thoroughfare from the left or right.Boat–Sea: This video describes a passing boat as an abnormal event. The video was recorded in RGB format at a resolution of 720 × 576, with a frame rate of 19 FPS, and it has 450 frames in total.Boat–River: This video illustrates a boat passing on a river as an abnormal event. The video was recorded in RGB format at a resolution of 720 × 576, with a frame rate of 5 FPS, and it has 250 frames in total.Canoe: This video describes a canoe passing on a river as an abnormal event. The video was recorded in RGB format at a resolution of 320 × 240, with a frame rate of 30 FPS, and it has 1050 frames in total.Camouflage: This video illustrates a person walking in camouflage. The right motion is learned as the normal behavior, and the opposite is the abnormal behavior. The video was recorded in RGB format at a resolution of 320 × 240, with a frame rate of 30 FPS, and it has 1629 frames in total.Airport-WrongDir: This video records people walking in a line at an airport. The video was recorded in RGB format at a resolution of 300 × 300, with a frame rate of 25 FPS, and it has 2200 frames in total. The anomalous event is people moving in the wrong direction.The Anomalous Behavior Database  was releStrange actions: behaviors such as running, throwing objects, and loitering.Wrong direction: people moving in the wrong direction.Abnormal objects: people carrying some strange objects with them, such as a bicycle.This database  was releThe circulation of non-pedestrian entities on the walkways such as bikers, skaters, and small carts.Anomalous pedestrian motion patterns, such as people walking across a walkway or in the grass that surrounds it.This database  was releThe Pedestrian 1 (Ped1) dataset includes 34 normal training videos and 36 abnormal testing videos of groups of people walking towards and away from the camera. These abnormal cases are mainly related to abnormal vehicles, such as bicycles and cars entering the crowd. Some sample images are shown in The Pedestrian 2 (Ped2) dataset contains 16 training videos and 12 testing videos with 12 abnormal events. Ped2 includes scenes with pedestrian movement parallel to the camera plane. The definition of an anomaly for Ped2 is the same as for Ped1. Some example images from the Ped2 dataset are shown in Strange actions: behaviors such as running, robbing, pushing, jumping, jumping over the fence, dropping, throwing objects, and fighting. Below are some sample images.Wrong direction: there is the case where people usually follow a normal direction, but someone does the inverse.Abnormal objects: this is a case where a person carries a strange object with them, such as a bicycle or baby stroller.This database  was releThe UCF-Crime database was released in 2018 . Then, the anomaly score is obtained using the following formula:The anomaly score Recent methods ,126,127 On the other hand, most recently proposed methods have tried to improve the accuracy of anomaly detection systems by applying a modern model ,131. We This section discusses the general challenges in AbHAR for video surveillance, as well as possible solutions and future research. Overall, researchers have relied on supervised learning methods for their approach. This requires a large amount of labeled data for training and improving the model accuracy. However, collecting data is a tedious and laborious process. There is also no standard dataset that can cover all abnormal behaviors in real situations. These problems can be solved by utilizing transfer learning techniques or crowd-sourcing . In addiDuring inference, there are also some limitations in most approaches, such as false alarms due to subtle details in human motion and appearance. In some cases, early detection is also necessary for crime prevention. These challenges can be approached by choosing representative features for AbHAR  that allA noisy environment is considered the main issue in many surveillance systems. A cluttered and dynamic background is challenging to model accurately. In addition, occlusion, low illumination, low-quality videos, and various viewpoints also occur in real-time surveillance. Multimodal data can overcome these challenges ,138, e.gFuture research will focus on using transfer learning methods in deep learning approaches,  such as Video surveillance systems are becoming increasingly important in detecting and preventing criminal activities in various settings, such as public spaces, offices, and homes. One of the essential components of a video surveillance system is abnormal human activity recognition (AbHAR). AbHAR is critical for detecting and understanding anomalous behaviors, which could be potential threats to the safety and security of the environment being monitored. This paper provides a comprehensive review of deep learning-based methods in video surveillance. Human activity recognition plays an important role in detecting and understanding anomalous behaviors. This review has covered the essential aspects of related works and background knowledge. It has also presented different benchmark databases used in AbHAR, with a detailed description of each one. These databases are increasing in both quantity and quality, allowing researchers to study many aspects related to real-time scenarios. This comprehensive review of deep learning-based methods has introduced methods such as reconstruction based approaches, multiclass classification, future frame prediction, and scoring methods. This diversity of approaches demonstrates the difficulty of AbHAR, which has forced researchers to find better solutions. In addition, future studies on the transfer learning method or multimodal datasets will provide initial steps toward a better analysis in anomaly detection. In fact, the choice of representative features in the feature engineering step is the most difficult part in any surveillance system. Robust feature extraction from a dynamic background is an essential part of capturing relative and discriminative patterns for tracking and understanding human behaviors.


Aims: This paper examines the co-occurrence of drinking alcohol and eating in Great Britain. Applying a practice-theoretical framework, it attends primarily to the nature and characteristics of events – to social situations. It asks whether drinking events involving food are significantly different from those without, whether differences are the same at home as on commercial public premises, and whether differences are the same for men and women. The focus is especially on episodes of drinking with meals at home, an infrequently explored context for a substantial proportion of contemporary alcohol consumption. Data: Employing a secondary analysis of commercial data about the British population in 2016, we examine reports of 47,645 drinking events, on commercial premises and at other locations, to explore how eating food and consumption of alcoholic beverages affect one another. Three types of event are compared – drinking with meals, with snacks, and without any food. Variables describing situations include group size and composition, temporal and spatial parameters, beverages, purposes, and simultaneous activities. Basic sociodemographic characteristics of respondents are also examined, with a special focus on the effects of gender. Results: Behaviours differ between settings. The presence of food at a drinking episode is associated with different patterns of participation, orientations, and quantities and types of beverage consumed. Gender, age, and class differences are apparent. Conclusions: Patterns of alcohol consumption are significantly affected by the accompaniment of food. This is a much-neglected topic that would benefit from further comparative and time series studies to determine the consequences for behaviour and intervention. Since 2000, a significantly greater proportion of the alcohol consumed in Britain has been drunk at home , based on a secondary analysis of a commercial database about British drinking since 2000, this paper examines the reports of 47,645 events in 2016, on licensed premises (“on-trade”) and in other locations (“off-trade”). It explores how eating food during a drinking episode is associated with the social arrangements of the event and the alcohol consumed. Three substantive empirical questions are addressed:Historical accounts of drinking establishments in Britain offer an adequate understanding of the institutional framework of drinking-and-eating in public settings. Food was available in pubs and taverns serving business districts in large cities, and hotels provided both elaborate food and drink from the mid-19th century . In resiDrinking in domestic settings is less well understood. An important change in the last 50 years has been the growth of off-trade sales and a tendency for people to drink alcohol more frequently at home. Beverages purchased to drink at home increased from 53% to 67% of the total between 2000 and 2017 . Previou Britain was similarly ranked for frequency of drinking with meals on commercial premises, including in pubs and restaurants.Many factors affect the likelihood of alcohol being present at a meal including family socialisation, religious commitment, and national culture. In the European perspective, Britons drink more frequently at home, both with and without meals, and in public venues such as pubs and restaurants than most other EU countries . A surveWhether alcohol is accompanied by food affects what is drunk, how much, for what reason, and with whom. Yet reference in the alcohol studies literature to drinking with food is very sparse and mostly incidental. Market research on the purchase of wine supplies some clues but mostly takes for granted that meals are the principal context for drinking wine and therefore investigates no further e.g., . HupkensWhat is to be eaten and drunk is often a function of who is present. Company at home is most likely to be other household members, although hospitable domestic events engage friends and non-resident kin. The gender composition of groups also matters. The analysis is approached in the terms of theories of practice . A meso-A case study in the intersection of the practices of drinking and eating, this paper addresses a thorny theoretical issue. People engage in several practices at the same time and simultaneous engagement may affect how each is done. Looking at situated activity systematically is valuable because drinking with a meal may modify the consumption of both alcohol and food. The survey data employed facilitate inquiry into how activity is situated because the primary focus is discrete events that direct attention to behaviour in context rather than the agency of the individual.The next section describes in more detail the data and the methods used for their analysis. Section 3 presents the basic findings, examining in turn off-trade and on-trade events and the differences between them, with consideration given to gender and class differences. The discussion section focuses on characteristic aspects of meal, snack and drink-only events, speculating about the nature of “normal” drinking, gender differences, and drinking-and-eating as practical performance.Tables A1 and A2). The appendix also includes information about sample weighting and robustness checks and gives additional detailed information about gender variation (Tables A3 and A4).The Alcovision survey, carried out annually by the market research company Kantar, recruits a quota sample of 30,000 participants representative of the adult population of Great Britain. Its primary purpose is to provide detailed marketing information to the alcohol and related industries. Participants complete a retrospective online diary of their drinking activity over a seven-day period. Alcovision has a complex multilevel data structure capturing information at three levels. Drink-level information describes the characteristics of beverages reported by the respondents . Occasion-level information describes the characteristics of events, such as location, starting time, and type of venue. Individual-level information refers to personal characteristics of the respondent invariant between drinking occasions . The focus of this study is on occasion and individual characteristics. The variables included in the analysis are described briefly below. The data reveal the circumstances in which alcohol is consumed. Most available variables describe the characteristics of episodes rather than individuals. Consequently, these data are not susceptible to methodological individualist interpretation as it is less about individual persons and more about the pattern of behaviour by event type. The explanation is therefore not primarily in terms of personal capacities, resources, or decisions, rather more in terms of norms governing the arrangements of drinking episodes. We treat the event as the vector that results in the exposure of participants to certain styles and levels of alcohol consumption.The main dependent variable for current purposes has three levels, drinking without food, with a meal, or with a snack. Alcovision defines “snack” simply as “light snack” when referring to domestic settings but specifies three sub-categories in on-trade locations: “crisps/nuts or other bagged snacks”, “sandwich/baguette/panini”, and “light snack/bar snack”. Note that the primary focus, militated by the data, is drinking events, so when discussing drinking with meals we are not making statements about all meals.Measures of factors determining the character of events include the following: group size and composition; gender composition and the social relationships between participants; temporal parameters of time of day, day of the week, and duration; spatial parameters, whether at home or away, and if away at what type of venue and in what type of location . Sociodemographic characteristics of individual respondents include age, household income, employment status, class , gender, and urban/rural residence. While the survey also includes batteries of questions about mood, reasons, and venues, most of these do not discriminate between types of event, so we retain information about only a few which do, such as “winding down” or “having a laugh”.The analysis compares the bivariate associations between the three types of event and the situational features of drinking occasions. The details for the models used to test for statistical differences between samples are explained in the Appendix (see footnote 11). Almost every measured difference is statistically significant because of the very large numbers of observations. However, for purposes of interpretation, we discuss only very strong associations. The focus of attention is the relative frequency of the interdependence of features of a social situation with the presence of food.In accounting for the differences between types of event – with meals, snacks, or without food – the effects of situational features, where sufficiently strong, are discussed in turn: amount and type of alcohol consumed; time of day and day of the week; duration of the event; status of companions; mood and purpose of events; and concurrent activities. Differences by class and gender are then noted.While Kantar data have been collected since 2001, methods of data collection and sampling have changed, radically in 2008. This paper concentrates on 2016. An examination of the data for 2009, the earliest comparable data point, shows no observable main trends.The data show that home was the principal location for drinking in 2016, on-trade occasions representing slightly less than one-quarter of all events reported. Occasions on- and off-trade are so differently structured that we describe them separately.A majority (66%) of drinking events at home are accompanied by food, either a meal (47%) or a snack (19%).More units of alcohol are consumed with food, on average 7.5 units with meals and 7.2 with snacks, compared with 5.9 at events without food. Quantity and type of beverage vary. Non-food events are more likely to involve less than 2 units of alcohol, meals more than 5. Wine is much more often present at meals, and beer and spirits at non-food events.As When drinking occurs alongside a meal the event is more protracted, 24% last over 2 hours. Events without food take much less time, with 38% lasting less than 1 hour. Meals occur most predominantly in the evening, as do the other types of event, but drinking without food is more common after 10 pm (15% of non-food events). Meals are described predominantly as involving a regular or a quiet drink. Non-food occasions are more frequently described as a quiet drink or a nightcap.The company present is an important parameter of the different types of event. A partner was present at 51% of meals, but at only 41% of non-food events. Family members were present at 29% of meals compared with 15% of non-food events. The implicit importance of evening household meals is corroborated by the gender composition of companions. Meals at home are much more likely to have either mixed pairs (couples/partners) or mixed groups present.  Events without food are disproportionately likely to involve men, alone or in pairs.Events of domestic hospitality are frequent; 14% of all events occur in the home of someone other than the respondent. Given the norm of reciprocity , such anAsked about activities occurring concurrently with drinking at home, respondents unsurprisingly reveal that drinking is not the only, and therefore perhaps not the primary, focus of attention. Over half of all occasions (55%) include watching television, more than one-quarter (27%) using the Internet, and more than one-fifth (22%) playing games. There is not much variation across the types of event, although snacks are more commonly associated with Internet usage and games. However, drinking episodes around meal events include chores in 26% of instances, 40% of which are explicitly cooking, capturing a habit, more common among women than men, of drinking during meal preparation.Drinking at home with meals is more common in households with higher incomes and higher socioeconomic status. The poorest households are less likely to be present at meals where alcohol is consumed. The higher classes (AB) opt to drink alcohol with meals; meals have more members of the professional managerial classes present, while working classes are more likely to drink at home without a meal. A degree of class polarisation is apparent.Table A3). Men report greater involvement in each of the three types of event. Difference is greatest for non-food events, 64% of which were reported by men and only 36% by women. Despite women doing most of their drinking at home, men register 50% more of such events. On average, individual female respondents record 2.5 events during a 7-day period (whereas men report three events) comprising a greater proportion of meals and significantly fewer non-food events. Of events reported by men, 44% are meals, 19% snacks, and 37% non-food. For women, 52% of events are meals, 18% snacks, and 30% non-food. Men exceed women by 10%–20% in units of alcohol consumed. Women do more of their drinking in the evening, with a greater proportion at meals. They define their experience less often as a regular drink than do men, perhaps because food is uppermost in consciousness. Wine was the primary drink at domestic meals for 55% of women but only 38% of men. The proportions for beer were 14% and 35%, respectively.Differences between events reflect frequently observed gender differences  are fewer and more last between 2 and 4 hours. Higher levels of alcohol are consumed, with beer more popular, and wine and spirits less frequently the primary beverage. Snack events are the type most likely to exceed a duration of 2 hours, implying that engagement with additional activities prolongs an episode and encourages recourse to convenient forms of minor nourishment.Meal occasions provide greater opportunity for family and household members to drink in public than events comprising only drinking. Family members are in attendance at meals; a partner being present in 41% of cases, children in 17%, and other family in 31%. Friends were present at 41% of meals but 57% of non-food events, the latter featuring only 22% of partners, 4% of children, and 11% other family. Although in absolute terms men eat out more often, they report a much higher proportion of non-food events and a smaller proportion of meals than women. Men report 30% meals, 61% no food, and 9% snacks. The equivalent for women is 44%, 45%, and 11%, respectively. When they drink, women are more likely than men to be at events where food is served. Men meet in groups containing only other men at non-food events five times more frequently than women; of all occasions, 40% are men-only but only 8% women-only. At non-food events, men present are on average 14 years older than women, implying that ageing men are the customers in commercial establishments where no food is served. Male groups are more likely to come together at non-food events (30% cf. 12% of women), which are often described as bonding or having a laugh.A high proportion of meal events (28%) are accounted for as “having time for myself, partner or family”, an indication that eating together away from home is an important part of the routines of many couples and partners. Non-food events, and also snacks, are more likely to cite “winding down” or “having a laugh” as a rationale. On-trade events often include complementary activities; live music (15% of events) was the most frequent, and watching TV and drinking outdoors each registered 12% of events. Complementary activities were least likely to occur alongside meals and most likely to involve snacks, suggesting that meals are a sufficient focus of attention in their own right while other entertainments and pastimes are accompanied by snacks.Appendix Table 4 which describes gender differences). Working class men are less likely to eat while drinking in both commercial and domestic settings. Working class women drink with meals less than their professional and managerial counterparts, but there is no class difference apparent at on-trade events.Members of the professional and managerial classes  and households with higher incomes more often report eating meals while drinking. Events without food are more or less class neutral; working class people are equally likely to be present at non-food occasions. Meals attract more class AB men and proportionately fewer from class DE . Women are more likely to be accompanied by a partner at non-food occasions (33% cf. 17%). They also report family members present on 14% of occasions (cf. 10% for men). Thus, the conventions surrounding drinking in public for men and women remain differentiated. Women are less likely to drink or eat alone, and they more often have male companions. Only 0.5% of meals have a woman alone, compared to 2.5% with a man alone, confirming that women remain averse to eating out unaccompanied. In less than 5% of non-food events involving women, the woman is alone (cf. 16% men). Overall, women are more likely to eat when drinking, a tendency that increases monotonically with age. Conversely, the younger a woman the more she attends events without food. Age effects can also be observed on companions present. The youngest and the oldest age groups drink more frequently with friends, while the middle aged, who are more likely to have dependent children, are more often accompanied by partners or family.The presence or absence of food marks significant differences in the social arrangements surrounding drinking. Meals, snacks, and drinks have different social meanings. The three types of events vary in terms of their procedures and purposes. They have different participants, companionship structures, and consumption patterns, and they deliver different experiences as a result of their different arrangements. The greatest contrast in form is between meal events and non-food events, with snack events mostly having intermediate characteristics. Most drinking events occur at home and a substantial proportion involve meals, a significant emergent facet of British alimentary and drinking culture. Demarcation between types of event is stronger in on-trade than in domestic settings.A major determinant of the character of both meal and non-food occasions is whether they occur in domestic or commercial settings. Commercial non-food events attract a greater proportion of men and a smaller proportion of women, but there is little other sociodemographic variation by location. However, the gender composition of parties varies significantly; in public fewer men and women drink alone or in mixed pairs, male groups and mixed groups are much more prevalent, and there are fewer partners and many more friends. Unsurprisingly, sectors also differ in the complementary activities that occur alongside drinking. On-trade venues offer dancing, musical performances, quizzes, etc., which are very rarely part of domestic provision. However, at home, complementary activities occur in similar proportions at all three types of event. The overall impression is that on-trade events, whether meals or just drinks, are more convivial and less rushed, while domestic events are privatised, reserved for partners and other household members.Meals contrast most strongly with non-food events but are very similar irrespective of sectoral setting. For example, in both domestic and public settings, meals result in more friends being present, are more frequently daytime appointments, and last longer. Thus, the event type has some integrity; the same norms or constellations of arrangements persist whether home or away. This suggests that explanation of diversity in the character of drinking occasions lies primarily in the different understandings and conventions that define types of social occasion.Meals are a minor element of commercial provision, notwithstanding the growing importance of catering for licensed businesses. Most on-trade events occur without food and only one-third (35%) involve a meal. Differences between meals at home and those in pubs and restaurants are limited. Meals away from home are more likely to involve friends and non-resident kin, but still partners and other household members comprise a high proportion of companions. Duration, units of alcohol consumed, time of day, and beverage preference are similar.Meals are more common in domestic settings. Perhaps unsurprisingly, given the preponderance of households whose members are likely to be together at home in the evening and at the time when most eat dinner, variation by gender is not very great. Partners eat together both at home and on commercial premises but are less frequently co-present when just drinking. The trend towards most people eating their main meal at home in the evening, a convenient arrangement for an increasing proportion of dual-earner households, offered new opportunities for drinking . Most drThe legitimacy of drinking alcohol with meals increases opportunities to drink for both men and women. Meals in restaurants for the sake of entertainment, where drinking is central to the format, only became a common practice for the majority of the population in the 1980s . DrinkinOur findings suggest a gradual shift, accelerating since the millennium, towards drinking with meals, especially at home. The dinner table is now the site of a substantial proportion of all drinking events. This additional setting for legitimate alcohol consumption has emerged to provide the opportunity for regular and routinised events involving moderate levels of drinking at home. The reasons adduced for domestic events – like “winding down”, “just a quiet drink”, “a regular drink” – suggest a degree of normalisation, typical of mundane social practices .Drinking with dinner remains more common among the professional classes and is the occasion when wine is most prevalent. The presence of alcohol probably elevates the meal in a hierarchy of occasions; more important meals justify wine and beer, although the normalisation of drinking on weekday evenings may progressively flatten any effect. The relative popularity of wine with meals, both at home and away, is consistent with trends towards greater diversity and flexibility in consumption patterns. An extended period of informalisation in manners and etiquette, across many fields of cultural behaviour and lifestyle, weakens previously observed rules of behaviour . For exaInformalisation may be reflected in changing class norms. Men in class AB drink with meals, whereas those in Class DE still do not. However, other indications of class differentiation are weak and perhaps diminishing. There is no social compulsion to mark position in a status hierarchy by selection of beverage, especially among women. Symbolic aspects of drink selection persist nevertheless. Intermediaries advise that beer should be drunk with South Asian dishes, and water has undergone a major revival, with sparkling water in restaurants a signifier of cultural capital and fashion .The social regulation of meals is well documented, with its consequent predictable variations in format and style. A hierarchy of meal events is fairly securely established, expressed through quantity of food, type of food, degree of elaboration, definition of the occasion, duration, company, location, and calendric significance  e.g., . It is mThe snack is an ill-defined and often residual alimentary category , althougThe snack signifies conviviality, facilitates a greater degree of sharing, and gives beverages a higher profile or standing. At events of domestic hospitality, offering a guest at least a small quantity of food to accompany an alcoholic drink is almost obligatory but is less likely to be a meal than a snack . Snacks Drinking without food remains the principal form of on-trade consumption. It is more popular with men, and groups much more often comprise only men. Such events ground the stereotype of traditional, masculine drinking involving consumption of rather a lot of beer in British pubs. While an iconic representation of British pub culture, men drinking together constitute less than one-fifth (17%) of on-trade events and therefore merely 4% of all drinking events. Women drinking without food use a wider variety of outlets and are much more likely to drink in mixed company. At home, while men still drink more often than women, gender differences are less stark with men and women alike describing non-food occasions most often as a quiet drink or a nightcap.The conventions governing drinking at home are fairly similar for men and women. No qualities of an event are exclusive to one or other sex. Men and women participate in every type of event, although at different rates. Thus while Settings are important for understanding eating-and-drinking. Adjusting flexibly to settings demonstrates personal and procedural competence to perform in accordance with the norms and conventions of established practices. The quiet drink, the winding down period, and the regular drink primarily with meals are the most common re-descriptions of all kinds of event. Big nights out, with long periods of sustained drinking, comprise a small proportion of all occasions, suggesting that the focus of research on episodes of excessive intoxication hampers appreciation of the more common and normal ways of using alcoholic beverages see . In manyThis paper points to theoretical and methodological complications arising when more than one practice is relevant to the understanding of patterns of behaviour. People doing more than one thing at a time is inconvenient for analyses concentrated on a single focal practice, as recent discussions of practice theory reveal . The pauvice versa, which potentially modifies the fundamental principles and procedures of both eating and drinking practices.Much drinking occurs simultaneously with subsistence and recreational activities, within and outside the home. Knowing whether drinking or eating are primary or subsidiary activities at an event is critical for understanding behaviour, not least because of its potential consequences for health-related interventions . People To our knowledge, no comparable surveys have been analysed to address this question, hence it is uncertain whether the same associations exist in other national contexts. Future research might usefully pay greater attention to the coincidence of eating and drinking, not least because the social structuring of different types of event affects levels of alcohol consumption, a matter important in its own right and useful when devising interventions to change behaviour. Collecting more elaborate and specifically targeted data on types of occasion and sociodemographic characteristics of individuals would pay dividends. A purpose-designed survey to explore the intersection of eating and drinking would be ideal because the Kantar survey is not of the whole population. Rather it records only the eating-and-drinking behaviour of a section of the population who imbibed at least 1 unit of alcohol in the previous 7 days. Consequently, the data collected are asymmetrical, a record of what those who drink eat, not what those who eat drink. Comparative studies, perhaps contrasting societies with different ratios of eating and drinking in domestic and public settings, would also enhance understanding of the association.Click here for additional data file.Supplemental material, sj-docx-1-nad-10.1177_14550725231157222 for Situated drinking: The association between eating and alcohol consumption in Great Britain by Alan Warde, Alessandro Sasso, John Holmes, Monica Hernández Alava, Abigail K. Stevely and Petra S. Meier in Nordic Studies on Alcohol and Drugs