bluuebunny/crossref_metadata_2025_split huggingface dataset:
İSTANBUL’DA YER ALAN RESTORANLARDAKİ YEŞİL UYGULAMALARIN DEĞERLENDİRİLMESİ
Authors: Kurnaz Alper , Özdoğan Osman Nuri 
Published: April 2018

Yeşil
restoranlar çevreye duyarlı hizmetler sunan ve bu hizmetleri sunabilmek için
gerekli alt yapıya sahip olan yiyecek içecek işletmeleridir. Bu çalışmanın
temel amacı, İstanbul’da yer alan restoranlardaki yeşil uygulamaların nasıl
yürütüldüğü ve neler yapıldığını keşfetmektir. Araştırma kapsamında sekiz tane
yeşil restoranla görüşülmüştür.
Araştırmada veri toplama tekniklerinden yarı yapılandırılmış görüşme
tekniği kullanılmış ve analiz edilmiştir. Yapılan araştırmanın sonucunda ise
yeşil restoranların fiziki çekicilikleri, menü zenginliği, coğrafi konumları,
dış görünüş ve atmosferleri diğer restoranlardan ayıran özellikler olarak
değerlendirilmektedir. Sektörde öncü
olmak, uluslararası bir zincir haline gelmek, büyümek ve en iyi olmak yeşil
restoranların hedefleri arasındadır. Su tasarruflu sistemlerin tüm
restoranlarda kullanıldığı görülmektedir. Enerji, en çok mutfak ekipmanları
tarafından harcanmaktadır.
Historical and Future Changes of Snowfall Events in China under a Warming Background
Authors: Zhou Botao , Wang Zunya , Shi Ying , Xu Ying , Han Zhenyu 
Published: April 2018

AbstractUsing station data and Regional Climate Model version 4 (RegCM4) simulations under the representative concentration pathway 4.5 (RCP4.5) scenario, this article addresses historical and future changes of the wintertime snowfall over China. The observational results generally show a decrease in the frequency and an increase in the mean intensity of snowfalls in northwestern China (NWC), northeastern China (NEC), the eastern Tibetan Plateau (ETP), and southeastern China (SEC) since the 1960s. The total amount of wintertime snowfall, however, has increased in NWC, NEC, and ETP but decreased in SEC. The decrease in snow days is primarily due to the reduction of light snowfall events. The increase in the total amount is primarily explained by increases in heavy snowfalls, and the corresponding decrease is the result of decreases in light-to-heavy snowfalls. The RegCM4 ensemble, which can well simulate the observed snowfall climatology, projects that the snow days will be further reduced by the end of the twenty-first century relative to 1986–2005, primarily owing to the decline of light snowfall events. The total amount is projected to increase in NWC but decrease in the other three subregions. The increase in the total amount in NWC is attributed to increases in heavy and large snowfalls. Decreases in light snowfalls play a leading role in the decrease of the total amount in NEC. In ETP and SEC, the decrease in the total amount is the result of overall decreases in light-to-heavy snowfalls. The mechanism for such changes is an interesting topic to study in the future.
Multiscale Land–Atmosphere Coupling and Its Application in Assessing Subseasonal Forecasts over East Asia
Authors: Zeng Dingwen , Yuan Xing 
Published: April 2018

Abstract
The land surface, with a memory longer than the atmosphere in nature, has been recognized as an important source for Subseasonal to Seasonal (S2S) predictability through land–atmosphere coupling at multiple time scales. Understanding of the land–atmosphere coupling is important for improving subseasonal forecasting that is expected to fill the gap between medium-range weather forecasts and seasonal forecasts. Based on reanalysis and S2S reforecast datasets, land–atmosphere coupling is investigated over East Asia from daily to monthly time scales during summertime. Reanalysis results show that soil moisture–evapotranspiration (ET) coupling is closely related to the monsoonal rain belt shift. The coupling can be significant over humid regions (e.g., south China) during postmonsoon periods, where soil is usually drier, but insignificant over semiarid regions (e.g., north China) after the arrival of a monsoon, where soil is wetter. The dependence of soil moisture–ET coupling on soil wetness conditions decreases as the time scale increases, indicating more significant coupling at longer time scales. Similar sensitivities to time scales are found between ET and lifting condensation level (LCL), and between ET and precipitation, especially over land–atmosphere coupling hotspots. Monthly coupling strength analysis shows that ET–LCL coupling is a key process that determines the soil moisture–precipitation coupling, and the response of convective instability to ET is stronger at longer time scales. Subseasonal forecasting models also show more significant land–atmosphere coupling at monthly than daily time scales, where the ECMWF and NCEP models that best reproduce the coupling and its changes with monsoonal rain belt shifts have the best precipitation forecast skill among S2S models.
Dynamics of an Abyssal Circulation Driven by Bottom-Intensified Mixing on Slopes
Authors: Callies Jörn , Ferrari Raffaele 
Published: April 2018

AbstractThe large-scale circulation of the abyssal ocean is enabled by small-scale diapycnal mixing, which observations suggest is strongly enhanced toward the ocean bottom, where the breaking of internal tides and lee waves is most vigorous. As discussed recently, bottom-intensified mixing induces a pattern of near-bottom up- and downwelling that is quite different from the traditionally assumed widespread upwelling. Here the consequences of bottom-intensified mixing for the horizontal circulation of the abyssal ocean are explored by considering planetary geostrophic dynamics in an idealized “bathtub geometry.” Up- and downwelling layers develop on bottom slopes as expected, and these layers are well described by boundary layer theory. The basin-scale circulation is driven by flows in and out of these boundary layers at the base of the sloping topography, which creates primarily zonal currents in the interior and a net meridional exchange along western boundaries. The rate of the net overturning is controlled by the up- and downslope transports in boundary layers on slopes and can be predicted with boundary layer theory.
Factors affecting occupational therapists’ decision to join their regional professional association
Authors: Reyes Angelica N. , Brown Cary A. 
Published: April 2018

Background. Voluntary occupational therapy organizations fill an important role. However, recruitment and retention can be problematic. Little is known about factors influencing occupational therapists to join/maintain membership in professional associations. Purpose. This study investigated factors influencing occupational therapists’ decision to join/remain members of their association. Method. An electronic survey was carried out and data were analyzed using SPSS software and manual categorization of open-ended comments. Findings. Two hundred and fifty-four therapists responded. Generation of new ideas, opportunities for professional development, self-improvement, maintenance of standards, improvement of the profession, and discounts on equipment/educational opportunities were significant factors in deciding to join the organization. The factors perceived as priorities varied in relation to participants’ year of graduation. Implications. More-customized strategies, reflecting priorities that vary during a therapist’s career path, may need to be employed to best address recruitment and retention across the range of therapists’ needs and goals.
The effectiveness of a theory-based drama intervention in preventing illegal drug use among students aged 14–15 years in Taiwan
Authors: Huang Su-Fei , Zheng Wan-Ling , Liao Jung-Yu , Huang Chiu-Mieh , Lin Tsung-Yi , Guo Jong-Long 
Published: April 2018

Objective: Age of initiation of drug use is closely associated with the risk of developing drug dependence or abuse. Effective programmes are needed to prevent adolescents from using drugs at an early age. The aim of this intervention programme was to prevent adolescents from using illegal drugs by using drama in education (DIE) to convey a universal prevention strategy. Method: We recruited 65 children aged 14–15 years from two junior high schools and assigned them to experimental ( n = 34) and comparison ( n = 31) groups. The experimental group attended six 45-minute sessions of a DIE preventive programme. The comparison group received traditional didactic teaching. We used a generalised estimating equation (GEE) to analyse the data. Results: GEE analysis revealed that the experimental group showed significant improvements in attitude, subjective norms, perceived behavioural control and drug-free intentions compared with counterparts in the comparison group. Student feedback indicated that DIE method can contribute to the prevention of illegal drug use. Conclusion: Applying DIE method to a theory-based drug prevention programme offers a promising way of increasing the intention to not use illegal drugs among students aged 14–15 years.
Tree-Related Injuries Associated With Response and Recovery From Hurricane Sandy, New Jersey, 2011-2014
Authors: Marshall Elizabeth G. , Lu Shou-En , Williams Abimbola O. , Lefkowitz Daniel , Borjan Marija 
Published: April 2018

Objectives: Extreme weather events require extensive tree removal and disposal, tasks associated with severe injury risks among workers and residents. To help understand the risks of such activities, we evaluated the impact of a large and destructive storm (Hurricane Sandy in 2012) on the incidence of tree-related injuries. Methods: We searched chief-complaint text fields for patients aged 18-65 from 2011-2014 emergency department visit records submitted by New Jersey hospitals through the state-based syndromic surveillance system. Tree-related keywords (eg, saw, branch, wood chip, woodchip, tree) identified possible injuries that we then reviewed to exclude unrelated cases and classify mechanisms of tree-related injury. We used Poisson regression analysis to evaluate changes in the rates of probable tree-related injuries, adjusting for total emergency department visits and seasonal variation. Results: We identified 698 probable tree-related injuries from 2011-2014 among patients aged 18-65, including 104 (14.9%) falls, 241 (34.5%) machine-related injuries, 311 (44.6%) struck-by injuries, and 42 (6.0%) other tree-related injuries. Tree-related injuries increased significantly in the quarter immediately after Hurricane Sandy (November 2012–January 2013) compared with the same quarter the year before (rate ratio [RR] = 1.67; 95% confidence interval [CI], 1.13-2.47) and the year after (RR = 2.47; 95% CI, 1.62-3.78) Hurricane Sandy, especially for struck-by injuries compared with the year before (RR = 2.74; 95% CI, 1.47-5.12) and the year after (RR = 4.17; 95% CI, 2.09-8.32) Hurricane Sandy. More than one-third of the injuries (33.4%) involved chainsaws. Conclusions: A major hurricane was associated with an increase in tree-related injuries in emergency departments, especially for mechanisms consistent with handling downed and damaged trees. Further research should confirm these findings and evaluate opportunities for preventing tree-related injuries.
Multi-modal imaging for dose planning and its benefits: the paradigm of head and neck tumours
Authors: Grégoire V. 
Published: April 2018

The ultimate goal of any radiotherapy is to eradicate the disease without inflicting damage on the normal tissues surrounding the tumours, which could be responsible for late treatment morbidity. To achieve this objective, the first step is to precisely select and delineate the target volumes to which a given dose will be prescribed. This step requires the use of multi-modal images from clinical examination to anatomical and molecular images. Imaging examination will be used not only to delineate the boundaries of the tumour volume, but also to assess tumour heterogeneity and, possibly, to guide a heterogeneous dose prescription (i.e. the so-called ‘dose painting’ approach). Last, re-imaging the patient during treatment to assess variation of the tumour volume during radiotherapy may also be performed in the framework of adaptive treatment. Over the last decade, a lot of information has been gathered on the use of multi-modal imaging for dose planning, and its potential and technical difficulties have been identified. During the lecture, the speaker will review the state-of-the-art of multi-imaging for treatment, using head and neck tumours as a paradigm, emphasising what should be considered as routine practice and what should still be viewed as research questions. © 2018 ICRP. Published by SAGE.
Effectiveness of virtual reality training for balance and gait rehabilitation in people with multiple sclerosis: a systematic review and meta-analysis
Authors: Casuso-Holgado María Jesús , Martín-Valero Rocío , Carazo Ana F , Medrano-Sánchez Esther M. , Cortés-Vega M. Dolores , Montero-Bancalero Francisco José 
Published: April 2018

Objective: To evaluate the evidence for the use of virtual reality to treat balance and gait impairments in multiple sclerosis rehabilitation. Design: Systematic review and meta-analysis of randomized controlled trials and quasi-randomized clinical trials. Methods: An electronic search was conducted using the following databases: MEDLINE (PubMed), Physiotherapy Evidence Database (PEDro), Cochrane Database of Systematic Reviews (CDSR) and (CINHAL). A quality assessment was performed using the PEDro scale. The data were pooled and a meta-analysis was completed. This systematic review was conducted in accordance with the (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) PRISMA guideline statement. It was registered in the PROSPERO database (CRD42016049360). Results: A total of 11 studies were included. The data were pooled, allowing meta-analysis of seven outcomes of interest. A total of 466 participants clinically diagnosed with multiple sclerosis were analysed. Results showed that virtual reality balance training is more effective than no intervention for postural control improvement (standard mean difference (SMD) = −0.64; 95% confidence interval (CI) = −1.05, −0.24; P = 0.002). However, significant overall effect was not showed when compared with conventional training (SMD = −0.04; 95% CI = −0.70, 0.62; P = 0.90). Inconclusive results were also observed for gait rehabilitation. Conclusion: Virtual reality training could be considered at least as effective as conventional training and more effective than no intervention to treat balance and gait impairments in multiple sclerosis rehabilitation.
Exploring the Predictors of Emergency Department Triage Acuity Assignment in Patients With Sepsis
Authors: Petruniak Leon , El-Masri Maher , Fox-Wasylyshyn Susan 
Published: April 2018

Background and purpose Evidence suggests that septic patients, who require prompt medical attention, may be undertriaged, resulting in delayed treatment. The purpose of this study was to examine patient and contextual variables that contribute to high- versus low-acuity triage classification of patients with sepsis. Methods Data were abstracted from the medical records of 154 adult patients with sepsis admitted to hospital through a Canadian Emergency Department. Logistic regression was used to explore the predictors of triage classification. Results Language barriers or chronic cognitive impairment (odds ratio 5.7; 95% confidence interval 2.15, 15.01), acute confusion (odds ratio 3.4; confidence interval 1.3, 8.2), unwell appearance (odds ratio 3.4; 95% confidence interval 1.7, 7.0), and hypotension (odds ratio 0.98; confidence interval 0.96, 1.0) were predictive of higher acuity classification. Temperature, heart rate, respiratory rate, and contextual factors were not related to triage classification. Conclusions Several patient-related factors were related to triage classification. However, the finding that temperature and heart and respiratory rates were not related to triage classification was troubling. Our findings point to a need for enhanced education for triage nurses regarding the physiological indices of sepsis. The sensitivity of the Canadian Triage Assessment Scale, used in Canadian Emergency Rooms, also needs to be examined.
An Investigation of Youth Assets and Physical Activity and BMI Using a Longitudinal Cohort Design
Authors: Oman Roy F. , Clements-Nolle Kristen , Lu Minggen , Lensch Taylor 
Published: April 2018

Purpose: Substantial research has demonstrated that assets (eg, family communication, school connectedness) protect youth from participation in numerous risk behaviors. However, very few studies have explored the relationship between assets and positive health behaviors. This study investigated prospective associations among assets and physical activity (PA) and body mass index (BMI). Design: Longitudinal design with 5 waves of data collected annually over a 4-year period. Setting: Community-based setting with participants recruited via door-to-door canvasing of homes located in stratified (by race and income) randomly selected census tracts and blocks. Participants: Participants were 1111 youth (baseline mean age = 14.3 years [SD = 1.6]; 53% female; 40.6% white, 28.6% Hispanic, 24.4% black, 6.4% other) and their parents. Measures: Weekly participation in PA, BMI, and 14 youth assets representing multiple levels of influence (individual, family, and community). Analysis: Generalized linear mixed models assessed associations among the assets and PA and BMI over the 5 waves of data. Results: There was a significant and graded relationship between assets and weekly participation in PA. For example, at the community-asset level, PA minutes were higher among youth with 2 assets ( P = .006), 3 assets ( P = .0006), and 4 to 5 assets ( P < .0001) compared to youth with 0 to 1 assets. No effects were found for BMI. Conclusion: Asset-based health promotion programs for youth may promote positive health behaviors and prevent participation in risk behaviors.
Sustainable Debt Policies of Indian State Governments
Authors: Renjith P.S. , Shanmugam K.R. 
Published: April 2018

This study analyses the public debt sustainability issue of 20 major Indian states using the Bohn framework for panel data from 2005–2006 to 2014–2015. It employs regular panel data estimation procedures and the penalized spline (p-spline) technique. The results indicate that the primary balance of state governments responds positively to high public debt, so debt policies are successful in sustaining the debt situation of Indian states as a whole. However, at the individual level, debt is sustainable only in 12 states; in 8 states, debt is unsustainable and so these states require corrective action. These findings may be useful to policymakers and other stakeholders to formulate appropriate strategies to improve the debt situation of Indian states. JEL Classification: E62, H63, H72, H740
Achilles Pullout Strength After Open Calcaneoplasty for Haglund’s Syndrome
Authors: Pfeffer Glenn , Gonzalez Tyler , Zapf Matthew , Nelson Trevor J. , Metzger Melodie F. 
Published: April 2018

Background: Haglund’s syndrome involves a prominent posterior superior prominence of the calcaneus. If nonoperative management fails, operative management with calcaneoplasty is often needed. No study has assessed Achilles tendon pullout strength after an open calcaneoplasty for Haglund’s syndrome. The purpose of this study was to investigate those changes in a cadaveric model and provide objective data upon which to base postoperative recovery. Methods: Seven matched pairs of cadaveric specimens (mid-tibia to toes) were divided into 2 cohorts: (1) intact/untreated and (2) open resection. The open resection group was treated with an open calcaneoplasty through a posterior approach using a microsagittal saw. We compared Achilles pullout strength between the 2 groups through the use of a mechanical testing system. Specimens were then loaded to failure. Lateral radiographs were obtained before and after surgery to quantify bone removal. Outcome measures included height of bony resection, angle of bone resection, and load to failure. Results: The mean maximum pullout strength was significantly higher in the intact specimens (1300 ± 500 N) compared to the open resection group (740 ± 180 N) ( P < .01), representing a 45% reduction in pullout force in the open resection group. Pullout force was significantly correlated to bone mineral density (BMD) ( P < .05). Pullout force was negatively correlated to both radiographic measures of resection level, angle, and height, but neither of these were significant. Conclusion: Open calcaneoplasty demonstrated a significant weakness of the Achilles tendon insertion. Pullout strength of the Achilles was also positively correlated with BMD. Clinical Relevance: Biomechanical evidence presented above supports the practice of protected weightbearing and cautious return to activity after open calcaneoplasty for Haglund’s syndrome.
The Pharmacologic Role and Clinical Utility of PCSK9 Inhibitors for the Treatment of Hypercholesterolemia
Authors: White C. Michael 
Published: April 2018

In addition to monoclonal antibodies against proprotein convertase subtilisin-kexin type 9 (PCSK9), vaccines against PCSK9 and smaller molecule inhibitors as well as RNA inhibitors of PCSK9 production have been created. The monoclonal antibodies against PCSK9 and the PCSK9 RNA inhibitors can reduce low-density lipoproteins (LDLs) by over 50%, non-high-density lipoprotein (HDL) cholesterol and triglycerides, and increasing HDL. Although effective in several homozygous familial hypercholesterolemia patient types, PCSK9 inhibitors does not work in all patient types. Outcome trials show no effects on mortality but do show reductions in atherosclerotic events such as myocardial infarctions, strokes, and need for coronary revascularization. PCSK9 inhibitors have a very attractive safety profile with no significant elevations in measures of muscle or liver damage. The current and more advanced experimental agents all require subcutaneous dosing, and injection site reactions are among the most common adverse events. Therapy for the Food and Drug Administration (FDA) approved agents is markedly expensive, and this is the primary barrier to utilization. However, it is possible to identify patients with a number needed to treat to prevent an atherosclerotic event low enough to render it cost-effective and one such factor is whether or not you require a 50% reduction in LDL in order to achieve your LDL goal.