bluuebunny/crossref_metadata_2025 huggingface dataset:
Methods for reducing the carbon footprint of industrial and construction facilities
Authors: Dolmatov S N , Kolesnikov P G , Smertin N V
Published: February 2022

Greater attention to technologies that reduce the carbon footprint is a consistent trend in the development of the world economy at the present stage. International agreements (the Kyoto and Paris Climate Agreements) create a regulatory ground for reducing carbon emissions into the atmosphere and greenhouse gases. Reducing CO2 emissions will require the adoption of modern principles for buildings and constructions design. Scientific substantiation of the stages and the life cycle of building structures with a limited operating time, taking into account the introduction of modern construction materials, is an effective way to reduce CO2 emissions in the industrial sector and in the field of residential municipal construction.
Territorial and geographical aspects of sable extraction, harvesting and sale of its skins - from Ancient Russia to the Russian Federation
Authors: Shadyul L V , Vashukevich Y E , Vashukevich E V
Published: February 2022

The article is devoted to territorial and geographical aspects of the fur trade formation and development in different periods of Russian history. The data of various departmental and literary sources on sable extraction volumes, starting from the 6th century AD, are analysed. Until now. The authors relying on the collected data have tried to clarify the dynamics of extraction the most valuable type of commercial fur. The information received from the largest fur fairs in Tsarist Russia, and later from international fur auctions, has been studied. It has been established that the data of various official reports and other literary sources differ to a large extent, which does not allow establishing the exact volumes of sable extraction with a high degree of reliability. It was confirmed that by the 30s of the 20th century, the sable was practically destroyed in most of the range, which required the adoption of measures to restore the species over several years. The article discusses development of the system of procurement and sale of sable skins, examples of selling prices in different historical periods are given. The dynamics of the preparation of sable skins in the Soviet and market periods is shown. The reasons for price fluctuations in the world fur market are revealed.
Growth and development analysis of silver Brium (Bryum argentium Hedw.) depending on illumination level influence
Authors: Kozlova E A , Orlova E E , Zubik I N , Simakhin M V
Published: February 2022

In modern ornamental gardening, there are many types and varieties of plants. In recent decades, representatives of bryophytes group (Bryophyta), in particular, silver Brium (Bryum argenteum Hedw.), have been especially popular. This moss is not only one of the most popular moss types used for decorative purposes, but it can also be considered a good subject for biomonitoring. Bryophytes are used as sources of information about environment state, which directly affects surrounding living objects life. The use of bryophytes makes it possible to detect places of pollution, to assess the harmfulness of pollutants, which, in turn, makes it possible to assess of environment changes rate. During our research, illumination level influence on the growth and development of silver Brium, in particular on the indicators of plant height and the number of plants per unit area, was established.
Development of a Software Package for Digital Forest Inventory Based on Aerial Photography Data
Authors: Yu Prosekov A , Rada A O , Kuznetsov A D , Timofeev A E , Osintseva M A
Published: February 2022

When clearing protective strips for linear infrastructure such as power lines, it is important to minimize tree felling. The purpose of the study is to develop and test a software package for digital forest inventory of tree and shrub vegetation in the zones of linear infrastructure facilities. In the study, a software package for digital forest inventory based on aerial photography with UAVs was developed and tested, based on the methods of multilayer perceptron and a self-organizing network based on competition (Kohonen network). The approbation has shown that it allows to accurately identifying the presence and height of trees and shrubs in the protection zones, to obtain precise coordinates for planning clearing works. At present, the areas of the territory where it is necessary to remove trees and shrubs are determined manually with an overestimation of 25-50%. Therefore, the use of a software package for digital forest inventory allows you to save up to 0.8 hectares of trees and shrubs per 1 kilometre of the length of the power transmission line, as well as save about 27 thousand rubles (about 375 US dollars) per 1 kilometre during work.
Numerical simulation of collection efficiency in separator with inclined double-T elements
Authors: Zinurov V E , Kharkov V V , Salakhova E I , Vakhitov M R , Kuznetsov M G
Published: February 2022

The article considers the problem of improving efficiency for capturing solid particles in the production of silicon dioxide. The authors propose a separator with inclined double-T elements. The operating principle of the device is described. It is shown that particles are captured from gas due to centrifugal forces when they pass through elements. The main parameters affecting the collection efficiency of the separator are the inlet gas velocity, which determines the centrifugal force of the swirls, the particle density, and the diameter of the particles determining the inertial knocking out of the structured flow. Numerical simulations have shown the device’s efficiency with inclined double-T elements in collecting fumed silica solids of 1 to 15 μm in size, a density of 2000 to 3000 kg/m3, and the inlet velocity of 3 to 10 m/s changes from 20.8 to 100%. Pressure loss of separator with inclined double-T elements is 168 to 1880 Pa at inlet gas velocity from 3 to 10 m/s.
Substantiation of cultivator points form of the lowest draught for stratifier tillage machine
Authors: Syromyatnikov Yu N , Belykh A V , Ivanov A A , Kalimullin M N , Lopareva S G , Luchinovich A A , Loparev D V
Published: February 2022

Soil cultivating loosening and separating stratifier machine performs soil detachment by separating lumps according to the working depth. When lifting and separating soil, the rotor rippers carry weeds onto the treated field surface. The machine can be used in systems of “No till” technologies, however, in order to reduce the energy intensity of operations on soil cultivation by a mechanical method, when developing soil-cultivating loosening-separating machines, it is important to substantiate the form of the cultivator points of the lowest draught. The cultivator points of the tillage machine are designed for cutting the soil layer, directing the soil to the loosening-separating device. The indicator of the energy intensity of the process is the resistance force of the movement of the cultivator points in the soil. To find the extremum of the functional, the direct method of the Ritz calculus of variations was used. As a result, a graph is obtained that depicts the shape of the line of the lowest draught. In order to determine the reliability of the results of theoretical studies, the energy indicators of the operation of the cultivator points device for cutting and lifting soil were calculated. The cultivator points with a theoretically substantiated profile, compared to the sidewall of the straight profile, have draught of 38.5%.
The influence of mineral inclusions on the heat efficiency of the enclosing construction from wood-cement composite in the rural house building
Authors: Dolmatov S N , Yu Maksimovich E , Kalimullin M N , Tihonov E A , Kamenchukov A V , Loparev D V , Sokolova V A
Published: February 2022

Reducing the cost of maintaining housing objects inevitably leads to the development of energy-saving technologies and building materials. Cost reduction is achieved by reducing heat losses through walls and floors of buildings and structures. Wood-cement composite materials are attractive not only from the point of view of energy saving and reducing construction costs, but also as materials in the production of which woodworking waste is used, therefore, the problem of complex waste-free use of raw materials is solved. In the course of the research, the influence of mineral inclusions on the indicators of the thermal efficiency of enclosing structures made of wood-cement composite (wood concrete and sawdust concrete) was determined. The work was based on the use of physical modeling methods (finite element method) implemented in the Elcut software package. The value of the heat loss indicator, depending on the type of wood-cement composite and operating conditions, was 34.2…. 54.8 W/(m2·°C). The indicator of resistance to heat transfer is 0.58 … 2.2 (m2·°C)/W. The presence of mineral inclusions worsens the thermal performance of the enclosing structure by an average of 7%. The results obtained can be used in the design and operation of building structures made of wood-cement composites.
Simulation of the stress state during blade wear and optimal design of the grain crusher wheel
Authors: Dorodov P V , Kasatkin V V , Petrov V A , Lebedev L Y , Litvinyuk A A
Published: February 2022

Currently, in the manufacture of agricultural products in the process of feed preparation, closed-type grain crushers are widely used, working on the principle of suction of the starting material and injection of the finished product. This type of crushers undergoes significant abrasive wear of working bodies (drums, hammers, sieves, etc.) due to their suboptimal geometric shape of the transition surface, where local stresses accumulate, as well as in the areas of contact of parts with particles of gas-dispersed material. It is possible to investigate the causes of the rapid destruction of the working bodies of the crusher by theoretical methods and modeling of physical processes, which will increase the speed, economic efficiency, reliability in the design of components and mechanisms, as well as optimize the design of the upgraded paddle wheel. The paper presents a theoretical model of the stress state on the working surface of the blade, the adequacy of which is confirmed by experimental data with a correlation coefficient of more than 0.95. Studies have allowed optimizing the position of the blade, at which it must be positioned at an angle of 10 ° to the axis of the wheel of the crusher drum, while the contact stresses on the wear surface are distributed almost evenly. This design change will lead to uniform wear of the blade and, as a result, to an increase in durability and reliability of the crusher.
Problems of metrological support of measurements in irrigation systems
Authors: Bondareva G I , Leonov O A , Zh Shkaruba N , Temasova G N , Vergazova Y G
Published: February 2022

Metrological activity in agriculture is not only a part of ensuring food security; measurement and control invisibly accompany both the production and the agricultural products processing. For the agro-industrial complex, it is especially important to control the accuracy of measuring water consumption, especially when irrigating crops and controlling soil moisture. The issues of metrological support in land melioration are considered. The analysis of the system of metrological support of the agro-industrial complex of Russia is carried out, a project for organizing a metrological service in land melioration under the Ministry of Agriculture is proposed. To highlight the discussed issue, the calculation of losses from the measurement errors with an annual water flow rate of 1,000,000 m3 is given; it is found that losses during control can be up to 50,000 m3, which in monetary terms are 1,250,000 rubles. It is recommended to pay special attention to the issues of introducing metering and control of water consumption, as well as ensuring the accuracy and uniformity of measurements. It is recommended to carry out annual calibration of flow measuring instruments.
About diagnostic features of Polygonum L. genus. Perianth
Authors: Tupitsyna N N
Published: February 2022

The genus Polygonum is quite difficult to define due to its inherent biological characteristics. Purpose of the work: to analyze the shape of the perianth of representatives of different subsections of the section Polygonum of the genus and to determine its diagnostic value.For diagnostic purposes, in addition to the known signs, it is proposed to use the shape of the perianth, which is determined by the following indicators: the ratio of the length and width of the perianth; the presence and position of the greatest width (in the lower, middle, upper part) of the perianth; the position of the perianth lobes, characterizing the degree of its openness - closed (closed), converging (half-open), erect and diverging (open). Siberian representatives of the genus Polygonum have 8 perianth forms: tubular, water lily, oblong-ovate, ovate, funnel-shaped, bell-shaped, goblet, and cupped. The perianth forms correspond to the subsections of the Polygonum section: tubular - Salsuginea, water lily - Polygonum, funnel-shaped - Arenaria, bell-shaped - Oxysperma, goblet - Humifusa. The presence of an oblong-ovoid perianth in the representatives of the subsections Acetosa, Patula and some species of the subsection Arenaria can be explained by their genetic proximity, and the goblet shape in some species of the subsections Polygonum, Patula - by their hybridogenic nature. The results of the performed analysis of the perianth forms reflect the system of the river. Polygonum. Both the distribution of perianths by subsections of the typical section, and deviations from the typical perianth forms for subsections are explained in the materials on the system and phylogeny of the r. Polygonum, obtained by the methods of factorial and discriminatory analyzes, RAPD-analysis of populations and in the results of the analysis of nucleotide polymorphism of the ITS 1-2 region of nuclear rDNA by the methods of maximum economy (MP) and maximum likelihood (ML).
Sorption of copper ions by immobilized yeast with poroforming additives
Authors: Garanin R A , Lykov I N
Published: February 2022

This study is devoted to the study of the processes of sorption of copper ions by living cells of the yeast Saccharomyces cerevisiae, immobilized on calcium alginate. It is shown that the biosorbent formulation used by us is capable of efficiently absorbing copper ions from the solutions under study in the concentration range from 0.1 mol/l to 0.001 mo l/l. We have identified the optimal amount of calcium alginate, at which the resulting bio sorbent in the form of spheres with a diameter of 2-5 mm absorbs the maximum possible amount of copper ions. The use of pore-forming additives (activated carbon or diatomaceous earth) doubles the sorption of copper ions and increases the completeness of sorption. The effect of exposure on the completeness of sorption of copper ions was studied.
Natural vegetation of Krasnoyarsk
Authors: Antipova E M , Antipova S V
Published: February 2022

The nature of the vegetation cover in Krasnoyarsk is due to the location of its territory near the border of the forest-steppe and taiga natural zones and anthropogenic impact. Natural vegetation includes 9 classes of formations, 18 groups of formations and 78 formations. The richest are the steppes (3 classes of formations, 6 groups of formations and 27 formations) and meadows (3 classes of formations, 8 groups of formations and 21 formations). A significant part of the city is covered with residential and industrial buildings, asphalted and concreted areas and roads, where the vegetation cover has been completely destroyed. Inside some city micro-districts and quarters, courtyards, clumps of forest vegetation have been preserved, on the outskirts of the city, river banks, canals, islands, meadow and swampy areas, bush and aquatic vegetation are common, steppe areas are found on the southern slopes of the Yenisei banks.
Evolution of bacterial pathogens of fish and ways to preserve ecosystems
Authors: Yukhimenko L N , Pimenov N V , Bychkova L I , Ivannikova R F , Laishevtcev A I , Sh Navruzshoeva G
Published: February 2022

During the study period from 1979 to 2014 .a retrospective analysis of changes in the species composition of the bacterial flora of fish and water was carried out in connection with the transition from pond fish cultivation technology to industrial methods. Studies to determine the composition of the microflora of fish and microbiocenosis of water were carried out in various fish farms (Konakovsky Commercial sturgeon Breeding Plant, sturgeon commodity farm of LLC «BioAcustic», Novomichurinsky fish farm, Mozhaisk industrial and Experimental fish farm). The analysis of the ratio of aeromonads and opportunistic microflora in the etiology of bacterial hemorrhagic septicemia of fish was carried out. When studying the microbiocenosis of salmon and sturgeon fish, the predominance of anaerobic aeromonads and non-fermenting alkali-forming agents was established. When analyzing the microbiocenosis of water, a high level of the total microbial number was established. In the studied water samples, bacteria of the Escherichia coli group, aeromonads, acinetobacteria, moraxella, proteus and myxobacteria were detected.
In vitro culture of Zingeria biebersteiniana (Claus) P. Smirn as a method of conservation and expanding its biodiversity
Authors: Khromov A V , Yu Cherednichenko M
Published: February 2022

Zingeria biebersteiniana (Claus) P. Smirn (2n = 4) is an insufficiently explored model plant and its research prospects are wide. At the same time, it is included in the Red List of Russia due to the narrow ecological amplitude of the species. During the work for the first time for this species, the conditions for the induction of callusogenesis and somatic organogenesis were studied. Aseptic plants were obtained by sterilization with 5 % sodium hypochlorite solution; seed stratification increased seed germination rate. Since rooting is often a problem by in vitro cultivation, various concentrations of the main components of MS nutrient medium were studied. It was found that for the induction of root formation the optimal composition of the nutrient medium contains 1/8-1/2 concentrations of mineral salts and vitamins according to the recipe MS. The study of the possibility of induction of callus formation was carried out on seeds and on leaf explants. For induction of callusogenesis on seeds, the greatest effectiveness was shown by MS with the addition of 4 mg/l 2,4-D, for further reproduction of callus - MS with the addition of 0.1-0.5 mg/l 2,4-D; however, it was not possible to achieve callus formation on leaf explants. The highest frequency of somatic organogenesis in callus tissue was achieved on MS with the addition of 1 mg/l BAP and 1/12 mg/l IAA.
Groundwater Vulnerability Zones Mapping Using DRASTIC and GOD Methods in Krendowahono Village, Karanganyar Regency
Authors: Koesuma Sorja , Rosidah Umi , Handono Ramelan Ari
Published: February 2022

Krendowahono Village is located in Karanganyar Regency, Central Java, Indonesia. During the dry season, several hamlets in Krendowahono Village experience a shortage of clean water. So an attempt must be made to maintain the quality and protect groundwater sources in areas of Krendowahono Village with fresh groundwater supplies. Analysing the vulnerability of groundwater is one of the attempts that can be made. The DRASTIC and GOD methods were used to conduct a vulnerability analysis of groundwater. The DRASTIC and GOD vulnerability assessments were then validated using water samples taken from resident wells. Groundwater vulnerability assessment utilizing the DRASTIC method resulted in the identification of two vulnerability classes: low vulnerability and medium vulnerability. While the GOD method generates three vulnerability classes for groundwater, they are low vulnerability class, medium vulnerability class, and high vulnerability class. The maximum correlation value between the results of the GOD method and the test of water samples with parameters of free ammonia, total dissolved solids (TDS), and salinity was obtained when the results of the GOD method and the test of water samples were validated using Spearman’s correlation. The correlation value associated with the pH parameter was the highest in the DRASTIC method. Likewise, the GOD method produced favourable performance in regional studies. This is demonstrated by the significant correlation between the GOD susceptibility test findings and the water sample test results.
Identification of aquifer zone in the southern part of Sukoharjo Regency using VES method as a means of irrigation of agricultural land
Authors: Maulana Rahma
Published: February 2022

Sukoharjo is one of the regencies in Indonesia that is famous for its agricultural land. Sukoharjo itself has 12 sub districts spread evenly throughout. In recent years, there have been many conflicts of irrigation water shortages for agricultural land. Therefore, research was conducted on the aquifer zone of the southern district of Sukoharjo. The research was conducted by Vertical Electrical Sounding method to determine the structure of soil in order to improve the efficiency of deep groundwater drilling for irrigation. The study used Schlumberger’s configuration with a target zone of deep aquifers for agricultural irrigation. The length of the track used is 275-300 meters. As a result of the study, it is suspected that the aquifer zone in southern Sukoharjo Regency has a depth of about 11.54-83.93 meters below the subsurface. The soil structure in south of Sukoharjo is dominated by sandy clay layers, limestone layers, and sedimentary layers.
Artificial neural network for landslide vulnerability mapping in Leitimur Peninsula Ambon Island
Authors: Puturuhu Ferad , Danoedoro Projo , Sartohadi Junun , Srihadmoko Danang
Published: February 2022

Artificial neural network (ANN) has been widely used in remote sensing to classify the various types of data. Moreover, it provides better accuracy results than statistical methods. In this study, AAN was applied to map landslide vulnerability zone in Leitimur Peninsula Ambon where landslide has frequently occurred in the period 2012 until now resulting in losses to community. The objective of this study was to determine the landslide vulnerability level zones of the study area. The method used was the logistic regression and ANN. The results showed that the largest zone (9957.33ha) or 65.47% of the study area is in low landslide vulnerability level, while the best result of the accuracy test is the ANN analysis with the value of 72.55%.
ICT application in CBDRM in Karangtengah village Bantul Regency
Authors: Mahendra S T , Pratomo A H , Paripurno E T
Published: February 2022

This research was conducted in Karangtengah Village, Imogiri District, Bantul Regency, Special Region of Yogyakarta. The landslide incident that occurred in the Karangtengah Village area on November 28, 2017 then prompted several groups to take the initiative to install an early warning system and several other supporting tools at the scene. This study aims to identify what Information and Communication Technology tools already exist in the Karangtengah Village area that can support landslide hazard monitoring activities, and see how residents manage these tools. This research was conducted with a qualitative method using a Participatory Rural Appraisal tool. The results of this study show that the presence of Information and Communication Technology tools requires the community to have the capacity to synergize with existing tools and manage them independently so that there is no failure of the role of Information and Communication Technology in supporting the work of Community-Based Disaster Risk Management in Karangtengah Village. Access to data generated by existing Information and Communication Technology tools will also be useful for residents to monitor phenomena or conditions around them.
Deriving a Measure of Social Recovery Capital From the Important People and Activities Instrument: Construction and Psychometric Properties
Authors: Francis Meredith W , Bourdon Jessica L , Chan Grace , Dick Danielle M , Edenberg Howard J , Kamarajan Chella , Kinreich Sivan , Kramer John , I-Chun Kuo Sally , Pandey Ashwini K , Pandey Gayathri , Smith Rebecca L , Bucholz Kathleen K , McCutcheon Vivia V
Published: February 2022

Aim

This study presents a measure of Social Recovery Capital (SRC) derived from the Important People and Activities instrument (IPA).

Methods

The sample comprised young adults who participated in the Collaborative Study on the Genetics of Alcoholism, a high-risk family study of alcohol use disorder (N = 2472). Exploratory and confirmatory factor analysis identified influential items and factor structure, adjusting for family relatedness. The final scale was tested for reliability and validity.

Results

Factor analysis retained 10 items loading on three factors (Network Abstinence Behaviors, Basic Network Structure and Network Importance) that together explained 42% of the variance in SRC. The total model showed adequate fit (Comparative Fit Index = 0.95; Tucker Lewis Index = 0.93; Root Mean Square Error of Approximation = 0.06; Standardized Root Mean Squared Residual = 0.05) and acceptable reliability (α = 0.60; McDonald’s ω = 0.73) and correlated with validation measures mostly in the weak to moderate range. Due to variable factor scores for reliability and validity, we only recommend using the total score.

Conclusion

The SRC-IPA is a novel measure of SRC derived from the IPA that captures social network data and has applications in research and clinical work. Secondary data analyses using the SRC-IPA in studies that collected the IPA can further demonstrate the interaction of SRC with a wide variety of clinical indicators and demographic characteristics, making it a valuable addition to other measures of SRC.
Community schools and community development: São Paulo’s Unified Education Centres seen from the other side of the street
Authors: Burgos Fernando , Exner Marina Katurchi , Spink Peter
Published: February 2022

Recent debate on the importance of education for socioeconomic development has largely focussed on school achievement, as measured by international rankings. The pressures from governments to improve results has led to concerns about the consequences for teachers and students, and to counter proposals to value schools that promote the general good of the surrounding community and, in doing so, return to the idea of community schools that was much debated in the 1970s in the developing and developed world. In 2001, the São Paulo city government began building a network of Unified Education Centres (CEUs) in vulnerable areas. In addition to enhanced educational and sports facilities, they all have a theatre, library, swimming pools, a computer centre, and spaces for workshops and community meetings. Evaluation studies have mainly focussed on the experience of education staff in learning how to deal with the broader inter-sectorial aspects of the Centres. We look at the Centres from the outside; from the position of those who live and/or work in the surrounding streets and neighbourhoods. Based on 68 street level conversations, the analysis concentrated on four dimensions: the use made of the CEU in the day to day; new perspectives for the young; the CEU as a space for sport, leisure, and culture in a peripheral region; and the socioeconomic impact. Results show that whilst the impact of the Centres ‘in the surrounding community’ is significant, there is still much to be learned for them to be seen as part ‘of the community’.
Rapid processing of threatening faces in the amygdala of nonhuman primates: subcortical inputs and dual roles
Authors: Inagaki Mikio , Inoue Ken-ichi , Tanabe Soshi , Kimura Kei , Takada Masahiko , Fujita Ichiro
Published: February 2022

A subcortical pathway through the superior colliculus and pulvinar has been proposed to provide the amygdala with rapid but coarse visual information about emotional faces. However, evidence for short-latency, facial expression-discriminating responses from individual amygdala neurons is lacking; even if such a response exists, how it might contribute to stimulus detection is unclear. Also, no definitive anatomical evidence is available for the assumed pathway. Here we showed that ensemble responses of amygdala neurons in monkeys carried robust information about open-mouthed, presumably threatening, faces within 50 ms after stimulus onset. This short-latency signal was not found in the visual cortex, suggesting a subcortical origin. Temporal analysis revealed that the early response contained excitatory and suppressive components. The excitatory component may be useful for sending rapid signals downstream, while the sharpening of the rising phase of later-arriving inputs (presumably from the cortex) by the suppressive component might improve the processing of facial expressions over time. Injection of a retrograde trans-synaptic tracer into the amygdala revealed presumed monosynaptic labeling in the pulvinar and disynaptic labeling in the superior colliculus, including the retinorecipient layers. We suggest that the early amygdala responses originating from the colliculo–pulvino–amygdalar pathway play dual roles in threat detection.
Oral anticoagulants in patients with atrial fibrillation at low stroke risk: a multicentre observational study
Authors: Komen Joris J , Pottegård Anton , Mantel-Teeuwisse Aukje K , Forslund Tomas , Hjemdahl Paul , Wettermark Björn , Hallas Jesper , Olesen Morten , Bennie Marion , Mueller Tanja , Carragher Raymond , Karlstad Øystein , Kjerpeseth Lars J , Klungel Olaf H
Published: February 2022

Aims

There is currently no consensus on whether atrial fibrillation (AF) patients at low risk for stroke (one non-sex-related CHA2DS2-VASc point) should be treated with an oral anticoagulant.

Methods and results

We conducted a multi-country cohort study in Sweden, Denmark, Norway, and Scotland. In total, 59 076 patients diagnosed with AF at low stroke risk were included. We assessed the rates of stroke or major bleeding during treatment with a non-vitamin K antagonist oral anticoagulant (NOAC), a vitamin K antagonist (VKA), or no treatment, using inverse probability of treatment weighted (IPTW) Cox regression. In untreated patients, the rate for ischaemic stroke was 0.70 per 100 person-years and the rate for a bleed was also 0.70 per 100 person-years. Comparing NOAC with no treatment, the stroke rate was lower [hazard ratio (HR) 0.72; 95% confidence interval (CI) 0.56–0.94], and the rate for intracranial haemorrhage (ICH) was not increased (HR 0.84; 95% CI 0.54–1.30). Comparing VKA with no treatment, the rate for stroke tended to be lower (HR 0.81; 95% CI 0.59–1.09), and the rate for ICH tended to be higher during VKA treatment (HR 1.37; 95% CI 0.88–2.14). Comparing NOAC with VKA treatment, the rate for stroke was similar (HR 0.92; 95% CI 0.70–1.22), but the rate for ICH was lower during NOAC treatment (HR 0.63; 95% CI 0.42–0.94).

Conclusion

These observational data suggest that NOAC treatment may be associated with a positive net clinical benefit compared with no treatment or VKA treatment in patients at low stroke risk, a question that can be tested through a randomized controlled trial.
Association between state-level malpractice environment and clinician electronic health record (EHR) time
Authors: Holmgren A Jay , Rotenstein Lisa , Downing Norman Lance , Bates David W , Schulman Kevin
Published: February 2022

Objective

Clinicians spend significant time working in the electronic health record (EHR). The US is an outlier in EHR time, suggesting that EHR-related work may be driven in part by the legal environment and threat of malpractice. To assess this, we evaluate the association between state-level malpractice climate and clinician time spent in the EHR.

Materials and Methods

We use EHR metadata from 351 ambulatory care health systems in the United States using Epic from January–August 2019 combined with state-level data on malpractice incidence and payouts. We used descriptive statistics to measure variation in clinician EHR time, including total EHR time, documentation time per day, and after-hours EHR time per day. Multi-variable regression evaluated the association between clinicians in high malpractice states and EHR use.

Results

We found no association between location in a state in the top-quartile of malpractice payouts and time spent in the EHR per day, time spent in the EHR outside of scheduled hours, or time spent documenting per day, except for a subgroup of the clinicians in the highest malpractice specialties, where there was a small increase in EHR time per day (B = 6.08 min, P < 0.001) and time spent documenting notes (B = 2.77 min, P < 0.001).

Discussion

State-level differences in malpractice incidence are unlikely to be a significant driver of EHR work for most clinicians.

Conclusion

Policymakers seeking to address EHR documentation burden should examine burden driven by other socio-technical demands on clinician time, such as billing or quality measurement.
Established Facts in an ‘Age of Misinformation’
Authors: Trifunović Jana
Published: February 2022

The contemporary significance of the doctrine of judicial notice has been overlooked. As a means of proving fact without hearing evidence, judicial notice has remained relevant vis-à-vis international criminal justice’s crucial objective of trial expediency. However, today’s fragmented information landscape demands a revision of the doctrine’s traditional understanding. This article presents a legal expressivist reading of the key judicial notice decision in Karemera and explores the epistemic potential of judicial notice in an ‘age of misinformation’. It argues that the act of establishing facts of ‘common knowledge’ inevitably elicits dialogue between international criminal tribunals and their relevant audiences. Accordingly, judicial notice is cautiously presented as a promising legal principle that, beyond judicial economy and factual uniformity, may serve a third policy consideration related to broader goals of international criminal justice.
Scanning electron microscopy of Escherichia coli encapsulated in a spacerized graphene sandwich
Authors: Sasaki Yuki , Hirayama Satoru , Nakao Ryoma
Published: February 2022

Electron microscopy of biological materials such as bacteria allows multifaceted analysis to understand their structure and function with high resolution, which is difficult to achieve with optical microscopy. However, the samples are damaged or broken by electron beam irradiation and by the vacuum environment. Here, we observed bacteria in a suspension encapsulated in a graphene sandwich that prevents electron beam damage without the need for fixation. Specifically, we demonstrated in situ scanning electron microscopy observation of Escherichia coli in a graphene sandwich containing a perforated membrane as a spacer, encapsulating non-immobilized E. coli between the graphene layers. However, E. coli activity, such as division, was not observed, although the irradiated cells grew slightly when resuspended under optimal culture conditions. Our findings suggest that the graphene sandwich methodology enables the observation of wet E. coli cells by electron microscopy but requires refinement to allow the live imaging of biological materials.
Evolving the architecture-ready brain
Authors: Arbib Michael A.
Published: February 2022

Exemplifying the EvoDevoSocio perspective, the chapter argues that hands, rather than voice, scaffolded the emergence of language, and that early humans did not have language (they had “protolanguage”) and yet their brains were little different from ours—early humans had “language-ready” brains, but not “language-using” brains. The mirror system hypothesis traces a path from distant ancestors with manual mirror systems to primate ancestors capable of imitation, laying the foundation for protohumans capable of both pantomime and pedagogy, supporting increasing rates of cultural innovation and their transmission. Such a brain was also construction-ready and drawing-ready: each must bring diverse elements together, linking mental construction with physical construction. Similarly, Merlin Donald posited post-biological changes that led to creating visual patterns as external memory to augment internal memory and create cohesion between members of a social group. Analysis of the neuropsychology of drawing and consideration of the “what” and “how” pathways in the visuomotor brain show how sketching links memory and imagination. Finally, linked discussion of language-readiness and architecture-readiness leads to assessment of the extent to which architecture may be considered as a language or, more appropriately, as an aggregate of diverse languages.
The Associated Clinical Manifestations of Behavioral Toxicity
Authors: Fava Giovanni A.
Published: February 2022

Withdrawal syndromes and persistent postwithdrawal disorders may be associated with loss of antidepressant efficacy, paradoxical effects, switching to bipolar course, resistance, and refractoriness. All these manifestations appear to be interrelated and may be subsumed under the rubric of behavioral toxicity. Each of these clinical events is discussed in the chapter, preceded by a case illustration from the author’s Affective Disorders Program. The concept of iatrogenic comorbidity refers to the unfavorable modifications in the course, characteristics, and responsiveness to treatment of an illness that may be related to previously administered therapies. Such vulnerabilities may manifest themselves during treatment administration and/or after its discontinuation.
The Setting of Guided Antidepressant Discontinuation
Authors: Fava Giovanni A.
Published: February 2022

Guided antidepressant discontinuation requires a revision of the current model of the outpatient clinic in a direction that maximizes the expertise of the specialist as well as of other clinicians in the healthcare team. The basic unit would consist of a psychiatrist (with an adequate background both in psychopharmacology and psychotherapy), an internist, and four clinical psychotherapists, who may provide evidence-based treatment after the initial evaluation of the psychiatrist. Its functioning emphasizes repeated assessments, sequential combination of treatments, and close coordination of team members. An alternative setting could be that of a clinical pharmacopsychology service specifically tailored to the problems produced by psychotropic drug discontinuation.
First Psychotherapeutic Module
Authors: Fava Giovanni A.
Published: February 2022

The first psychotherapeutic module is based on Kellner’s explanatory therapy—a psychotherapeutic approach for improving illness behavior (an important factor in modulating the individual response to the emergence and persistence of new withdrawal symptoms) and treating hypochondriacal fears and beliefs. It consists of providing accurate information, clarification, teaching of the principles of selective perception (i.e., attention to one part of the body makes the patient more aware of sensations in that part of the body than in other parts), reassurance, and repetition. The protocol was devised to increase endurance to withdrawal symptoms during tapering and after discontinuation of antidepressants.
A Different Psychiatry Is Possible
Authors: Fava Giovanni A.
Published: February 2022

The notion of psychiatric disease is not in line with the changed spectrum of health and the complex interplay of biological and psychosocial factors. Pharmaceutical reductionism leads to overtreatment or mistreatment, and does not offer solutions to the complexity of clinical situations, such as the problems related to discontinuation of antidepressant medications. A different psychiatric approach is outlined. Psychiatrists have the potential to move from their traditionally assigned position as marginal components of the medical profession to leaders in multidisciplinary medicine, favoring the role of clinical judgment. It is possible to practice highly effective precision psychiatry now.
The Art of Conversation in Cancer Care
Authors: McQuellon Richard P. , Cowan Michael A.
Published: February 2022

The Art of Conversation in Cancer Care: Lessons for Caregivers, is organized around the themes of mortal time and healing conversation with patients and their caregivers. Mortal time is not so much a specific period, but rather, the psychological experience encountering mortality that accompanies the diagnosis of cancer. The book has three major sections. In part I, the many ways people experience mortal time are articulated. These include a range of adaptive and less adaptive methods such as dysfunctional avoidance. In part II, the basic elements of healing conversation are described, with an emphasis on the hope that can spring from talking with a trusted companion. We discuss empathy, listening carefully and responding thoughtfully and compassionately. In Part III, the topic is guidance for caregivers. This section includes material on the risks and costs of caregiving as well as personal virtues that help a person navigate the demands of mortal time with their loved one. We discuss resilience and the consequences of absorbing suffering including empathy shift where the cancer caregiver becomes less empathic with minor illnesses in others. We conclude with the power of healing conversation in mortal time as a source of hope. The book includes numerous patient vignettes that illustrate the art of conversation in cancer medicine.
Case Discussions: Neurologic Disorders Presenting With Gastrointestinal Dysmotility
Authors: Camilleri Michael
Published: February 2022

The gastrointestinal tract receives extensive autonomic neural input from the nervous system; therefore, neurologic diseases are associated with gut motility disorders. In addition, neurologic diseases may involve the enteric or intrinsic nervous system and result in gut dysmotility. These conditions are reviewed in Chapter 7 (“Neuromuscular Disorders Causing Gut Dysmotility”). This chapter reviews illustrative cases of such neurologic diseases encountered in clinical practice at Mayo Clinic.
Chronic Diarrhea
Authors: Camilleri Michael
Published: February 2022

Acute diarrhea is most often caused by infection. In contrast, chronic watery, nonbloody diarrhea, which is defined by a duration of more than 4 weeks, can result from decreased absorption, increased secretion, reduced barrier function, and various extra-epithelial mechanisms. This chapter addresses clinical evaluation and investigation that guide therapy of patients presenting with chronic diarrhea.
Chronic Constipation
Authors: Camilleri Michael
Published: February 2022

Chronic constipation is a common condition affecting quality of life. Three subtypes of primary constipation are generally recognized, although there is overlap among them: normal-transit constipation, rectal evacuation disorders, and slow-transit constipation. The first step in diagnosis is exclusion of alarm symptoms. The second step is a therapeutic trial with dietary changes, lifestyle modifications, and over-the-counter laxatives. If symptoms do not improve, it is important to identify rectal evacuation disorders with digital rectal examination and anorectal testing, followed by colonic motility evaluation. In addition to diet and lifestyle interventions, the main treatments are pharmacologic and, rarely, surgical.
Biases and Heuristics That Subtly Shape Decisions
Authors: Blumenthal-Barby Jennifer
Published: February 2022

Empirical research on the psychology of decision making, including research into decisional heuristics and biases, is of great importance for the study and practice of decision making by patients, by clinicians, and between patients and clinicians. This chapter reviews some of the most well-studied heuristics and biases that have been shown to play a role in medical decision making and argues that they present nuances and challenges for thinking about core bioethics concepts such as autonomy, informed consent, and shared decision making. The chapter argues that one implication is that clinicians need to do more than simply deliver information and elicit values from patients during decision making in order to respect and promote autonomy. They need to understand patients’ heuristics and biases and frame choices in a way that increases the likelihood that their choices will reflect their values—a practice called “choice architecture” or “nudging” of patient decision making.
Shared Decision Making, Truth Telling, and the Recalcitrant Family
Authors: Lantos John D.
Published: February 2022

Discussions between pediatricians and parents about withholding or withdrawing life-sustaining treatment are emotionally difficult. There is uncertainty on both sides. Doctors are often making a probabilistic assessment of the chances that the child will survive. Parents must decide whether to trust the doctors and whether to trust their own conflicting feelings. In such circumstances, straightforward conversations are difficult. Instead, doctors and parents both may try to avoid discussions about prognosis or, if they have them, elide difficult truths. Literature and poetry offer insights into the ways that such discussions may take place and about the ways that important truths can be approached obliquely, rather than straightforwardly. Examples from the poetry of Emily Dickinson, the fiction of Fyodor Dostoevsky and Kenzaburo Oe, and a memoir by Alan Shapiro illustrate the treacherous ground upon which such discussions inevitably take place and the all-too-human ways in which difficult truths are broached.
Lymphoma
Authors: Cheow Heok , Hoskin Peter , Ajithkumar Thankamma
Published: February 2022

Chapter 6 discusses lymphoma, which covers a broad spectrum of disease entities that is reflected in a wide range of imaging involved in its diagnosis and management. Whilst the pathological subtypes are of considerable importance in disease management, they do not greatly influence the staging processes in which imaging is used, although the two main groups, Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) have very different patterns of disease distribution which can influence imaging strategies. Discussion on various imaging modalities, in particular the use of positron emission tomography/computer tomography (PET-CT) for staging and post therapy assessment. This chapter also includes international working group consensus response evaluation criteria in lymphoma.
Hepatic and biliary tumours
Authors: Reinius Marika , Godfrey Edmund , Basu Bristi
Published: February 2022

Hepatobiliary cancers represent a dynamic area of oncology, with rapidly rising global incidence rates, but also with a fast-evolving therapeutic landscape in recent years. This chapter covers the essential anatomical and radiological principles that underpin classification, diagnosis, and management of these tumours. Typical radiological appearances are highlighted, to allow the reader to appreciate imaging features of primary malignant disease, as well as differentiating these from benign pathologies and secondary metastatic disease from other primary sites. Current diagnostic and staging approaches are summarized for each primary tumour of the hepatobiliary system (including hepatocellular carcinoma, cholangiocarcinoma, and gallbladder carcinoma), with illustrative examples. The roles of different imaging modalities in the therapeutic assessment and follow-up are also explored, and further contextualized through discussion of current management strategies, including interventional radiology (ablative or transcatheter) techniques as well as systemic therapeutic approaches.