Geometry at work: Re-reading the Persian bazaar

The paper focuses on three issues concerning the Persian bazaar12 A BRIEF INTRODUCTION ON THE GRAND BAZAAR OF ISFAHAN : (1) considering the bazaar as an interiorized urban environment; (2) the way the bazaar achieves this interiority while obtaining such a large scale and; (3) how this interiority affects the experience of the bazaar. The subject of the Persian bazaar first came to my attention through research I conducted during the first year of my studies at the Staedelschule Architecture Class. During this year I discovered the main elements of this Persian archetype and analyzed the underlying geometrical principles that gave rise to them while focusing on specific examples. The second motivation that led to this subject was the current body of texts on the Persian bazaar. Almost all of the texts that have been published on this subject are merely descriptive and historical; this paper attempts to offer a more subjective reading of the bazaar in the hope of not just raising awareness of the subject but also opening up new possibilities for its interpretation. It has been tried to keep the main focus on answering questions of "what" and "how" instead of "why". Architectural elements have been analyzed cut off from their symbolic meanings and/or their religious attributes in order to consider them as elements with the capacity to produce purely spatial architectural effects. Despite the fact that there are strong connections between the material form of the bazaar and the climate, religion and culture of its surroundings, these issues have not been taken into account for such subjects stretch far beyond the scope of this paper. The grand bazaar of Isfahan was chosen as a reference example. The main reason for this choice was the location of the bazaar, its accessibility, and the availability of materials related to it. Due to the scarce references that offer a more in depth study of the bazaar, the personal documentation and experience of the bazaar of Isfahan, through film and photography came to be of great help

Estimating Free Field Seismic Settlement History in a Saturated Layered Soil Profile

Existing methods proposed for estimating the earthquake-induced one-dimensional free-field settlement in saturated soil, focus on the post-liquefaction permanent volumetric strain. These methods rely on undrained cyclic laboratory tests that subject the sandy samples to uniform cycles. A new method is presented to estimate the free-field one-dimensional settlement histories induced by random base motions. This approach uses an existing incremental volumetric strain model to determine the settlement history before and after liquefaction. The shear strain history of a layered profile was obtained from an effective stress-based response analysis available as an option in DEEPSOIL and was subsequently used as an input to the proposed method. A simple two-parameter porewater pressure generation model available in DEEPSOIL was employed. This model, which is capable of simulating strain-softening, was calibrated to an existing probabilistic liquefaction potential curve and acceptable rate of porewater pressure generation. The proposed method was then used to calculate the settlements at the Marina District after the 1989 Loma Prieta earthquake, at Port Island after the 1995 Kobe earthquake, and at 6 different sites located within Christchurch and Ferrymead after the 2011 Christchurch earthquake. The estimated settlements were compared to the measured values along with those estimated by existing methods.Subsequently, the proposed incremental volumetric strain model is used to calculate the earthquake-induced one-dimensional free-field settlement in liquefiable three-layered profiles subjected to a variety of earthquake ground motions. The shear strain histories of these profiles, obtained from the effective stress-based response analysis using DEEPSOIL, were used as an input to the incremental volumetric strain model. A new simplified equation has been developed to estimate the free-field one-dimensional settlement based on the analytical results from the three-layered profiles. This equation includes the influence of important earthquake parameters and soil layer configuration and properties. The proposed equation is compared to the predictions made by an established model. This equation is then used to estimate the free-field settlements at 7 locations in the Marina District after the 1989 Loma Prieta earthquake and at 3 different sites after the 2011 Christchurch earthquake. The evaluated settlements were found to be consistent to those observed at the site and the ones estimated by an existing method

The Seven Valleys

Starting from my roots in Persian traditions, I am branching out, seeking my place in the universe, and looking for enlightenment among other belief systems. I draw inspiration from Persian poets and scholars like Rumi that form the basis of my research – and the Sufi mystic Attar in particular. Attar wrote about the steps one must complete to attain enlightenment in his tale The Conference of the Birds. In this tale, a group of birds must survive through seven challenges, or valleys, to reach spiritual perfection. The Seven Valleys combines seven screen-printed Plexiglass panels with projected video, sound, and shadow to explore spirituality. This immersive, multilayered installation is an investigation of the phenomenology of flow, unity, and transcendence and how humans can experience ecstasy in connection with the natural world

Possible Role of Selective Serotonin Reuptake Inhibitors (SSRIs) in Clinical Outcome of COVID-19 Patients

In February 2020, the World Health Organization officially named the disease caused by the new corona virus as COVID-19 (Corona Virus Disease 2019). For COVID-19 patients, there are usually four phases of the disease. The first one is virus reproduction phase. The second phase is accompanied with mild symptoms and usually includes flu-like symptoms. The third phase is associated with the development of acute respiratory distress syndrome (ARDS) and is characterized by its symptoms. The fourth phase is associated with high fever, systemic inflammatory responses, especially in the lungs, and eventual respiratory failure. COVID-19 is associated with upregulations of inflammatory cytokines. In the acute phase of COVID-19, the function of TCD4+ cells are impaired and the production of interferon-gamma (IFN-γ) and Tumor Necrosis Factor-alpha (TNF-α) in these cells is reduced. With impaired immune function, virus replication continues, and damaged lung cells induce excessive inflammatory responses and overproduction of inflammatory cytokines such as TNF-α, IL-1β, and IL-6 from immune cells. This eventually induce cytokine storm with systemic inflammatory responses and end organ damage. The level of inflammatory cytokines such as IL-1β, IL-6 and IL-10 in COVID-19 patients has been reported to be higher in COVID-19 patients admitted in ICU. The lack of effective treatment for the severe infection caused by COVID-19 has led scientists and physicians to repurpose popular medications that are indicated for other similar conditions. No effective modality to successful management of this viral disease has yet been identified. Immunosuppressive and anti-inflammatory drugs have been suggested for acute patients with cytokine storms and severe lung involvement. Recently, due to the anti-inflammatory effects of selective serotonin reuptake inhibitors (SSRIs), their therapeutic effects have been proposed for COVID-19 patients. This group of drugs are usually prescribed to treat depressive disorders. SSRIs have been shown to reduce inflammation and the expression of inflammatory cytokines such as TNF⍺ and IL-1β. The decrease in inflammatory cytokines such as IL-1β and TNF-α in the cerebral tissue has been shown as a result of sertraline administration, indicating the anti-inflammatory effects of this drug. In another study, Fluvoxamine could lower IL-1β, IL-6, and TNFα expression in the striatum in depressed mice. Much attention is paid to sertraline due to its very low anticholinergic activity which is especially desirable for the elderly with coronary heart diseases. Moreover, the anti-inflammatory properties of this compound is attributed to prevention of the expression of pro-inflammatory cytokines. Recently, it was demonstrated that treatment of patients with major depression with SSRIs could reduce the expression of inflammatory cytokines, such as IL-10, TNF-α, and IL-6 in these patients. The expression of these inflammatory mediators increase in critically ill COVID-19 patients. Therefore, the use of this class of medications in the management of COVID-19 patients could be considered, especially for acute patients with cytokine storms. In a recently published study, the use of antidepressants SSRI and paroxetine and SNRI venlafaxine in hospitalized patients due to COVID-19 reduced the risk of intubation and death. This therapeutic effect on COVID-19 could be attributed to the inhibition of acid sphingomyelinase activity, which prevents epithelial cell from being infection by SARS-CoV2. It has also been suggested that S1A (σ-1- receptor) agonists can prevent cytokine storms in severe COVID-19. SSRIs, especially fluvoxamine and to a lesser extent sertraline have a moderate to high affinity for this receptor. Antidepressants are associated with decreased plasma levels of pro-inflammatory cytokines which elevate in COVID-19. Furthermore, the antiviral activity of some antidepressants such as fluoxetine has been reported in COVID-19 patients. In a randomized clinical trial on adult outpatients with COVID-19, administration of 100 mg of fluvoxamine reduced the likelihood of clinical deterioration over 15 days. This has been attributed to the high affinity of fluvoxamine for S1R, which reduces the inflammatory responses. It seems that SSRIs are potential candidates for COVID-19 due to their anti-inflammatory properties. Future clinical studies will determine the exact role of this class of medications in clinical outcomes of COVID-19 patients

Designing Criteria and Indices for Educational Ranking of Paramedical Sciences Schools in Iran

Background: Assessing the statue of educational services in schools of Paramedical Sciences can help authorities to plan for further promotion through identifying schools' strengths and weaknesses. Objective: To design criteria and indices for educational ranking of associate programs of Paramedical Sciences including Laboratory Sciences, Operating Room Nursing, Technology of Radiology, Anesthesiology, Nuclear Medicine, Technology of Radiotherapy and Medical Emergencies in Iran. Methods: In an expert committee, criteria used in worldwide rankings and medical education standards were reviewed. Then a set of criteria and indices which were compatible to Iran educational system was devised and their weights were defined through consensus developing methods. Each school was asked to introduce a representative to collect schools’ information and schools were visited to verify the gathered data. Then schools' scores for each criterion were calculated. Results: A set of 42 criteria sorted as a tree diagram was devised. Main branches of this tree included input branch consisting of National Entrance Examination (Weight: 2%), faculty members (weight: 18%), and facilities and equipment (weight: 20%), process branch consisting of administrations (weight: 40.5%) and support and counseling systems (weight: 4.5%) and output branch consisting of students' output (weight: 9%) and faculty members' output (weight: 6%). Conclusion: This study provided the educational strengths and weaknesses of Paramedical Sciences programs in Iran. The results can be used in devising practical strategies for qualitative and quantitative improvement . Keywords: Education, Allied health, Ranking, Stratification, School, Associate program

A Comparison of inflammatory markers in two different CLP procedures in murine polymicrobial sepsis model

Introduction: Sepsis, a common and costly cause of inpatient mortality in both sexes and all age groups (particularly in intensive care units), ensues an inflammatory process involving a variety of pathogen-expressed conserved structures called pathogen associated molecular pattern (PAMP) which are considered the main cause of oxidative stress and increase in inflammatory markers. Methods and Results: In this murine model study, male Wistar rats were assigned into three groups: CLP with gauge 18, CLP with gauge 21, and a sham group (a group without CLP). Subsequently, 24 hours following the surgery, all animals were sacrificed and inflammatory markers such as myeloperoxidase (MPO), reactive oxygen species (ROS) and lipid peroxidation (LPO) were measured in their cardiac tissues. In CLP group with gauge 18, LPO, ROS, and MPO were significantly increased in comparison with the other two groups. Moreover, although lower in comparison with the gauge 18 CLP group, LPO, ROS, and MPO were significantly higher in gauge 21 CLP group compared to the sham group. Conclusions: In murine models of sepsis, the gauge size can be influential in study outcomes and inflammatory changes observed in gauge 18 CLP mice can be considered as the most reliable and clinically-relevant indicators of sepsis-induced inflammation in humans.&nbsp

Pamphlet as a tool for continuing medical education: Performance assessment in a randomized controlled interventional study

Background: Pamphlet is a tool used for distance continuous professional development programs. In this study, we assessed the impact of an educational pamphlet on improving prescription writing errors in general physicians' performance. Methods: In this randomized controlled interventional study, we prepared a training pamphlet according to the most prevalent prescription writing problems. We randomized 200 participants among general physicians affiliated with Tehran Social Security Insurance Organization, and randomly divided them into intervention and control groups. Participants' prescriptions (N= 34888) were investigated over a month, and then the prepared pamphlet was sent out to the participants in the intervention group. After three months we examined their one-month prescriptions again (N= 30296) and investigated the changes in prescription errors. Results: There was no significant difference in the mean number of prescriptions in two groups before and after intervention (p= 0.076). Mean number of medicinal items reduced significantly in intervention group. Also mean number of prescriptions including injection drugs (p= 0.024), Corticosteroids (p= 0.036), Cephalosporin (p= 0.017) and non-steroidal anti-inflammatory drugs (p=0.005) reduced significantly. No significant differences were found for other errors. Conclusion: This study showed that use of an appropriate pamphlet has a considerable impact on improving general physicians' performance and could be applied for continuous professional development

Designing a Model of Student Support in e-Learning Using Qualitative Content Analysis and Analytic Hierarchy Process

Student support services, especially for students who study virtually, increase satisfaction, attract new students, complete the course, and improve overall student performance. Given the importance of student support in e-learning and the fact that student support models should be specific to the culture and economic conditions and technology of their context, the present study set to design a native model of student support in e-learning for post-graduate students. To conduct the research, first a systematic search was performed to extract the existing models of student support. Through forming an expert panel and rating the models, more compatible models with the context of Iran were selected. The interview questions were then extracted from the concepts of the models who scored the most in the expert panel session. In relation to the examples of student support, interviews were conducted with 22 university teachers, education officials, and post-graduate students studying in educational branches leading to a virtual degree of medical sciences. Using content analysis of codes, sub-categories and the resulting categories were extracted from the interviews. Finally, in the expert panel session, using the (analytic hierarchy process) AHP, the categories were prioritized and the model was designed. After analyzing the content of the interviews, four main categories, namely teaching and learning, interactions and communications, empowerment, and structural support were extracted and the final model of student support was designed using the opinions of e-learning instructors. Despite relatively similar similarities between the native model of student support for e-learning students and the existing models, this model, which is designed based on the needs of students and faculty and e-learning officials, places more emphasis on teaching, learning, interactions, and communications

Porównanie wpływu leczenia metforminą i insuliną na kontrolę glikemii u krytycznie chorych pacjentów

Introduction: It is accepted that preventing hyperglycaemia during critical illness while assuring adequate caloric intake can reduce mortality and morbidity. The aim of this study was to compare the metabolic effects of metformin and insulin on hyperglycaemia in ICU patients. Methods: This double-blind randomised clinical trial was performed on 24 patients who were admitted to the intensive care unit (ICU) from 20 March to 20 September 2007. All patients with serious injuries or with major non-abdominal surgeries were included if they met the inclusion criteria, and were assigned randomly to one of the study groups. Patients in Group 1 received intensive insulin therapy, and patients in Group 2 were treated with metformin. Moreover, the Acute Physiology And Chronic Health Evaluation (APACHE) II scoring system was used to grade disease severity. Results: Both glycaemic management protocols led to significantly improved glucose levels without any report of hypoglycaemia. The mean initial glucose levels for the insulin group decreased significantly after the intravenous infusion of insulin (p < 0.001). Additionally, the blood glucose concentration was significantly lower after two weeks of metformin administration compared to baseline measurements (p < 0.001). Moreover, the blood glucose concentration decrease during these two weeks was significantly higher in the insulin group (p = 0.01). Besides, APACHE II score was lower than baseline at the end of the study for both therapeutic groups (score of 10 vs. 15 [insulin] and 16 [metformin]). Finally, new renal dysfunction (maximum serum creatinine level at least double the initial value) was observed in three of the patients (two patients from the metformin group and one from the insulin group) in the last days of the protocol, although none of the patients showed lactic acidosis after ICU admission. Conclusions: Both metformin and intensive insulin therapy significantly decreased hyperglycaemia in ICU patients. Insulin caused a greater reduction in blood glucose concentration but required more attention and trained personnel.Wstęp: Dowody naukowe wskazują, że zapobieganie hiperglikemii u osób w stanie krytycznym przy zapewnieniu odpowiedniego poboru kalorii może zmniejszyć śmiertelność i chorobowość. Celem niniejszego badania było porównanie wpływu metforminy i insuliny na występowanie hiperglikemii u pacjentów leczonych na oddziale intensywnej opieki medycznej (OIOM). Materiał i metody: Badanie z randomizacją przeprowadzone metodą podwójnie ślepej próby obejmowało 24 chorych przyjętych na OIOM w okresie od 20 marca do 20 października 2007 roku. Wszystkich pacjentów z ciężkimi obrażeniami lub po poważnych zabiegach chirurgicznych niedotyczących jamy brzusznej, którzy spełniali kryteria włączenia, przydzielono losowo do jednej z grup terapeutycznych. U chorych przydzielonych do grupy 1. stosowano intensywną insulinoterapię, natomiast chorym z grupy 2. podawano metforminę. Do oceny ciężkości stanu chorych wykorzystano skalę APACHE (Acute Physiologic Assessment and Chronic Health Evaluation) II. Wyniki: Oba protokoły leczenia hipoglikemizującego spowodowały istotną poprawę wyrównania glikemii, przy czym nie odnotowano żadnego przypadku hipoglikemii. W grupie stosującej insulinoterapię średnie stężenie glukozy obniżyło się istotnie w stosunku do wartości wyjściowych po dożylnym wlewie insuliny (p < 0, 001). U osób leczonych metforminą po 2 tygodniach przyjmowania leku stężenie glukozy we krwi było istotnie niższe od poziomu wyjściowego (p < 0,001). Redukcja stężenia glukozy w ciągu tych 2 tygodni była istotnie większa w grupie przyjmującej insulinę (p = 0,01). W obu grupach terapeutycznych punktacja w skali APACHE II w momencie zakończenia badania była niższa od wartości wyjściowych (10 punktów v. 15 [insulina] i 16 [metformina]). U 3 chorych (2 osoby przydzielone do leczenia metforminą i 1 osoba przydzielona do insulinoterapii) zaobserwowano rozwój niewydolności nerek de novo (maksymalne stężenie kreatyniny w surowicy co najmniej 2-krotnie większe od wartości wyjściowych) w ostatnich dniach stosowania protokołu leczenia hipoglikemizującego, chociaż u żadnego z pacjentów nie stwierdzono kwasicy mleczanowej po przyjęciu na OIOM. Wnioski: Zarówno leczenie metforminą, jak i intensywna insulinoterapia istotne zmniejszają hiperglikemię u pacjentów na OIOM. Insulina powoduje większą redukcję stężenia glukozy, jednak jej stosowanie wymaga większej uwagi, a personel medyczny musi być odpowiednio przeszkolony