Urban mobility planning as a frame for urban design of squares and streets, the Peja case in Kosovo

Urban streets and squares have a dual function: as links in transport networks and as places for accommodating urban life. In this paper an integrated approach of urban design of the public domain is developed, highlighting the layers multimodal mobility planning can provide for the design. The approach is shown on the basis of some cases for the city of Peja (Kosovo). The designs of two strategic elements in the urban network, the railway station boulevard and the Haxhi Zeka Square as well as a district collector street within the Zatra living area are described. These design projects were elaborated by a mixed international and local team, working together in design studios within the frame of the ‘MOBKOS’ cooperation project (www.mobkos.eu). This project was co financed by the Flemish and the Kosovar Governments in the period 2009-2011. A well the structured road categorisation system and urban parking strategy are determining elements of the design. But even so a ‘soft spine’ accommodating walking and biking routes and a new system of urban bus routes are important layers of the design. The paper doesn’t call for a traffic engineering dominated design. It is gradually understood that the prevailing ‘city for cars’ practices in Kosovo (that had already shown its limits in Pristine) would lead Peja into a dead end street. That is why concepts such as urban boulevards, ‘shared spaces’, green trails… are used in the designs. The same international team is preparing design studios in the city of Shkodra in Albania

Molecular detection of Rickettsia, Borrelia, and Babesia species in Ixodes ricinus sampled in northeastern, central, and insular areas of Italy.

The aim of the present study was to provide insight into the diversity of tick-borne pathogens circulating in Italy, carried/transmitted by Ixodes ricinus, one of the most abundant tick species in the country. A total of 447 specimens sampled in five areas of northeastern, central and insular Italy were analysed by polymerase chain reaction and sequencing for the presence of rickettsiae, borreliae and babesiae. Several rickettsial species of the spotted fever group of zoonotic concern and other zoonotic pathogens were found, such as Borrelia burgdorferi s.s., Borrelia afzelii, Borrelia garinii, and Babesia venatorum. These findings confirm a wide distribution of tick-borne bacterial and protozoan species in Italy, and highlight the sanitary importance of I. ricinus, often recorded as feeding on humans

Minor mutations in HIV protease at baseline and appearance of primary mutation 90M in patients for whom their first protease-inhibitor ntiretroviral regimens failed

The association between minor mutations in human immunodeficiency virus (HIV) protease at baseline and development of common primary mutation 90M at virological failure (conferring some resistance to all protease inhibitors [PIs]) was evaluated in 93 previously drug-naive patients experiencing failure of their first PI-based antiretroviral regimens. In logistic regression analysis, the probability of accumulating a new 90M mutation at virological failure was associated with the presence at baseline of minor mutation 36I (naturally occurring in ∼25% of HIV clade B and in >80% of HIV non-clade-B viruses) (adjusted odds ratio, 13.5 [95% confidence interval, 1.89–95.6]; P=.009) and, possibly, of 10I/V. This suggests a potential role for the presence of 36I at baseline in predicting the appearance of 90M at virological failure

Characteristics of Belgian 'life-ending acts without explicit patient request' : a large-scale death certificate survey revisited

BACKGROUND: “Life-ending acts without explicit patient request,” as identified in robust international studies, are central in current debates on physician-assisted dying. Despite their contentiousness, little attention has been paid to their actual characteristics and to what extent they truly represent nonvoluntary termination of life. METHODS: We analyzed the 66 cases of life-ending acts without explicit patient request identified in a large-scale survey of physicians certifying a representative sample of deaths (n = 6927) in Flanders, Belgium, in 2007. The characteristics we studied included physicians’ labelling of the act, treatment course and doses used, and patient involvement in the decision. RESULTS: In most cases (87.9%), physicians labelled their acts in terms of symptom treatment rather than in terms of ending life. By comparing drug combinations and doses of opioids used, we found that the life-ending acts were similar to intensified pain and symptom treatment and were distinct from euthanasia. In 45 cases, there was at least 1 characteristic inconsistent with the common understanding of the practice: either patients had previously expressed a wish for ending life (16/66, 24.4%), physicians reported that the administered doses had not been higher than necessary to relieve suffering (22/66, 33.3%), or both (7/66, 10.6%). INTERPRETATION: Most of the cases we studied did not fit the label of “nonvoluntary life-ending” for at least 1 of the following reasons: the drugs were administered with a focus on symptom control; a hastened death was highly unlikely; or the act was taken in accordance with the patient’s previously expressed wishes. Thus, we recommend a more nuanced view of life-ending acts without explicit patient request in the debate on physician-assisted dying

BALL VELOCITY AND KINETICS OF THE SUPPORTING FOOT DURING TWO SOCCER KICKS, PERFORMED BY FEMALE SOCCER PLAYERS

INTRODUCTION: This study compared the ground reaction forces (GRFs) of the plant foot during soccer inside and instep kicks performed by experienced collegeaged female soccer players. METHODS: Eleven college-aged female soccer players performed six inside kicks and sixinstep kicks. A KISTLER piezoelectric force platform was used to sample the GRFs at 500 Hz. Video images of the twelve kicks performed were recorded from a sagittal view at 60 fields/s. An Ariel Performance Analysis system (APAS) was used to collect and analyze the kinetic and kinematic data from all trials. A 2 x 6 (kicking-style x trial) ANOVA with repeated measures on both factors was used to analyze the data information for each of the following variables; peak vertical GRFs during heel-strike and during toe-off, peak anterio-posterior and mediallateral GRFs, time of the supporting foot contact, and ball velocity. RESULTS: The mean vertical GRFs during heel-strike of the plant foot were 199% BW and 218% BW during the inside and instep kicks. Mean plant foot vertical GRFs during toe-off were 154% BW and 170% BW for the inside and instep kicks. Significantly greater peak antero-posterior GRFs (p=.019) were applied by the supporting foot during the instep kick. The video calculated ball velocities were 14.6 m/s and 14.4 m/sec for the inside and instep kicking techniques. CONCLUSIONS: The instep kicking technique generated greater plant foot vertical and antero-posterior GRFs. These increased forces were due to a larger kicking leg preparatory windup combined with a more vertical body position during a quicker instep kicking movement

Ovarian stimulation and endometriosis progression or recurrence: a systematic review

Available evidence on the impact of ovarian stimulation on the progression of endometriosis or its recurrence was systematically reviewed. Data from ovarian stimulation alone, or associated with intrauterine insemination (IUI) or IVF, were included. Sixteen studies were selected. Initial case reports (n = 11) documented some severe clinical complications. However, subsequent observational studies were more reassuring. Overall, five conclusions can be drawn: (i) IVF does not worsen endometriosis-related pain symptoms (moderate quality evidence); (ii) IVF does not increase the risk of endometriosis recurrence (moderate quality evidence); (iii) the impact of IVF on ovarian endometriomas, if present at all, is mild (low quality evidence); (iv) IUI may increase the risk of endometriosis recurrence (low quality evidence); (v) deep invasive endometriosis might progress with ovarian stimulation (very low quality evidence). In conclusion, available evidence is generally reassuring (at least for IVF) and does not justify aggressive clinical approaches such as prophylactic surgery before assisted reproductive technology treatment to prevent endometriosis progression or recurrence. However, further evidence is required before being able to reach definitive conclusions. In particular, the potential effects on deep invasive endometriosis and the possible synergistic effect of stimulation and pregnancy are two areas that need to be explored further

Tenofovir disoproxil fumarate for the treatment of chronic hepatitis B monoinfection

Introduction: Resistance in nucleoside/nucleotide analog (NA) therapy has always been a challenge in the management of chronic hepatitis B (CHB). Clinical studies: Initially developed for the treatment of HIV infection, early in vitro and clinical observational studies had shown tenofovir disoproxil fumarate (TDF) to be also active against CHB. Recent data from various multicenter phase 3 and 4 clinical trials have confirmed TDF being able to achieve a high viral suppression in both NA-naive and -experienced CHB patients. There are also emerging data on the efficacy of TDF in decompensated CHB. Although there are in vitro studies identifying certain mutation loci associated with a reduced susceptibility to TDF, there have so far been no reports of virologic resistance to TDF in clinical studies. TDF has a favorable safety profile, although more long-term data would be needed. Conclusions: TDF has the makings of an 'ideal' first-line drug for the treatment of CHB. © 2011 Asian Pacific Association for the Study of the Liver.postprin

Research Priorities for Endometriosis:Recommendations From a Global Consortium of Investigators in Endometriosis

The 3rd International Consensus Workshop on Research Priorities in Endometriosis was held in São Paulo on May 4, 2014, following the 12th World Congress on Endometriosis. The workshop was attended by 60 participants from 19 countries and was divided into 5 main sessions covering pathogenesis/pathophysiology, symptoms, diagnosis/classification/prognosis, disease/symptom management, and research policy. This research priorities consensus statement builds on earlier efforts to develop research directions for endometriosis. Of the 56 research recommendations from the 2011 meeting in Montpellier, a total of 41 remained unchanged, 13 were updated, and 2 were deemed to be completed. Fifty-three new research recommendations were made at the 2014 meeting in Sao Paulo, which in addition to the 13 updated recommendations resulted in a total of 66 new recommendations for research. The research recommendations published herein, as well as those from the 2 previous papers from international consensus workshops, are an attempt to promote high-quality research in endometriosis by identifying and agreeing on key issues that require investigation. New areas included in the 2014 recommendations include infertility, patient stratification, and research in emerging nations, in addition to an increased focus on translational research. A revised and updated set of research priorities that builds on this document will be developed at the 13th World Congress on Endometriosis to be held on May 17-20, 2017, in Vancouver, British Columbia, Canada.Peter A. W. Rogers, G. David Adamson, Moamar Al-Jefout, Christian M. Becker, Thomas M. D, Hooghe, Gerard A. J. Dunselman, Asgerally Fazleabas, Linda C. Giudice, Andrew W. Horne, M. Louise Hull, Lone Hummelshoj, Stacey A. Missmer, Grant W. Montgomery, Pamela Stratton, Robert N. Taylor, Luk Rombauts, Philippa T. Saunders, Katy Vincent, Krina T. Zondervan for the WES/WERF Consortium for Research Priorities in Endometriosi

Urban mobility planning as a frame for urban design of squares and streets, the Peja case in Kosovo

Urban streets and squares have a dual function: as links in transport networks and as places for accommodating urban life. In this paper an integrated approach of urban design of the public domain is developed, highlighting the layers multimodal mobility planning can provide for the design. The approach is shown on the basis of some cases for the city of Peja (Kosovo). The designs of two strategic elements in the urban network, the railway station boulevard and the Haxhi Zeka Square as well as a district collector street within the Zatra living area are described. These design projects were elaborated by a mixed international and local team, working together in design studios within the frame of the 'MOBKOS' cooperation project (www.mobkos.eu). This project was co financed by the Flemish and the Kosovar Governments in the period 2009-2011. A well the structured road categorisation system and urban parking strategy are determining elements of the design. But even so a 'soft spine' accommodating walking and biking routes and a new system of urban bus routes are important layers of the design. The paper doesn't call for a traffic engineering dominated design. It is gradually understood that the prevailing 'city for cars' practices in Kosovo (that had already shown its limits in Pristine) would lead Peja into a dead end street. That is why concepts such as urban boulevards, 'shared spaces', green trails... are used in the designs. The same international team is preparing design studios in the city of Shkodra in Albania

Updates in the treatment of chronic hepatitis B

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