Indoor environmental quality in WELL-certified and LEED-certified buildings.

International building certification systems, such as the WELL and Leadership in Energy and Environmental Design (LEED) standards, play a pivotal role in the design of healthy and sustainable buildings. While LEED adopts a holistic approach to designing healthy and sustainable buildings, the WELL standard has a strong emphasis on human health, comfort, and well-being. Although prior research has revealed inconsistent results for occupant satisfaction in office buildings with WELL certification compared to buildings without WELL certification, or are certified using another certification system (e.g., LEED), most of these comparisons tend to lack methodological rigor. This study used a statistical procedure to match and compare 1634 occupant surveys from LEED-certified buildings to 1634 surveys from WELL-certified buildings. Six important architectural and experiential parameters were matched, masking their influence on the outcome. Overall building and workspace satisfaction was high in both WELL-certified buildings (94% and 87%) and LEED-certified (73% and 71%). We found that there is a 39% higher probability of finding occupants who are more satisfied in WELL-certified buildings compared to LEED-certified buildings, indicating occupant satisfaction is higher in buildings with WELL certification. Although we were unable to pinpoint the reason for higher occupant satisfaction in WELL-certified buildings, the results consistently showed that perceived indoor environmental quality was enhanced across all parameters except for the amount of space.

Passive and low-energy strategies to improve sleep thermal comfort and energy resilience during heat waves and cold snaps.

Sleep is a pillar of human health and wellbeing. In high- and middle-income countries, there is a great reliance on heating, ventilation, and air conditioning systems (HVAC) to control the interior thermal environment in the bedroom. However, these systems are expensive to buy, maintain, and operate while being energy and environmentally intensive-problems that may increase due to climate change. Easily-accessible passive and low-energy strategies, such as fans and electrical heated blankets, address these challenges but their comparative effectiveness for providing comfort in sleep environments has not been studied. We used a thermal manikin to experimentally show that many passive and low-energy strategies are highly effective in supplementing or replacing HVAC systems during sleep. Using passive strategies in combination with low-energy strategies that elevate air movement like ceiling or pedestal fans enhances the cooling effect by three times compared to using fans alone. We extrapolated our experimental findings to estimate heating and cooling effects in two historical case studies: the 2015 Pakistan heat wave and the 2021 Texas power crisis. Passive and low-energy strategies reduced sleep-time heat or cold exposure by 69-91%. The low-energy strategies we tested require one to two orders of magnitude less energy than HVAC systems, and the passive strategies require no energy input. These strategies can also help reduce peak load surges and total energy demand in extreme temperature events. This reduces the need for utility load shedding, which can put individuals at risk of hazardous heat or cold exposure. Our results may serve as a starting point for evidence-based public health guidelines on how individuals can sleep better during heat waves and cold snaps without relying on HVAC.

Overcooling of offices reveals gender inequity in thermal comfort.

Growth in energy use for indoor cooling tripled between 1990 and 2016 to outpace any other end use in buildings. Part of this energy demand is wasted on excessive cooling of offices, a practice known as overcooling. Overcooling has been attributed to poorly designed or managed air-conditioning systems with thermostats that are often set below recommended comfort temperatures. Prior research has reported lower thermal comfort for women in office buildings, but there is insufficient evidence to explain the reasons for this disparity. We use two large and independent datasets from US buildings to show that office temperatures are less comfortable for women largely due to overcooling. Survey responses show that uncomfortable temperatures are more likely to be cold than hot regardless of season. Crowdsourced data suggests that overcooling is a common problem in warm weather in offices across the US. The associated impacts of this pervasive overcooling on well-being and performance are borne predominantly by women. The problem is likely to increase in the future due to growing demand for cooling in increasingly extreme climates. There is a need to rethink the approach to air-conditioning office buildings in light of this gender inequity caused by overcooling.

Predicting thermal pleasure experienced in dynamic environments from simulated cutaneous thermoreceptor activity.

Research into human thermal perception indoors has focused on "neutrality" under steady-state conditions. Recent interest in thermal alliesthesia has highlighted the hedonic dimension of our thermal world that has been largely overlooked by science. Here, we show the activity of sensory neurons can predict thermal pleasure under dynamic exposures. A numerical model of cutaneous thermoreceptors was applied to skin temperature measurements from 12 human subjects. A random forest model trained on simulated thermoreceptor impulses could classify pleasure responses (F1 score of 67%) with low false positives/negatives (4%). Accuracy increased (83%) when excluding the few extreme (dis)pleasure responses. Validation on an independent dataset confirmed model reliability. This is the first empirical demonstration of the relationship between thermoreceptors and pleasure arising from thermal stimuli. Insights into the neurophysiology of thermal perception can enhance the experience of built environments through designs that promote sensory excitation instead of neutrality.

Lidocaine iontophoresis for topical anesthesia before dermatologic procedures in children: a randomized controlled trial.

Local anesthesia by injection in pediatric patients undergoing dermatologic procedures is not well received because of the pain of injection and the fear of needles. Lidocaine iontophoresis is a method of topical anesthesia where lidocaine is driven into the skin under the influence of electric current. We performed a prospective double-blind, placebo-controlled evaluation of iontophoresis of 2% lidocaine with 1:100,000 epinephrine. Sixty children requiring dermatologic procedures were enrolled (50 shave biopsy, 7 curettage, 2 injection, 1 punch biopsy). Twenty-nine of 31 patients in the lidocaine group versus 2 of 29 placebo patients required no supplemental anesthesia (p < 0.001). The pain reported by the patients on the Oucher pain scale subsequent to the procedure was significantly lower in the lidocaine group (p < 0.001). Investigators and parents also rated pain lower in the lidocaine group (p < 0.001). Blanching and/or erythema occurred in 58 of 60 patients, but resolved within 1 hour in all patients. There were no other adverse events. Lidocaine iontophoresis is a safe and effective method of topical anesthesia prior to dermatologic procedures in children.

Lidocaine iontophoresis for local anesthesia before shave biopsy.

BACKGROUND: Lidocaine iontophoresis is a method of topical anesthesia in which lidocaine is driven into the skin under the influence of electric current. OBJECTIVE: To compare lidocaine iontophoresis to placebo for topical anesthesia before shave biopsy in adult patients. METHODS: This was a single-center, double-blind, placebo-controlled evaluation of iontophoresis of 2% lidocaine with 1:100,000 epinephrine in patients undergoing shave biopsy. Patients were evaluated for sensation to pinprick after iontophoresis. After completion of the procedure, those patients who did not receive supplemental lidocaine rated the pain associated with the procedure using a 10-cm visual analog scale. The investigator also evaluated the patient's pain after biopsy. Treatment sites were examined for evidence of adverse events such as erythema, urticaria, or burns. RESULTS: Forty-one patients undergoing shave biopsy for evaluation of skin lesions were enrolled. Nineteen of 21 patients in the lidocaine group versus 2 of 20 placebo patients required no supplemental anesthesia (P<0.001). The pain reported by the patient on the visual analog scale subsequent to the procedure was significantly lower in the lidocaine group (P<0.001). In concordance with the results reported by the patients, investigators rated pain lower in the lidocaine group (P<0.001). Blanching and/or erythema occurring at the iontophoresis-treated site in 37 of 41 patients resolved within 1 hour. There were no other treatment-related events. CONCLUSIONS: Lidocaine iontophoresis is a safe and effective method of administering topical anesthesia before shave biopsy in adult patients.

Tolerance of ocular iontophoresis in healthy volunteers.

To evaluate ocular tolerance, healthy volunteers were iontophoresed transclerally using novel OcuPhor trade mark hydrogel drug delivery applicators filled with balanced salt solution. In this three-period crossover study in 24 male and female subjects, 16 subjects received 0 mA and two of the following DC currents: 0.1, 0.5., 1.0, 2.0, 3.0, or 4.0 mA for 20 min; 6 subjects received 3 mA for 20 min and 1.5 mA for 40 min (both equivalent to 60 mAmin total charge). Safety and tolerance were determined by subjective VAS and objective ophthalmic assessments. Subjects were evaluated before and up to 22 hr after dosing. The applicators were well-tolerated and no clinically significant changes in symptomology or in ophthalmic assessments were seen following exposure to 0-3.0 mA for 20 min or 1.5 mA for 40 min. At 4.0 mA 2 of 4 subjects reported a burning sensation under the applicator during dosing which resolved by 22 hr post-dose; superficial changes in fluorescein staining were observed at 1 hr, but not at 22 hr. The OcuPhor trade mark system has promise for noninvasive drug delivery to the eye.

In vivo transscleral iontophoresis of amikacin to rabbit eyes.

The objectives of these studies were to determine the amount and distribution of the aminoglycoside antibiotic amikacin delivered to rabbit eyes following transscleral iontophoresis and to determine the inter-study reproducibility of delivery over three identical studies. New Zealand White rabbits (N = 6 per dose group) were treated with a 200-mg/mL amikacin solution at 0, 2, 3 or 4 mA of (+) DC current for 20 minutes. Amikacin concentrations in eye tissues were highest with the 4-mA treatment. Concentrations for all three studies at this current were approximately 5.4, 40, 41, 343, and 92 mcg/g in the vitreous humor, anterior segment, non-treated hemisphere of the sclera, treated hemisphere of the sclera, and retina/choroid, respectively. These values were approximately 27, 50, 40, 10, and 13 fold greater than in the 0-mA control group and are well above the in vitro minimum inhibitory concentrations (MICs) for this drug. Inter-study reproducibility (measured as %CV) depended on the tissue type and treatment group and ranged from 8% for the retina/choroid to 51% for the anterior segment in the 4-mA group. Pretreatment with topical proparacaine hydrochloride local anesthetic did not affect amikacin delivery and total drug delivered was not affected by delivery time for the same total charge administered. Therapeutically relevant amounts of amikacin were delivered into eye tissues in a reproducible and controllable manner.