948 resultados para Urban climate - Respiratory diseases


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Over the last decades, the growing evidence of human-caused climate change has raised awareness of the consequences of exceeding global temperature by 2˚C. This awareness has led to a contemporary approach to the conceptualization and management of green adaptation policies in spatial planning. This thesis aims to develop a comprehensive methodology for assessing the adaptability of existing neighborhoods to green strategies. The reliability of the proposed method is examined in the cities of Bologna and Imola and proved to be applicable in other geoghraphical locations. This thesis integrates three key themes of conceptual and implementation principles for urban green adaptation. This thesis initially defines methods for narrowing uncertainties in urban planning energy forecasting modeling by exploring the roles of integrated energy planning. The second is by exploring green retrofitting strategies in building, this thesis examines the effects of various energy-saving factors in roofing scenarios including a green roof, rooftop greenhouse, and insolated roof. Lastly, this thesis analyzes green strategies in urban spaces to enhance thermal comfort through facing urban heat exposure related to urban heat island effects. The roles of integrated energy policies and green strategic thinking are discussed to highlight various aspects of green adaptation on the neighborhood scale. This thesis develops approaches by which cities can face the challenges of current green urban planning and connect the conceptual and practical aspects of green spatial planning. Another point that this thesis highlight is that due to the interdependency of individuals and places, it is difficult to assure whether all the adaptation policies on a large scale are enhancing the resiliency of the neighborhood or they are simply shuffling the vulnerability through the individuals and places. Besides, it asserts that neglecting to reflect on these reallocations of the effects generates serious complications, and will result in long-term dysfunctional consequences.

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Air pollution is one of the greatest health risks in the world. At the same time, the strong correlation with climate change, as well as with Urban Heat Island and Heat Waves, make more intense the effects of all these phenomena. A good air quality and high levels of thermal comfort are the big goals to be reached in urban areas in coming years. Air quality forecast help decision makers to improve air quality and public health strategies, mitigating the occurrence of acute air pollution episodes. Air quality forecasting approaches combine an ensemble of models to provide forecasts from global to regional air pollution and downscaling for selected countries and regions. The development of models dedicated to urban air quality issues requires a good set of data regarding the urban morphology and building material characteristics. Only few examples of air quality forecast system at urban scale exist in the literature and often they are limited to selected cities. This thesis develops by setting up a methodology for the development of a forecasting tool. The forecasting tool can be adapted to all cities and uses a new parametrization for vegetated areas. The parametrization method, based on aerodynamic parameters, produce the urban spatially varying roughness. At the core of the forecasting tool there is a dispersion model (urban scale) used in forecasting mode, and the meteorological and background concentration forecasts provided by two regional numerical weather forecasting models. The tool produces the 1-day spatial forecast of NO2, PM10, O3 concentration, the air temperature, the air humidity and BLQ-Air index values. The tool is automatized to run every day, the maps produced are displayed on the e-Globus platform, updated every day. The results obtained indicate that the forecasting output were in good agreement with the observed measurements.

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The way we live has revealed a lot about the choices made in the last decades. These choices are mostly based on a predatory socioeconomic structure, based on the pillars of anthropocentrism and inconsistent with the principles of global sustainability. This structure based on fossil fuels degrades the environment and directly and indirectly impacts the biomes. According to The International Energy Agency (2020), the sector was responsible for more than a third of global energy consumption and 40% of total GHG emissions into the atmosphere (directly and indirectly). This thesis presents the main effects of climate change observed in the built environment and at the urban territorial scale, through a review of the state of the art of the subject in the last decade (2010-2021). The thesis breaks down the projectual process seeking to identify how the architect and urban planner can mitigate the effects of climate change, adapting existing structures or in projects, and also promoting the expansion of the resilience of these building systems.

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Urbanization has grown during the last decades, with an increase in population concentrated in cities. Cities are usually relatively nature-poor, and the loss of green urban space likely leads to less contact with the natural world for urban dwellers. It is known that the natural environment could provide important advantages, and the loss of contact with this type of environment has potential negative impacts on the quality of life. The use of green urban space demonstrated stronger benefits for mental health and stress reduction. In general, exposure to green urban space is linked to a reduction in mortality rates, due to the promotion of a healthy lifestyle. Green urban space could be an optimal environment in which to perform physical activity. Undertaking regular physical activity is one of the major determinants of health. The benefits of exercise have been widely demonstrated through a wide range of studies. Benefits are linked to the treatment and prevention of most chronic and non-communicable diseases, that are not contagious, but they are usually long-lasting. Regular physical activity could reduce mental health problems, such as anxiety. The World Health Organization proposed to improve physical activity programs through the implementation of interventions in green urban spaces. Green urban space provides a safe, accessible, and attractive place to perform physical activity. All the interventions aimed to promote the practice of physical activity and to reduce sedentary behavior are important. It is well known that physical activity has several positive effects, a great amount of the population remains inactive. A good strategy could be to show people how integrated physical activity into their all-day life, for example through the use of green urban space or active commuting. The results in the present thesis showed the effectiveness of performing physical activity in a natural environment and of active commuting.

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Urban health and well-being are becoming current issues of modern cities due to local climate change and environmental noise. The Urban Heat Island and the Urban Noise Island have a direct impact on the economic, social, and environmental aspects of urban life, negatively affecting the well-being of worldwide citizens. The present research is focused on the study of innovative materials employed in the production of wearing course mixtures aiming to mitigate these phenomena. In particular, a synthetic transparent binder substituting bitumen and recycled aggregates produced from construction and demolition waste. Four mixtures were analysed. Among them, Mix 1 and Mix 2 are conventional wearing courses. The first is exclusively made of natural aggregates, while the second is constituted of 45 % of recycled aggregates (RA). Mix 3 and Mix 4 are draining wearing courses and, in this case, Mix 4 was produced by using 55 % of RA. Laboratory tests were required to fully characterize all the produced samples, allowing a proper comparison of results. Overall, all the mixtures studied provide prominent results suggesting potential applications of these innovative wearing courses in cycle lanes, historical centres, plazas, and parking lots. Among the conventional mixtures, Mix 2 is the most likely to assure the best performance in terms of road safety, efficiency, and durability while as far as the draining mixtures are concerned, Mix 4 is preferable due to its high content of recycled aggregates.

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Since the majority of the population of the world lives in cities and that this number is expected to increase in the next years, one of the biggest challenges of the research is the determination of the risk deriving from high temperatures experienced in urban areas, together with improving responses to climate-related disasters, for example by introducing in the urban context vegetation or built infrastructures that can improve the air quality. In this work, we will investigate how different setups of the boundary and initial conditions set on an urban canyon generate different patterns of the dispersion of a pollutant. To do so we will exploit the low computational cost of Reynolds-Averaged Navier-Stokes (RANS) simulations to reproduce the dynamics of an infinite array of two-dimensional square urban canyons. A pollutant is released at the street level to mimic the presence of traffic. RANS simulations are run using the k-ɛ closure model and vertical profiles of significant variables of the urban canyon, namely the velocity, the turbulent kinetic energy, and the concentration, are represented. This is done using the open-source software OpenFOAM and modifying the standard solver simpleFoam to include the concentration equation and the temperature by introducing a buoyancy term in the governing equations. The results of the simulation are validated with experimental results and products of Large-Eddy Simulations (LES) from previous works showing that the simulation is able to reproduce all the quantities under examination with satisfactory accuracy. Moreover, this comparison shows that despite LES are known to be more accurate albeit more expensive, RANS simulations represent a reliable tool if a smaller computational cost is needed. Overall, this work exploits the low computational cost of RANS simulations to produce multiple scenarios useful to evaluate how the dispersion of a pollutant changes by a modification of key variables, such as the temperature.

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Polycyclic aromatic hydrocarbons (PAHs) are common environmental pollutants that occur naturally in complex mixtures. Many of the adverse health effects of PAHs including cancer are linked to the activation of intracellular stress response signaling. This study has investigated intracellular MAPK signaling in response to PAHs in extracts from urban air collected in Stockholm, Sweden and Limeira, Brazil, in comparison to BP in HepG2 cells. Nanomolar concentrations of PAHs in the extracts induced activation of MEK4 signaling with down-stream increased gene expression of several important stress response mediators. Involvement of the MEK4/JNK pathway was confirmed using siRNA and an inhibitor of JNK signaling resulting in significantly reduced MAPK signaling transactivated by the AP-1 transcription factors ATF2 and c-Jun. ATF2 was also identified as a sensitive stress responsive protein with activation observed at extract concentrations equivalent to 0.1 nM BP. We show that exposure to low levels of environmental PAH mixtures more strongly activates these signaling pathways compared to BP alone suggesting effects due to interactions. Taken together, this is the first study showing the involvement of MEK4/JNK/AP-1 pathway in regulating the intracellular stress response after exposure to nanomolar levels of PAHs in environmental mixtures.

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Human bocavirus 1 (HBoV1) is associated with respiratory infections worldwide, mainly in children. Similar to other parvoviruses, it is believed that HBoV1 can persist for long periods of time in humans, probably through maintaining concatemers of the virus single-stranded DNA genome in the nuclei of infected cells. Recently, HBoV-1 was detected in high rates in adenoid and palatine tonsils samples from patients with chronic adenotonsillar diseases, but nothing is known about the virus replication levels in those tissues. A 3-year prospective hospital-based study was conducted to detect and quantify HBoV1 DNA and mRNAs in samples of the adenoids (AD), palatine tonsils (PT), nasopharyngeal secretions (NPS), and peripheral blood (PB) from patients undergoing tonsillectomy for tonsillar hypertrophy or recurrent tonsillitis. HBoV1 was detected in 25.3% of the AD samples, while the rates of detection in the PT, NPS, and PB samples were 7.2%, 10.5%, and 1.7%, respectively. The viral loads were higher in AD samples, and 27.3% of the patients with HBoV had mRNA detectable in this tissue. High viral loads and detectable mRNA in the AD were associated with HBoV1 detection in the other sample sites. The adenoids are an important site of HBoV1 replication and persistence in children with tonsillar hypertrophy. The adenoids contain high HBoV1 loads and are frequently positive for HBoV mRNA, and this is associated with the detection of HBoV1 in secretions.

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Otorhinolaryngological manifestations of rheumatologic diseases represent a great challenge not only to the generalistphysician but also to the ENT doctor andrheumatologist. They often represent early manifestations of an autoimmune disorder which requires prompt and aggressive immunosuppressive treatment. Auditory, nasal, laryngeal and eye symptoms can be the first manifestation of rheumatic diseases and their proper assessment helps the doctor to identify signs of disease activity. The objective of this study is to identify the ENT manifestations in patients with rheumatic diseases in a high complexity hospital, regarding facilitating an early diagnosis and treatment. We performed clinical and complete otorhinolaryngological evaluations in patients selected from the outpatient rheumatology in a standardized manner by the use of a standardized form filling during the secondhalf of 2010. In the study group, systemic lupus erythematosus (SLE) patients had predominantly laryngeal manifestations, while patients with Sjögren's syndrome showed a higher prevalence of otologic manifestations. Changes in audiometric tests were found in 53% of Wegener's granulomatosis (WG) patients, 80% of relapsing polychondritis (RP), 33% of systemic lupus erythematosus (SLE) and 50% of Churg-Strauss syndrome (SCS). Regarding nasal alterations, these were found so prevalent in all conditions, especially Churg-Strauss syndrome. This study demonstrated that most patients treated in our hospital has the ENT signs and symptoms commonly associated in previous studies on rheumatic diseases, but further studies with a larger number of patients must be made to establish such relations.

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To evaluate intervention practices associated with hypothermia at both 5 minutes after birth and at neonatal intensive care unit (NICU) admission and to determine whether hypothermia at NICU admission is associated with early neonatal death in preterm infants. This prospective cohort included 1764 inborn neonates of 22-33 weeks without malformations admitted to 9 university NICUs from August 2010 through April 2012. All centers followed neonatal International Liaison Committee on Resuscitation recommendations for the stabilization and resuscitation in the delivery room (DR). Variables associated with hypothermia (axillary temperature <36.0 °C) 5 minutes after birth and at NICU admission, as well as those associated with early death, were analyzed by logistic regression. Hypothermia 5 minutes after birth and at NICU admission was noted in 44% and 51%, respectively, with 6% of early neonatal deaths. Adjusted for confounding variables, practices associated with hypothermia at 5 minutes after birth were DR temperature <25 °C (OR 2.13, 95% CI 1.67-2.28), maternal temperature at delivery <36.0 °C (OR 1.93, 95% CI 1.49-2.51), and use of plastic bag/wrap (OR 0.53, 95% CI 0.40-0.70). The variables associated with hypothermia at NICU admission were DR temperature <25 °C (OR 1.44, 95% CI 1.10-1.88), respiratory support with cold air in the DR (OR 1.40, 95% CI 1.03-1.88) and during transport to NICU (OR 1.51, 95% CI 1.08-2.13), and cap use (OR 0.55, 95% CI 0.39-0.78). Hypothermia at NICU admission increased the chance of early neonatal death by 1.64-fold (95% CI 1.03-2.61). Simple interventions, such as maintaining DR temperature >25 °C, reducing maternal hypothermia prior to delivery, providing plastic bags/wraps and caps for the newly born infants, and using warm resuscitation gases, may decrease hypothermia at NICU admission and improve early neonatal survival.

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hematopoietic stem cell transplantation (HSCT) is associated with more respiratory infections due to immunosuppression. this study aimed to verify the frequency of rhinosinusitis after HSCT, and the association between rhinosinusitis and chronic graft vs. host disease (GVHD) and type of transplantation, clinical treatment, surgical treatment, and survival. this was a retrospective study in a tertiary university hospital. A total of 95 patients with hematological diseases undergoing HSCT between 1996 and 2011 were selected. chronic myeloid leukemia was the most prevalent disease. The type of transplant most often performed was the allogenic type (85.26%). The frequency of rhinosinusitis was 36%, with no difference between the autologous and the allogenic types. Chronic GVHD occurred in 30% of patients. Patients with GVHD had a higher frequency and recurrence of rhinosinusitis, in addition to more frequent need for endoscopic sinusectomy and decreased overall survival. there was a higher frequency of rhinosinusitis in HSCT and GVHD. The type of transplant does not appear to predispose to the occurrence of rhinosinusitis. GVHD seems to be an aggravating factor and requires a more stringent treatment.

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Obstructive lung diseases of different etiologies present with progressive peripheral airway involvement. The peripheral airways, known as the silent lung zone, are not adequately evaluated with conventional function tests. The principle of gas washout has been used to detect pulmonary ventilation inhomogeneity and to estimate the location of the underlying disease process. Volumetric capnography (VC) analyzes the pattern of CO2 elimination as a function of expired volume. To measure normalized phase 3 slopes with VC in patients with non-cystic fibrosis bronchiectasis (NCB) and in bronchitic patients with chronic obstructive pulmonary disease (COPD) in order to compare the slopes obtained for the groups. NCB and severe COPD were enrolled sequentially from an outpatient clinic (Hospital of the State University of Campinas). A control group was established for the NCB group, paired by sex and age. All subjects performed spirometry, VC, and the 6-Minute Walk Test (6MWT). Two comparisons were made: NCB group versus its control group, and NCB group versus COPD group. The project was approved by the ethical committee of the institution. Statistical tests used were Wilcoxon or Student's t-test; P<0.05 was considered to be a statistically significant difference. Concerning the NCB group (N=20) versus the control group (N=20), significant differences were found in body mass index and in several functional variables (spirometric, VC, 6MWT) with worse results observed in the NCB group. In the comparison between the COPD group (N=20) versus the NCB group, although patients with COPD had worse spirometric and 6MWT values, the capnographic variables mean phase 2 slope (Slp2), mean phase 3 slope normalized by the mean expiratory volume, or mean phase 3 slope normalized by the end-tidal CO2 concentration were similar. These findings may indicate that the gas elimination curves are not sensitive enough to monitor the severity of structural abnormalities. The role of normalized phase 3 slope may be worth exploring as a more sensitive index of small airway disease, even though it may not be equally sensitive in discriminating the severity of the alterations.

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The aim of this work was to characterize the effects of partial inhibition of respiratory complex I by rotenone on H2O2 production by isolated rat brain mitochondria in different respiratory states. Flow cytometric analysis of membrane potential in isolated mitochondria indicated that rotenone leads to uniform respiratory inhibition when added to a suspension of mitochondria. When mitochondria were incubated in the presence of a low concentration of rotenone (10 nm) and NADH-linked substrates, oxygen consumption was reduced from 45.9 ± 1.0 to 26.4 ± 2.6 nmol O2 mg(-1) min(-1) and from 7.8 ± 0.3 to 6.3 ± 0.3 nmol O2 mg(-1) min(-1) in respiratory states 3 (ADP-stimulated respiration) and 4 (resting respiration), respectively. Under these conditions, mitochondrial H2O2 production was stimulated from 12.2 ± 1.1 to 21.0 ± 1.2 pmol H2O2 mg(-1) min(-1) and 56.5 ± 4.7 to 95.0 ± 11.1 pmol H2O2 mg(-1) min(-1) in respiratory states 3 and 4, respectively. Similar results were observed when comparing mitochondrial preparations enriched with synaptic or nonsynaptic mitochondria or when 1-methyl-4-phenylpyridinium ion (MPP(+)) was used as a respiratory complex I inhibitor. Rotenone-stimulated H2O2 production in respiratory states 3 and 4 was associated with a high reduction state of endogenous nicotinamide nucleotides. In succinate-supported mitochondrial respiration, where most of the mitochondrial H2O2 production relies on electron backflow from complex II to complex I, low rotenone concentrations inhibited H2O2 production. Rotenone had no effect on mitochondrial elimination of micromolar concentrations of H2O2. The present results support the conclusion that partial complex I inhibition may result in mitochondrial energy crisis and oxidative stress, the former being predominant under oxidative phosphorylation and the latter under resting respiration conditions.

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Palpable mass is a common complaint presented to the breast surgeon. It is very uncommon for patients to report breast mass associated with palpable masses in other superficial structures. When these masses are related to systemic granulomatous diseases, the diagnosis and initiation of specific therapy can be challenging. The purpose of this paper is to report a case initially assessed by the breast surgeon and ultimately diagnosed as granulomatous variant of T-cell lymphoma, and discuss the main systemic granulomatous diseases associated with palpable masses involving the breast.