Capitalization, Scale, and Investment: Does Growth Equal Gain?

This study, commissioned by the William Penn Foundation, examines the state of Philadelphia's arts and culture sector.The study is divided into two major sections: trends in the greater Philadelphia ecosystem and assessing investments toward growth

How Boston and Other American Cities Support and Sustain the Arts: Funding for Cultural Nonprofits in Boston and 10 Other Metropolitan Centers

A new study commissioned by the Boston Foundation on how Boston and comparable cities support the arts shows that only New York City has higher per capita contributed revenue for the art than Boston, among major American cities.The study, titled "How Boston and Other American Cities Support and Sustain the Arts: Funding for Cultural Nonprofits in Boston and 10 Other Metropolitan Cities," also examined Baltimore, Chicago, Cleveland, Houston, Minneapolis-St. Paul, Philadelphia, Portland Oregon, San Francisco, and Seattle. "How Boston" is a follow-up of sorts to a 2003 Boston Foundation report titled, "Funding for Cultural Organizations in Boston and Nine Other Metropolitan Areas."Key findings of this study, regarding Boston, include the fact that Boston's arts market is quite densely populated. While Greater Boston is the nation's 10th largest metro area and ranks ninth for total Gross Domestic Product, its non-profit arts market, which consists of more than 1,500 organizations, is comparable to that of New York and San Francisco, and consistently surpasses large cities such as Houston, Chicago and Philadelphia, in terms of the number of organizations and their per capita expenses

Mosquito coil emissions and health implications.

Burning mosquito coils indoors generates smoke that can control mosquitoes effectively. This practice is currently used in numerous households in Asia, Africa, and South America. However, the smoke may contain pollutants of health concern. We conducted the present study to characterize the emissions from four common brands of mosquito coils from China and two common brands from Malaysia. We used mass balance equations to determine emission rates of fine particles (particulate matter < 2.5 microm in diameter; PM(2.5)), polycyclic aromatic hydrocarbons (PAHs), aldehydes, and ketones. Having applied these measured emission rates to predict indoor concentrations under realistic room conditions, we found that pollutant concentrations resulting from burning mosquito coils could substantially exceed health-based air quality standards or guidelines. Under the same combustion conditions, the tested Malaysian mosquito coils generated more measured pollutants than did the tested Chinese mosquito coils. We also identified a large suite of volatile organic compounds, including carcinogens and suspected carcinogens, in the coil smoke. In a set of experiments conducted in a room, we examined the size distribution of particulate matter contained in the coil smoke and found that the particles were ultrafine and fine. The findings from the present study suggest that exposure to the smoke of mosquito coils similar to the tested ones can pose significant acute and chronic health risks. For example, burning one mosquito coil would release the same amount of PM(2.5) mass as burning 75-137 cigarettes. The emission of formaldehyde from burning one coil can be as high as that released from burning 51 cigarettes

Tradução e adaptação cultural para a língua portuguesa falada no Brasil da Canadian survey of mobilization of ICU patients

Este estudio tuvo como objetivo traducir y adaptar culturalmente el cuestionario Canadian survey of mobilization of intensive care unit patients al portugués de Brasil. Esteinstrumento evalúa a los profesionales de la unidad de cuidados intensivos (UCI) en cuanto al conocimiento sobre la movilización temprana (MT) y su importancia, las percepciones sobre lasbarreras y las prácticas de  rehabilitación con pacientes críticos.El protocolo incluyó las siguientes etapas: autorización y cesión de derechos de uso; traducción del instrumento al portugués brasileño; reconciliación; retrotraducción al idioma original; revisión y armonización de la retrotraducción; aprobación de la autora principal al cuestionario original; revisión de la versión al portugués; despliegue cognitivo; y reconciliación y preparación de la versión final. Debido a algunas diferencias conceptuales y culturales entre los dos países, se discutieron algunas dudas con la autora principal del instrumento, quien estuvo de acuerdo con los cambios sugeridos. En el despliegue cognitivo, los 10 profesionales seleccionados probaron la claridad, la comprensióny la aceptabilidad del cuestionario, y demostraron las dificultades de los contenidos. Numerosos entrevistados manifestaron que el instrumento suscita importantes reflexiones sobre las prácticas cotidianas y beneficios de llevar a cabo la MT. El cuestionario titulado Investigación en movilización de pacientes en unidades de cuidados intensivos: conocimientos, perspectivas y prácticas actuales está traducido y adaptado culturalmente al portuguésde Brasil, y puede ser utilizado para evaluar aspectos de MT por parte de profesionales que participan en este proceso en UCI de adultos y pediátrica. Se necesitarán estudios futuros que utilicen esta versión para verificar que el cuestionario proporciona la reproducibilidad y la validez de las medidas.Este estudo teve como objetivo traduzir e adaptar culturalmente o questionário Canadian survey of mobilization of intensive care unit patients para a língua portuguesa falada no Brasil. Este instrumento avalia profissionais de unidade de terapia intensiva (UTI) em relação aos conhecimentos sobre a mobilização precoce (MP) e sua importância, as percepções sobre barreiras e as práticas de reabilitação com o paciente crítico. O protocolo incluiu as etapas: autorização e cessão de direitos de uso; tradução do instrumento para a língua portuguesa;reconciliação; retrotradução para a língua original; revisão e harmonização da retrotradução; aprovação da autora principal do questionário original; revisão da versão em português; desdobramento cognitivo; e reconciliação e elaboração da versão final. Devido a algumas diferenças conceituais e culturais entre os dois países, algumas dúvidas foram discutidas com a autora principal do instrumento, a qual concordou com as alterações sugeridas. No desdobramento cognitivo, os 10 profissionais selecionados testaram a clareza, compreensão e aceitabilidade do questionário, e demonstraram suas dificuldades quanto ao conteúdo deste. Muitos entrevistados evidenciaram que o instrumento desperta reflexões importantes sobre as práticas diárias e os benefícios com a realização da MP. O questionário intitulado Pesquisa de mobilização de pacientes em unidade de terapia intensiva: conhecimento, perspectivas e práticas atuais encontra-se traduzido e adaptado culturalmente para a língua portuguesa falada no Brasil, podendo ser utilizado para avaliar aspectos da MP por profissionais que participam deste processo em UTIs adulto e pediátricas. Estudos futuros utilizando esta versão serão necessários para verificar se o questionário fornece medidas reprodutíveis e válidas.This study aimed to translate and culturally adapt the “Canadian survey of mobilization of intensive care unit patients” questionnaire to Brazilian Portuguese. This instrument evaluates intensive care unit (ICU) professionals’knowledge about early mobilization and its importance, their perceptions about barriers and rehabilitation practices with critically ill patients. The protocol includes the following steps: authorization and assignment of rights of use; translation of the instrument into Portuguese; reconciliation; back-translation to the original language; revision and harmonization of back-translation; approval from the main author of the original questionnaire; revision of the Portuguese version; cognitive debriefing; reconciliation; and preparation of the final version. Due to some conceptual and cultural differences between the two countries, some questions were discussed with the author of the original instrument, who agreed with the suggested  alterations. During cognitive debriefing, the 10 selected professionals tested the  questionnaire’s clarity, understanding, and acceptability, indicating any difficulties they had regarding its content. Many interviewees reported that the instrument raises important reflections on daily practices and thebenefits of early mobilization. The questionnaire entitled “Pesquisa de mobilização de pacientes em unidade de terapia intensiva: conhecimento, perspectivas e práticas atuais” was translated and culturally adapted to Brazilian Portuguese and can be usedto evaluate aspects of early mobilization by professionals whoparticipate in this process in adult and pediatric ICUs. Future studies using this version will be necessary to verify that the questionnaire provides  reproducible and valid measurements

Dermatite alérgica de contato a medicamentos de uso tópico: uma análise descritiva Allergic contact dermatitis to topical drugs: a descriptive analysis

FUNDAMENTOS: A dermatite de contato é uma dermatose comum e suas múltiplas causas dificultam seutratamento. OBJETIVO: O objetivo do estudo foi avaliar a frequência da sensibilização aos medicamentos de uso tópico, em serviço universitário; estudar as características da população afetada e identificar os principais sensibilizantes relacionados aos medicamentos tópicos. MÉTODOS: Realizou-se um estudo retrospectivo dos pacientes com hipótese diagnóstica de dermatite alérgica de contato e que foram submetidos a testes epicutâneos. Avaliaram-se os que tiveram diagnóstico final de dermatite alérgica de contato a medicamentos tópicos. RESULTADOS: Em um grupo de 329 pacientes submetidos a testes de contato, 42 (13%) tiveram testes de contato positivos e relevantes para medicamentos tópicos, pelo princípio ativo e/ou por outros componentes. Entre os testes positivos, 36 (85,7%) corresponderam aos princípios ativos e 28 (66,7%), a outros componentes das fórmulas, com alguns pacientes apresentando mais de um teste positivo. Entre os princípios ativos, a neomicina foi o mais frequente. CONCLUSÕES: Entre os pacientes estudados, a sensibilização aos medicamentos tópicos ocorreu em 13% dos casos, com discreta preferência pelo sexo feminino e maior número de casos entre pacientes brancos. Houve elevada frequência de dermatite alérgica de contato pela neomicina, agente de uso comum como automedicação e também como prescrição médica.<br>BACKGROUND: Allergic Contact Dermatitis is a common type of dermatitis, but its multiple etiologies hinder its management. OBJECTIVE: the objective of this study was to evaluate the frequency of sensitization to topical drugs in a university center, to study the main characteristics of the affected population, and to identify the allergens related with the dermatitis. METHODS: a retrospective and descriptive study with patients submitted to patch tests. The study was conducted with subjects whose patch test to topical drugs was positive. RESULTS: 329 patients were submitted to patch tests and 42 (13%) had positive and relevant patch tests to topical drugs. Among these patients, 36 (85.7%) had positive patch tests to the principal component and 28 (66.7%) to the other components. Some patients had more than one sensitization. Neomycin was the most important allergen. CONCLUSIONS: Among the studied patients, sensitization to topical agents happened in 13% of the cases, with slight preference for females and Caucasians. There was elevated sensitization to neomycin, a popular agent among patients and medical doctors

Fatal Powassan Encephalitis (Deer Tick Virus, Lineage II) in a Patient With Fever and Orchitis Receiving Rituximab.

Importance:Powassan virus is a rare but increasingly recognized cause of severe neurological disease. Objective:To highlight the diagnostic challenges and neuropathological findings in a fatal case of Powassan encephalitis caused by deer tick virus (lineage II) in a patient with follicular lymphoma receiving rituximab, with nonspecific anti-GAD65 antibodies, who was initially seen with fever and orchiepididymitis. Design, Setting, and Participants:Comparison of clinical, radiological, histological, and laboratory findings, including immunohistochemistry, real-time polymerase chain reaction, antibody detection, and unbiased sequencing assays, in a single case report (first seen in December 2016) at an academic medical center. Exposure:Infection with Powassan virus. Main Outcomes and Measures:Results of individual assays compared retrospectively. Results:In a 63-year-old man with fatal Powassan encephalitis, serum and cerebrospinal fluid IgM antibodies were not detected via standard methods, likely because of rituximab exposure. Neuropathological findings were extensive, including diffuse leptomeningeal and parenchymal lymphohistiocytic infiltration, microglial proliferation, marked neuronal loss, and white matter microinfarctions most severely involving the cerebellum, thalamus, and basal ganglia. Diagnosis was made after death by 3 independent methods, including demonstration of Powassan virus antigen in brain biopsy and autopsy tissue, detection of viral RNA in serum and cerebrospinal fluid by targeted real-time polymerase chain reaction, and detection of viral RNA in cerebrospinal fluid by unbiased sequencing. Extensive testing for other etiologies yielded negative results, including mumps virus owing to prodromal orchiepididymitis. Low-titer anti-GAD65 antibodies identified in serum, suggestive of limbic encephalitis, were not detected in cerebrospinal fluid. Conclusions and Relevance:Owing to the rarity of Powassan encephalitis, a high degree of suspicion is required to make the diagnosis, particularly in an immunocompromised patient, in whom antibody-based assays may be falsely negative. Unbiased sequencing assays have the potential to detect uncommon infectious agents and may prove useful in similar scenarios