Moving Home to College: Socio-Physical Factorsin Creating 'Home' in Temporary Environments

Intentionally temporary housing environments, like student housing, where residents know they will settle for a short period may lack the social and physical factors that inspire a sense of home and community. Yet, these environments compete with traditional housing options to retain residents and therefore, universities want to create housing that makes students feel at home and bond with their fellow students and their eventual alma maters. This research asks how do the social, psychological, and physical structures of a temporary living environment create a sense of `home?' This study analyzes these connections in residence halls on the campus of the University of Kansas, as a way to develop principles that will result in high-quality design for temporary living environments. Methods used in this study adapt a series of five focus-group activities combined with interviews and observations to investigate the social and physical factors that inspire students to create `home' in the halls. Four major themes developed through this study address the social-physical connection in the environment: choice and control; flexibility and adaptability; comfort and well-being; and community. These themes suggest a set of design principles that respond to the social development of residents and the physical requirements for successful student spaces. The principles encourage the incorporation of smaller, clustered residential communities to improve identity and community, the use of adaptable furnishings, and the incorporation of `third places' for socialization. This study proves that scale matters; it sets forth design principles for temporary environments that emphasize the importance of social and physical scale in the living environment, and it highlights the viability of a design process to develop ongoing practice in the field of student housing. Student housing officials may use the results of this study to evaluate housing policies and set agendas for future construction projects

Towards an Integrative Understanding of 'authenticity' of cultural heritage: An analysis of World Heritage Site designations in the Asian Context

In the World Heritage Sites (WHS) designation, it is required to define the conditions that ‘authenticate’ the Outstanding Universal Value (OUV) of heritage sites. Initially, the notion of authenticity had been understood as an objective and measurable attribute inherent in the material fabric of sites. This perspective overlooked the fact that authenticity of a place is culturally constructed, contextually variable, and observer dependent. In 1994, United Nations Educational, Scientific and Cultural Organization (UNESCO) introduced a set of attributes that facilitate a holistic understanding of authenticity of heritage sites which considers both tangible and intangible aspects of heritage together. To find out the extent to which this holistic understanding of authenticity is currently applied in the WHS designations, we analysed nomination dossiers of 31 sites from the Asian context that were designated as World Heritage between 2005 and 2014. The findings point towards the continuing need to apply systematic, holistic and integrative perspectives of authenticity standards to heritage sites

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

A human neurodevelopmental model for Williams syndrome

Williams syndrome (WS) is a genetic neurodevelopmental disorder characterized by an uncommon hypersociability and a mosaic of retained and compromised linguistic and cognitive abilities. Nearly all clinically diagnosed individuals with WS lack precisely the same set of genes, with breakpoints in chromosome band 7q11.23(1–5). The contribution of specific genes to the neuroanatomical and functional alterations, leading to behavioral pathologies in humans, remains largely unexplored. Here, we investigate neural progenitor cells (NPCs) and cortical neurons derived from WS and typically developing (TD) induced pluripotent stem cells (iPSCs). WS NPCs have an increased doubling time and apoptosis compared to TD NPCs. Using an atypical WS subject(6, 7), we narrowed this cellular phenotype to a single gene candidate, FZD9. At the neuronal stage, WS-derived layers V/VI cortical neurons were characterized by longer total dendrites, increased numbers of spines and synapses, aberrant calcium oscillation and altered network connectivity. Morphometric alterations observed in WS neurons were validated after Golgi staining of postmortem layers V/VI cortical neurons. This human iPSC model(8) fills in the current knowledge gap in WS cellular biology and could lead to further insights into the molecular mechanism underlying the disorder and the human social brain