bluuebunny/crossref_metadata_2025_split huggingface dataset:
O PAPEL DA VEGETAÇÃO NO CONTROLE DOS VENTOS PARA O CONFORTO TÉRMICO
Authors: Zanlorenzi Helena Cristina Padovani , Silva Filho Demóstenes Ferreira da 
Published: April 2018

Entender o clima dos espaços urbanos em suas diversas conformações é objeto de grande interesse para a melhoria da qualidade de vida de seus usuários. O presente estudo é parte integrante da dissertação de mestrado que teve por objetivo avaliar elementos de vegetação como barreira aos ventos visando o conforto térmico em espaços abertos. O procedimento utilizado foi quantificar a interferência de elementos vegetais na passagem dos ventos, na altura dos pedestres, a partir de configurações de vegetação pré-estabelecidas. O cenário eleito para este estudo foi a área externa do Campus da Universidade Metodista de Piracicaba (UNIMEP), localizado no bairro Taquaral em Piracicaba, SP. Foram estudadas três espécies dispostas em arranjos de barreira aos ventos: Jasminum mesnyi Hance, Pseudosasa japonica (Steud.) Makino e Pinus caribaea Morelet. As variáveis microclimáticas medidas foram temperatura do ar, umidade relativa do ar e velocidade dos ventos, em três posições distintas por espécie: em um campo aberto próximo, antes e depois da barreira. O período de coleta de dados foi das 9 às 21 horas, em intervalos de 3 a 5 minutos, durante três dias por espécie, nos meses de agosto e setembro de 2014. Foi feita a medição do LAI (Índice de Área Foliar) das barreiras, para análise da viabilidade de adoção do LAI como parâmetro na previsão de resultados, o que permitiria sua aplicabilidade a outras espécies. Os resultados obtidos indicam uma tendência favorável a este princípio, porém estudos com maior intensidade amostral são necessários para obtenção desta correlação. Outras aplicações podem ser beneficiadas com esta linha de estudo, como a previsão do risco de queda de árvores.
Health Care Costs After Cardiac Arrest in the United States
Authors: Damluji Abdulla A. , Al-Damluji Mohammed S. , Pomenti Sydney , Zhang Tony J. , Cohen Mauricio G. , Mitrani Raul D. , Moscucci Mauro , Myerburg Robert J. 
Published: April 2018

Background:
This study was designed to estimate the costs of index hospitalizations after cardiac arrest in the United States.

Methods and Results:

We used the US Nationwide Inpatient Sample (2003–2012) to identify patients with cardiac arrest. Log transformation of inflation-adjusted cost was determined for care to patient outcomes. Overall, an estimated 1 387 396 patients were hospitalized after cardiac arrest. The mean age of the cohort was 66 years, 45% were women, and the majority were white. Inpatient procedures included coronary angiography (15%), percutaneous coronary intervention (7%), intra-aortic balloon pump (4.4%), therapeutic hypothermia (1.1%), and mechanical circulatory support (0.1%). The rates of therapeutic hypothermia increased from zero in 2003 to 2.7% in 2012 (
P
<0.001). Both hospital charges and inflation-adjusted cost increased linearly over time. In a multivariate analysis, predictors of inflation-adjusted cost included large hospital size, urban teaching hospital, and length of stay. Among comorbidities, atrial fibrillation or fluid and electrolytes imbalance was most associated with cost. Among selected interventions, the cost was significantly increased with automatic implantable cardioverter defibrillators (odds ratio, 1.83;
P
<0.001), intra-aortic balloon pump (odds ratio, 1.50;
P
<0.001), hypothermia (odds ratio, 1.28;
P
<0.001), and extracorporeal membrane oxygenation (odds ratio, 2.38;
P
<0.001).

Conclusions:
In the period between 2003 and 2012, postcardiac arrest hospitalizations resulted in a steady rise in associated health care cost, likely related to increased length of stay, medical procedures, and systems of care. Although targeted cost containment for postarrest interventions may reduce the finance burden, there is an increasing need for funding research into prediction and prevention of cardiac arrest, which offers greater societal benefit.
New Substrate-Guided Method of Predicting Slow Conducting Isthmuses of Ventricular Tachycardia
Authors: Kuroki Kenji , Nogami Akihiko , Igarashi Miyako , Masuda Keita , Kowase Shinya , Kurosaki Kenji , Komatsu Yuki , Naruse Yoshihisa , Machino Takeshi , Yamasaki Hiro , Xu Dongzhu , Murakoshi Nobuyuki , Sekiguchi Yukio , Aonuma Kazutaka 
Published: April 2018

Background:
Several conducting channels of ventricular tachycardia (VT) can be identified using voltage limit adjustment (VLA) of substrate mapping. However, the sensitivity or specificity to predict a VT isthmus is not high by using VLA alone. This study aimed to evaluate the efficacy of the combined use of VLA and fast-Fourier transform analysis to predict VT isthmuses.

Methods and Results:
VLA and fast-Fourier transform analyses of local ventricular bipolar electrograms during sinus rhythm were performed in 9 postinfarction patients who underwent catheter ablation for a total of 13 monomorphic VTs. Relatively higher voltage areas on an electroanatomical map were defined as high voltage channels (HVCs), and relatively higher fast-Fourier transform areas were defined as high-frequency channels (HFCs). HVCs were classified into full or partial HVCs (the entire or >30% of HVC can be detectable, respectively). Twelve full HVCs were identified in 7 of 9 patients. HFCs were located on 7 of 12 full HVCs. Five VT isthmuses (71%) were included in the 7 full HVC+/HFC+ sites, whereas no VT isthmus was found in the 5 full HVC+/HFC− sites. HFCs were identical to 9 of 16 partial HVCs. Eight VT isthmuses (89%) were included in the 9 partial HVC+/HFC+ sites, whereas no VT isthmus was found in the 7 partial HVC+/HFC− sites. All HVC+/HFC+ sites predicted VT isthmus with a sensitivity of 100% and a specificity of 80%.

Conclusions:
Combined use of VLA and fast-Fourier transform analysis may be a useful method to detect VT isthmuses.
Ideal Cardiovascular Health and Adiposity: Implications in Youth
Authors: Fyfe‐Johnson Amber L. , Ryder Justin R. , Alonso Alvaro , MacLehose Richard F. , Rudser Kyle D. , Fox Claudia K. , Gross Amy C. , Kelly Aaron S. 
Published: April 2018

Background

The American Heart Association set 2020 Strategic Impact Goals that defined cardiovascular risk factors to be included in the concept of ideal cardiovascular health (
ICH
). The prevalence of
ICH
among differing levels of adiposity in youth, especially severe obesity, is uncertain.

Methods and Results

The cross‐sectional study measured
ICH
metrics in 300 children and adolescents stratified by adiposity: normal weight, overweight/obese, and severely obese.
ICH
incorporates 7 behavioral and health metrics, and was characterized as poor, intermediate, or ideal. Individual
ICH
metrics were transformed into standardized sample
z
‐scores; a summary
ICH
sample
z
‐score was also calculated. Multivariable linear regression models were used to estimate differences in
ICH
sample
z
‐scores by adiposity status. Of the 300 participants, 113 were classified as having normal weight, 87 as having overweight/obesity, and 100 as having severe obesity (mean age 12.8 years,
SD
2.7; 48% female). No participants met the criteria for
ICH
; 80% of those classified as having normal weight, 81% of those with overweight/obesity, and all of those with severe obesity were in poor cardiovascular health. After multivariable adjustment, those with overweight/obesity (sample
z
‐score: −1.35; 95% confidence interval, −2.3, −1.1) and severe obesity (sample
z
‐score: −1.45; 95% confidence interval, −2.9, −0.92) had lower overall
ICH
sample
z
‐scores compared with participants with normal weight. Results were similar for individual
ICH
metrics.

Conclusions

Poor cardiovascular health was highly prevalent in youth;
ICH
sample
z
‐scores increased across levels of adiposity. Youth with obesity, particularly those with severe obesity, remain a rich target for primary prevention efforts.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
01508598.
Predictors of Mortality and Symptomatic Outcome of Patients With Low‐Flow Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement
Authors: Mangner Norman , Stachel Georg , Woitek Felix , Haussig Stephan , Schlotter Florian , Höllriegel Robert , Adam Jennifer , Lindner Anna , Mohr Friedrich W. , Schuler Gerhard , Kiefer Philipp , Leontyev Sergey , Borger Michael A. , Thiele Holger , Holzhey David , Linke Axel 
Published: April 2018

Background

Impaired left ventricular (LV) ejection fraction is a common finding in patients with aortic stenosis and serves as a predictor of morbidity and mortality after transcatheter aortic valve replacement. However, conflicting data on the most accurate measure for
LV
function exist. We wanted to examine the impact of LV ejection fraction, mean pressure gradient, and stroke volume index on the outcome of patients treated by transcatheter aortic valve replacement.

Methods and Results

Patients treated by transcatheter aortic valve replacement were primarily separated into normal flow (
NF
; stroke volume index >35 mL/m
2
) and low flow (
LF
; stroke volume index ≤35 mL/m
2
). Afterwards, patients were divided into 5 groups: “NF–high gradient,” “NF–low gradient” (
NF
‐
LG
), “LF–high gradient,” “paradoxical LF‐LG,” and “classic LF‐LG.” The 3‐year mortality was the primary end point. Of 1600 patients, 789 (49.3%) were diagnosed as having
LF
, which was characterized by a higher 30‐day (
P
=0.041) and 3‐year (
P
<0.001) mortality.
LF
was an independent predictor of all‐cause (hazard ratio, 1.29; 95% confidence interval, 1.03–1.62;
P
=0.03) and cardiovascular (hazard ratio, 1.37; 95% confidence interval, 1.06–1.77;
P
=0.016) mortality. Neither mean pressure gradient nor LV ejection fraction was an independent predictor of mortality. Patients with paradoxical LF‐LG (35.0%), classic LF‐LG (35.1%) and
LF
–high gradient (38.1%) had higher all‐cause mortality at 3 years compared with
NF
–high gradient (24.8%) and
NF
‐
LG
(27.9%) (
P
=0.001). However, surviving patients showed a similar improvement in symptoms regardless of aortic stenosis entity.

Conclusions

LF
is a common finding within the aortic stenosis population and, in contrast to LV ejection fraction or mean pressure gradient, an independent predictor of all‐cause and cardiovascular mortality. Despite increased long‐term mortality, high procedural success and excellent functional improvement support transcatheter aortic valve replacement in patients with
LF
severe aortic stenosis.
Evaluation of Acute Kidney Injury and Mortality After Intensive Blood Pressure Control in Patients With Intracerebral Hemorrhage
Authors: Burgess L. Goodwin , Goyal Nitin , Jones G. Morgan , Khorchid Yasser , Kerro Ali , Chapple Kristina , Tsivgoulis Georgios , Alexandrov Andrei V. , Chang Jason J. 
Published: April 2018

Background

We sought to assess the risk of acute kidney injury (
AKI
) and mortality associated with intensive systolic blood pressure reduction in acute intracerebral hemorrhage.

Methods and Results

Patients with acute intracerebral hemorrhage had spontaneous cause and symptom onset within 24 hours. We excluded patients with structural causes, coagulopathy, thrombocytopenia, and preexisting end‐stage renal disease. We defined
AKI
using the Acute Kidney Injury Network criteria. Chronic kidney disease status was included in risk stratification and was defined by Kidney Disease Outcomes Quality Initiative staging. Maximum systolic blood pressure reduction was defined over a 12‐hour period and dichotomized using receiver operating characteristic curve analysis. Descriptive statistics were done using independent sample
t
tests, χ
2
tests, and Mann‐Whitney
U
tests, whereas multivariable logistic regression analysis was used to evaluate for predictors for
AKI
and mortality. A total of 448 patients with intracerebral hemorrhage met inclusion criteria. Maximum systolic blood pressure reduction was dichotomized to 90 mm Hg and found to increase the risk of
AKI
in patients with normal renal function (odds ratio, 2.1; 95% confidence interval, 1.19–3.62;
P
=0.010) and chronic kidney disease (odds ratio, 3.91; 95% confidence interval, 1.26–12.15;
P
=0.019). The risk of
AKI
was not significantly different in normal renal function versus chronic kidney disease groups when adjusted for demographics, presentation characteristics, and medications associated with
AKI
.
AKI
positively predicted mortality for patients with normal renal function (odds ratio, 2.41; 95% confidence interval, 1.11–5.22;
P
=0.026) but not for patients with chronic kidney disease (odds ratio, 3.13; 95% confidence interval, 0.65–15.01;
P
=0.154).

Conclusions

These results indicate that intensive systolic blood pressure reduction with a threshold >90 mm Hg in patients with acute intracerebral hemorrhage may be an independent predictor for
AKI
.
Estrogen Deficiency Promotes Cerebral Aneurysm Rupture by Upregulation of Th17 Cells and Interleukin‐17A Which Downregulates E‐Cadherin
Authors: Hoh Brian L. , Rojas Kelley , Lin Li , Fazal Hanain Z. , Hourani Siham , Nowicki Kamil W. , Schneider Matheus B. , Hosaka Koji 
Published: April 2018

Background
Estrogen deficiency is associated with the development of cerebral aneurysms; however, the mechanism remains unknown. We explored the pathway of cerebral aneurysm development by investigating the potential link between estrogen deficiency and inflammatory factors.

Methods and Results

First, we established the role of interleukin‐17 (
IL
‐17)A. We performed a cytokine screen demonstrating that
IL
‐17A is significantly expressed in mouse and human aneurysms (
P
=0.03). Likewise,
IL
‐17A inhibition was shown to prevent aneurysm formation by 42% (
P
=0.02) and rupture by 34% (
P
<0.05). Second, we found that estrogen deficiency upregulates T helper 17 cells and
IL
‐17A and promotes aneurysm rupture. Estrogen‐deficient mice had more ruptures than control mice (47% versus 7%;
P
=0.04). Estradiol supplementation or
IL
‐17A inhibition decreased the number of ruptures in estrogen‐deficient mice (estradiol 6% versus 37%;
P
=0.04;
IL
‐17A inhibition 18% versus 47%;
P
=0.018). Third, we found that
IL
‐17A‐blockade protects against aneurysm formation and rupture by increased E‐cadherin expression.
IL
‐17‐inhibited mice had increased E‐cadherin expression (
P
=0.003). E‐cadherin inhibition reversed the protective effect of
IL
‐17A inhibition and increased the rate of aneurysm formation (65% versus 28%;
P
=0.04) and rupture (12% versus 0%;
P
=0.22). However, E‐cadherin inhibition alone does not significantly increase aneurysm formation in normal mice or in estrogen‐deficient mice. In cell migration assays, E‐cadherin inhibition promoted macrophage infiltration across endothelial cells (
P
<0.05), which may be the mechanism for the estrogen deficiency/
IL
‐17/E‐cadherin aneurysm pathway.

Conclusions

Our data suggest that estrogen deficiency promotes cerebral aneurysm rupture by upregulating
IL
‐17A, which downregulates E‐cadherin, encouraging macrophage infiltration in the aneurysm vessel wall.
TÜRKİYE’DE İÇ GÖÇÜN BELİRLEYİCİLERİNİN ANALİZİ
Authors: ÇETİN İrem , ÇETİN Semih 
Published: April 2018

Türkiye’de 1950’lili yıllardan itibaren artış gösteren iç göç, nedenleri ve sonuçları dikkatli bir şekilde ele alınması gereken önemli bir sorunsal haline gelmiştir. Türkiye İstatistik Kurumu Adrese Dayalı Nüfus Kayıt Sistemi 2015 yılı sonuçlarına göre, Türkiye’de nüfusun %64.9’u doğduğu ilden farklı bir ilde ikamet etmektedir. Bu çerçevede, çalışmada, Türkiye’de iç göçün belirleyicilerinin analiz edilmesi amaçlanmıştır. Bu amaçla, Türkiye İstatistik Kurumu İstatiksel Bölge Birimleri Sınıflaması 2. Düzey (26 bölge) için 2008-2013 yılları verileri kullanılarak panel veri analizi yapılmıştır. Çalışmada elde edilen sonuçlara göre, kişi başına düşen gelir ve eğitim hizmetleri göçü pozitif yönde etkilerken, tarım sektörü istihdam oranı ve enflasyon oranı göçü negatif yönde etkilemektedir. Diğer taraftan, işsizlik oranı ve sağlık hizmetlerinin göç üzerindeki etkisi ise istatistiksel olarak anlamsız bulunmuştur.
TÜRK KAMU YÖNETİMİ PERSPEKTİFİNDEN E-SAĞLIK HİZMETLERİ VE SAĞLIK POLİTİKALARINDAKİ YERİ ÜZERİNE BİR İNCELEME
Authors: COŞKUN Mehmet Burhanettin 
Published: April 2018

Cumhuriyet sonrası dönem ile birlikte önemli bir yer edinen sağlık
politikaları kamu yönetiminde önemli bir konumdadır. Özellikle dönemsel olarak
ön plana çıkan toplum sağlığı konularının da gelişmesiyle Anadolu insanının en
önemli ihtiyaçlarının temelinde sağlık konuları belirmiştir. Konu güncel küresel tartışmaların
gözlemlendiği 2000’li yıllarda da önemini artırmış ve bu konuda kapsamlı
çalışmalarla birlikte reformlar hayata geçirilmiştir. Bu reformların konuları
genel olarak uluslararası kuruluşlarca belirlenen çeşitli standartlar olmasıyla
birlikte, Türkiye’nin özgün olarak oluşturduğu çeşitli politika oluşumları da
kamu yönetimi açısından önem kazanmıştır.
Türk Kamu Yönetimi içerisinde Sağlık Bakanlığı’nca vatandaşların
hizmetine sunulan, sağlık politikalarının temelini oluşturan E-Sağlık
Hizmetleri ve kamusal önemi araştırmanın ana konusunu oluşturmaktadır.
LANFEX: A Field and Modeling Study to Improve Our Understanding and Forecasting of Radiation Fog
Authors: Price J. D. , Lane S. , Boutle I. A. , Smith D. K. E. , Bergot T. , Lac C. , Duconge L. , McGregor J. , Kerr-Munslow A. , Pickering M. , Clark R. 
Published: April 2018

AbstractFog is a high-impact weather phenomenon affecting human activity, including aviation, transport, and health. Its prediction is a longstanding issue for weather forecast models. The success of a forecast depends on complex interactions among various meteorological and topographical parameters; even very small changes in some of these can determine the difference between thick fog and good visibility. This makes prediction of fog one of the most challenging goals for numerical weather prediction. The Local and Nonlocal Fog Experiment (LANFEX) is an attempt to improve our understanding of radiation fog formation through a combined field and numerical study. The 18-month field trial was deployed in the United Kingdom with an extensive range of equipment, including some novel measurements (e.g., dew measurement and thermal imaging). In a hilly area we instrumented flux towers in four adjacent valleys to observe the evolution of similar, but crucially different, meteorological conditions at the different sites. We correlated these with the formation and evolution of fog. The results indicate new quantitative insight into the subtle turbulent conditions required for the formation of radiation fog within a stable boundary layer. Modeling studies have also been conducted, concentrating on high-resolution forecast models and research models from 1.5-km to 100-m resolution. Early results show that models with a resolution of around 100 m are capable of reproducing the local-scale variability that can lead to the onset and development of radiation fog, and also have identified deficiencies in aerosol activation, turbulence, and cloud micro- and macrophysics, in model parameterizations.
Reexamining the Gradient and Countergradient Representation of the Local and Nonlocal Heat Fluxes in the Convective Boundary Layer
Authors: Zhou Bowen , Sun Shiwei , Yao Kai , Zhu Kefeng 
Published: April 2018

Abstract
Turbulent mixing in the daytime convective boundary layer (CBL) is carried out by organized nonlocal updrafts and smaller local eddies. In the upper mixed layer of the CBL, heat fluxes associated with nonlocal updrafts are directed up the local potential temperature gradient. To reproduce such countergradient behavior in parameterizations, a class of planetary boundary layer schemes adopts a countergradient correction term in addition to the classic downgradient eddy-diffusion term. Such schemes are popular because of their simple formulation and effective performance. This study reexamines those schemes to investigate the physical representations of the gradient and countergradient (GCG) terms, and to rebut the often-implied association of the GCG terms with heat fluxes due to local and nonlocal (LNL) eddies. To do so, large-eddy simulations (LESs) of six idealized CBL cases are performed. The GCG fluxes are computed a priori with horizontally averaged LES data, while the LNL fluxes are diagnosed through conditional sampling and Fourier decomposition of the LES flow field. It is found that in the upper mixed layer, the gradient term predicts downward fluxes in the presence of positive mean potential temperature gradient but is compensated by the upward countergradient correction flux, which is larger than the total heat flux. However, neither downward local fluxes nor larger-than-total nonlocal fluxes are diagnosed from LES. The difference reflects reduced turbulence efficiency for GCG fluxes and, in terms of physics, conceptual deficiencies in the GCG representation of CBL heat fluxes.
Use of Neural Response Telemetry for Pediatric Cochlear Implants: Current Practice
Authors: Almosnino Galit , Anne Samantha , Schwartz Seth R. 
Published: April 2018

Objectives: Evaluate usage trends of neural response telemetry (NRT) in cochlear implant centers across the nation and assess reported benefits of intraoperative NRT for pediatric cochlear implant recipients. Study Design: Survey. Study Participants: All US cochlear implant centers (n = 110). Methods: A 15-question multiple-choice survey was distributed electronically to all centers. The survey captured demographic information of all centers, practice patterns surrounding the use of NRT, and the extent to which intraoperative NRT is of benefit. Results: Thirty-two invited participants (29%) completed the survey. A majority of participants reported practicing in an academic center (66%), followed by a hospital setting (19%) and private practice (16%). Seventy-two percent of survey participants reported using NRT for pediatric cochlear implant recipients. Sixty-three percent felt it improved the ability to program at initial activation, and 50% of participants felt that NRT improves satisfaction at initial activation. Conclusion: This study suggests that a majority of surgeons use intraoperative NRT for pediatric cochlear implantation as an additional measure to ensure appropriate electrode placement and improve device activation. Larger studies are needed to better establish the relationship between intraoperative NRT and postoperative outcomes and justify the additional costs associated with intraoperative NRT.
A Scientific Basis for Humanae Vitae and Natural Law
Authors: Lanfranchi Angela 
Published: April 2018

This article will review Humanae Vitae’s predictions of the effect of oral contraceptives (the pill) on male–female relationships and societal behaviors. A scientific, biochemical basis underpinning these predictions is made. Evidence of human pheromones will be given. Evidence for the changes in male and female pheromones caused by the pill is given. Observational and experimental evidence of changes in primate and human behaviors by pheromones is detailed. The role these changes have caused in attractiveness and selection of mate by both males and females in preferences concerning major histocompatibility genes is examined. These changes have also resulted in societal changes in sexual behavior and family structure and have led to increased violence against women. Biochemical evidence for the abortifacient properties of the pill is given. The use of natural family planning is given as a needed alternative to the harms of the pill. Summary: The human biological bases of Humanae Vitae’s predictions of the effect of the pill on male–female relationships are examined. Evidence of the presence of pheromones in primates and humans is given. The pill changes human pheromones, odors which are subconsciously detected. These pheromones cause humans to change what they find attractive in a mate. Choosing a mate while on the pill can result in unstable and more violent unions. The biological basis for the fact that the pill causes abortion of human embryos is given. A healthy alternative for fertility control is explained.