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The purpose of this research is to develop a designer’s checklist encompassing the various categories of healthcare facilities (HCFs). This checklist is based on the research available about the elements/factors of the healing environment. An evidence-based design was used to conduct this study. Online database searches on Google Scholar, JSTOR, Scopus, and PubMed using various keywords, such as healing environment, evidence-based design, patient safety, infection, medical errors, patient falls, stress reduction, social support, single bedroom, views of nature, daylighting, music therapy, and noise levels in a healthcare setting were used for data collection. The collected data was analyzed based on the level of evidence and sorted accordingly for the development of three types of a designer’s checklist encompassing optimal healing environments. All the elements/ factors of environmental design were coded according to their level of evidence and were sorted into three categories: 1) Fair level of evidence (F) comprising expert opinions, case series, and case reports, 2) Good level of evidence (G) comprising cohort studies and case-control studies, and 3) Excellent level of evidence (E) comprising randomized controlled trials and systematic reviews. To create an optimal healing environment, this study proposes three different levels of healing environments corresponding with the three levels of HCFs as follows: 1)healing environment Level-I for tertiary HCFs includes elements/ factors of environmental design with E, G, and F levels of evidence, 2)healing environment Level-II for secondary HCFs includes elements/ factors of environmental design with E and G levels of evidence, and 3)healing environment Level-III for primary HCFs includes elements/ factors of environmental design with E level of evidence. This study makes the designing and renovation of HCFs to create an optimal healing environment easily measurable and achievable. Keywords: Checklist, healing environment, healthcare facilities (HCFs), hospital design, measurement

Purpose: The purpose of this paper is to analyze the spatial configurations of a sample of Korean regional emergency medical centers (REMCs) to explore its underlying genotypes and thus produce a base line data for the analysis and evaluations of future REMCs designs using space syntax theory. Methods: Space syntax analysis was used as a major tool for the analysis and exploration of Genotype. The measures of Integration(overall integration with exterior and without exterior as well as the integration of individual clinical spaces for each center), base difference factor (DF) and Space link ratio were calculated for a sample of seven Korean REMCs. Results: The result shows a strikingly similar pattern of Syntactic measures across the sample, the mean integration of sample ranges from 0.82-0.99 with exterior (while considering the exterior space as a root) and 0.81-1.01 without exterior (considering the connections of interior spaces only with no outside connection). The base difference factor (DF) of the sample varies from 0.60-0.81 with exterior and from 0.59-0.82 without exterior. Case number-1 was identified as non-genotype with differing order of Syntactic values. Although the genotype had different forms, layouts and even sizes, these results cannot be ex-plained by Phenotypical comparisons. Implications: This study will contribute to the configurational analysis and evaluation of existing and future Korean REMCs design and practice of emergency healthcare delivery system in Korea.Keywords Korean Regional Emergency Medical Center (REMC) Design, Genotype, Phenotype, Spatial Configuration, Design Evaluation.

This study analyzes the domestic kindergarten attached to elementary school, and that is to present the basic data to be established in the future on the basis of the problems seen in kindergarten attached to elementary school analysis of construction planning. For this study, selecting 10 kindergartens in Hwaseong, Gyeonggi-do, and the selected spatial configuration of kindergarten. And then, analyzes Space Organization, Circulation Plan, Area Distribution, Spatial Hierarchy of them. The results were as follows. 1) The current kindergarten attached to elementary school is associated with the most elementary building planes are independent. 2) Most of them don't have space for secondary activities such as playroom or hallway space between the classrooms and the entrance. 3) Interior space is composed of educational space, service space, administrative space. 4) Kindergarten attached to elementary school should plan increase the area because it is small scale there are a lot of dead space. 5) The main users of kindergarten children should be planned simultaneously in a space that is used along with the teacher. Such a kindergarten attached to elementary school in order to be implemented in construction and environmental characteristics of the kindergarten curriculum developers and juxtaposition of kindergarten teachers and architects such exchanges should be made a doctor of the tripartite briskly.

We tried to analyze the growth time for secretion of the iron containing superoxide dismutase by comparing the intra-and extracellular enzyme activity from Streptomyces subrutilus P5 and analyze possible genetic information for this enzyme secretion. The mycelial dry weights and glucose concentrations in culture filtrates were determined during growth. Glucose was consumed rapidly during logarithmic growth phase and almost exhausted at 24 h of cultivation. While the intracellular activity of iron containing superoxide dismutase was first appeared at three hours, the extracellular activity of this enzyme appeared from 7.5 h of cultivation, early logarithmic growth phase. This early presence of the superoxide dismutase might not be the result of cell lysis but active secretion pathway. There was no information for signal peptide responsible for the enzyme secretion in sodF. However, we found a type three secretion box in the promoter region of sodF that has been known for the genes of type III secreted proteins in other bacteria. This is the first report on the possible existence of type III secretion in Streptomyces.

KEYW O RD Purpose: Healthcare is on the whole a personal and critical service that consumer's use, whereas hospitalization is as a rule painful, because nature nurtures and Sun Light Luminosity for healthcare settings is considered healing. The performance and design of climate responsive buildings such as AKU requires a detailed study of attributes of climate both at micro as well as macro level. The therapeutic value of contact with nature through window view, greenery and landscape is calculated there. Method: A two prong strategy is been devised for this article, at micro level three typical morphologies are analysed by creating same environment of neighboring building on sun shading chart, radiation and temperature range. Since the analysis of local climate helps to determine the design strategies for hospital Healing Environment which is suitable for Karachi climate; in order to track the macro climatic behaviour, a considerable analysis of psychometrics chart for AKU Karachi are designed on Climate Consultant (CC) and analysed by Machine Learning. Climate Consultant proposes different design strategies suitable for Karachi. And on the other hand time wise illumination sources for clinical area which are then measured on psychrometric chart— according to singular space: multi patient admission, secondly: acute ambulatory ward, and tertiary: multi windowed space according to the mushrabiyah and sky light pattern. Result: Our findings support the hypothesis that windowed wall is 75-80% more healing wall; an accelerated evidence was found for healing at macro level if the form of the hospital is designed according to the climatologically preferences, whereas at micro level: the light resource becomes the staff attentiveness determinant. In Conclusion evidence was provided that the actual form of luminosity results consequently in satisfaction while light entering from several set of windows and other sources might be valued if design according to the healing environment. The data added on the sun shading chart to calculate rays entraining into space in patient room equal to 124416.21 Watts/ meter m 2 is calculated as precise healing rate—and is confirmed by questionnaire from patients belonging from each clinical

Purpose: Maximizing human comfort in design of medical environments depends immensely on specialized architects particularly critical care design; the study proposes Evidence-Based Design as an apparent analog to Evidence-Based Medicine. Healthcare facility designs are substantially based on the fin...

The applicability of Saccharomycopsis fibuligera CJN1020, Pichia jadinii CJN1287, and Saccharomyces cerevisiae CJN1514 isolated from Korean nuruk, a starter culture, for preparation makgeolli was investigated. These yeasts were suitable for preparation of both white rice makgeolli using a steam method and white rice-brown rice-wheat flour (WBW) makgeolli using a complex method. Upon physicochemical evaluation, there were no differences in the final ethanol concentrations between white rice makgeolli and WBW makgeolli. Differences in final ethanol yields occurred according to yeast species. Final ethanol yields using S. fibuligera and P. jadinii were 16 and 18% using S. cerevisiae. WBW makgeolli samples received higher sensory scores than white rice makgeolli for overall preference. GC/MS analysis revealed higher amounts of aromatic compounds in WBW makgeolli than in white rice makgeolli. The complex method was suitable for preparation of makgeolli using brown rice and wheat flour.

Purpose: The aim of this paper is to reduce the stress and the disturbance occur in selective action of patient. This article will also help us to control spreading and reduce the order and bacteria produced by leprosy disease among the lepers. This will be achieved with the help of several variables and these variables help us on health benefits is 5s (Sort, Straighten, Shine, Standardize, Sustain) i.e. ratio of sectional morphology, lessor 90 degree angles, day light, universal design building and maximum ventilation. The replies from the questionnaire were collected based on varying levels of satisfaction and gloominess on the scale of 1-10. Methods: The multi-layer methodological framework for maximising the healing environment obtained from the observation of schemes and parameters of ANOVA: (Analysis Of Variance between five deciding factors) are. Firstly applied for the calculation of the patient`s satisfaction for U.V light from sun on ECOTECT simulation, secondly the number of 90 angle, along the corridors. Thirdly understanding the ways to represent people`s perceptual structures and way finding with Space Syntax software. Fourthly the ratio of depth to height of the building typology and finally interviewing the subjects describing their special experiences based on scale value. The focus of this testing of human subjects was to receive data for the existence of image scheme in way-finding and to identify the mechanisms by which sun light impacts human (lepers) health. Results: AMPVA studies concluded that there is similarity between I and O plan as well as L and H plan whereas U plan was difference among the five selected architectural shapes. Implications: The purpose of this research is to show the effects of the I-type, L-type, C-type, U-type and O-type plan design, and to analyse the morphology for EBD (Evidence=Based Design) healing environment which is a universal design for Munghopir Karachi, in Pakistan.

Purpose: It seems obvious that the hospital structures become more large-sized and tall-risen in Korea today. Nothing is more influential than the vertical core plan on the movements of various people in such large-tall hospitals. The present paper, therefore, aims to study on the efficient hospital core space paying first attention to patients by analysing the data on relations between/among department layouts of vertical and horizontal movements. Methods: This study sampled representative 14 hospitals and drew their degrees of data importance on the basis of precedented relative studies. This study also analysed their placements on the blueprint and made confirmations of their arrangements through their homepage on line. Actual visits were made to make sure of the spacial connections between/among departments in the hospitals as well. Results: Even in emergency case in need for vertical movements, the central main core spaces are usually used, which is because special vertical transportation systems are not provided. In these cases, the main core spaces are very important for those who have to move vertically and/or horizontally according to the locations and types of main cores. While special lifts or dumbwaiters are prepared to install for the important articles, such as samples of pathology department, most patients should share with regular visitors the elevators not separated visually and spatially from them. Implications: Vertical core plans are greatly dependent on the ward types and hospital styles. This study is hopefully expected to contribute itself to the standard setting-up of comfortable and quick vertical core system operations for patients.

Cystic fibrosis transmembrane conductance regulator (CFTR) gene and sodium-independent Cl?/HCO₃? anion exchanger (AE) genes are expressed in a wide variety of mammalian tissues including cholangiocytes. They play an important role in the regulation of intracellular pH (pHi) as well as in transepithelial acid/base transport necessary for biliary bicarbonate secretion. The aim of this study was to examine the expression level of CFTR gene and AE genes (AE1, AE2 and AE3) in the cholangiocytes and the hepatocytes, and also measure AE2 gene expression level after bile duct ligation (BDL). As we previously described, isolated hepatocytes and cholangiocytes from the liver of normal and BDL rats were prepared and gene expression levels were measured by using RT-PCR. We found that AE1, AE2, and AE3 genes were expressed in both hepatocytes and cholangiocytes, but CFTR was only in cholangiocytes. AE2 gene expression level was higher in the BDL hepatocytes than normal hepatocytes, which was significantly different between two groups. AE2 gene expression level was lower in the BDL cholangiocytes than normal cholangiocytes. However, AE2 gene expression level in both hepatocytes and cholangiocytes were not changed with a longer duration of BDL. These results suggest that CFTR and AE2 may play an important role in the pathogenetic mechanism of biliary cholestatic liver disease.

We generated mice expressing a human type III CIITA transgene (CIITA Tg) under control of the CD4 promoter to study the role of CIITA in CD4 T cell biology. The transgene is expressed in peripheral CD4 and CD8 T cells, as well as in thymocytes. When CD4 T cells were differentiated towards the Th2 lineage, both control and CIITA Tg Th2 cells expressed similar levels of Th2 cytokines. Th1 cells from control and CIITA Tg mice cells produced comparable levels of IFN-γ. CIITA Tg Th1 cells also expressed IL-4, IL-5, and IL-13 in the absence of Stat6. There was an approximate 10-fold increase in the number of peripheral naive CD4 T cells and NK1.1− thymocytes producing IL-4 from CIITA Tg mice compared to control mice. Finally, Th1 cells from irradiated control mice reconstituted with CIITA Tg bone marrow displayed the same cytokine production profiles as Th1 cells from CIITA Tg mice. Together, our data demonstrate that CIITA expression pre-disposes CD4 T cells to produce Th2 type cytokines. Moreover, phenotypic similarities between Th1 cells expressing the CIITA transgene and CIITA deficient Th1 cells suggest that the role of CIITA in cytokine regulation is complex and may reflect both direct and indirect mechanisms of T cell development and differentiation.

BACKGROUND Bronchial asthma is a clinical syndrome characterized by reversibility of airway obstruction. However, many asthmatics have evidence of residual airway obstruction. It has become evident that the repair of the chronic inflammatory process can lead to various irreversible changes. It is generally accepted that the most common cause for the change is cigarette smoking but it is controversial whether asthma progresses to emphysema. High resolution computed tomography (HRCT) is more sensitive and more accurate than chest plain films in determining the type and extent of emphysema. This study was carried out to determine whether asthma can be a cause of emphysema without the effect of cigarette smoking and to evaluate clinical characteristics in asthmatics with emphysema. METHODS We studied 58 asthmatic patients with reversible airway obstruction and evaluated the presence of emphysema using HRCT and pulmonary function test. According to HRCT findings, they were divided into 2 groups: Asthmatics with emphysema and the ones without emphysema. RESULTS Of the 58 patients, 7 were revealed to have emphysema. (1) 6 asthmatics with emphysema were smokers, but one patient was a nonsmoker. (2) Highly significant differences between asthmatics with and without emphysema were found in cigarette smoking (p < 0.01) and smoking consumption (p < 0.01). (3) There were no significant differences in the duration of asthma, age or sex between patients with and without emphysema. (4) There were no significant differences in FEV1(%), FEV1/FVC (%), diffusing capacity for carbon monoxide (DLco) (%) and DLco/alveolar volume between patients with and without emphysema (5) Differences between asthma patients without emphysema and those with emphysema were found to be significant in bronchial wall thickness (p < 0.05) and in total Ig E levels (p = 0.07). CONCLUSION These results indicate that smoking is a main factor in causing emphysema in asthmatics.

Ligand‐receptor clustering event is the most important step in leukocyte adhesion and spreading on endothelial cells. Intercellular adhesion mole‐cule‐1 (ICAM‐1) has been shown to enhance leukocyte adhesion, but the molecular event during the process of adhesion is unclear. To visualize the dynamics of ICAM‐1 movement during adhesion, we have engineered stable Chinese hamster ovary cell lines expressing ICAM‐1 fused to a green fluorescent protein (IC1GFP/CHO) and examined them under the fluorescence microscopy. The transfection of IC1GFP alone in these cells was sufficient to support the adhesion of K562 cells that express aLβ2 (LFA‐1) integrin stimulated by CBR LFA‐1/2 mAb. This phenomenon was mediated by ICAM‐1‐LFA‐1 interactions, as an mAb that specifically inhibits ICAM‐1‐LFA‐1 interaction (RR1/1) completely abolished the adhesion of LFA‐1+ cells to IC1_GFP/CHO cells. We found that the characteristic of adhesion was followed almost immediately (∼10min) by the rapid accumulation of ICAM‐1 on CHO cells ...

Calcium (Ca2+) pathways are important in cell volume regulation in many cells, but its role in volume regulatory processes in cholangiocytes is unclear. Thus, we have investigated the role of Ca2+ in regulatory volume decrease (RVD) in cholangiocytes using freshly isolated bile duct cell clusters (BDCCs) from normal mouse. No significant increase in [Ca2+]i was observed during RVD, while ionomycin and ATP showed significant increases. Confocal imaging also showed no significant changes in the levels or distributions of intracellular Ca2+ during RVD. Cell volume study by quantitative videomicroscopy indicated that removal and chelation of extracellular Ca2+ by ethylene glycol-bis (beta-aminoethyl ether)-N,N,N-tetraacetic acid (EGTA) or administration of nifedipine did not affect RVD but verapamil significantly inhibited the RVD. Moreover, Ca2+ agonists or inhibitors of Ca2+ release from intracellular stores had no significant effect on RVD. However, 1,2-bis (2-aminophenoxy) ethane-N,N,N'N'-tetraacetic acid-AM (BAPTA-AM) showed significant decreases in [Ca2+]i and significantly inhibited RVD, which was reversed with coadministration of valinomycin, suggesting that BAPTA-AM-induced inhibition is due to potassium conductance or other cellular processes requiring permissive [Ca2+](i. These findings indicate that an increase in [Ca2+]i or extracellular Ca2+ is not required for RVD but Ca2+ has a permissive role in RVD of mouse cholangiocytes.

This investigation is based on the event that occur in 2000 and 2012 at Moen-Jo-Daro the extensive decay of Moen-Jo-Daro wall that replacement of bricks with new over damaged bricks. Damaged bricks due to the formation of various generated forces, continutiy of thrust resulted in the progressive instability of the lateral wall and formation of minor and major cracks. There are several walls which are facing similar problem, hence, a cubical clay model in 1/4-scale was built and investegated under service conditions. Finite-element FE, Models were generated to simulate the response of the structure, behaviour and safety of the prototype.

Mast cells have long been believed to be the central effector cells in the development of immunoglobulin (Ig)E-dependent anaphylaxis. In this study, we investigated the role of mast cells in IgE-dependent hapten-induced active fatal anaphylaxis using mast cell–deficient WBB6F1- W/Wv (W/Wv) and congenic normal (+/+) mice. Although a 5-min delay in shock signs and death were observed in W/Wv mice, 100% fatal reactions to penicillin V (Pen V) occurred in both +/+ and W/Wv mice. Administration of monoclonal anti–IL-4 antibody completely prevented the fatal reactions, and the effect of anti–IL-4 was associated with its suppressive activity on Pen V–specific serum levels of IgE, but not IgG. The platelet-activating factor (PAF) antagonist, BN 50739, completely prevented the fatal reactions in both strains of mice. Our kinetic study revealed, in contrast to no elevation of plasma histamine level in W/Wv mice, high levels of PAF in the circulation after challenge in both +/+ and W/Wv mice, albeit to a lesser degree in the latter case. These data indicate that cells other than mast cells are sufficient to induce an IgE-dependent active fatal anaphylaxis by elaborating PAF, which is the critical mediator for fatal murine anaphylaxis.