İbn Münâzil’in İzinde: Bağdat ve Nişabur’da İlk Tasavvuf Mektepleri

Bu çalışma bir dizi sorunun cevabını aramaktadır: [İlk olarak] uzun müstensih silsilelerinden kaynaklanıp süregelen bir yazım hatasını düzeltme girişimidir ki bu hata sebebiyle, Abdullah b. Mübârek (öl. 181/797) ve daha aztanınan Abdullah b. Münâzil (öl. 330/941-942) gibi iki tarihi şahsiyet birbirinekarıştırılmıştır. Bu makale aynı zamanda, Nişaburlu ilk zâhidlerden biri olanAbdullah b. Münâzil’i tanıtmayı; 4./10. yüzyıl tasavvuf eserlerinden biri olupbugüne kadar ihmal edilen Tehzîbül-esrâr’ın önemini hatırlatmayı; kabaca daolsa, Bağdat ve Nişabur’daki ilk zâhidleri buluşturan bağlara ilişkin bir haritaçizmeyi; tasavvuf literatürüne yaklaşım tarzını belirleyen yorum metotlarınıana hatlarıyla belirlemeyi; tasavvuf alanında hâlihazırdaki araştırmalara birkatkı sunmayı ve son fakat çok önemli olarak, hac ritüelini ifa etmenin endoğru yolu üzerine kafa yormayı amaçlamaktadır. Bu liste anlamsız ve cüretkârgözüküyorsa da, makale boyunca yukarıdaki başlıkların birbirileriyle olanalakasını göstereceğime dair umudumu ifade etmek istiyorum

Sehen mit drei Augen. Ibn al-ʽArabīs barzakh und die zeitgenössische Weltsituation

Autorica ovog rada nastoji pisati o misteriji barzakha (prevlake, istmusa, purgatorija, tj. čistilišta) u perspektivi Ibn al-ʽArabīja i iz njegove perspektive. Ibn al-ʽArabījeva perspektiva motri stvari iz tri dimenzije: dvije dimenzije pozitivnog i negativnog, koje su nam bliske zbog naše svakidašnje binarne percepcije, i dodatne, treće dimenzije, koja ne pripada ni jednoj ni drugoj. To je dimenzija barzakha, koju možemo nazvati tercijarnom jer ona ujedinjuje i uključuje ove dvije poznate dimenzije. »Viđenje« treće dimenzije, barzakha, nije dostižno uobičajenoj binarnoj percepciji, nego je dostižno, sukladno Ibn al-ʽArabīju, samo onima koji posjeduju naročitu vrstu viđenja; oni su ahl al-kashf, oni koji, takoreći, »vide« trima očima. Ipak, između binarnih i tercijarnih/ujedinjujućih percepcija postoji šireća povezanost. Ovo je dinamična napetost koja obilježava sve stupnjeve postojanja, svjesno ili nesvjesno. Drugim riječima kazano: iako barzakh pripada dimenziji mističnog »trećeg«, snažno je prisutan i utjecajan posvuda. Manifestira se kao kognitivna funkcija koju Ibn al-ʽArabī naziva ‘imaginacijom’ (al-khayāl). Za njega je barzakh-imaginacija najsnažnija kognitivna funkcija u ljudskom ustrojstvu i ona ovisi o paradoksu: ona čini sve što koncipira »to/nije to«. Također, Bog, motren iz ove perspektive, jest »On/nije On«. Kako slijedi iz kognitivnog polja koje nastaje iz tercijarne-barzakh-imaginativne perspektive, smatram da je ovaj pojam coincidentia oppositorum (‘jedinstvo suprotnosti’, al-jamʽ bayna al-ḍiddayn). Konačno, primjenjujem uvide koji proistječu iz Ibn al-ʽArabījeve perspektive na pitanje ‘identiteta’ i na etičke dileme našeg suvremenog svijeta.The author of this paper attempts to write about the mystery of the barzakh in and from Ibn al-ʽArabī’s perspective. Ibn al-ʽArabī’s perspective observes things from three dimensions: the two dimensions of the positive and negative, which are familiar to us by means of our ordinary binary perception, and in addition the third dimension that belongs neither to the one, nor to the other. This is the dimension of the barzakh, which can be called tertiary, since it is unitive and inclusive of the two familiar dimensions. “Seeing” the third dimension of the barzakh is not accessible to ordinary binary perception; it is accessible, according to Ibn al-ʽArabī, only to those who possess a special kind of seeing; they are the ahl al-kashf, those who “see” with three eyes, as it were. Nevertheless, between the binary and the tertiary/unitive perceptions there is a pervasive tension of relatedness. It is a dynamic tension that makes its mark on all levels of existence, whether consciously or unconsciously. In other words, although the barzakh belongs to the dimension of the mysterious “third”, it is powerfully present and influential all around. It manifests itself as the cognitive function that Ibn al-ʽArabī calls ‘imagination’ (al-khayāl). For him, the barzakh-imagination is the most powerful cognitive function in the human makeup, and it hinges on a paradox: it makes everything that it conceives an “it/not it”. God, too, from this perspective, is “He/not He”. Following from the cognitive field that evolves from the tertiary-barzakh-imaginative perspective, I consider the notion coincidentia oppositorum (‘the union of the opposites’, aljamʽ bayna al-ḍiddayn). Finally, I apply the insights stemming from Ibn al-ʽArabī’s perspective to the question of ‘identities’ and to the ethical dilemmas of our contemporary world.L’auteur de ce travail entreprend d’écrire sur le mystère du barzakh, dans et à partir de la perspective d’Ibn al-ʽArabī. La perspective d’Ibn al-ʽArabī observe les choses sur la base de trois dimensions : deux dimensions, celle du positif et celle du négatif, qui nous sont proches car notre perception quotidienne binaire reposent sur elles, et une troisième dimension en plus, qui n’appartient ni à l’une ni à l’autre. C’est la dimension du barzakh, que l’on pourrait appeler de tertiaire car elle unit et inclut les deux dimensions qui nous sont bien connues. « Voir » la troisième dimension du barzakh n’est pas accessible à la perception binaire ordinaire; elle est accessible, selon Ibn al-ʽArabī, seulement à ceux qui possèdent une qualité particulière dans « le voir » : ce sont des al-kashfs, ceux qui, pour ainsi dire, « voient » avec trois yeux. Néanmoins, il existe entre les perceptions binaires et tertiaires/unissantes une intime et omnipré- sente connexion de l’ordre d’une tension dynamique qui révèle tous les niveaux de l’existence, conscients ou inconscients. En d’autres termes, bien que le barzakh appartienne à la dimension mystique du « troisième », il est est fortement présent et exerce son influence en tout lieu. Il se manifeste comme une fonction cognitive que Ibn al-ʽArabī nomme « imagination » (al-khayāl). Pour lui, l’imagination-barzakh est la plus puissante des fonctions cognitives présentes dans la constitution de l’Homme et repose sur un paradoxe : elle forme tout ce qui conçoit le « cela/cela n’est pas ». De même, Dieu, pensé à partir de cette perspective est « Lui/n’est pas Lui ». Sur la base du champ cognitif qui est apparu à partir de l’idée de l’imaginative-barzakh-tertiaire, je pense qu’il est question du concept de coincidentia oppositorum (« l’unité des opposés », al-jamʽ bayna al-ḍiddayn). Enfin, j’applique les idées qui découlent de la perspective d’Ibn al-ʽArabī à la question des « identités » et aux dilemmes éthiques de notre monde contemporain.Die Verfasserin dieses Beitrags macht den Versuch, über das Mysterium von barzakh in und aus Ibn al-ʽArabīs Perspektive zu schreiben. Ibn al-ʽArabīs Blickwinkel beobachtet die Dinge aus drei Dimensionen: zwei Dimensionen des Positiven und Negativen, die uns dank unserer alltäglichen binären Wahrnehmung vertraut sind, und darüber hinaus eine dritte Dimension, die weder der einen noch der anderen angehört. Dies ist die Dimension des barzakhs, die man tertiär nennen kann, da sie vereinigend ist und die beiden bekannten Dimensionen einbezieht. Das „Sehen“ der dritten Dimension des barzakhs ist nicht erreichbar für gewöhnliche binäre Wahrnehmung; es ist, Ibn al-ʽArabī zufolge, nur für jene realisierbar, die über eine besondere Art des Sehens verfügen; sie sind die ahl al-kashf, also diejenigen, die sozusagen mit drei Augen „sehen“. Nichtsdestoweniger existiert zwischen den binären und den tertiären/vereinigenden Wahrnehmungen eine durchdringende Spannung der Verwandtschaft. Es ist eine dynamische Spannung, die auf allen Ebenen der Existenz, ob bewusst oder unbewusst, ihre Spuren hinterlässt. Mit anderen Worten, obzwar das barzakh zur Dimension des mysteriösen „Dritten“ gehört, ist es allenthalben stark präsent und einflussreich. Es manifestiert sich als kognitive Funktion, die Ibn al-ʽArabī „Imagination“ (al-khayāl) nennt. Für ihn ist die barzakh-Imagination die stärkste kognitive Funktion in der Struktur eines Menschen, wobei sie von einem Paradox abhängt: Alles, was sie konzipiert, macht sie zu einem „es/nicht es“. Aus dieser Perspektive ist Gott ebenfalls ein „Er/nicht Er“. Mit dem Ausgangspunkt im kognitiven Feld, das sich aus der tertiär-barzakh-imaginativen Perspektive herausbildet, nehme ich den Begriff coincidentia oppositorum („Zusammenfall der Gegensätze“, al-jamʽ bayna al-ḍiddayn) in Augenschein. Schließlich verwende ich die Einsichten, die aus Ibn al-ʽArabīs Perspektive hervorgehen, bei der Frage der „Identitäten“ sowie bei ethischen Dilemmas unserer zeitgenössischen Welt

Bilateral pneumothoraces, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema after percutaneous tracheostomy -A case report-

We report a rare case of a 72-year-old female who developed extensive subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, pneumoperitoneum, and pneumoretroperitoneum after a percutaneous dilatational tracheostomy. The patient's T-cannula was accidentally connected to the oxygen line with a non-perforated connector. The patient rapidly developed respiratory insufficiency and subcutaneous emphysema in the neck and both shoulders. The bilateral pneumothoraces were managed using a chest tube. CT scans of the chest, abdomen, and pelvis revealed an extensive distribution of air throughout the chest and abdomen. The patient was treated successfully with supportive care. This case illustrates the rare occurrence of air passing into multiple body compartments, highlighting the potentially serious complications of a tracheostomy and the importance of intensive care during the recovery period

Who gets the ventilator? A multicentre survey of intensivists' opinions of triage during the first wave of the COVID-19 pandemic

Background The COVID-19 pandemic has caused a shortage of intensive care resources. Intensivists' opinion of triage and ventilator allocation during the COVID-19 pandemic is not well described. Methods This was a survey concerning patient numbers, bed capacity, triage guidelines, and three virtual cases involving ventilator allocations. Physicians from 400 ICUs in a research network were invited to participate. Preferences were assessed with a five-point Likert scale. Additionally, age, gender, work experience, geography, and religion were recorded. Results Of 437 responders 31% were female. The mean age was 44.4 (SD 11.1) with a mean ICU experience of 13.7 (SD 10.5) years. Respondents were mostly European (88%). Sixty-six percent had triage guidelines available. Younger patients and caretakers of children were favoured for ventilator allocation although this was less clear if this involved withdrawal of the ventilator from another patient. Decisions did not differ with ICU experience, gender, religion, or guideline availability. Consultation of colleagues or an ethical committee decreased with age and male gender. Conclusion Intensivists appeared to prioritise younger patients for ventilator allocation. The tendency to consult colleagues about triage decreased with age and male gender. Many found such tasks to be not purely medical and that authorities should assume responsibility for triage during resource scarcity.publishedVersio

Noninvasive ventilation in COVID-19 patients aged ≥ 70 years-a prospective multicentre cohort study.

BACKGROUND Noninvasive ventilation (NIV) is a promising alternative to invasive mechanical ventilation (IMV) with a particular importance amidst the shortage of intensive care unit (ICU) beds during the COVID-19 pandemic. We aimed to evaluate the use of NIV in Europe and factors associated with outcomes of patients treated with NIV. METHODS This is a substudy of COVIP study-an international prospective observational study enrolling patients aged ≥ 70 years with confirmed COVID-19 treated in ICU. We enrolled patients in 156 ICUs across 15 European countries between March 2020 and April 2021.The primary endpoint was 30-day mortality. RESULTS Cohort included 3074 patients, most of whom were male (2197/3074, 71.4%) at the mean age of 75.7 years (SD 4.6). NIV frequency was 25.7% and varied from 1.1 to 62.0% between participating countries. Primary NIV failure, defined as need for endotracheal intubation or death within 30 days since ICU admission, occurred in 470/629 (74.7%) of patients. Factors associated with increased NIV failure risk were higher Sequential Organ Failure Assessment (SOFA) score (OR 3.73, 95% CI 2.36-5.90) and Clinical Frailty Scale (CFS) on admission (OR 1.46, 95% CI 1.06-2.00). Patients initially treated with NIV (n = 630) lived for 1.36 fewer days (95% CI - 2.27 to - 0.46 days) compared to primary IMV group (n = 1876). CONCLUSIONS Frequency of NIV use varies across European countries. Higher severity of illness and more severe frailty were associated with a risk of NIV failure among critically ill older adults with COVID-19. Primary IMV was associated with better outcomes than primary NIV. Clinical Trial Registration NCT04321265 , registered 19 March 2020, https://clinicaltrials.gov

Variations in end-of-life care practices in older critically ill patients with COVID-19 in Europe

BACKGROUND: Previous studies reported regional differences in end-of-life care (EoLC) for critically ill patients in Europe. OBJECTIVES: The purpose of this post-hoc analysis of the prospective multi-centre COVIP study was to investigate variations in EoLC practices among older patients in intensive care units during the coronavirus disease 2019 pandemic. METHODS: A total of 3105 critically ill patients aged 70 years and older were enrolled in this study (Central Europe: n = 1573; Northern Europe: n = 821; Southern Europe: n = 711). Generalised estimation equations were used to calculate adjusted odds ratios (aOR) to population averages. Data were adjusted for patient-specific variables (demographic, disease-specific) and health economic data (GDP, health expenditure per capita). The primary outcome was any treatment limitation, and 90-day-mortality was a secondary outcome. RESULTS: The frequency of the primary endpoint (treatment limitation) was highest in Northern Europe (48%), intermediate in Central Europe (39%), and lowest in Southern Europe (24%). The likelihood for treatment limitations was lower in Southern than in Central Europe (aOR 0.39; 95%CI 0.21-0.73; p = 0.004), even after multivariable adjustment, whereas no statistically significant differences were observed between Northern and Central Europe (aOR 0.57; 95%CI 0.27-1.22; p = 0.15). After multivariable adjustment, no statistically relevant mortality differences were found between Northern and Central Europe (aOR 1.29; 95%CI 0.80-2.09; p = 0.30) or between Southern and Central Europe (aOR 1.07; 95%CI 0.66-1.73; p = 0.78). CONCLUSION: This study shows a north-to-south gradient in rates of treatment limitation in Europe, highlighting the heterogeneity of EoLC practices across countries. However, mortality rates were not affected by these results. This article is protected by copyright. All rights reserved.publishersversionepub_ahead_of_prin

Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe

The primary aim of this study was to assess the outcome of elderly intensive care unit (ICU) patients treated during the spring and autumn COVID-19 surges in Europe. This was a prospective European observational study (the COVIP study) in ICU patients aged 70 years and older admitted with COVID-19 disease from March to December 2020 to 159 ICUs in 14 European countries. An electronic database was used to register a number of parameters including: SOFA score, Clinical Frailty Scale, co-morbidities, usual ICU procedures and survival at 90 days. The study was registered at ClinicalTrials.gov (NCT04321265). In total, 2625 patients were included, 1327 from the first and 1298 from the second surge. Median age was 74 and 75 years in surge 1 and 2, respectively. SOFA score was higher in the first surge (median 6 versus 5, p < 0.0001). The PaO/FiO ratio at admission was higher during surge 1, and more patients received invasive mechanical ventilation (78% versus 68%, p < 0.0001). During the first 15 days of treatment, survival was similar during the first and the second surge. Survival was lower in the second surge after day 15 and differed after 30 days (57% vs 50%) as well as after 90 days (51% vs 40%). An unexpected, but significant, decrease in 30-day and 90-day survival was observed during the second surge in our cohort of elderly ICU patients. The reason for this is unclear. Our main concern is whether the widespread changes in practice and treatment of COVID-19 between the two surges have contributed to this increased mortality in elderly patients. Further studies are urgently warranted to provide more evidence for current practice in elderly patients. , registered March 19th, 2020. The online version contains supplementary material available at 10.1186/s13054-021-03739-7