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Objective: Extracorporeal membrane oxygenation (ECMO) is an intervention used for patients with acute respiratory distress syndrome (ARDS) from COVID-19 who have failed conventional ventilatory strategies. Very few studies have given insight into the outcomes of pregnant and postpartum patients requiring ECMO support. Methods: Single center, retrospective, observational study of female pregnant and postpartum patients suffering COVID-19 ARDS and requiring ECMO. Results: Eight SARS-CoV-2 positive patients were identified. The average age was 31 ± 4 years, with Body Mass Indices (BMI) and SOFA scores ranging between 32–49 and 8–11, respectively. Two patients were pregnant at the time of ECMO initiation, two were peripartum, and four were postpartum. Five patients (63%) had bleeding, and one patient had a hysterectomy. Seven patients (88%) were supported by V-V ECMO and one with V-A ECMO. Patients had between one and three circuit exchanges due to oxygenator failure or clots in the circuit. All patients were in ICU between 7 and 74 days, with hospital length of stay between 8 and 81 days. All patients were weaned off ECMO and were successfully discharged from the hospital. All newborns were born via cesarean section, and all survived to discharge. Conclusion: Our study shows a 100% neonatal and maternal survival rate demonstrating that ECMO in this patient population is safe. These patients should be transferred to experienced high-volume ECMO centers with the ability to perform emergent cesarean sections. ECMO should be considered a life-saving therapy for pregnant women with severe COVID-19 with an overall excellent maternal and neonatal survival rate.

Objective: The ProtekDuo with oxygenator mimics veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) in veno-pulmonary (V-P) configuration. We have recently developed a new configuration by utilizing a 25 Fr multistage femoral venous drainage cannula and by returning oxygenated blood through both lumina of the double lumen ProtekDuo cannula (V-VP configuration), thereby creating partial right ventricular bypass and oxygenated blood flow of up to seven LPM. We investigated our experience with V-P and V-VP ECMO in patients suffering from COVID-19 acute respiratory distress syndrome (ARDS). Methods: Single center, retrospective observational study. Results: Of nine patients, one was initiated on V-A, two on V-P, and six on V-V ECMO. All patients were reconfigured to V-P and five patients in addition had V-VP ECMO configuration. All patients had at least one and up to three circuit exchanges. Patients were on ECMO support between 20 and 122 (55 ± 29) days, were in ICU between 46 and 161 (78 ± 40) days with a total hospital length of stay between 35 and 171 (82 ± 42) days. Six of nine (67%) patients could successfully be weaned off ECMO, survived, and were discharged. Conclusion: The ProtekDuo cannula in V-P configuration provides ECMO blood flow while reducing RV flow, wall-stress and dilatation, as well as oxygen consumption. The V-VP configuration is useful to provide high blood flows of up to seven LPM of oxygenated blood, and partial RV support without over-circulating the pulmonary vascular bed. Our results show that V-P and V-VP ECMO configurations are feasible, have good outcome and are without complications.

The ProtekDuo® is a dual lumen cannula that can be used in numerous configurations to treat cardiogenic shock and hypotension. Its default function is as a temporary percutaneous right ventricular assist device (RVAD) system, however, other configurations both alone and with other mechanical circulatory support (MCS) devices have evolved. In addition to its use as a component of a ventricular assist device (VAD), it can be used as a cannula for extracorporeal membrane oxygenation (ECMO) and may serve as double lumen drainage cannula on cardiopulmonary bypass (CPB). The role of the cannula in ECMO has been described in multiple configurations including traditional veno-pulmonary (V-P) or “oxygenated RVAD” (oxyRVAD), veno-venopulmonary (V-VP), or venopulmonary-arterial (VP-A). This book chapter summarizes various configurations and technical aspects of the ProtekDuo(R) cannula in the management of hypotension and cardiogenic shock.

Introduction: Urban studies have examined the potential of urban interventions to upgrade spaces. This is the focus of relational approaches that emphasize interactions between interventions and users. One approach, actor–network theory, views these interactions as temporary stabilized relational effects. Despite its usefulness in uncovering diverse interactions in urban spaces, the utilization of actor–network theory in unpacking these relations has been limited.Methods: This study utilized an actor–network theory-inspired ethnography in a temporary urban intervention in Abdali Boulevard, in Jordan, to bridge this gap. It relied on desk research, interviews, and site observations to explore the different intervention–user interactions.Results: The findings revealed various interactions and relational patterns occurring between interventions and their users through their presence and absence in space and time, where users attended to, engaged with, overlooked, bypassed, disturbed the intervention, or floated between different modes of interaction.Discussion: Unpacking these diverse interactions and relations provides a nuanced perspective on the effects of urban interventions on spaces. This would be useful for designers in developing new ways of designing through offering interventions that engage the public.

Purpose The purpose of this study is to explore the multifaceted challenge of managing construction and demolition waste within the context of the Jordan construction industry. Design/methodology/approach Using data sourced through desk research, interviews and questionnaires, this study examines the principal causes of increased volumes of construction and demolition waste, as well as the obstacles to both developing and implementing better waste management strategies. Findings This study identifies multiple causes of issues related to waste management and barriers to developing and implementing solutions and concludes by recommending a holistic approach to this multifaceted problem. A lack of adequate construction waste management infrastructure, regarding both physical facilities and regulations, was highlighted as the key challenge. Social implications The accumulation of waste that results from construction and demolition activity, and activities characterized by unsustainable utilization of raw materials and inefficiency are a global issue. The challenge of effectively managing construction waste is importantly tied to factors including the availability of the necessary infrastructure; economic conditions; and the scarcity of skilled laborers, among others. Originality/value This study focuses on the Jordan construction industry, which is so far not very well researched. By building upon previous studies, this study supports further research to illuminate the causes of waste and the barriers to better management, an issue that is not only a pillar of progress at the country level but also key for a sustainable development in general.

Indoor air quality is a significant factor influencing occupant comfort, health and productivity. Indoor air comfort and its relationship to occupant comfort and productivity are widely documented. Statistical correlation between the two has been highlighted in scientific literature. This paper investigates any unique correlations between non-air quality parameters (such as lux level, temperature, and noise level) and indoor air comfort and presents a study investigating the effect of indoor environmental quality on occupant air comfort and productivity. This study was conducted by collecting data on indoor environmental parameters using remote sensors and an online survey for occupant responses for twelve months. Data analysis was performed using Response Surface Analysis to present mathematical relationships between indoor environmental quality parameters and occupant air comfort. Results show that carbon dioxide up to 600 ppm, VOC up to 25% (by volume) and humidity up to 60% have a positive impact on occupant air comfort and productivity. Our research highlighted that some non-air quality parameters, such as outdoor temperature and lux levels, affect occupant air comfort. These results would enable built environment professionals to design and operate offices (subtropical desert climate) conducive to occupant comfort and productivity.

The applicability of building rating systems has gained attention for achieving indoor environmental quality. Considering the wider internationalized recognition of LEED (Leadership in Energy and Environmental Design) and other rating systems, the case of Jordan provides a sense of particularity in consideration to its rather recent history in acknowledging these progressive standards. Utilizing a mixed approach based on paired comparisons between local LEED and non-LEED certified buildings, this research paper explores the level of satisfaction pertaining to Indoor Environmental Quality of building occupants. While it touches on the generality of such satisfaction, it proceeds to unpack and investigate how it resonates with the sustainability of the building measured through various means. The research outcomes reflected an overall appeal of LEED certified buildings and a decent level of comfort of their dwellers. Yet, it conveyed a vague, rather sporadic relation when comparing the subjective perception to the objective measures due to multiple potential reasons. The paper concludes by stressing the need for further appropriation of international environmental codes to better suit the local context. It lays a reliable foundation for further research, utilizing more case studies and exploring the applicability of rating systems in Jordan.

PurposeThis study aims at unpacking the multiplicity of the sitting activity in public spaces through the lens of actor-network theory. In line with previous urban research focussing on outdoor activities, such empirical investigation aims to show the importance of the physical aspects of spaces, including seating, in supporting sitting activities as a way of encouraging the use of public space.Design/methodology/approachThis study adopts the overlap between actor–network theory and affordances. It utilises ethnographic research involving frequent users in Dahiyat Al Hussein Park in Amman-Jordan. Data were gathered on the different seat–user relations and the translated sitting activity networks.FindingsAnalysis demonstrates different cases of alignment, misalignment and realignment between what is intended and experienced, and where these relations are maintained, disrupted or changed. These findings reveal the multiplicity of sitting activities; this is significant for understanding how they are maintained.Originality/valueThe research suggests a new way of conceptualising the relationship between the physical environment and users and an approach for examining sitting activities. Some studies have applied actor–network theory and/or the concept of “affordance” by highlighting relations between the object and its user and how they create sitting activities. However, only few studies have problematised the multiplicity of sitting when considering seating uses.

Purpose The purpose of this paper is to detail an actor-network theory inspired ethnography of recording heritage buildings. The case study focusses on Irbid School in Al Tal area, which is one of the oldest schools in Jordan and an important heritage building. Design/methodology/approach The recording process was undertaken by third-year architectural design studio students from Philadelphia University. The paper documents the interaction between the heritage building and the students in a two-phased ethnography, including fieldwork conducted between September and December 2017. Findings The paper proposes the concept of “transfer ethnography”, which considers the continuous changes in design across different locations. This extends beyond traditional ethnography, which focusses on a single location. Here, in contrast to the classical viewpoint, following the recording process shows that building design is ongoing and extends beyond implementation through the years as the building ages. Research limitations/implications Due to the chosen research approach, the research investigated the most relevant events from the author’s perspective, which might extend in various ways. Future research is encouraged to investigate more events that support the empirical findings. Practical implications The paper provides a new angle from which building design networks can be followed through the transfer ethnography, which has implications for the recording and similar processes that necessitate the continuous following of actors. Originality/value The research suggests the transfer ethnography, which entails close and in-depth engagement with actors but changes with the transformation of a design while following the actors and networks’ shifts between the different locations. It is more delicate, attentive and indispensable considering the dynamics of design.

Jordan's built environment is considered a major contributor to local environmental concerns. The construction industry faces pressures to increase the sustainability of its practices thro...

Built environment research has long been interested in understanding the complexities of transitional spaces by investigating their hosted interactions. One approach used in efforts of this kind is actor-network theory (ANT), which conceptualizes built spaces as networks of relations that allow for certain interactions but not others. Previous studies have not considered the full variety of such interactions, having either addressed such multiplicity generically or focused on particular interactions related to a specific activity. Filling this gap, this article utilizes an ANT-inspired ethnographic approach to unpack the spatial diversity of a Jordanian university’s corridor space by mapping the various interactions therein. The findings present the relational dynamics within the various networks created and show how they have diversifying effects on the very shaping of the corridor. Ultimately, this article suggests a more nuanced conceptualization of transitional spaces through a better understanding of the multitude of interactions, offering designers a tool to create distinctive spaces that serve different user needs.

The paper aims at providing an understanding of sustainable architectural design through an ethnographic study of Masdar City. Following how design travels from the practice of an architect in London (Foster and Partners (F+P)) and is translated, implemented and used by embracing the inherent dynamism and unpredictability embedded in the process. Focus is on the designs and technologies of Masdar City as the main case study; a project that is designed by F+P and developed in the United Arab Emirates. This has been followed through a two-part ethnographic study that was conducted through fieldwork taking place from January to September 2014. The first part was carried out in F+P office in London, UK, where the designs and technologies were initiated. The second part was completed in F+P office in Abu Dhabi, UAE, where the designs and technologies were implemented and put to use.