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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

Citation searching and bibliometrics are terms foreign to many chemists and educators, yet well-known and used by librarians and information specialists. This article aims to help chemistry students, educators, and other readers of this "Journal" to better appreciate and use these powerful and profound methods. Although these subjects have been described previously, several developments in the methods and new alternative metrics have occurred in the intervening 16 years, so the field is being reviewed again. Citation practices have also contributed to the study of bibliometrics which is used to evaluate publications, authors, and journals.

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]

Turning around chronically low-performing schools is challenging work requiring fundamental rethinking of the change process, and a systemic rather than school-by-school approach. Without a doubt, high-impact school leaders are critical to turnaround success, and pockets of success around the country demonstrate this. However, transformational and sustainable success at scale requires substantial engagement by school district leaders with the capacity and will to initiate, support, and enhance dramatic change. The most successful turnaround efforts have both--high-impact leaders and the district capacity to initiate, support, and enhance transformational change.

Turning around chronically low-performing schools is challenging work requiring fundamental rethinking of the change process, and a systemic rather than school-by-school approach. Without a doubt, high-impact school leaders are critical to turnaround success, and pockets of success around the country demonstrate this. However, transformational and sustainable success at scale requires substantial engagement by school district leaders with the capacity and will to initiate, support, and enhance dramatic change. The most successful turnaround efforts have both--high-impact leaders and the district capacity to initiate, support and enhance transformational change. In this article, the authors, based on their work in 43 school districts, identify the basic conditions that are necessary for a school turnaround to be effective, sustainable, and scalable.

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)

Importance: Depression is a frequent comorbid condition in patients with persistent back pain and is associated with substantial adverse consequences, including the risk of developing opioid use disorders. Shifting the focus from depression treatment to preventing depression might be a viable way to reduce the disease burden.Objective: To evaluate the effectiveness of a web-based self-help intervention to reduce the incidence of major depressive episode (MDE) in patients with persistent back pain.Design, Setting, and Participants: Prevention of Depression in Back Pain Patients (PROD-BP) was a pragmatic, observer-blinded randomized clinical trial with a parallel design conducted in Germany. Eligible adults with a diagnosis of persistent back pain and subclinical depressive symptoms, but who were depression free, were recruited either on-site or after discharge from 82 orthopedic clinics between October 1, 2015, and July 31, 2017. All analyses were conducted according to the intention-to-treat principle from October 31, 2018, to April 30, 2019.Interventions: The intervention group received an e-coach-guided, web-based self-help intervention that was based on cognitive behavioral therapy and tailored to the needs of patients with persistent back pain. The intervention included 6 obligatory modules and 3 optional modules to be completed by participants as well as feedback from e-coaches. Both the intervention and control groups had unrestricted access to treatment as usual.Main Outcomes and Measures: Primary outcome was time to onset of an MDE over a 12-month period as assessed by blinded diagnostic raters using the Structured Clinical Interview for DSM-5. Secondary outcomes included depression severity, quality of life, pain intensity, pain-related disability, pain self-efficacy, work capacity, and user satisfaction assessed with a variety of instruments.Results: A total of 295 participants (mean [SD] age, 52.8 [7.7] years; 184 women [62.4%]) were recruited and randomized to either the intervention group (n = 149) or control group (n = 146). The intervention reduced the risk of MDE onset by 52% (hazard ratio, 0.48; 95% CI, 0.28-0.81; P < .001). Twenty-one participants (14.1%) in the intervention group and 41 participants (28.1%) in the control group experienced an MDE over the 12-month period. The number needed to treat to prevent 1 new case of MDE was 2.84 (95% CI, 1.79-9.44).Conclusions and Relevance: Results of this trial showed that among patients with persistent back pain, depression can be prevented by a guided web-based self-help intervention in addition to treatment as usual. This finding suggests that using a scalable digital approach to integrate psychological treatment into routine pain management is feasible.Trial Registration: German Clinical Trials Register Identifier: DRKS00007960. [ABSTRACT FROM AUTHOR]

Examines the searching environment at Amoco Research Center as it affects the performance of online searching, regardless of the subject matter of the search itself. A comparison of general search strategies using various models is also presented. (CWM)

On the typical university campus, the notion of a business school collaborating in fundamental ways with a school of education is somewhat akin to an unnatural act. Leaders in K-12 education often bristle at the idea of incorporating best business practices into their field. Nevertheless, the authors' experience at University of Virginia is proving that good ideas, when contextualized for environment, can transcend all artificial barriers. This is evidenced not only by the flow of business practice to education but also by the application of education practices to business. Recognizing that the nature and quality of leadership in schools is a primary driver of school success, the Darden Graduate School of Business Administration and the Curry School of Education at the University of Virginia established a formal collaboration, the Partnership for Leaders in Education, to bring the latest thinking from educational leadership and general management to focus on the leadership and management backbone of school systems. This collaboration is described in this article.

Behcet disease is a rare, chronic multisystem vasculitis of unknown etiology. It commonly causes oral and genital ulcers, eye lesions, and vascular lesions. There are limited published reports on this condition in pregnant patients and the data that does exist shows remission of the disease in most pregnant patients. Arterial and venous thrombotic events appear to be a major comorbidity in patients with Behcet disease. This is a case report of a 24-year-old pregnant woman who presented with worsening Behcet disease symptoms during her second pregnancy. Her first pregnancy was not affected by the disease. Worsening of symptoms must be considered in pregnant women with Behcet disease and treated promptly due to potential life-threatening consequences. [ABSTRACT FROM AUTHOR]

Uterine arteriovenous malformation (AVM) is a rare condition that is potentially life-threatening. There are limited published reports on this condition. This is a case report of a 25-year-old woman who presented with a symptomatic AVM. We review the differential diagnoses, evaluation, and treatment options. Conservative treatment with interventional radiology can be considered in select women who desire fertility preservation. [ABSTRACT FROM AUTHOR]

Introduction: The Coyote Clinic is a student-run clinic that provides free services to Sioux Falls residents without insurance. It has not historically provided routine women's health screenings. The project addressed this lack of preventative care. We aimed to increase the percentage of female patients that are up to date on Papanicolaou (Pap) smears, mammograms, and human papillomavirus (HPV) vaccines through the implementation of screening questions. Methods: A screening questionnaire was created and asked to female patients between the ages of 18-65 about the dates and results of their last Pap smear, mammogram, and the administration of any HPV vaccine Results: 27 patients answered the questions. Fifty-two percent were Caucasian, 26 percent Hispanic, 15 percent African American, and 7 percent Middle Eastern. Two patients were eligible for HPV vaccination: one had not received the vaccination and the other was unknown. All 27 women were eligible for Pap smears. Seventy-six percent had normal results, 19 percent were unsure of their results, and 5 percent had abnormal results. Eight patients were eligible for mammograms: five were up to date, two were tested in the last three years, and one had an unknown test date. Conclusions: The majority of eligible female patients were up to date on Pap smears and mammograms. The health maintenance questionnaire was a valuable resource for patient care, patient health literacy, and medical student education. [ABSTRACT FROM AUTHOR]

The John F. Kennedy Center for the Performing Arts is located on the banks of the Potomac River in Washington, D.C. The Kennedy Center is home to the National Symphony Orchestra, the Washington National Opera and The Suzanne Farrell Ballet. In addition to being the nation's busiest arts facility, the Kennedy Center is also a "Living Memorial" to President Kennedy. The south expansion of the Kennedy Center, known as the REACH, provides much needed educational and rehearsal space, as well as a pedestrian link to the nearby Memorials. The new structure combines practicality, versatility and innovation. Each surface and space created is unique, forming complex geometries and large span to depth ratios. The cast-in-place concrete structure is exposed on the interior or the exterior, including three white concrete pavilions rising out of the landscaped substructure. The pedestrian bridge connects the Kennedy Center to the river with over a 35-to-1 span to depth ratio. The REACH is scheduled to open in the Fall of 2019. [ABSTRACT FROM AUTHOR]