412 research outputs found
Re-visiting the Park: Reviving the âCultural Park for Childrenâ in Sayyeda Zeinab in the shadows of Social Sustainability
This paper aims to question the level of success of one of Egyptâs 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 parkâs 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 geĂŒbte Kataraktchirurg plant minutiös operative Manipulationen an der Hornhaut,
da er weiĂ, dass VerĂ€nderungen der Biomechanik derselben durch clear cornea
Zugang auch zu einer Ănderung der refraktiven Parameter fĂŒhren. Im ungĂŒnstigen
Fall bewirken diese refraktiven VerÀnderungen eine VerÀnderung des intendierten
postoperativen Ergebnisses. Teilweise vermag der Kataraktchirurg jedoch auch diese
VerÀnderungen 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 bezĂŒglich der
Hornhautdicke untersucht. Es ist somit bislang unklar, wie der Augeninnendruck
durch rein biomechanische VerÀnderungen beeinflusst wird. Ziel dieser Arbeit ist
es, die mit dem ORA gemessenen biomechanischen VerÀnderungen 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 LinsentrĂŒbung im Stadium I oder II. Bei allen Patienten wurde der gleiche
clear cornea Zugang gewÀhlt. Die Patienten wurden prÀoperativ und 4 Wochen
postoperativ zwischen 7 und 10 Uhr morgens untersucht, um eine Beeinflussung
durch Tagesfluktuation zu vermeiden. Dabei wurden mit dem ORA folgende
ZielgröĂen bestimmt: Corneale Hysterese (CH), corneal resistance factor (CRF),
GoldmannMrelated intraocular pressure (IOPg) und corneal compensated intraocular
pressure (IOPcc). Analog wurden Untersuchungen mit dem
HornhauttopographiegerÀt TMSM5, dem VorderabschnittsMOCT von CASIA, dem IOLM
Master von Zeiss, dem Autorefraktor von Nidek, und dem EMM3000 von Tomey
durchgefĂŒhrt. 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
BulbuslÀnge (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. DarĂŒber
hinaus wurde der Einfluss der prÀoperativen biometrischen Parameter auf die
Ănderung (Î) der biomechanischen ZielgröĂen 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 darĂŒber 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 fĂŒr IOPg und p<0,001, p=0,009, p=0,014, p=0,003, p<0,001 fĂŒr IOPcc). Die
durchschnittlichen Werte der Ănderungen betrugen fĂŒr ÎCH = M0,45±1,27 mmHg,
ÎCRF = M0,88±1,1 mmHg, ÎIOPg = M1,58±3,15 mmHg und ÎIOPcc = 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 gröĂer 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 prĂ€operativ flachere HornhautrĂŒckflĂ€che mit einer
höheren cornealen Hystere assoziiert. DarĂŒber hinaus sind eine postoperativ steilere
HornhautvorderflĂ€che und eine flachere HornhautrĂŒckflĂ€che mit einer höheren
cornealen Hysterese assoziiert. Gleichzeitig sind steile Hornhautvorder- und-
rĂŒckflĂ€chen mit einem höheren Augeninnendruck assoziiert. Dies bedeutet fĂŒr den
Kataraktpatienten, dass Informationen ĂŒber die Brechkraft der HornhautrĂŒckflĂ€che
dabei helfen können, die durch ORA bestimmten Werte (CH und IOPcc) korrekt
einzuordnen. Die Ănderung von biomechanischen Eigenschaften durch die
Kataraktchirurgie wird von prÀoperativen biometrischen Parametern, wie z.B.
Hornhautdicke und AugenlÀnge, signifikant beeinflusst. Ein Kataraktchirurg sollte
vom biomechanischen Gesichtspunkt aus, sich nicht nur auf tomographische
Untersuchungen verlassen, sondern auch den hornhautkompensierten
Intraokulardruck, besonders fĂŒr die Nachsorgeuntersuchungen nach
Kataraktoperation berĂŒcksichtigen.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 (Î) 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: ÎCH = M0.45±1.27 mmHg,
ÎCRF = M0.88±1.1 mmHg, ÎIOPg = M1.58±3.15 mmHg and ÎIOPcc = 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 â 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 â 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 â 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 â 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-AminophenylÂiminio)ethÂyl]-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 intraÂmolecular N+âHâŻOâ hydrogen bond to the phenolate O atom, forming an S(6) motif. In the crystal structure, NâHâŻO hydrogen bonds form a C(9) chain parallel to [100] and a C(11) chain parallel to [010], while CâHâŻO hydrogen bonds form a C(11) chain parallel to [010]. The combination of NâHâŻO and CâHâŻO 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 âChild-Friendly Spacesâ. 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
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