Social Fluidity and Its Impact on Contemporary Architectural Space

ظهرت في مطلع القرن العشرين العديد من القوى المؤثرة على الفضاء المعماري المعاصرعلى المستويين المادي والفكري، إذ برزت مفاهيم وطروحات حاولت التصدي لمشكلة التطور المتسارع في تلك القوى ومن تلك المفاهيم والطروحات هو مفهوم السيولة الذي يُعد صفة لابد أن يتصف بها الفضاء المعماري المعاصر لإستيعاب أي تغير مفاجئ لأي قوة من القوى المؤثرة عليه سواء كانت إجتماعية، إقتصادية، سياسية، بيئية، مادية، فلسفية، ...الخ ، من هنا ظهرت المشكلة البحثية «في عدم وضوح مفهوم  السيولة في العلوم الإجتماعية وتأثيرها على الفضاء المعماري المعاصر». إذ يهدف البحث الى بيان كيف أثرت السيولة الإجتماعية على المكون الفضائي المعاصر وجعلته يتجه بإتجاه السيولة شكلاً وأداءاً. وإتبع البحث المنهج التحليلي في تتبع مفهوم السيولة في الفيزياء والفكر الاجتماعي وصولا الى بلورة هذا المفهوم في الفكر المعماري المعاصر، ومن ثم تحليل لبعض النماذج المعمارية المعاصرة، وفق المؤشرات التي خرج بها البحث من إطاره النظري. إذ توصل البحث الى إن السيولة في العلوم الاجتماعية ساهمت في جعل الفضاء المعماري المعاصر يسلك سلوكين: الأول سلوكاً شكلياً من خلال االتدفق الشكلي والفضائي وسلوك تفاعلي من خلال العلاقات المتمثلة بعلاقة المستخدم مع المستخدم، علاقة المستخدم مع الفضاء، علاقة الفضاء مع المحيط.At the beginning of the twentieth century, many forces that influenced the architectural space on the material and intellectual levels, where concepts and ideas that tried to address the problem of rapid development in these forces emerged.These concepts and fluidity, which is characteristic of modern architectural space to accommodate any sudden change For any power that affects it, be it social, economic, political, environmental, material, philosophical, etc.hence the research problem emerged «in the lack of clarity of the concept of fluidity in social sciences and its impact on contemporary architectural space».The study aims to explain how social fluidity affected the contemporary space component and its tendency towards fluidity in form and performance.The research followed the analytical approach in tracking the concept of liquidity in physics and social thought to crystallize this concept in contemporary architectural thought, and then analysis of some contemporary architectural models, according to the indicators that emerged from the theoretical framework.The research concluded that the fluidity in social sciences contributed to making modern architectural space behave in two types: First, formal behavior through formal and spatial flow .Second, interactive behavior through relationships like user-with-user, user - with -space, space – with - the environment

Antimicrobial Effect of Eco- Friendly Silver Nanoparticles Synthesis by Iraqi Date Palm (Phoenix dactylifera) on Gram-Negative Biofilm-Forming Bacteria

يعد تصنيع دقائق الفضة النانوية بواسطة التمر بالطريقة الخضراء او النباتية واستخدامه كمضاد بكتيري. في الوقت الحاضر حصلت هذه الطريقة على اهتمام الباحثين النها امينة وغير سامة وقليلة التكلفة وصديقة للبيئة. تشتمل البكتريا المكونة للغشاء الحيوي والموجودة في الحليب المحلي المتوفر باالسواق على خطورة عالية على صحة المجتمع بسبب ان اغلب البكتريا المكونة للغشاء الحيوي تكون مقاومة للمضادات الحياتية. الهدف من الدراسة هو القضاء على البكتريا المكونة للغشاء الحيوي والموجودة بالحليب المحلي باستخدام عالجا بديال بتحضير دقائق الفضة النانوية من التمر. حيث كشفت قابلية البكتريا المعزولة من الحليب المحلي على تكوين الغشاء الحيوي باستخدام طريقة صبغة الكونغو الحمراء. حضرت دقائق الفضة النانوية باستخدام خالصة التمر. حيث تم فحص دقائق الفضة المصنوعة بواسطة جهاز االشعة فوق البنفسجية ومجهر القوة الذرية. تم تقييم فاعلية دقائق الفضة المصنعة المضادة للبكتريا بواسطة طريق االنتشار الحفر باألكار. اظهرت النتائج ان البكتريا المعزولة من الحليب والمنتجة للغشاء الحيوي هي االشرشيا القولونيةcoli. E بعدد 3 وال pneumoniae Klebsiellaبعدد 5 عزالت ضمن العزالت السالبة لصبغة غرام. حجم النانو المحضر كان 35 نانوميتر حيث تم الكشف عن تكونه بواسطة التغيير اللوني للمستخلص النباتي من اللون االصفر الى البني وقمة امتصاص عند 410 نانوميتر. كذلك اظهرت النتائج عن الفاعلية العالية لدقائق الفضة في القضاء على البكتريا السالبة لصبغة غرام و المنتجة للغشاء الحيوي. نستنتج من هذه الدراسة ان دقائق الفضة المصنعة من مستخلص التمر ذو كفاءة عالية في القضاء على البكتريا السالبة لصبغة غرام والمنتجة للغشاء الحيوي.Date palm silver nanoparticles are a green synthesis method used as antibacterial agents. Today, there is a considerable interest in it because it is safe, nontoxic, low costly and ecofriendly. Biofilm bacteria existing in marketed local milk is at highly risk on population health and may be life-threatening as most biofilm-forming bacteria are multidrug resistance. The goal of current study is to eradicate biofilm-forming bacteria by alternative treatment green synthesis silver nanoparticles. The biofilm formation by bacterial isolates was detected by Congo red method. The silver nanoparticles were prepared from date palm(khestawy) fruit extract. The formed nanoparticles were characterized with UV-Vis and AFM. The antibacterial activity of synthetic silver nanoparticles was evaluated by agar well diffusion method. Gram-negative bacteria isolates were E. coli in 3 isolates and Klebsiella pneumoniae in 5 isolates and all are biofilm producer. The size of synthetic green silver nanoparticles is 18 nm and the generation of silver nanoparticles was confirmed by change of date extract color from yellow to brown with an absorption maximum at 410 nm. Highly antibacterial activity of silver nanoparticles was recorded in comparison to plant extract and silver nitrate against gram-negative biofilm-forming bacteria. From this study, the antibacterial activity of date palm silver nanoparticles was more efficient to eradicate gram negative biofilm[1]forming bacteria isolated from marketed local mil

Architecture Between Mind and Empirical Experience

The research aims to identify the level of balance in the architectural thought influenced by the rational type human consciousness, the materialistic based on the Empirical type, moral based on human experience as source of knowledge. This was reflected in architecture in the specialized thought that the mind is the source of knowledge which explains the phenomena of life. The rational approach based on objectivity and methodology in (Form Production), the other approach is based on subjectivity in form production (Form Inspiration). The research problem is that there is imbalance in the relationship between the rational side and the human experience in architecture, which led into imbalance between theory and application in architecture according to architectural movements

Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study

OBJECTIVES: Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. DESIGN: A multicentre, international, collaborative cohort study. SETTING: 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. PARTICIPANTS: Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. MAIN OUTCOME MEASURE: All-cause mortality at 30 days and 90 days. RESULTS: 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). CONCLUSIONS: The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally

International Variations in Surgical Morbidity and Mortality Post Gynaecological Oncology Surgery: A Global Gynaecological Oncology Surgical Outcomes Collaborative Led Study (GO SOAR1)

Simple Summary Little is known about factors contributing to early post-operative morbidity and mortality in low and middle income countries with a paucity of data limiting global efforts to improve gynaecological cancer care. In this multicentre, international prospective cohort study of women undergoing gynaecological oncology surgery, we show that low and middle versus high income countries were associated with similar post-operative major morbidity. Capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention.Abstract Gynaecological malignancies affect women in low and middle income countries (LMICs) at disproportionately higher rates compared with high income countries (HICs) with little known about variations in access, quality, and outcomes in global cancer care. Our study aims to evaluate international variation in post-operative morbidity and mortality following gynaecological oncology surgery between HIC and LMIC settings. Study design consisted of a multicentre, international prospective cohort study of women undergoing surgery for gynaecological malignancies (NCT04579861). Multilevel logistic regression determined relationships within three-level nested-models of patients within hospitals/countries. We enrolled 1820 patients from 73 hospitals in 27 countries. Minor morbidity (Clavien-Dindo I-II) was 26.5% (178/672) and 26.5% (267/1009), whilst major morbidity (Clavien-Dindo III-V) was 8.2% (55/672) and 7% (71/1009) for LMICs/HICs, respectively. Higher minor morbidity was associated with pre-operative mechanical bowel preparation (OR = 1.474, 95%CI = 1.054-2.061, p = 0.023), longer surgeries (OR = 1.253, 95%CI = 1.066-1.472, p = 0.006), greater blood loss (OR = 1.274, 95%CI = 1.081-1.502, p = 0.004). Higher major morbidity was associated with longer surgeries (OR = 1.37, 95%CI = 1.128-1.664, p = 0.002), greater blood loss (OR = 1.398, 95%CI = 1.175-1.664, p <= 0.001), and seniority of lead surgeon, with junior surgeons three times more likely to have a major complication (OR = 2.982, 95%CI = 1.509-5.894, p = 0.002). Of all surgeries, 50% versus 25% were performed by junior surgeons in LMICs/HICs, respectively. We conclude that LMICs and HICs were associated with similar post-operative major morbidity. Capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research