Urban Form and Liveability: Towards a Socio-Morphological Perspective

acceptedVersionNon peer reviewe

Coexistence in Space: Stimulating Encounter in the Socially Fragmented Open Urban Fabrics

As one of the most problematic issues in urban societies exhibiting prejudiced cultural plurality, social distancing manifests itself as a form of spatial segregation even within an open urban fabric that does not have physical boundaries. Rather than addressing the achievement of full social integration at the risk of eliminating the richness of local identities, the interactional approach acknowledges the value of intersubjective encounters in the urban space. In this regard, the emerging studies of 'encounter' aim to explore the capacity of social interaction to build mutual learning and solidarity within diff erent socio-cultural groups, even at the risk of con flict. With the fundamental assumption of the social encounter that occurs through particular (spatial and programmatic) conditions within the physical fabric, the paper explores the morphological capacity of the built form to enable the coexistence of diff erences by stimulating encounters. Following a comprehensive review of the literature on the issue, we suggest a multi-scalar approach that involves the macromorphological perspective of spatial con figuration and the micro characteristics of the small public spaces (the so-called 'micropublics'). Accordingly, the paper revisits the notion of 'threshold' as the place of encounter within the city's social fabric. To reveal the interactional capacity of a socially segregated (open) urban fabric for a high possibility of encounters, the paper focuses on the case of the Emek District in Bursa, Turkey, a living fabric composed of divided socio-spatial territories. Following the con figurational analysis of the district, the paper explores some micro-spatial con figurations as thresholds at the street, block, plot, and building levels. Providing a morphological perspective on coexistence within the fragmented social fabric of the city, the research aims to contribute to the extant discussions on liveability from the perspective of interaction and cohesion.acceptedVersionPeer reviewe

Czy łagodny stan przedrzucawkowy powoduje sztywność tętnic i przebudowę komory serca poprzez zapalenie?

Background: A link between preeclampsia (PE) and excessive maternal morbidity and mortality is a commonly recognized fact. Moreover, it has been suggested that chronic inflammatory state connected with PE contributes to accelerated atherosclerosis. There is also an association between PE and maternal cardiac remodeling and biventricular diastolic dysfunction. The aim of the study was to investigate the presence of impaired myocardial performance and increased arterial stiffness in patients who experienced a mild case of PE five years previously. Methods: The study included forty PE patients (40 women; mean age 33.75±7.95) and 27 healthy volunteers (27 women; mean age 36.44±10.45)Transthoracic echocardiography, including Doppler echocardiography combined with tissue Doppler imaging (TDI), and aortic stiffness index (AoSI), aortic distensibility (AoD), and aortic elastic modulus (AoEM) values were measured in each study participant. Results: There was a statistically significant increase in hsCRP, aortic stiffness index, and aortic elastic modulus in PE patients as compared to controls (2.43±1.91 vs. 3.80±2.06, p=0.007; 3.09±2.41 vs. 7.32±6.89, p=0.001; 2.89±2.11 vs. 7.00± 6.83, p=0.001), while a significant decrease was observed in the aortic strain and distensibility (respectively, 22.35±15.99 vs. 12.24±9.22, p=0.005; 11.17±9.68 vs. 6.13±4.99, p=0.018). No differences between the two groups were observed with regard to the left ventricular myocardial performance index (MPI) (0.55±0.16 vs. 0.53± 0.19, p= 0.630). Conclusions: To the best of our knowledge, this has been the first study to demonstrate impaired aortic elasticity and unaffected myocardial performance index in patients with mild PE. Moreover, these effects turned out to be significantly correlated with inflammation.Wstęp: Istnieje powiązanie pomiędzy stanem przedrzucawkowym (PE) a nadmierną zachorowalnością i śmiertelnością. Ponadto, sugeruje się, że przewlekły stan zapalny udzielający się w PE przyczynia się do przyspieszenia miażdżycy. Istnieje również związek między PE przebudowy mięśnia sercowego ze strony matki i dwukomorową dysfunkcją rozkurczową. Zaplanowaliśmy ocenić w tym badaniu, czy nie została osłabiona wydolność mięśnia sercowego oraz zwiększenie sztywności tętnic u pacjentek, które pięć lat wcześniej miały łagodny przypadek PE. Metody: W badanie włączonych zostało czterdzieści pacjentek (40 kobiet; średnia wieku 33,75±7,95) oraz 27 zdrowych ochotniczek (27 kobiet: średnia wieku: 36,44±10,45). Każda z pacjentek została zbadana za pomocą echokardiografii przezklatkowej, w tym echokardiografii dopplerowskiej w połączeniu z tkankową echokardiografią dopplerowską (TDI). Zostały również zmierzone takie wartości, jak wskaźnik sztywności aorty (AoSI), rozciągliwość aorty, a także moduł sprężystości aorty (AoEM). Wyniki: Stwierdzono statystycznie istotny wzrost hsCRP, wskaźnika sztywności aorty i modułu sprężystości aorty u pacjentów z PE w porównaniu z grupą kontrolną (2,43±1,91vs. 3,80±2,06, p=0.007; 3,09±2,41 vs. 7,32±6,89, p=0,001; 2,89±2,11 vs. 7,00± 6,83, p=0,001), natomiast znaczne zmniejszenie zaobserwowano w odkształceniu aorty i jej rozciągliwości (odpowiednio 22,35±15,99 vs. 12,24±9,22, p= 0,005; 11,17±9,68 vs. 6,13±4,99, p=0.018). Nie wystąpiły różnice pomiędzy tymi dwoma grupami w odniesieniu do wskaźnika wydolności mięśnia sercowego lewej komory (0,55± 0,16 vs 0,53± 0,19, p=0,630). Wnioski: Stwierdziliśmy po raz pierwszy w tym badaniu, że wystąpiły osłabiona elastyczność aorty i niezmieniony wskaźnik wydolność mięśnia sercowego (MPI) u pacjentek z łagodnym PE, ponadto, efekty te były znacząco skorelowane ze stanem zapalnym

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Ambulation, lesion level, and health-related quality of life in children with myelomeningocele

Purpose The aim is to investigate the health-related quality of life (HRQOL) in children with myelomeningocele (MMC), compare the results with those of healthy children, and determine the factors related to HRQOL. Methods Fifty children with MMC with a mean age of 8.96 +/- 2.57 and 50 healthy children with a mean age of 9.50 +/- 2.42 were included in the study. The demographic information form and the CHQ-PF-50 (Child Health Questionnaire Parent form 50) were completed to determine the quality of life (QOL) for the children. Ambulation levels of children with MMC and disease-specific findings were recorded. The HRQOL scores of children with MMC were compared with healthy children and assessed according to lesion levels and ambulation status. Results The CHQ-PF-50 scores of healthy and MMC children had no significant difference in the sub-dimensions of health change (p > 0.05), but the mean QOL score of children with MMC was significantly lower in all other sub-dimensions (p < 0.05). In addition, QOL scores according to lesion levels in children with MMC were significantly different between the three groups (p < 0.05). The QOL scores were the highest in the sacral group and the lowest in the thoracic-high lumbar group. The QOL for non-ambulatory children was significantly lower than for ambulatory children with MMC (p < 0.05). Conclusions The present study confirms that children with MMC have diminished HRQOL and non-ambulatory and children with high lesion levels are affected the most. Our result suggests that focusing on the activities that will enable children to acquire the ability to walk can positively affect the HRQOL

Administration of paracetamol versus dipyrone by intravenous patient-controlled analgesia for postoperative pain relief in children after tonsillectomy

Background and objective: We compared the efficacy of intravenous (iv) paracetamol versus dipyrone via patient-controlled analgesia (PCA) for postoperative pain relief in children. Methods: The study was composed of 120 children who had undergone elective tonsillectomy after receiving general anesthesia. Patients were divided into 3 groups according to the dosage of postoperative intravenous-patient-controlled analgesia: paracetamol, dipyrone, or placebo. Pain was evaluated using a 0- to 100-mm visual analog scale and 1- to 4-pain relief score at 30 min, 1, 2, 4, 6, 12, and 24h postoperatively. Pethidine (0.25 mg kg 1) was administered intravenously to patients requiring rescue analgesia. Pethidine requirements were recorded during the first 24h postoperatively, and treatment related adverse effects were noted. Results: Postoperative visual analog scale scores were significantly lower with paracetamol group compared with placebo group at 6h (p 0.05). Postoperative pethidine requirements were significantly lower with paracetamol and dipyrone groups compared with placebo group (62.5%, 68.4% vs 90%, p 0.05). Conclusions: Paracetamol and dipyrone have well tolerability profile and effective analgesic properties when administered iv-PCA for postoperative analgesia in children after tonsillectomy. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved

Comparison of chemical composition of the essential oil of Laurus nobilis L. leaves and fruits from different regions of Hatay, Turkey

The essential oils of the leaves and fruits from bay (Laurus nobilis L.) grown in Antakya, Yayladagi and Samandagi were isolated by solvent extraction and analysed by capillary gas chromatography (GC), gas chromatography and mass spectrometry (GC/MS). In Antakya, Yayladagi and Samandagi the chemical compositions of the fruits and leaves were similar according to qualitative and quantitative analysis. Although in both fruits and leaves the major component was found to be 1.8-Cineole a concentration of about 50% compared with essential oils. The composition of the essential oil from the leaves has high content of 1.8-Cineole, Sabinene and alpha-Terpinyl acetate, but a low content of alpha-Pinene, alpha-Phellandrene and trans-beta-osimen. 1.8-Cineole was found major component of the leaves essential oil collected from Samandagi (59.94%) which is sea coast of region. Interestingly alpha-Pinene, beta-Pinene, alpha-Phellandrene, 1.8-Cineole and trans-beta-osimen were found the major components of fruits of Laurus nobilis L. harvested from Antakya, Yayladagi and Samandagi. Trans-beta-osimen was detected as the major component of fruits essential oil collected again from Samandagi (28.35%)

Does mild preeclampsia cause arterial stiffness and ventricular remodeling through inflammation?

Background: A link between preeclampsia (PE) and excessive maternal morbidity and mortality is a commonly recognized fact. Moreover, it has been suggested that chronic inflammatory state connected with PE contributes to accelerated atherosclerosis. There is also an association between PE and maternal cardiac remodeling and biventricular diastolic dysfunction. The aim of the study was to investigate the presence of impaired myocardial performance and increased arterial stiffness in patients who experienced a mild case of PE five years previously. Methods: The study included forty PE patients (40 women; mean age 33.75 +/- 7.95) and 27 healthy volunteers (27 women; mean age 36.44 +/- 10.45) Transthoracic echocardiography, including Doppler echocardiography combined with tissue Doppler imaging (TDI), and aortic stiffness index (AoSI), aortic distensibility (AoD), and aortic elastic modulus (AoEM) values were measured in each study participant. Results: There was a statistically significant increase in hsCRP, aortic stiffness index, and aortic elastic modulus in PE patients as compared to controls (2.43 +/- 1.91 vs. 3.80 +/- 2.06, p=0.007; 3.09 +/- 2.41 vs. 7.32 +/- 6.89, p=0.001; 2.89 +/- 2.11 vs. 7.00 +/- 6.83, p=0.001), while a significant decrease was observed in the aortic strain and distensibility (respectively, 22.35 +/- 15.99 vs. 12.24 +/- 9.22, p=0.005; 11.17 +/- 9.68 vs. 6.13 +/- 4.99, p=0.018). No differences between the two groups were observed with regard to the left ventricular myocardial performance index (MPI) (0.55 +/- 0.16 vs. 0.53 +/- 0.19, p=0.630). Conclusions: To the best of our knowledge, this has been the first study to demonstrate impaired aortic elasticity and unaffected myocardial performance index in patients with mild PE. Moreover, these effects turned out to be significantly correlated with inflammation