Journal of Interior Design最新文献

Background: Most Clostridioides difficile toxinogenic strains produce both toxins A and B (A+B+), but toxin A-negative, toxin B-positive (A-B+) variants also cause disease. We report the identification of a series of pathogenic clinical C. difficile isolates that produce high amounts of toxin A with low or nondetectable toxin B.

Methods: An ultrasensitive, quantitative immunoassay was used to measure toxins A and B in stool samples from 187 C. difficile infection (CDI) patients and 44 carriers. Isolates were cultured and assessed for in vitro toxin production and in vivo phenotypes (mouse CDI model).

Results: There were 7 CDI patients and 6 carriers who had stools with detectable toxin A (TcdA, range 23-17 422 pg/mL; 5.6% of samples overall) but toxin B (TcdB) below the clinical detection limit (<20 pg/mL; median TcdA:B ratio 17.93). Concentrations of toxin A far exceeded B in in vitro cultures of all 12 recovered isolates (median TcdA:B ratio 26). Of 8 toxin A>>B isolates tested in mice, 4 caused diarrhea, and 3 of those 4 caused lethal disease. Ribotyping demonstrated strain diversity. TcdA-predominant samples were also identified at 2 other centers, with similar frequencies (7.5% and 6.8%).

Conclusions: We report the discovery of clinical pathogenic C. difficile strains that produce high levels of toxin A but minimal or no toxin B. This pattern of toxin production is not rare (>5% of isolates) and is consistently observed in vitro and in vivo in humans and mice. Our study highlights the significance of toxin A in human CDI pathogenesis and has important implications for CDI diagnosis, treatment, and vaccine development.

While storefront churches are pervasive in central city neighborhoods throughout the United States, the spatial disciplines have been slow to incorporate them as a subject of research. The current paper examines the emergence of storefront churches and the ways in which their interior spaces are adapted and experienced by their congregants and clergy. This paper brings to light how disenfranchised groups became associated with the storefront churches and contested a history of marginalization to create unique spaces of religious, social, and cultural importance for themselves. Observations of the arrangement of interior space, the use of everyday objects to shape religious and social gatherings, and in-depth interviews were conducted in seven storefront churches. The study found that clergy and congregants shared a history of migration from the rural South and that the churches generally adhered to southern forms of worship of the sanctified church. Storefront church space was adapted to support aspects of sanctified worship, along with particularistic forms of expressivity of each church's view of the world. The study provides insight into the ways in which storefront churches have emerged as an important space where marginalized groups shape their own designs for modes of worship, communion, and expressivity, disassociated from the dominant society.

While multisensory environments (or sensory rooms) are gaining traction in the learning environments, few studies have assessed the comparative effectiveness of specific elements and the link to individuals' unique sensory needs. This study describes the creation and evaluation of a sensory well-being hub for diverse learners with developmental disabilities and distinct sensory profiles in a Chicago public high school. The sensory well-being hub is a simple and adaptable freestanding structure with various sensory affordances, supporting a wide range of atypical sensory processing in neurodiverse individuals. Data were collected during one academic year using surveys, focus groups, field observations, sensor data, log-in sheets, and student records. Results show that the hub was used for both scheduled (preventive) visits and unscheduled (spontaneously needed) ones. The most visited elements in the hub were a beanbag with weighted blanket, sensory cocoon with tensile fabric and a media wall, and a fidget wall with various components. The sensory affordances most often sought by users were compression, quietness, tactility, and proprioception. Students with autism spectrum disorders (ASD) differed from those without ASD in the ways they used sensory intervention even though the two groups were equivalent in sensory profiles (in thresholds for registration and active-to-passive response to stimuli). Based on the study findings, design suggestions were included to inform sensory hub design in other learning environments.

People experiencing homelessness often face recoveries complicated by mental disability, substance abuse, and trauma. They can withdraw into self-imposed isolation and avoid important support services, making recovery more difficult. Affirmative relationships developed in part within the designed settings of transitional housing may play a significant role in countering these tendencies. The presence and effectiveness of communal gathering spaces in supportive housing must be better understood as a design problem, particularly given users' diverse ages, ethnicities, and health needs, which effectively inclusive environments must accommodate. In recent decades, architecture as a discipline has pivoted toward more human-centered approaches, with the individual's dignity and well-being at center stage. This study applies social science-based research methods and spatial analytics to the end of understanding how specific interior spaces, key to the recovery process, might be improved. The authors posit that the success of resident gathering spaces intended to prompt and support resident relationships and decrease users' feelings of marginalization may be influenced by a range of sociospatial design factors (i.e. visibility and ease of access, adjacencies, access to daylight and views, furniture types, and aesthetics) together with facility policies and events programming. The authors use a combination of space syntax, surveys, and qualitative methods to analyze two contrasting layouts in supportive housing locations in the UK and Florida, drawing conclusions intended to steer the development of typologies for similar facilities.