Prognosis of HIV-1-infected patients up to 5 years after initiation of HAART: collaborative analysis of prospective studies

OBJECTIVE: To estimate the prognosis over 5 years of HIV-1-infected, treatment-naive patients starting HAART, taking into account the immunological and virological response to therapy. DESIGN: A collaborative analysis of data from 12 cohorts in Europe and North America on 20,379 adults who started HAART between 1995 and 2003. METHODS: Parametric survival models were used to predict the cumulative incidence at 5 years of a new AIDS-defining event or death, and death alone, first from the start of HAART and second from 6 months after the start of HAART. Data were analysed by intention-to-continue-treatment, ignoring treatment changes and interruptions. RESULTS: During 61 798 person-years of follow-up, 1005 patients died and an additional 1303 developed AIDS. A total of 10 046 (49%) patients started HAART either with a CD4 cell count of less than 200 cells/microl or with a diagnosis of AIDS. The 5-year risk of AIDS or death (death alone) from the start of HAART ranged from 5.6 to 77% (1.8-65%), depending on age, CD4 cell count, HIV-1-RNA level, clinical stage, and history of injection drug use. From 6 months the corresponding figures were 4.1-99% for AIDS or death and 1.3-96% for death alone. CONCLUSION: On the basis of data collected routinely in HIV care, prognostic models with high discriminatory power over 5 years were developed for patients starting HAART in industrialized countries. A risk calculator that produces estimates for progression rates at years 1 to 5 after starting HAART is available from www.art-cohort-collaboration.org.

Habitat Associations of the Golden-Winged Warbler in Honduras

The global population of the Neotropical migrant Golden-winged Warbler (Vermivora chrysoptera) has declined steadily over the past fifty years. While factors influencing this decline have been well researched on the breeding grounds, little is known about the distribution and habitat requirements of this warbler on its stationary non-breeding range. Recent efforts to quantify the non-breeding habitat requirements of this warbler have focused on Colombia and Costa Rica, though the species ranges as far north as the Yucatan Peninsula, Mexico. To address the gap in knowledge from the northern portion of the non-breeding range, I conducted 80 serial point-count surveys targeting Goldenwinged Warblers at eight field sites in Honduras, Central America. I found that Goldenwinged Warblers occupy a greater variety of habitats than previously recognized, including pine-oak forest and semi-deciduous broadleaf forest. I also documented habitat associations that have not been observed in other parts of the non-breeding range with respect to elevation, rainfall, and spatial segregation by sex. These results demonstrate the need to consider the entire non-breeding range in conservation planning, as Goldenwinged Warbler habitat associations appear to vary regionally.

Effects of forest management and time on herbaceous species dynamics in the western Upper Peninsula of Michigan

The herbaceous layer is a dynamic layer in a forest ecosystem which often contains the highest species richness in northern temperate forests. Few long-term studies exist in northern hardwood forests with consistent management practices to observe herbaceous species dynamics. The Ford Forest (Michigan Technological University) reached its 50th year of management during the winter of 2008-2009. Herbaceous species were sampled during the summers pre- and post-harvest. Distinct herbaceous communities developed in the 13-cm diameter-limit treatment and the uncut control. After the harvest, the diameter-limit treatments had herbaceous communities more similar to the 13-cm diameter-limit treatment than the uncut control; the herbaceous layer contained more exotic and early successional species. Fifty years of continuous management changed the herbaceous community especially in the diameter-limit treatments. Sites used in the development of habitat classification systems based on the presence and absence of certain herbaceous species can also be used to monitor vegetation change over time. The Guide to Forest Communities and Habitat Types of Michigan was developed to aid forest managers in understanding the potential productivity of a stand, and often aid in the development of ecologically-based forest management practices. Subsets of plots used to create the Western Upper Peninsula Guide were resampled after 10 years. During the resampling, both spring and summer vegetation were sampled and earthworm populations were estimated through liquid extraction. Spring sampling observed important spring ephemerals missed during summer sampling. More exotic species were present during the summer 2010 sampling than the summer 2000 sampling. Invasive European earthworms were also observed at all sample locations in all habitat types; earthworm densities increased with increasing habitat richness. To ensure the accuracy of the guide book, plots should be monitored to see how herbaceous communities are changing. These plots also offer unique opportunities to monitor for invasive species and the effects of a changing climate.

Periodontal disease progression in subjects with orofacial clefts over a 25-year follow-up period

AIMS: To assess rates of periodontal disease progression in subjects with cleft lip, alveolus and palate (CLAP) over a 25-year period without regular maintenance care in a specialist setting and to compare those with those of subjects without alveolar clefts, i.e. cleft lip (CL) or cleft palate (CP). MATERIAL AND METHODS: Ten subjects with CLAP and 10 subjects with CL/CP were examined in 1979, 1987, 1993 and 2004. Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BoP) and plaque control record (PCR) scores were recorded in all 20 subjects. RESULTS: High plaque and BoP scores were recorded at all examinations in both groups. Over 25 years, a statistically significant loss of mean full-mouth CAL of 1.52 +/- 0.12 mm (SD) and 1.66 +/- 0.15 mm occurred in the CLAP and CL/CP group respectively (p<0.05). A statistically significant increase (p<0.05) in mean full-mouth PPD of 0.35 +/- 0.12 mm was observed in the CL/CP group, whereas only a trend for a mean full-mouth increase in PPD of 0.09 +/- 0.11 mm was observed in the CLAP group. In subjects with CLAP, a statistically significant increase (p<0.05) in PPD of 0.92 +/- 1.13 mm at cleft sites was observed compared with that of 0.17 +/- 0.76 mm at control sites. With respect to CAL, the loss at the corresponding sites amounted to 2.71 +/- 1.46 and to 2.27 +/- 1.62 mm, respectively (p=0.36). CONCLUSIONS: When stringent and well-defined supportive periodontal therapy was not provided, subjects with orofacial clefts were at high risk for periodontal disease progression. Over 25 years, alveolar cleft sites tended to have more periodontal tissue destruction compared with control sites.

Alternative Rotational Grazing Systems at the Beef Teaching Farm

Fifty-six acres of central Iowa corn land were seeded to bromegrass and divided with high-tensile wire into eight seven-acre plots. This bromegrass was fertilized with 70 pounds of nitrogen each spring and fall, 1987-1990. In 1991 – 1995, the nitrogen was increased to 80 pounds both spring and fall. The plots were stocked with 1.3 cow/calf pairs per acre in 1987-1991 and 1993–1995, but in 1992 the plots were stocked with 1.55 cow/calf pairs per acre. The pairs were rotated using two distinct schemes among four cells for about 150 days. The plots averaged 607 pounds of net calf weight per acre per year over nine years. Rainfall was quite variable during the grazing seasons and was reflected in calf performance as well as summer feed costs. This intensive rotational grazing system has greatly reduced both weed population and the need for mechanical clipping.

Clinical and radiographic outcomes at 2 years and the effect of tocilizumab discontinuation following sustained remission in the second and third year of the ACT-RAY study

OBJECTIVE To assess the efficacy and safety of tocilizumab (TCZ) plus methotrexate/placebo (MTX/PBO) over 2 years and the course of disease activity in patients who discontinued TCZ due to sustained remission. METHODS ACT-RAY was a double-blind 3-year trial. Patients with active rheumatoid arthritis despite MTX were randomised to add TCZ to ongoing MTX (add-on strategy) or switch to TCZ plus PBO (switch strategy). Using a treat-to-target approach, open-label conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), other than MTX, were added from week 24 if Disease Activity Score in 28 joints based on erythrocyte sedimentation rate (DAS28-ESR) >3.2. Between weeks 52 and 104, patients in sustained clinical remission (DAS28-ESR <2.6 at two consecutive visits 12 weeks apart) discontinued TCZ and were assessed every 4 weeks for 1 year. If sustained remission was maintained, added csDMARDs, then MTX/PBO, were discontinued. RESULTS Of the 556 randomised patients, 76% completed year 2. Of patients entering year 2, 50.4% discontinued TCZ after achieving sustained remission and 5.9% achieved drug-free remission. Most patients who discontinued TCZ (84.0%) had a subsequent flare, but responded well to TCZ reintroduction. Despite many patients temporarily stopping TCZ, radiographic progression was minimal, with differences favouring add-on treatment. Rates of serious adverse events and serious infections per 100 patient-years were 12.2 and 4.4 in add-on and 15.0 and 3.7 in switch patients. In patients with normal baseline values, alanine aminotransferase elevations >3×upper limit of normal were more frequent in add-on (14.3%) versus switch patients (5.4%). CONCLUSIONS Treat-to-target strategies could be successfully implemented with TCZ to achieve sustained remission, after which TCZ was stopped. Biologic-free remission was maintained for about 3 months, but most patients eventually flared. TCZ restart led to rapid improvement. TRIAL REGISTRATION NUMBER NCT00810199.

Glass ionomer cement in otological microsurgery: experience over 16 years

A retrospective evaluation of glass ionomer cement (GIC) in middle ear surgery with emphasis on short- and long-term safety was conducted at the tertiary referral center. GIC was applied between 1995 and 2006 in 444 patients in otologic surgery. Technical aspects, safety, benefits and complications due to GIC were analysed until 2011 (follow-up 5-16 years; mean 10 years). GIC was applied in stapes surgery (228 primary, 92 revisions), cochlear implants (108) and implantable hearing aids (7), ossiculoplasty (7), for coverage of opened mastoid air cells towards the external ear canal (1) and inner ear fistula closure (1). GIC turned out to be very handy in stapes surgery for optimal prosthesis fixation at the incus (260) and on the malleus handle (60) without complications. Results suggest that GIC may diminish the danger of incus necrosis in primary stapedotomy. In cochlear implants and implantable hearing aids, GIC was used for casing alone (74), casing and electrode fixation (27) and electrode alone fixation (14). Inflammatory reactions were observed in five cases (4.3 %), mostly after trauma. Broken cement fragments appeared to promote foreign body rejection. In seven cases an incudo-stapedial gap was repaired with GIC with excellent hearing gain; in three cases (43 %) revision surgery was needed due to cement breakage. In one case, GIC was applied for a watertight coverage of opened mastoid cells, and in the other for fistula closure of the lateral semi-circular canal over cartilage, covered with bone pathé; follow-up was uneventful. Targeted use of GIC in middle ear surgery rarely poses problems. GIC cannot be used in neuro-otosurgery in contact with cerebrospinal fluid because of possible aluminium encephalopathy.

Pastoral-Farmer conflicts over natural resources in the Lake Rukwa basin : Challenges facing policy makers in Tanzania

Despite the important role that pastoralism plays in supporting rural livelihoods, national economy and diverse ecological services, its capacity to adapt to change is facing many challenges including adverse policy, pastoral-farmer conflicts and recently, adverse climate change. The recurring conflicts between the two groupings are rather a result of a reaction by a community which has been marginalized over the years. A survey to analyze conflicts, institutional frameworks, policies, laws and regulations governing NRs utilization by pastoral and farmers was conducted in the Lake Rukwa Basin in 2008. The study noted violent conflicts and their causes, including the scarcity of NRs, poor local institutional frameworks and deeper socio-cultural aspects among pastoralists and farmers. The conflicts have become major impediments to the developmental activities in the study areas, to a degree that requires intervention. This, therefore, calls for reorganization of local institutional framework, policies, laws and regulations and participatory planning and co-management of NRs as part of conflicts management and sustainable utilization of them. Key words: Policies, Natural Resources, Conflicts, Pastoralism, Institutional frameworks

Fertility-preservation counselling and treatment for medical reasons: data from a multinational network of over 5000 women.

Fertility-preservation techniques for medical reasons are increasingly offered in national networks. Knowledge of the characteristics of counselled patients and techniques used are essential. The FertiPROTEKT network registry was analysed between 2007 and 2013, and included up to 85 university and non-university centres in Germany, Austria and Switzerland; 5159 women were counselled and 4060 women underwent fertility preservation. In 2013, fertility-preservation counselling for medical reasons increased significantly among nullipara and women aged between 21 and 35 years (n = 1043; P < 0.001). Frequency of GnRH applications slowly decreased, whereas tissue, oocytes and zygote cryopreservation increased. In 2013, women with breast cancer mainly opted for tissue freezing, whereas women with lymphoma opted for GnRH agonist. Women younger than 20 years predominantly opted for GnRH agonists and ovarian tissue cryopreservation; women aged between 20 and 40 years underwent a variety of techniques; and women over 40 years opted for GnRH agonists. The average number of aspirated oocytes per stimulation cycle decreased as age increased (< 30 years: 12.9; 31-35 years: 12.3; 36-46: 9.0; > 41 years: 5.7). For ovarian tissue cryopreservation, removal and cryopreservation of fewer than one ovary was preferred and carried out in 97% of cases in 2013.

Relationship between dietary patterns and body mass index in Hispanic children ages 4--19 years of age

Background. In over 30 years, the prevalence of overweight for children and adolescents has increased across the United States (Barlow et al., 2007; Ogden, Flegal, Carroll, & Johnson, 2002). Childhood obesity is linked with adverse physiological and psychological issues in youth and affects ethnic/minority populations in disproportionate rates (Barlow et al., 2007; Butte et al., 2006; Butte, Cai, Cole, Wilson, Fisher, Zakeri, Ellis, & Comuzzie, 2007). More importantly, overweight in children and youth tends to track into adulthood (McNaughton, Ball, Mishra, & Crawford, 2008; Ogden et al., 2002). Childhood obesity affects body functions such as the cardiovascular, respiratory, gastrointestinal, and endocrine systems, including emotional health (Barlow et al., 2007, Ogden et al., 2002). Several dietary factors have been associated with the development of obesity in children; however, these factors have not been fully elucidated, especially in ethnic/minority children. In particular, few studies have been done to determine the effects of different meal patterns on the development of obesity in children. Purpose. The purpose of the study is to examine the relationships between daily proportions of energy consumed and energy derived from fat across breakfast, lunch, dinner, and snack, and obesity among Hispanic children and adolescents. Methods. A cross-sectional design was used to evaluate the relationship between dietary patterns and overweight status in Hispanic children and adolescents 4-19 years of age who participated in the Viva La Familia Study. The goal of the Viva La Familia Study was to evaluate genetic and environmental factors affecting childhood obesity and its co-morbidities in the Hispanic population (Butte et al., 2006, 2007). The study enrolled 1030 Hispanic children and adolescents from 319 families and examined factors related to increased body weight by focusing on a multilevel analysis of extensive sociodemographic, genetic, metabolic, and behavioral data. Baseline dietary intakes of the children were collected using 24-hour recalls, and body mass index was calculated from measured height and weight, and classified using the CDC standards. Dietary data were analyzed using a GEE population-averaged panel-data model with a cluster variable family identifier to include possible correlations within related data sets. A linear regression model was used to analyze associations of dietary patterns using possible covariates, and to examine the percentage of daily energy coming from breakfast, lunch, dinner, and snack while adjusting for age, sex, and BMI z-score. Random-effects logistic regression models were used to determine the relationship of the dietary variables with obesity status and to understand if the percent energy intake (%EI) derived from fat from all meals (breakfast, lunch, dinner, and snacks) affected obesity. Results. Older children (age 4-19 years) consumed a higher percent of energy at lunch and dinner and less percent energy from snacks compared to younger children. Age was significantly associated with percentage of total energy intake (%TEI) for lunch, as well as dinner, while no association was found by gender. Percent of energy consumed from dinner significantly differed by obesity status, with obese children consuming more energy at dinner (p = 0.03), but no associations were found between percent energy from fat and obesity across all meals. Conclusions. Information from this study can be used to develop interventions that target dietary intake patterns in obesity prevention programs for Hispanic children and adolescents. In particular, intervention programs for children should target dietary patterns with energy intake that is spread throughout the day and earlier in the day. These results indicate that a longitudinal study should be used to further explore the relationship of dietary patterns and BMI in this and other populations (Dubois et al., 2008; Rodriquez & Moreno, 2006; Thompson et al., 2005; Wilson et al., in review, 2008). ^

Antibiotic susceptibility and resistance among bacterial enteropathogens isolated from international travelers to Mexico, Guatemala, and India, 2006--2008

The incidence rates of travelers' diarrhea (TD) have remained unchanged for the last fifty years. More recently, there have been increasing recommendations for self-initiated therapy and even prophylactic therapy for TD. There is no recent data on the in vitro activities of commonly used antibiotics for TD therapy and whether there have been any changes in susceptibilities over the last ten years. 456 enteropathogens were isolated from adult travelers to Mexico, India, and Guatemala between the years 2006 to 2008. MICs were determined for 10 different antimicrobials by the agar dilution method. Traditional antibiotics such as ampicillin, trimethoprim/sulfamethoxazole, and doxycycline continue to show high levels of resistance. Current first line antibiotic agents including fluoroquinolones and azithromycin had significantly higher MICs when compared to 10 years ago and MIC90 levels were beyond the CSLI cutoffs for resistance. There were significant geographical differences in resistance patterns when comparing Central America with India. Entertoxigenic Escherichia coli (ETEC) isolates were more resistant to ciprofloxacin (p=0.023), and levofloxacin (p=0.0078) in India; whereas, enteroaggregative Escherichia coli (EAEC) isolates from Central America showed more resistance. When compared to MICs of isolates 10 years prior, there was a four to ten-fold increase in MIC90s for ceftriaxone, ciprofloxacin, levofloxacin and azithromycin for both ETEC and EAEC. There were no significant changes in rifaximin MICs over the last ten years, which makes it a promising agent for TD. Rising MICs over time implicate the need for continuous surveillance of susceptibility patterns worldwide and for geography specific recommendations in TD therapy.^

Revisiting labour and gender issues in Export Processing Zones : the cases of South Korea, Bangladesh and India

The establishment of Export Processing Zones (EPZs) is a strategy for economic development that was introduced almost fifty years ago and is nowadays employed in a large number of countries. While the number of EPZs including several variants such as Special Economic Zone (SEZs) has increased continuously, general interest in EPZs has declined over the years in contrast to earlier heated debates regarding the efficacy of the strategy and its welfare effects especially on women workers. This article re-evaluates the historical trajectories and outstanding labour and gender issues of EPZs on the basis of the experiences of South Korea, Bangladesh and India. The findings suggest the necessity of enlarging our analytical scope with regard to EPZs, which are inextricably connected with external employment structures, whether outside the EPZ but within the same country, or outside the EPZ and its host country altogether.

Simulation techniques for design of overhead conductor rail lines for speeds over 140 km/h

In overhead conductor rail lines, aluminium beams are usually mounted with support spacing between 8 and 12 meters, to limit the maximum vertical deflection in the center of the span. This small support spacing limits the use of overhead conductor rail to tunnels, therefore it has been used almost exclusively in metropolitan networks, with operation speeds below 110 km/h. Nevertheless, due to the lower cost of maintenance required for this electrification system, some railway administrations are beginning to install it in some tunnels on long-distance lines, requesting higher operation speeds [1]. Some examples are the Barcelona and Madrid suburban networks (Spain), and recent lines in Turkey and Malaysia. In order to adapt the design of the overhead conductor for higher speeds (V > 160 km/h), particular attention must be paid to the geometry of the conductor rail in critical zones as overlaps, crossings and, especially, transitions between conductor rail and conventional catenary, since the use of overhead conductor rail is limited to tunnels, as already mentioned. This paper describes simulation techniques developed in order to take into account these critical zones. Furthermore, some specific simulations results are presented that have been used to analyze and optimizes the geometry of this special zones to get a better current collection quality, in a real suburban network. This paper presents the work undertaken by the Railways Technology Research Centre (CITEF), having over 10 years of experience in railways research [1-4].

Modelling ozone stomatal flux over wheat under Mediterranean conditions

Correct estimation of leaf-level stomatal conductance (gsto) is central for current ozone (O3) risk assessment of wheat yield loss based on the absorbed O3 phytotoxic dose (POD). The gsto model parameterizations developed in Europe must be checked in the different climatic regions where they are going to be applied in order to reduce the uncertainties associated with the POD approach. This work proposes a new gsto model parameterization for estimating POD of Triticum aestivum and Triticum durum under Mediterranean conditions, based on phenological observations over 25 years and gsto field measurements during 5 growing seasons. Results show that POD in the Mediterranean area might be higher than previously estimated. However, caution must be paid when assessing the risk of yield loss for wheat in this area since field validation of O3 impacts is still limited.

Andrea Branzi y la “Città senza architettura”: De la No-Stop City a los modelos de urbanización débil

El tema de estudio de esta tesis son las propuestas urbanas que Andrea Branzi ha desarrollado durante los últimos cincuenta años, centrándose especialmente en aquellas más elaboradas y completas: la No-Stop City (1970-71), que elabora como miembro del grupo radical Archizoom, y dos de sus modelos de urbanización débil, Agronica (1995) y el Master Plan para el Strijp Philips de Eindhoven (2000). Se trata de una parte de su obra que ha mantenido constante, a lo largo del tiempo, una propuesta de disolución de la arquitectura de notable consistencia que puede describirse con la fórmula “città senza architettura”, acuñada por él mismo. Una voluntad que ya se apunta en la muy variada producción de Archizoom previa a la No-Stop City, y que cristaliza y se hace explícita en este proyecto que aspiraba a: “liberar al hombre de la arquitectura”. A pesar de la continuidad de esta idea en el tiempo, la ciudad sin arquitectura de Branzi ha evolucionado claramente dando lugar a distintos tipos de disolución. Una disolución que, obviamente, no supone la efectiva desaparición de la disciplina, sino la formulación de una arquitectura “otra” basada en un replanteamiento radical de la naturaleza y el papel de la misma. Esta agenda contra la disciplina se ha desplegado a través de una serie de temas que socavan el objeto arquitectónico canónico (su vaciamiento expresivo, la pérdida de importancia de la envolvente y la forma acabada, el carácter anticompositivo, la independencia entre forma y función, la mutabilidad en el tiempo…), pero va más allá al poner en crisis el rol que la propia arquitectura ha tenido en la configuración material, política y simbólica del hábitat humano. Una pérdida de protagonismo y centralidad en la sociedad contemporánea que, en el discurso del arquitecto, implica necesariamente un papel subordinado. De este proceso de disolución surge un nuevo tipo de ciudad en la que la forma urbana o se ha perdido o se ha convertido en superflua, en la que se ha disuelto la zonificación funcional, cuyos espacios interiores se hallan en un proceso de permanente reprogramación que ignora las tipologías, que trasciende la división entre lo urbano y lo agrícola y que es, ante todo, un espacio de flujos y servicios. La crisis de la ciudad tradicional implica, en definitiva, un cambio en la naturaleza misma de lo urbano que pasa de considerarse un lugar físico y construido, a convertirse en una condición inmaterial y virtualmente omnipresente que se despliega independientemente de su soporte físico. En las investigaciones urbanas de Branzi convergen, además, muchas de las reflexiones que el arquitecto ha desarrollado sobre, y desde, las distintas “escalas” de la actividad profesional: diseño, arquitectura y urbanismo. Estas propuestas no sólo cuestionan las relaciones establecidas entre objetos, edificios, ciudades y territorios sino que ponen en cuestión estas mismas categorías. Unas ciudades sin arquitectura que se basan, en última instancia, en plantear preguntas que son muy sencillas y, por otra parte, eternas: ¿Qué es un edificio? ¿Qué es una ciudad? ABSTRACT The subject of study of this thesis are the urban proposals developed by Andrea Branzi over the last fifty years, with a special focus on the more developed and comprehensive ones: the No- Stop City (1970-1971), produced as a member of the architettura radicale group Archizoom, and two of his “weak urbanization models”: Agronica (1995) and the Master Plan for Philips Strijp in Eindhoven (2000). This area of his work has kept, over time, a remarkably consistent proposal for the dissolution of architecture that can be described with the motto città senza architettura (city without architecture), coined by himself. A determination, already latent in the very diverse production of Archizoom prior to No-Stop City, that crystallizes and becomes explicit in this project which was aimed to "liberate man from the architecture." Despite the continuity of this idea over time, Branzi’s city without architecture has clearly evolved leading to different types of dissolution. A dissolution that, obviously, does not mean the effective demise of the discipline, but rather, the formulation of an architecture autre based on a radical rethinking of its nature and role. This agenda against the discipline has been developed through a number of issues that undermine the canonical architectural object (its expressive emptying, the loss of importance of the envelope and the finished shape, the anticompositional character, the independence between form and function, the mutability over time...), but goes beyond it by putting into crisis the role that architecture itself has had in the material, political and symbolic configuration of the human habitat. A loss of prominence and centrality in contemporary society that, in the architect’s discourse, implies a subordinate role. From this dissolution process, a new type of city arises: a city where urban form has been lost or has become superfluous, in which functional zoning has dissolved, whose interiors are in a permanent process of reprogramming that ignores typologies, that transcends the division between urban and agricultural and becomes, above all, a space of flows and services. Ultimately, the crisis of the traditional city implies a change in the very nature of the urban that moves from being regarded as a physical and built place, to become an immaterial and virtually omnipresent condition that unfolds regardless of its physical medium. Many of the ideas Branzi has developed on, and from, the different "scales" of professional activity (design, architecture and urbanism) converge in his urban research. These proposals not only question the relations between objects, buildings, cities and territories but also these very categories. Cities without architecture that are based, ultimately, on raising simple questions that are, on the other hand, eternal: What is a building? What is a city?