Dynamic Landscapes, Emerging Territories

As a result of the pressing environmental and technological conditions dominant today, new frontiers for architectural production are emerging. Fueled by accelerated change and increased connectivity, these trajectories operate across multiple scales and domains. The evolving relationship between place, technology, and occupancy formulates a complex active structure that tends to have fluctuating levels of activity and impact. These conditions are giving way to hybridized settings where the interdependence of digital and analog is altering the very politics of place and identity. In response to the prevalence of amalgamated settings, the paradigm of “Dynamic Landscapes, Emerging Territories” is presented. Dynamic Landscapes have definitions and presence in multiple locations simultaneously, requiring new methods of documentation and assessment in order to conceive appropriate design responses. The paper uses the Syrian Refugee Crisis as a case study for deciphering the implications inherent in displacement in the context of dynamic landscapes. Furthermore, it presents an opportunity to think of new architectural trajectories rooted and driven by the animation of such sites. Inherently dynamic, forced displacement presents rich emerging territories where design carries significant impact and facilitates a tangible reassessment of a refugee’s narrative. Supported by robust information networks and active feedback loops, displaced landscapes as such can learn from their residents and inform their imminent futures specifically, as well as our collective human occupancy at large. Within constantly changing milieus, architecture’s premises and processes are being challenged to respond to fluctuating contexts and provide for transient occupancies. While some may see this as a loss of spatial agency when it comes to design, these conditions present an opportunity to think of new architectural trajectories that are rooted and driven by the dynamism of multilayered landscapes and new approaches towards practice

Nanoarchitectured Array Electrodes for Rechargeable Lithium- and Sodium-Ion Batteries

Rechargeable ion batteries have contributed immensely to shaping the modern world and been seriously considered for the efficient storage and utilization of intermittent renewable energies. To fulfill their potential in the future market, superior battery performance of high capacity, great rate capability, and long lifespan is undoubtedly required. In the past decade, along with discovering new electrode materials, the focus has been shifting more and more toward rational electrode designs because the performance is intimately connected to the electrode architectures, particularly their designs at the nanoscale that can alleviate the reliance on the materials' intrinsic nature. The utilization of nanoarchitectured arrays in the design of electrodes has been proven to significantly improve the battery performance. A comprehensive summary of the structural features and fabrications of the nanoarchitectured array electrodes is provided, and some of the latest achievements in the area of both lithium‐ and sodium‐ion batteries are highlighted. Finally, future challenges and opportunities that would allow further development of such advanced electrode configuration are discussed

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe