Local mixed streets are hugely complex, yet fundamental and inherently sustainable pieces of the city

Matthew CarmonaThe UK’s mixed streets have come under increasing pressure partly due to neglect by local policymakers who don’t adequately understand them. Drawing on his own research, Matthew Carmona writes that mixed streets are more resilient and far more significant than may at first seem apparent. The challenge, he argues, is to see mixed streets in a holistic manner and to develop a new view of the city and its streets

Coding urban design: Constructing a wireframe for a place-focused urbanism

This paper explores the nature and use of coding in urban design, both conceptually and as a tool for delivering a greater attention to place-focused urbanism. It discusses how these practices have been used on both sides of the Atlantic before conceptualising this role in the light of different ‘model’ coding prescriptions and processes. The paper draws from two major pilot programmes, 17 years apart, that examined the use and potential of codes in England, alongside evidence on the spread and effectiveness of coding in the country. The work is particularly relevant internationally as the only known large-scale and longitudinal evaluation of coding practices in urban design. Ultimately, the evidence points to the value of codes as a distinct urban design governance tool that can establish a ‘wireframe’ of essential urbanistic elements with the potential to optimise place value

Public space in an age of austerity

Through an overview of the decade 2008 to 2017, and looking comparatively across four northern European cities, this paper reflects on the changing nature of public space during these austerity years and on the processes of shaping public spaces. The paper draws from the experiences of London, Copenhagen, Malmo and Oslo to explore processes of the design, development, use and management of public spaces during this period. The evidence suggests that we have witnessed a period of significant innovation, side by side with major challenges to the collective approach to public spaces. This has led to distinct forms of public spaces that for good or ill have multiplied as a result of the trends discussed in the paper, spaces of; expectation; the private/public sphere; spectacle; respite; infrastructure; diversion; income generation; security; the ephemeral city; community control; occupation; disadvantage; and decline. Episodes of changing practice are set out in the paper and cumulatively reveal distinct and significant changes during the austerity era, although not necessarily in the manner that might have been expected. Instead, in these four cities, the impact of austerity seems to have been eclipsed by other evolving and competing public policy goals, and by the evolving range of public space types

Effects of green space spatial pattern on land surface temperature: Implications for sustainable urban planning and climate change adaptation

The urban heat island (UHI) refers to the phenomenon of higher atmospheric and surface temperatures occurring in urban areas than in the surrounding rural areas. Mitigation of the UHI effects via the configuration of green spaces and sustainable design of urban environments has become an issue of increasing concern under changing climate. In this paper, the effects of the composition and configuration of green space on land surface temperatures (LST) were explored using landscape metrics including percentage of landscape (PLAND), edge density (ED) and patch density (PD). An oasis city of Aksu in Northwestern China was used as a case study. The metrics were calculated by moving window method based on a green space map derived from Landsat Thematic Mapper (TM) imagery, and LST data were retrieved from Landsat TM thermal band. A normalized mutual information measure was employed to investigate the relationship between LST and the spatial pattern of green space. The results showed that while the PLAND is the most important variable that elicits LST dynamics, spatial configuration of green space also has significant effect on LST. Though, the highest normalized mutual information measure was with the PLAND (0.71), it was found that the ED and PD combination is the most deterministic factors of LST than the unique effects of a single variable or the joint effects of PLAND and PD or PLAND and ED. Normalized mutual information measure estimations between LST and PLAND and ED, PLAND and PD and ED and PD were 0.7679, 0.7650 and 0.7832, respectively. A combination of the three factors PLAND, PD and ED explained much of the variance of LST with a normalized mutual information measure of 0.8694. Results from this study can expand our understanding of the relationship between LST and street trees and vegetation, and provide insights for sustainable urban planning and management under changing climat

Sex differences on multikinase inhibitors toxicity in patients with advanced gastroenteropancreatic neuroendocrine tumours

Purpose: There is an increasing interest in the role of sex and gender in cancer pa-tients. The impact of sex differences in oncological systemic therapies is still unknown, and there is a lack of evidence specially in uncommon neoplasms like neuroendocrine tumours (NET). In the present study, we combine the differential toxicities by sex in five published clinical trials with multikinase inhibitors (MKI) in gastroenteropancreatic (GEP) NET.Methods: We performed a pooled univariate analysis of reported toxicity in patients treated in five phase 2 and phase 3 clinical trials with MKI in the GEP NET setting: sunitinib (SU11248, SUN1111), Pazopanib (PAZONET), sorafenib-bevacizumab (GETNE0801) and Lenvatinib (TALENT). Differential toxicities between male and female patients were evaluated considering relationship with study drug and different weights of each trial by random effect adjustment.Results: We found nine toxicities which were more frequent in female patients (leukopenia, alopecia, vomiting, headache, bleeding, nausea, dysgeusia, neutrophil count decreased and dry mouth) and two toxicities being more frequent in male patients (Anal Symptoms and Insomnia). Asthenia and diarrhoea were the only severe (Grade 3-4) toxicities more frequent in female pa-tients.Conclusions: Sex-related differences in toxicity with the MKI treatment require targeted in-formation and individualised management of patients with NET. Differential reporting of toxicity should be promoted when clinical trials are published.(c) 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY -NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Imputing HIV treatment start dates from routine laboratory data in South Africa: a validation study

Background: Poor clinical record keeping hinders health systems monitoring and patient care in many low resource settings. We develop and validate a novel method to impute dates of antiretroviral treatment (ART) initiation from routine laboratory data in South Africa’s public sector HIV program. This method will enable monitoring of the national ART program using real-time laboratory data, avoiding the error potential of chart review. Methods: We developed an algorithm to impute ART start dates based on the date of a patient’s “ART workup”, i.e. the laboratory tests used to determine treatment readiness in national guidelines, and the time from ART workup to initiation based on clinical protocols (21 days). To validate the algorithm, we analyzed data from two large clinical HIV cohorts: Hlabisa HIV Treatment and Care Programme in rural KwaZulu-Natal; and Right to Care Cohort in urban Gauteng. Both cohorts contain known ART initiation dates and laboratory results imported directly from the National Health Laboratory Service. We assessed median time from ART workup to ART initiation and calculated sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) of our imputed start date vs. the true start date within a 6 month window. Heterogeneity was assessed across individual clinics and over time. Results: We analyzed data from over 80,000 HIV-positive adults. Among patients who had a workup and initiated ART, median time to initiation was 16 days (IQR 7,31) in Hlabisa and 21 (IQR 8,43) in RTC cohort. Among patients with known ART start dates, SE of the imputed start date was 83% in Hlabisa and 88% in RTC, indicating this method accurately predicts ART start dates for about 85% of all ART initiators. In Hlabisa, PPV was 95%, indicating that for patients with a lab workup, true start dates were predicted with high accuracy. SP (100%) and NPV (92%) were also very high. Conclusions: Routine laboratory data can be used to infer ART initiation dates in South Africa’s public sector. Where care is provided based on protocols, laboratory data can be used to monitor health systems performance and improve accuracy and completeness of clinical records

Immunochip analysis identifies multiple susceptibility loci for systemic sclerosis

In this study, 1,833 systemic sclerosis (SSc) cases and 3,466 controls were genotyped with the Immunochip array. Classical alleles, amino acid residues, and SNPs across the human leukocyte antigen (HLA) region were imputed and tested. These analyses resulted in a model composed of six polymorphic amino acid positions and seven SNPs that explained the observed significant associations in the region. In addition, a replication step comprising 4,017 SSc cases and 5,935 controls was carried out for several selected non-HLA variants, reaching a total of 5,850 cases and 9,401 controls of European ancestry. Following this strategy, we identified and validated three SSc risk loci, including DNASE1L3 at 3p14, the SCHIP1-IL12A locus at 3q25, and ATG5 at 6q21, as well as a suggested association of the TREH-DDX6 locus at 11q23. The associations of several previously reported SSc risk loci were validated and further refined, and the observed peak of association in PXK was related to DNASE1L3. Our study has increased the number of known genetic associations with SSc, provided further insight into the pleiotropic effects of shared autoimmune risk factors, and highlighted the power of dense mapping for detecting previously overlooked susceptibility loci

Differential diagnosis of Alzheimer’s disease using spectrochemical analysis of blood

The progressive aging of the world’s population makes a higher prevalence of neurodegenerative diseases inevitable. The necessity for an accurate, but at the same time, inexpensive and minimally invasive, diagnostic test is urgently required, not only to confirm the presence of the disease but also to discriminate between different types of dementia to provide the appropriate management and treatment. In this study, attenuated total reflection FTIR (ATR-FTIR) spectroscopy combined with chemometric techniques were used to analyze blood plasma samples from our cohort. Blood samples are easily collected by conventional venepuncture, permitting repeated measurements from the same individuals to monitor their progression throughout the years or evaluate any tested drugs. We included 549 individuals: 347 with various neurodegenerative diseases and 202 age-matched healthy individuals. Alzheimer’s disease (AD; n = 164) was identified with 70% sensitivity and specificity, which after the incorporation of apolipoprotein ε4 genotype (APOE ε4) information, increased to 86% when individuals carried one or two alleles of ε4, and to 72% sensitivity and 77% specificity when individuals did not carry ε4 alleles. Early AD cases (n = 14) were identified with 80% sensitivity and 74% specificity. Segregation of AD from dementia with Lewy bodies (DLB; n = 34) was achieved with 90% sensitivity and specificity. Other neurodegenerative diseases, such as frontotemporal dementia (FTD; n = 30), Parkinson’s disease (PD; n = 32), and progressive supranuclear palsy (PSP; n = 31), were included in our cohort for diagnostic purposes. Our method allows for both rapid and robust diagnosis of neurodegeneration and segregation between different dementias