Espace en creux

Dharavi est un bidonville qui présente une remarquable résilience au sein de Mumbai, Inde. Interrogeant cette pérennité, l’article – condensé d’un mémoire de fin d’étude en architecture – met en valeur la structure des espaces en creux, son évolution, ses morphologies, et donne vie aux vides. Il brosse le portrait d’un lieu riche et multiple où vivre et travailler s’imbriquent et se chevauchent

Recording Permanence and Ephemerality in the North Quarter of Brussels: Drawing at the Intersection of Time, Space, and People

Lying in the Senne River Valley, the North Quarter of Brussels is a physical record of spatial transformations unevenly distributed over time. Waves of developments and unfinished plans colonized its original landscape structure, erasing, writing, and re-writing it with large-scale metropolitan projects and transportation systems, around which an industrial and urban fabric developed. Accumulated expansions left an assemblage of incomplete infrastructures in which a multi-faceted and highly identifiable quarter lies punctuated by weakly defined morphological mismatches. At the center of this diverse and mutilated fabric, Maximilien Park stands as pars pro toto. From a combination of research methods that includes ethnographic fieldwork and interpretative mapping, three drawings are overlaid with the moving dimensions of space, time, and people, and assembled in a reinterpreted triptych to investigate the production of that public space. The first panel “Traces” overlaps lost urban logics and remaining traces on the urban tissue. The second panel “Cycles” traces the uneven deconstruction of the North Quarter during the last century, identifying scars of its past. The third panel “Resignifications” focuses on recent events in the area, examining how people have appropriated and transformed the park since 2015. With this triptych, the article aims to re-interpret the palimpsest of the North Quarter, represent the area’s transforming character, and unravel a spatial reading of the lived experiences of the place through time

Colorectal anastomotic leakage:a call for a different approach

Patients with colon cancer often undergo surgery in which the affected piece of intestine is removed and the two remaining ends are reconnected, creating an anastomosis. Anastomotic leakage occurs in about 10% of cases and the reasons for that remain unclear. It has been shown that certain medications and bacterium can influence the healing of such an anastomosis, partly by affecting the intestine’s mucous layer. In addition, new techniques make it possible to view the anastomosis at the molecular level and thus to unravel the mystery of seam leakage. This is necessary to reduce the long-term burden of the disease and the risk of death after bowel surgery

2 days versus 5 days of postoperative antibiotics for complex appendicitis:a pragmatic, open-label, multicentre, non-inferiority randomised trial

Background: The appropriate duration of postoperative antibiotics for complex appendicitis is unclear. The increasing global threat of antimicrobial resistance warrants restrictive antibiotic use, which could also reduce side-effects, length of hospital stay, and costs. Methods: In this pragmatic, open-label, non-inferiority trial in 15 hospitals in the Netherlands, patients with complex appendicitis (aged ≥8 years) were randomly assigned (1:1) to receive 2 days or 5 days of intravenous antibiotics after appendicectomy. Randomisation was stratified by centre, and treating physicians and patients were not masked to treatment allocation. The primary endpoint was a composite endpoint of infectious complications and mortality within 90 days. The main outcome was the absolute risk difference (95% CI) in the primary endpoint, adjusted for age and severity of appendicitis, with a non-inferiority margin of 7·5%. Outcome assessment was based on electronic patient records and a telephone consultation 90 days after appendicectomy. Efficacy was analysed in the intention-to-treat and per-protocol populations. Safety outcomes were analysed in the intention-to-treat population. This trial was registered with the Netherlands Trial Register, NL5946. Findings: Between April 12, 2017, and June 3, 2021, 13 267 patients were screened and 1066 were randomly assigned, 533 to each group. 31 were excluded from intention-to-treat analysis of the 2-day group and 30 from the 5-day group owing to errors in recruitment or consent. Appendicectomy was done laparoscopically in 955 (95%) of 1005 patients. The telephone follow-up was completed in 664 (66%) of 1005 patients. The primary endpoint occurred in 51 (10%) of 502 patients analysed in the 2-day group and 41 (8%) of 503 patients analysed in the 5-day group (adjusted absolute risk difference 2·0%, 95% CI −1·6 to 5·6). Rates of complications and re-interventions were similar between trial groups. Fewer patients had adverse effects of antibiotics in the 2-day group (45 [9%] of 502 patients) than in the 5-day group (112 [22%] of 503 patients; odds ratio [OR] 0·344, 95% CI 0·237 to 0·498). Re-admission to hospital was more frequent in the 2-day group (58 [12%] of 502 patients) than in the 5-day group (29 [6%] of 503 patients; OR 2·135, 1·342 to 3·396). There were no treatment-related deaths. Interpretation: 2 days of postoperative intravenous antibiotics for complex appendicitis is non-inferior to 5 days in terms of infectious complications and mortality within 90 days, based on a non-inferiority margin of 7·5%. These findings apply to laparoscopic appendicectomy conducted in a well resourced health-care setting. Adopting this strategy will reduce adverse effects of antibiotics and length of hospital stay. Funding: The Netherlands Organization for Health Research and Development.</p

Travailler en creux

n/

Mapping the undocumented: recording ephemerality in the Northern Quarter of Brussels

status: publishe

Orbitally forced hyperstratification of the Oligocene South Atlantic Ocean

Pelagic sediments from the subtropical South Atlantic Ocean contain geographically extensive Oligocene ooze and chalk layers that consist almost entirely of the calcareous nannofossil Braarudosphaera. Poor recovery and the lack of precise dating of these horizons in previous studies has limited the understanding of the number of acmes, their timing and durations, and therefore their likely cause. Here we present a high‐resolution, astronomically tuned stratigraphy of Braarudosphaera oozes (29.5–27.9 Ma) from Ocean Drilling Program Site 1264 in the southeastern Atlantic Ocean. We identify seven episodes with highly abundant Braarudosphaera. Four of these acme events coincide with maxima and three with minima in the ~110‐ky and 405‐ky paced eccentricity cycles. The longest lasting acme event corresponds to a pronounced minimum in the ~2.4‐My eccentricity cycle. In the modern ocean, Braarudosphaera occurrences are limited to shallow marine and neritic settings, and the calcified tests of Braarudosphaera probably represent a resting stage in its life cycle. Therefore, we hypothesize that the Oligocene acmes point to extensive and episodic (hyper)stratified surface water conditions, i.e., a shallowly situated pycnocline that may have served as a virtual sea floor, which (partially) prevented the tests from sinking in the pelagic realm. We speculate that hyperstratification was either ocean‐basin‐wide, through the formation of relatively hyposaline surface waters, or eddy‐contained through strong isopycnals at the base of eddies. Astronomical forcing of atmospheric and/or oceanic circulation could have triggered these conditions through either sustained rainfall over the open ocean and adjacent land masses or increased Agulhas Leakage