Max Rosenfeld, The Home Architect

1949 marks the beginning of a radical change in the relation between New Zealanders and their homes. The new government at that time began encouraging home ownership in opposition to the existing policy of renting state houses. In those days, one of the most influential architects in the country was Max Rosenfeld, a Czech immigrant who became known mainly through the Auckland magazine The Weekly News. Rosenfeld hadn't produced any iconic building or brought any revolutionary aesthetic style. Nevertheless his contribution to New Zealand domestic architecture was tremendous, though today he is hardly ever mentioned. This paper proposes to shed light on the work of this architect focusing on his participation in The Weekly News publication which started in 1949. For almost a decade Rosenfeld became known as the "Home Architect" following the name of his magazine column. His ideas and architectural advice became very popular and his publications inspired owners and helped builders to familiarize themselves with the Modern way of living and building. Rosenfeld is mainly quoted in reference to the popularization of New Zealand plan books, a kind of publication renowned for containing projects made to fit just about any taste, budget and site. Seen with disdain by some, those books were, nevertheless, the most efficient vehicle for the dissemination of architecture into the everyday life of ordinary Kiwis. In that sense Rosenfeld can be seen as one of the essential contributors to the modern building practice we find in New Zealand, which decisively influences the way Kiwis live today

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt