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Aluminum is a widely used material offering many advantages when used in buildings. Supply has dramatically increased with better recycling practices. With this in mind during the 1990s, Japanese subsidies targeted exploratory development of new uses for aluminum in buildings. This paper reviews innovative aluminum developments by Japanese architect Toyo ITO and structural engineer Masato ARAYA. With strong industry support, the two professionals designed and built five free-standing aluminum structures: a house, a dormitory, a cottage, an exhibition kiosk and a pavilion. Teaming up with several different industry partners both at home and abroad, Ito and Araya explored a variety of formal approaches. Their work received numerous awards and accolades and was in some cases patented. However, in the end the structures the two professionals built remain unique.

Aluminum is a widely used material offering many advantages when used in buildings. Supply has dramatically increased with better recycling practices. With this in mind during the 1990s, Japanese subsidies targeted exploratory development of new uses for aluminum in buildings. This paper reviews innovative aluminum developments by Japanese architect Toyo ITO and structural engineer Masato ARAYA. With strong industry support, the two professionals designed and built five free-standing aluminum structures: a house, a dormitory, a cottage, an exhibition kiosk and a pavilion. Teaming up with several different industry partners both at home and abroad, Ito and Araya explored a variety of formal approaches. Their work received numerous awards and accolades and was in some cases patented. However, in the end the structures the two professionals built remain unique.

There are three imperial residences in Kyoto: Gosho (京都御所), rebuilt in 1855 and used for formal affairs even today; Shūgakuin (修学院離宮), a summer retreat on mountain slopes built in the mid-seventeenth century; and Katsura Imperial Retreat (桂離宮), slightly older than Shūgakuin. Upon the death of the Hachijō imperial line in 1881, Katsura came into the hands of the reigning household; shortly afterward, the Imperial Household Ministry was formed and took responsibility for the care of such sites. Sometimes grouped with the other residences, Nijō Palace was originally built not for the imperial household but for the warriors who effectively ruled Japan from the seventeenth to the middle of the nineteenth century; today, it too is managed by the Imperial Household Agency (the scope and name of the Imperial Household Ministry having changed at the end of World War II). Of these four, Katsura, with its extensive grounds and esteemed teahouses in addition to a large, shoin-style residence, is best known of all, used both at home and abroad to illustrate arguments about architecture and national tradition. Yet even so, much remains to be said about the complex, as demonstrated by this brief descriptive bibliography. Download High-Resolution PDF

Background: Stress is highly prevalent and known to be a risk factor for a wide range of physical and mental disorders. The effectiveness of digital stress management interventions has been confirmed; however, research on its economic merits is still limited. Objective: This study aims to assess the cost-effectiveness, cost-utility, and cost-benefit of a universal digital stress management intervention for employees compared with a waitlist control condition within a time horizon of 6 months. Methods: Recruitment was directed at the German working population. A sample of 396 employees was randomly assigned to the intervention group (n=198) or the waitlist control condition (WLC) group (n=198). The digital stress management intervention included 7 sessions plus 1 booster session, which was offered without therapeutic guidance. Health service use, patient and family expenditures, and productivity losses were self-assessed and used for costing from a societal and an employer's perspective. Costs were related to symptom-free status (PSS-10 [Perceived Stress Scale] score 2 SDs below the study population baseline mean) and quality-adjusted life years (QALYs) gained. The sampling error was handled using nonparametric bootstrapping. Results: From a societal perspective, the digital intervention was likely to be dominant compared with WLC, with a 56% probability of being cost-effective at a willingness-to-pay (WTP) of €0 per symptom-free person gained. At the same WTP threshold, the digital intervention had a probability of 55% being cost-effective per QALY gained relative to the WLC. This probability increased to 80% at a societal WTP of €20,000 per QALY gained. Taking the employer's perspective, the digital intervention showed a probability of a positive return on investment of 78%. Conclusions: Digital preventive stress management for employees appears to be cost-effective societally and provides a favorable return on investment for employers. Trial Registration: German Clinical Trials Register DRKS00005699; https://drks.de/search/en/trial/DRKS00005699 [ABSTRACT FROM AUTHOR]

Examines some of the many Internet/World Wide Web versions of MEDLINE and reports whether the file is "healthier" now than it was before. Describes two search examples and two non-National Library of Medicine Web MEDLINE sites. Notes that for MEDLINE searching, the user should pick a couple of sites and perform a personal comparisons and evaluations. (AEF)

Defines "disintermediation" as the process of diminishing the act of coming between by intermediaries (information specialists, librarians, patent searchers). Discusses the need for professional searchers to prove their value, anticipate customers' needs, and know the Internet; and to get active in professional associations. (AEF)

Abstract: This paper addresses a very specific problem of identifying patients diagnosed with a specific condition for potential recruitment in a clinical trial or an epidemiological study. We present a simple machine learning method for identifying patients diagnosed with congestive heart failure and other related conditions by automatically classifying clinical notes dictated at Mayo Clinic. This method relies on an automatic classifier trained on comparable amounts of positive and negative samples of clinical notes previously categorized by human experts. The documents are represented as feature vectors, where features are a mix of demographic information as well as single words and concept mappings to MeSH and HICDA classification systems. We compare two simple and efficient classification algorithms (Naïve Bayes and Perceptron) and a baseline term spotting method with respect to their accuracy and recall on positive samples. Depending on the test set, we find that Naïve Bayes yields better recall on positive samples (95 vs. 86%) but worse accuracy than Perceptron (57 vs. 65%). Both algorithms perform better than the baseline with recall on positive samples of 71% and accuracy of 54%. [Copyright &y& Elsevier]

Background: The evidence base for internet-based cognitive behavioral therapy for insomnia (iCBT-I) is firm; however, little is known about iCBT-I's health-economic effects.Objective: This study aimed to evaluate the cost-effectiveness and cost-utility of iCBT-I in reducing insomnia among schoolteachers.Methods: Schoolteachers (N=128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided iCBT-I or a wait list control group, both with unrestricted access to treatment as usual. Health care use, patient and family expenditures, and productivity losses were self-assessed and used for costing from a societal and a public health care perspective. Costs were related to symptom-free status (score <8 on the insomnia severity index) and quality-adjusted life years (QALYs) gained. Sampling error was handled using nonparametric bootstrapping.Results: Statistically significant differences favoring the intervention group were found for both health outcomes (symptom-free status yes or no: β=.30; 95% CI 0.16-0.43; QALYs: β=.019, 95% CI 0.01-0.03). From a societal perspective, iCBT-I had a 94% probability of dominating the wait list control for both health outcomes. From a public health care perspective, iCBT-I was more effective but also more expensive than the wait list control, resulting in an incremental cost-effectiveness ratio of €650 per symptom-free individual. In terms of QALYs, the incremental cost-effectiveness ratio was €11,285. At a willingness-to-pay threshold of €20,000 per QALY gained, the intervention's probability of being cost-effective was 89%.Conclusions: Our trial indicates that iCBT could be considered as a good value-for-money intervention for insomnia.Trial Registration: German Clinical Trial Registry: DRKS00004700; https://tinyurl.com/2nnk57jm.International Registered Report Identifier (irrid): RR2-10.1186/1745-6215-14-169. [ABSTRACT FROM AUTHOR]

Background: Many individuals engaging in Internet-based interventions fail to complete these treatments as intended. The processes responsible for treatment adherence in Internet-based interventions are still poorly understood.Objective: The aim of this study was to investigate to what extent adherence in an Internet-based intervention can be predicted by motivational and volitional factors outlined in the health action process approach (HAPA).Methods: This study investigated motivational and volitional factors included in HAPA in a randomized controlled trial to predict treatment adherence of N=101 individuals with subclinical depression in the intervention group of a depression prevention intervention (GET.ON Mood Enhancer). Adherence was operationalized as the number of completed treatment modules. Using longitudinal structural equation modeling, HAPA variables (motivational, maintenance, and recovery self-efficacy, outcome expectancies, intention, and planning) were assessed at baseline and their associations with adherence 7 weeks later.Results: Planning predicted adherence. Better planning was, in turn, associated with higher levels of maintenance self-efficacy, and the latter significantly affected treatment adherence via planning. The other hypothesized direct associations were not significant. In total, the HAPA variables accounted for 14% of variance in treatment adherence.Conclusions: Planning emerged as the strongest predictor of treatment adherence in highly motivated participants in an Internet-based intervention out of all HAPA variables investigated. Findings are in line with the hypothesis that planning facilitates the translation of good intentions into actions. The findings imply that systematically fostering planning skills and maintenance self-efficacy prior to or during Internet-based interventions would help participants to successfully complete these treatments.Trial Registration: German Clinical Trials Register DRKS00005973; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00005973 (Archived by WebCite at http://www.webcitation.org/6uxCy64sy). [ABSTRACT FROM AUTHOR]

Background: Psychological interventions for the prevention of depression might be a cost-effective way to reduce the burden associated with depressive disorders.Objective: To evaluate the cost-effectiveness of a Web-based guided self-help intervention to prevent major depressive disorder (MDD) in people with subthreshold depression (sD).Methods: A pragmatic randomized controlled trial was conducted with follow-up at 12 months. Participants were recruited from the general population via a large statutory health insurance company and an open access website. Participants were randomized to a Web-based guided self-help intervention (ie, cognitive-behavioral therapy and problem-solving therapy assisted by supervised graduate students or health care professionals) in addition to usual care or to usual care supplemented with Web-based psycho-education (enhanced usual care). Depression-free years (DFYs) were assessed by blinded diagnostic raters using the telephone-administered Structured Clinical Interview for DSM-IV Axis Disorders at 6- and 12-month follow-up, covering the period to the previous assessment. Costs were self-assessed through a questionnaire. Costs measured from a societal and health care perspective were related to DFYs and quality-adjusted life years (QALYs).Results: In total, 406 participants were enrolled in the trial. The mean treatment duration was 5.84 (SD 4.37) weeks. On average, participants completed 4.93 of 6 sessions. Significantly more DFYs were gained in the intervention group (0.82 vs 0.70). Likewise, QALY health gains were in favor of the intervention, but only statistically significant when measured with the more sensitive SF-6D. The incremental per-participant costs were €136 (£116). Taking the health care perspective and assuming a willingness-to-pay of €20,000 (£17,000), the intervention's likelihood of being cost-effective was 99% for gaining a DFY and 64% or 99% for gaining an EQ-5D or a SF-6D QALY.Conclusions: Our study supports guidelines recommending Web-based treatment for sD and adds that this not only restores health in people with sD, but additionally reduces the risk of developing a MDD. Offering the intervention has an acceptable likelihood of being more cost-effective than enhanced usual care and could therefore reach community members on a wider scale.Trial Registration: German Clinical Trials Register: DRKS00004709; http://www.drks.de/DRKS00004709 (Archived by WebCite at http://www.webcitation.org/6kAZVUxy9). [ABSTRACT FROM AUTHOR]