Change in identity of Saudis' built environments: the case of Jeddah

Identity is an essential human demand for life. It is with the identity that human beings introduce a sense of meaning into existence. It can be demonstrated through many different human expressions. The built environment, however, is the main medium discussed in this research. Nevertheless the research traces the identity and the impact of its change in both physical and non -physical environments. This is to understand the expression of identity in Jeddah, as a case study that represents the Saudi community and that has been exposed to drastic changes since the 1950s which stretched the gap between the traditional and the modern. The main objective is to construct a means to evaluate the built environment according to how it conveys, interprets, expresses, enhances or confuses Saudi identity.The research follows a quantitative -qualitative approach in investigating the relationship between the identity and the built environment. This is conducted through a theoretical enquiry which addresses a definition of identity and its elements, natural environment, underlying factors and built environment, and an empirical investigation through the case study (Jeddah) which will include a documents review to trace the change and a questionnaire that aims at investigating Saudis' perception of their environment as a medium of presentation for their identity.The study therefore, probes the concept of identity in general, aiming to develop a theoretical understanding towards considering it in architectural and planning practices. On the other hand the research concentrates on Jeddah, to provide feedback for architectural design and planning that accommodates a Saudi identity

Recombinant Factor VIIa for The Management of Uncontrollable Bleeding Following The Repair of Acute Type A Aortic Dissection

Background: Bleeding is a serious complication after surgical repair of acute type A aortic dissection. Recombinant factor VIIa (rFVIIa) could be used for the management of severe bleeding; however, it could lead to thromboembolic events. We aimed to report our experience in using rFVIIa in the management of severe bleeding following the surgical repair of acute type A aortic dissection. Methods:  We performed a retrospective study, including patients who had surgery for acute aortic dissection type A and received rFVIIa, in the period between January 2012 and January 2019. We reported the amount of bleeding 4 hours before and after the administration of rFVIIa, the number of blood products transfused before and after the use of rFVIIa, thrombosis of the central venous line, as well as the presence of disseminated intravascular coagulation. Results: There were ten patients (2 females and 8 males) out of 120 patients with acute type A aortic dissection, who required the use of rFVIIa for severe postoperative bleeding. The mean age was 67.7±10.5 years. The amount of drainage decreased from 889±585.6 ml during the 4 hours prior to the infusion, to 165±73.5 ml during the following 4 hours (p<0.001). The patients received 2752±1362.9 ml, and  618±483.3 ml packed RBCs before and after rFVIIa administration, respectively (p< 0.001). The patients received 1601±693.4 and 246±419.6 ml of fresh frozen plasma before and after the use of rFVIIa, respectively (p< 0.001). The prothrombin time decreased after the infusion of rFVIIa (42.7±32 and 17.1±8 seconds, p= 0.001). There were no clinical signs of thromboembolism after its use. Mortality occurred in five patients (50%). Conclusion: In the life-threatening situation of uncontrollable bleeding following surgical repair of type A acute aortic dissection, rFVIIa may have benefits to control bleeding. Furthers studies are recommended

Track E Implementation Science, Health Systems and Economics

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138412/1/jia218443.pd

Islamic Influence on the Local Majapahit Hindu Dwelling of Indonesia in the 15th Century

Majapahit was one of Indonesia’s most prominent and last Hindu kingdoms in the 12–15th centuries. During this time, there was a process of changing religious beliefs among the Javanese population, who then embraced Hinduism to eventually become Muslim. In the 14th and 15th centuries, according to estimates, Islam began to spread throughout the Majapahit Empire. There was also a cultural shift in the Majapahit Kingdom’s society, from how they dressed to the shape of their houses. This study aims to determine how structures from that time were interpreted using a 3D model based on field surveys and previous studies. This documentation’s findings are divided into typology, spatial distribution, and architectural elements. Each of these three groups was further defined through Islamic law to determine the extent of Islam’s Influence on dwellings throughout the Majapahit Era. The impact of Islam on Majapahit architecture during that time was characterised by openness in terms of building typology, compactness in the internal layout of buildings, and the employment of ornamental architectural features based on plant and abstract patterns

Does Kidney Transplant Increase the Risk of Ipsilateral Lower Extremity Deep Venous Thrombosis?

Introduction: There is limited information on the development and laterality of symptomatic deep vein thrombosis (DVT) following kidney transplantation. In this study, we want to define the incidence of DVT in this population and determine if the side of DVT corresponds to the side of the transplanted kidney. Methods: We performed a retrospective review of all kidney transplant recipients from January, 2004 to August, 2014 at our institution and who subsequently developed symptomatic DVT. Kidney transplant recipients and confirmed DVT patients were obtained as two separate data files and were matched to obtain our cohort. Patients with concomitant pancreatic transplants, repeat, and bilateral kidney transplants were excluded. We used Cohen’s kappa statistic to test the agreement between the surgical incision site of the kidney transplant to the side at which the DVT occurred. Results: A total of 1827 kidney transplant recipients were performed between January 2004 to August 2014. A total of 877 kidney transplant recipients met the inclusion criteria as our total cohort. From our total cohort, 217 recipients underwent ultrasounds to rule out DVT. A total of 41 kidney transplant patients received a positive duplex ultrasound. The incidence of DVT in our kidney transplant cohort was 4.7%. The most common period of DVT diagnosis was in the perioperative period within the first 4 weeks. A Cohen kappa statistic of -0.02 occurred between the surgical incision site of the kidney transplant and the side of DVT occurrence. Large positive kappa statistic values indicate agreement, whereas large negative values indicate disagreement. Approximately 64.6% of transplant patients with a positive duplex ultrasound had a 1:1 correlation to the side of DVT, although this did not reach statistical significance. There was no statistically significant difference in patient sex, race, or age between the two groups. Conclusion: The incidence of symptomatic DVT in this cohort was 4.7%, which is lower than that reported in the literature. DVT was highest during the first four weeks postoperatively. There was an increased rate of ipsilateral DVTs to the kidney transplant, although this did not reach statistical significance.https://scholarlycommons.henryford.com/merf2019clinres/1056/thumbnail.jp