Re-visiting the Park: Reviving the “Cultural Park for Children” in Sayyeda Zeinab in the shadows of Social Sustainability

This paper aims to question the level of success of one of Egypt’s contemporary architectural milestones which is the Aga-Khan Award-winning project of the Child Park in Sayyeda Zeinab - designed by the Egyptian architect Abdel-Halim Ibrahim; from a community participation perspective. Stemming from the fact that the level of successful community participation in architecture and urban design projects affects the sustainability of the added value, this paper tackles the current process of operation of the Park and the adjacent pedestrian street, as complementary aspects of a community participatory process, and evaluates the social sustainability of the project as well. The study sheds light on the operation of the park after twenty-eight years of the initiation of the project, it explores its functional and social role in the district of Sayyeda, located at the centre of Cairo city.In order to achieve this end, the paper adopts a two-fold methodology. Based on those two main research approaches, the paper concludes with a framework and several guidelines to enhance the social sustenance of the place through rephrasing the park’s role in relation to the changing needs of the community

Effect of phacoemulsification on the corneal biomechanical properties : Auswirkungen der Phakoemulsifikation auf biomechanische Eigenschaften der Hornhaut

1.1.1 Hintergrund Der geübte Kataraktchirurg plant minutiös operative Manipulationen an der Hornhaut, da er weiß, dass Veränderungen der Biomechanik derselben durch clear cornea Zugang auch zu einer Änderung der refraktiven Parameter führen. Im ungünstigen Fall bewirken diese refraktiven Veränderungen eine Veränderung des intendierten postoperativen Ergebnisses. Teilweise vermag der Kataraktchirurg jedoch auch diese Veränderungen zu nutzen und sie in seine Operationsplanung mit einzubeziehen. Hierzu ist es jedoch notwendig, diese noch besser zu verstehen. In den vergangenen Jahren wurde zur besseren Untersuchung der biomechanischen Eigenschaften der Hornhaut der Ocular Response Analyzer (ORA) entwickelt. Die viskoelastischen Eigenschaften der Hornhaut haben einen nachweislichen Einfluss auf die Augeninnendruckmessung. Dieser Einfluss ist jedoch bislang nur bezüglich der Hornhautdicke untersucht. Es ist somit bislang unklar, wie der Augeninnendruck durch rein biomechanische Veränderungen beeinflusst wird. Ziel dieser Arbeit ist es, die mit dem ORA gemessenen biomechanischen Veränderungen der Hornhaut in Beziehung zu Standardparametern der ophthalmologischen Diagnostik vor und nach einfacher Phakoemulsifikation zu setzen. 1.1.2 Patienten und Methoden In diese Studie wurden 54 Augen von 54 Patienten eingeschlossen. Alle Patienten hatten eine Linsentrübung im Stadium I oder II. Bei allen Patienten wurde der gleiche clear cornea Zugang gewählt. Die Patienten wurden präoperativ und 4 Wochen postoperativ zwischen 7 und 10 Uhr morgens untersucht, um eine Beeinflussung durch Tagesfluktuation zu vermeiden. Dabei wurden mit dem ORA folgende Zielgrößen bestimmt: Corneale Hysterese (CH), corneal resistance factor (CRF), GoldmannMrelated intraocular pressure (IOPg) und corneal compensated intraocular pressure (IOPcc). Analog wurden Untersuchungen mit dem Hornhauttopographiegerät TMSM5, dem VorderabschnittsMOCT von CASIA, dem IOLM Master von Zeiss, dem Autorefraktor von Nidek, und dem EMM3000 von Tomey durchgeführt. Hierbei wurden folgende Parameter bestimmt: anterior equivalent power (EQTMS), cylinder power (CYLTMS), center surround index (CSI) und surface asymmetry index (SAI))m Casia anterior und posterior equivalent power (EQaCASIA, EQpCASIA) sowie Casia cylinder power (CYLaCASIA, CYLpCASIA). Mit dem IOLMMaster wurden anterior equivalent power (EQIOL) und cylinder equivalent power (CYLIOL) und Bulbuslänge (AL) untersuchtm ebenso die entsprechenden Werte anterior equivalent power (EQAR) und cylinder equivalent power (CYLAR) mit dem Autorefraktor. Mit dem EMM3000 wurden zentrale Hornhautdicke (CCT) und Endothelcellcount (ECC) extrahiert. Die Ergebnisse der ORA-Untersuchung wurden mittels Pearson- Korrelation mit denen der topograpischen Untersuchungen in Bezug gesetzt. Darüber hinaus wurde der Einfluss der präoperativen biometrischen Parameter auf die Änderung (Δ) der biomechanischen Zielgrößen untersucht. 1.1.3 Ergebnisse Vor der Operation korrelierte die corneale Hysterese CH mit CYLTMS (p=0,031), mit den Messergebnissen des VorderabschnittsMOCTS EQaCASIA (p=0,033), CYLaCASIA (p=0,04), EQpCASIA (p=0,001) und CYLpCASIA (p=0,002), postoperativ mit EQTMS (p=0.038), EQAR (p=0,043), EQaCASIA (p=0,021) und EQpCASIA (p=0,022). Postoperativ korrelierten darüber hinaus IOPg und IOPcc mit allen gemessenen Brechkraftwerten (EQTMS, EQIOL, EQAR, EQaCASIA und EQpCASIA) (p=0,001, p=0,015, p=0,030, p=0,007, p=0,001 für IOPg und p<0,001, p=0,009, p=0,014, p=0,003, p<0,001 für IOPcc). Die durchschnittlichen Werte der Änderungen betrugen für ΔCH = M0,45±1,27 mmHg, ΔCRF = M0,88±1,1 mmHg, ΔIOPg = M1,58±3,15 mmHg und ΔIOPcc = M1,45±3,93 mmHg. Je höher CSI war, desto geringer war die Abnahme der CH (r = 0,302, p = 0,028). Je höher die CCT, desto größer war die Abnahme des CRF (r = M0,371, p = 0,013). Je höher die AL, desto geringer fiel die Abnahme des IOPg aus (r = 0,417, p = 0,005). Je höher AL, SAI und EEC, desto geringer war die Abnahme des IOPcc (r = 0,351, p = 0,001m r = M0,478, p < 0,001m r = 0,339, p = 0,013). 1.1.4 Schlussfolgerungen Nach unseren Ergebnissen ist eine präoperativ flachere Hornhautrückfläche mit einer höheren cornealen Hystere assoziiert. Darüber hinaus sind eine postoperativ steilere Hornhautvorderfläche und eine flachere Hornhautrückfläche mit einer höheren cornealen Hysterese assoziiert. Gleichzeitig sind steile Hornhautvorder- und- rückflächen mit einem höheren Augeninnendruck assoziiert. Dies bedeutet für den Kataraktpatienten, dass Informationen über die Brechkraft der Hornhautrückfläche dabei helfen können, die durch ORA bestimmten Werte (CH und IOPcc) korrekt einzuordnen. Die Änderung von biomechanischen Eigenschaften durch die Kataraktchirurgie wird von präoperativen biometrischen Parametern, wie z.B. Hornhautdicke und Augenlänge, signifikant beeinflusst. Ein Kataraktchirurg sollte vom biomechanischen Gesichtspunkt aus, sich nicht nur auf tomographische Untersuchungen verlassen, sondern auch den hornhautkompensierten Intraokulardruck, besonders für die Nachsorgeuntersuchungen nach Kataraktoperation berücksichtigen.1.2.1 Background Knowing that clear corneal incisions may lead to a change in the corneal biomechanics as well as the corneal refractive parameters, an experienced cataract surgeon always plans every corneal manipulation methodically. In critical cases, these refractive changes may cause alternate unintended postoperative results. However, the experienced cataract surgeon will consider these changes carefully and will plan his/her surgery accordingly. Thus, it is necessary to understand these changes. In recent years, it became possible to examine corneal biomechanics through the development of the Ocular Response Analyzer (ORA). It is well known, that the viscoelastic properties of the cornea play an important role in the applanation tonometry during the intraocular pressure (IOP) measurement. However, until today the focus has always been limited to a correlation between the IOP and corneal thickness. The influence of the corneal biomechanical changes on the IOP is unclear. The objective of our study is to investigate the correlation between the examined corneal biomechanical changes measured by the ORA, and the standard comprehensive ophthalmic examinations, before and after uneventful cataract phacoemulsification. 1.2.2 Patients and Methods This study involved 54 eyes from 54 patients. All patients suffered from cataract with significant lens opacification in stages I or II. They underwent phacoemulsification with a clear corneal incision (2.8 mm incision). Each patient was examined before their intervention as well as 4 weeks after, between 7 and 10 a.m., to avoid the diurnal fluctuation. ORA was used to measure corneal hysteresis (CH), corneal resistance factor (CRF), GoldmannMrelated intraocular pressure (IOPg), and corneal compensated intraocular pressure (IOPcc). Concurrently, examinations from the corneal topography TMSM5, Casia anterior segment OCT, Zeiss IOLMMaster, Nidek autorefractometer, and the Tomey EMM3000 were carried out. The biometric characteristics included: TMSM5 anterior equivalent power (EQTMS), cylinder (CYLTMS) power, center surround index (CSI) and surface asymmetry index (SAI)m Casia anterior and posterior equivalent (EQaCASIA, EQpCASIA) and cylinder (anterior and posterior cylinder (CYLaCASIA, CYLpCASIA) power). Those parameters derived from the IOLMMaster were anterior equivalent (EQIOL), cylinder (CYLIOL) power and axial length (AL). In addition, the readings from the autorefractor were anterior equivalent (EQAR) and cylinder (CYLAR) power. Central corneal thickness (CCT) and endothelial cell count (ECC) were extracted from the Tomey EMM3000. Results from ORA were analyzed using the Pearson Correlation method and compared with those from all other examinations. In addition, the impact of the preoperative biometric parameters, or the change (Δ) of biomechanical outcome measures, was investigated. 1.2.3 Results During preoperative examination the corneal hysteresis (CH) was correlated with CYLTMS (p=0.031), also with anterior segment OCT EQaCASIA (p=0.033), CYLaCASIA (p=0.04), EQpCASIA (p=0.001) and CYLpCASIA (p=0.002). During postoperative examination CH was correlated with EQTMS (p=0.038), EQAR (p=0.043), EQaCASIA (p=0.021) and EQpCASIA (p=0.022). Postoperatively, both the IOPcc and IOPg were correlated with all measured equivalent powers (EQTMS, EQIOL, EQAR, EQaCASIA and EQpCASIA) (p=0.001, p=0.015, p=0.030, p=0.007, p=0.001 for IOPg and p<0.001, p=0.009, p=0.014, p=0.003, p<0.001 for IOPcc). The average values of the changes of the biomechanical outcome measures were as follows: ΔCH = M0.45±1.27 mmHg, ΔCRF = M0.88±1.1 mmHg, ΔIOPg = M1.58±3.15 mmHg and ΔIOPcc = M1.45±3.93 mmHg. The higher CSI, the smaller the decrease in CH was (r = 0.302, p = 0.028). The higher CCT, the larger the decrease in CRF was (r = M0.371, p = 0.013). The higher AL, the smaller the decrease in IOPg was (r = 0.417, p = 0.005). The higher AL, SAI and ECC, the smaller the decrease in IOPcc was (r = 0.351, p = 0.001m r = M 0.478, p < 0.001m r = 0.339, p = 0.013). 1.2.4 Conclusions According to our results, a flatter corneal back surface before surgery is associated with a higher corneal hysteresis, while postoperatively a steeper corneal front surface and a flatter corneal back surface are associated with a higher corneal hysteresis. In addition, the steep corneal front and back surfaces were associated with a higher intraocular pressure. This means that gathering information about the corneal power of the posterior surface in a cataract surgery patient, may help to understand the unique indices provided by ORA (CH and IOPcc). The change of biomechanical properties during cataract surgery is influenced significantly by preoperative biometric parameters such as corneal thickness and axial length. From a biomechanical point of view, cataract surgeons should not solely rely on tomographic examinations, but also consider corneal compensated IOP, especially in followMup studies after cataract surgery

Effects of Dual Coating Proteins in Intraosseous Transcutaneous Amputation Prosthesis (ITAP)

Intraosseous transcutaneous amputation prostheses (ITAP) provide an alternative method of attaching artificial limbs for amputees. Conventional stump-socket devices are associated with soft tissue complications including pressure sores, neuroma formation and tissue necrosis. ITAP overcomes these problems by attaching the articial limb transcutaneously to the skeleton. In order for ITAP to be successful, it requires an infection-resistant transcutaneous barrier at the skin-implant interface. Fibronectin (Fn) and Laminin 332 (Ln), are glycoproteins found abundantly in the extracellular matrix. Dual coating proteins 125 I-Fn + Ln and 125 I-Ln +Fn were covalently bonded to Ti6Al4V through silanization. The hypothesis tested was: silanized dual coating protein coatings with fibronectin and laminin, enhances both keratinocyte and fibroblast spreading and increases vinculin focal adhesion plaques on Ti6Al4V in vitro. Both remained stable when immersed in foetal calf serum compared with adsorbed dual coating proteins at all time points up to 72 hours (p<0.05). There was non-competitive binding of laminin on Ti6Al4V in the presence of fibronectin. Keratinocytes and fibroblasts were grown on Ti6Al4V surfaces with single coating Fn, Ln, and dual coating FnLn on adsorbed, silanized with passivation and silanized without passivation discs. Vinculin focal adhesion markers and cell size were quantified. Silanized dual coating proteins without passivation (SiFnLn-) produced the largest number of vinculin markers and biggest cell size at all time points upt to 24 hours (p<0.05). Hydroxyapatite (HA) is a naturally occurring osteoinductive mineral in the body. 125 I-Fn coated on HA discs was assessed for optimal time for loading, concentration and durability. Fibroblasts were grown on polished, HA and Fn coated HA discs. Vinculin markers and cell size were quantified. Fn coated HA discs increased fibroblast attachment compared to uncoated controls of Ti6Al4V discs and HA discs (p<0.05). My thesis demonstrated silanized without passivation dual coating proteins FnLn produced more viculin markers per cell unit and per cell area when compared to uncoated controls and single coating proteins on adsorbed and silanized, passivated discs. Further research is required to establish whether dual coating proteins will produce the same effect in vivo. This can be achieved by silanizing ITAP with dual coating FnLn and implanting them in animals. Histopathological analysis at the skin-implant interface would provide valuable information whether this biochemical and physical modification improve soft tissue integration to percutaneous implants

The efficiency of healthcare systems in the Arab countries: a two-stage data envelopment analysis approach

Purpose – This study aims at evaluating the technical efficiency (TE) of healthcare systems in the Arab region and exploring the key factors that affect the efficiency performance. Design/methodology/approach – The study applies a two-stage Data Envelopment Analysis (DEA) approach to a sample of 20 Arab countries. In the first stage, a DEA model is used to calculate the TE scores of the examined healthcare systems in 2019 and 2010, following both the output and input orientations of efficiency. In the second stage, a censored Tobit model is estimated to investigate the determinants of healthcare efficiency. Findings – DEA results of 2019 indicate that achievable efficiency gains of the Arab countries range from 0.4% to 16% under the output and input orientations, respectively. Six countries are efficient under both orientations. Although the average efficiency scores of the Arab countries have deteriorated between 2010 and 2019, Djibouti and Sudan had the greatest efficiency improvements between the two years. Bahrain, Mauritania, Morocco and Qatar proved to be efficient in 2010 and 2019 under the two orientations of efficiency and according to the two DEA specifications followed. The Tobit model reveals that corruption and government health expenditure tend to have an adverse impact on healthcare efficiency. Originality/value – The author evaluates healthcare efficiency and healthcare's efficiency determinants in the Arab countries. Regardless Arab countries' diversity, these countries are facing common health challenges, including diminishing role of governments in healthcare financing; increased out-of-pocket healthcare spending; poor healthcare outputs and prevalence of health inequities resulting from weak governance institutions. Comparing the efficiency of healthcare systems between 2010 and 2019 gives insights on the potential impact of the Arab spring uprisings on healthcare efficiency. Moreover, examining the determinants of healthcare efficiency allows for better understanding of how to improve the efficiency of healthcare systems in the region

8-[(1E)-1-(2-Aminophenyl­iminio)eth­yl]-2-oxo-2H-chromen-7-olate

The title Schiff base, C17H14N2O3, exists as an NH tautomer with the H atom of the phenol group transferred to the imine N atom. The iminium H atom is involved in a strong intra­molecular N+—H⋯O− hydrogen bond to the phenolate O atom, forming an S(6) motif. In the crystal structure, N—H⋯O hydrogen bonds form a C(9) chain parallel to [100] and a C(11) chain parallel to [010], while C—H⋯O hydrogen bonds form a C(11) chain parallel to [010]. The combination of N—H⋯O and C—H⋯O hydrogen bonds generates R 4 3(30) rings parallel to the ab plan

Roles of Drop-in Centers in Street Children Interventions: Design Guidelines and Humanitarian Emergency Architecture Adaptations

For decades, numerous countries have been witnessing the Street Children phenomenon where millions of children worldwide are subjected to risks. Despite the crucial role of intermediate non-residential interventions - using drop-in centers- in protecting and rehabilitating street children, there is a paucity of research addressing the quality of design of these centers and how architecture might influence their operational process. Those observations invite investigating drop-in centers used in practice from a design perspective and question adapting architectural applications for humanitarian emergencies, focusing on “Child-Friendly Spaces”. The study aims to provide solutions for better quality design, facilitating operational challenges. The methodology undertakes the investigation through primary and secondary axes. This involves conducting literature and international precedents review and secondarily, an Egyptian contextual first-hand documentation and qualitative analysis of selected centers.

Study of traditional, contemporary and proposed systems of control over residential developments in Cairo, Egypt

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Architecture, 1987.MICROFICHE COPY AVAILABLE IN ARCHIVES AND ROTCH.Includes glossary of Arabic terms.Includes bibliographical references (p. 131-138).This thesis deals with contemporary residential developments presently being carried out by the formal private sector in Cairo. These developments are typical of many other cities in Egypt, and indeed throughout the Middle-East and other Arab and Muslim countries. The thesis stems from my dissatisfaction with the present morphology generated by the use of certain physical models, as well as the limitations imposed on architectural and urban designs by building laws and regulations that I believe to be inadequate in many ways. In searching for solutions, guidelines, and appropriate concepts, I shall refer to traditional Arab-Islamic environments, which I feel offer a number of interesting principles and concepts from which we may benefit. The study will be carried out based on the premise that "Tradition per se should have no authority, bur it does have value" (Al-Hathloul, 1981, p.11). Therefore I shall also attempt to clarify the reasons and circumstances that have led to - or influenced - the development of traditional built forms, as well as determining how valid and applicable the traditional concepts remain under contemporary conditions. The study will not be limited to historical precedent alone since many of the present conditions of modern life do not have any precedent in traditional environments. Therefore the search will go beyond the boundaries of regional heritage to include other valid references without geographical or historical limitations. The object is to reach a set of guidelines offering an alternative approach to the issues of forming and controlling residential developments in this part of the world. It is hoped that such an approach will prove to be more responsive to local physical conditions, as well as to the socio-cultural values of the communities, and that the proposals therein may contribute to the development of a built environment that is physically and spiritually more fulfilling.by Mohamed A. El-Husseiny.M.S

Historical Review and Update of Surgical Treatment for Corneal Endothelial Diseases

The cornea remains in a state of deturgescence, maintained by endothelial cell Na+/K+ ATPase and by tight junctions between endothelial cells that limit entrance of fluid into the stroma. Fuchs' endothelial corneal dystrophy (FECD) was initially described by Fuchs in 1910 as a combination of epithelial and stromal edema in older patients. It manifests as bilateral, albeit asymmetric, central corneal guttae, corneal edema, and reduced vision. When edema is severe, the corneal epithelium can detach from its basement membrane, creating painful bullae on the anterior surface of the cornea. The course of this dystrophy can be further accelerated after intraocular surgery, specifically cataract extraction. Pseudophakic bullous keratopathy (PBK) is endothelial cell loss caused by surgery in the anterior chamber. If the corneal endothelium is damaged during surgery, the same spectrum of symptoms as found in FECD can develop. In the nineteenth century, penetrating keratoplasty was the only surgical procedure available for isolated endothelial disease. In the 1960s, Dr. José Barraquer described a method of endothelial keratoplasty using an anterior approach via laser-assisted in situ keratomileusis (LASIK) flap. In 1999, Melles and colleague described their technique of posterior lamellar keratoplasty. Later, Melles et al. started to change host dissection using simple "descemetorhexis" in a procedure known as Descemet's stripping endothelial keratoplasty. Following the widespread adoption of Descemet's stripping automated endothelial keratoplasty, the Melles group revisited selective Descemet's membrane transplantation and reported the results of a new procedure, Descemet's membrane endothelial keratoplasty (DMEK). Recently, some eye banks have experimented with the preparation of DMEK/Descemet's membrane automated endothelial keratoplasty donor tissue that may help the surgeon avoid the risk of tissue loss during the stromal separation step. Recently, the authors described a new bimanual technique for insertion and positioning of endothelium-Descemet membrane grafts in DMEK

Decrease in local volumetric bone mineral density (vBMD) in osteoarthritic joints is associated with the increase in cartilage damage: a pQCT study

Osteoarthritis (OA) is one of the most prevalent joint diseases, which causes pain and disability in the adult population. OA affects the osteochondral unit in the joints, which comprises both cartilage and subchondral bone. There has been some progress in understanding the changes in subchondral bone with progression of OA. However, local changes in subchondral bone such as microstructure or volumetric bone mineral density (vBMD) in connection with the defect in cartilage are relatively unexplored. To develop an effective treatment for progression of OA, it is important to understand how the physical environment provided by the subchondral bone affects the overlying cartilage. In this study, we examined the vBMD distribution in the OA joint tissues obtained from total hip replacement surgeries due to OA, using peripheral quantitative CT (pQCT). It was found that there is a significant decrease in vBMD, which co-localizes with the damage in the overlying cartilage. This was not limited to the subchondral bone immediately adjacent to the cartilage defect but continued in the layers below. Bone resorption and cyst formation in the OA tissues were also detected. We observed that the bone surrounding subchondral bone cysts exhibited much higher vBMD than that of the surrounding bones. pQCT was able to detect significant changes in vBMD between OA and non-OA samples, as well as between areas of different cartilage degeneration, which points to its potential as a technique for detection of early OA