Graduation Design Studio 2016/17 Medical Architecture Design Studio
BIO-NEERING MEDICAL CITY at Borg Al Arab city Group M4 Presented By: Marina Emil Youhana Monica William Makram Nardeen Albear Milad Sara Fayez Keriakous Sarah Gamal El-Din Undergraduate Students, ASU, FEDA Fourt Year of Architecture 2016-2017 A report submitted as a partial requirement of graduation project fulfilment Supervised By: Professor Dr. Yasser Mansour, Head of Arcitecture department
Introduction
I
I-A What is the problem? Heart diseases is one of the top causes of death in Egypt. (1)
According to the latest WHO data published in may 2014 Coronary Heart Disease Deaths in Egypt reached 107,232 or 23.14% of total deaths. The age adjusted Death Rate is 186.36 per 100,000 of population ranks Egypt #23 in the world. The number of transplant surgeries from donor organs hasn't grown during the last 10 years, and transplants from living donors have declined nearly 16 percent, because there's a critical shortage of organs. Increase of the patients waiting list. “A crisis in organ donation is threatening the lives of hundreds of people who desperately
need transplants,” The NHS has warned. The organ shortage crisis led to increase the number of patients on the waiting list for organ transplantation. The need of skin transplantation. Burn Accidents and Skin diseases are neglected in Egypt despite their danger and the physical and psychological damage that affects the patient. According to WHO the percentage of Burn accidents in Egypt varies from 80,000 to 100,000 case a year. Which leads to the need to Skin transplantation to Burn and skin patients. The increase of orthopaedic diseases in
(2)
Fig. (1-2) Egypt’s Health Rating
Fig. (1-1) WHO annual report for Egypt
(3)
Fig.(1-3) Al-Ahram Journal article 29 May 2016
(1) http://www.worldlifeexwpectancy.com/egypt-coronary-heart-disease (2) WHO Statistical profile for Egypt. (3) Al-Ahram Journal article 29 May 2016
II
Egypt. In the recent years It is noticed the increase for orthopaedic disease and the need for transplantation surgeries for either muscles or bones or even spinal cords.
assumed that poorer Egyptians are sicker than richer Egyptians, and are thus in greater need of health care, then this distribution does not indicate that access to health care is equal for those of equal need.
Late arrival of modern science and medicine in Egypt and the low level of health in Egypt. Late arrival of modern medicine due to the absence of the facilities the would help in holding international medical conferences in Egypt . However the level of health in Egypt has increased in the past years but it can still be considered so low in relative to the latest science, technological and medical achievements across the globe. Distribution utilization
of by
health income
Fig.(1-3) Outpatient visits
care level
Figures 1 to 2 give the distribution of utilization of health care services by income level, separately for outpatient and inpatient services (further details given in tables in Statistical Annex). As can be observed, utilization of both public and private health care services show a significant income gradient, with richer Egyptians using higher volumes of both inpatient and outpatient services, with the exception of MOH outpatient services which are used more by poorer Egyptians. If it can be
Fig.(1-3) Inpatient beds
III
I-B What is Tissue Engineering ? Tissue engineering evolved from the field of biomaterials development and refers to the practice of combining scaffolds, cells, and biologically active molecules into functional tissues. The goal of tissue engineering is to assemble functional constructs that restore, maintain, or improve damaged tissues or whole organs. Artificial skin and cartilage are examples of engineered tissues that have been approved by the FDA. This field is concerned with the transplantation of cells that perform a specific biochemical function, these could be artificial skin that includes living fibroblasts, cartilage repaired with living chondrocytes, or other types of cells used in other ways.
environment is right, a tissue develops. In some cases, the cells, scaffolds, and growth factors are all mixed together at once, allowing the tissue to “self-assemble.�
How ??? The process often begins with building a scaffold from a wide set of possible sources, from proteins to plastics. Once scaffolds are created, cells can be introduced. If the
Bioprinting process centers around the identification of key architectural and compositional elements of a target tissue, and the creation of a design that can be utilized by a bioprinter to generate that tissue in the laboratory environment.
Fig. (1-4) Tissue Engineering Process
Fig. (1-5) 3D BioPrinting Process
Another method to create new tissue uses an existing scaffold. The cells of a donor organ are stripped and the remaining collagen scaffold is used to grow new tissue. This process has been used to bioengineer heart, liver, lung, and kidney tissue. This approach holds great promise for using scaffolding from human tissue discarded during surgery and combining it with a patient’s own cells to make customized organs that would not be rejected by the immune system.
https://www.nibib.nih.gov/science-education/science-topics/tissue-engineering-and-regenerative-medicine
IV
Ain Shams Univeristy Bio-neering Medical City Introduction
Once a tissue design is established, the first step is to develop the bioprocess protocols required to generate the multi-cellular building blocks—also called bio-ink—from the cells that will be used to build the target tissue. The bio-ink building blocks are then dispensed from a bioprinter, using a layerby-layer approach that is scaled for the target output. Bio-inert hydrogel components may be utilized as supports, as tissues are built up vertically to achieve three-dimensionality, or as fillers to create channels or void spaces within tissues to mimic features of native tissue.
Fig. (1-5) 3D BioPrinting Process
Fig. (1-6) Bio-Printed Ear
Bio Ink from seaweeds ?!! Seaweed polysaccharide-based hydrogels used for the regeneration of articular cartilage. Polymer scaffolds have many different functions in the field of tissue engineering. They are applied as space filling agents, as delivery vehicles for bioactive molecules, and as three-dimensional structures that organize cells and present stimuli to direct the formation of a desired tissue. Much of the success of scaffolds in these roles hinges on finding an appropriate material to address the critical physical, mass transport, and biological design variables inherent to
each application. Hydrogels are an appealing scaffold material because they are structurally similar to the extracellular matrix of many tissues, can often be processed under relatively mild conditions, and may be delivered in a minimally invasive manner. Consequently, hydrogels have been utilized as scaffold materials for drug and growth factor delivery, engineering tissue replacements, and a variety of other applications.
V
Industry challenges Quality control of the materials used in various surgical applications is a key challenge for the tissue engineering industry. For example, living human cells are being used in scaffolds to repair structural tissue damage. These materials need to be produced and cultured under good manufacturing practice (GMP) conditions to meet FDA standards—especially the cells that are grown ex vivo. As a result, the tissue engineering industry is striving to create appropriate quality control standards and evaluate them. A good example is that of autologous cultured chondrocytes used to repair knee damage. Recently, Genzyme Tissue Repair reported on a quality control program for this material that was based on evaluating 303 patients who had received the material. Another challenge concerns acquiring a fundamental understanding of tissue differentiation mechanisms that might be harnessed for the development of tissueengineered products. One product that the tissue engineering industry is pursuing is bone-on-demand, to be used in cases where new bone formation is needed. An important component here is the bone morphogenetic protein (BMP) complex, which is capable of inducing extra skeletal bone formation. Researchers are trying to concentrate BMP complex locally, using appropriate implants rather than the individual constituents, which could potentially lead to bone formation.
develop tissue-engineered products for a number of surgery-related applications, such as vasculature. For example, a recent report describes the generation of a tissueengineered blood vessel without any synthetic or exogenous materials. The vessels were produced by wrapping a sheet of human vascular smooth muscle cells around a tubular support, followed by wrapping a sheet of human fibroblasts around the first sheet. After cell maturation, the tubular support was removed and endothelial cells were seeded in the lumen of the putative blood vessel. The vessel showed all the necessary key markers of activity, and also had a burst strength comparable to human vessels. In short-term grafts in a dog model, (1)
Fig. (1-7) Selected companies with tissue engineering programs.
Finally, the industry is challenged to (1)http://www.nature.com/nbt/journal/v18/n10s/fig_tab/nbt1000_IT56_T1.html
VI
this engineered vessel demonstrated good handling and saturability characteristics. The future Tissue engineering has significant market potential and financial investment continues apace. A 1997 survey of the field reported that in that year alone, R&D expenditure directly linked to corporate tissue engineering projects was about $0.5 billion, with a growth rate of about 22% per year. This demonstrates the sustained interest in this area, driven in part by positive results regarding specific products and processes in clinical settings. Technical advances in the various components of the industry will contribute to market growth. One component is the availability of biomaterials that act as scaffolds for tissue repair and reconstruction, or for the deposition of engineered tissues and cells preceding implantation. An increasing amount of R&D is directed toward addressing the properties of these scaffolds with the goal of creating materials that have the desired functional profiles for various applications. For example, so-called blended-polymer scaffolds have an extended lifetime in the body that is more suitable for orthopaedic applications than non blended scaffolds. Another study has shown how collagenbased scaffolds, used to grow keratinocytes in artificial skin preparations, can be manipulated by cross-linking collagen with glycosaminoglycan17. The result was increased biological stability,
which augmented the likelihood that the keratinocytes would ÂŤtakeÂť and grow out of the scaffold. In yet another application, a sacchitin glycolipid-type membrane prepared from the residue of a fungal fruiting body has been shown to have significant promise in animal models of skin damage as a skin substitute that facilitated wound healing and fibroblast growth. Development of new materials of this type that enable different applications of tissue engineering is likely to be the focus of considerable future research. For the biological component of tissue engineering, rapid advances are being made in identifying new cell types for use in tissue regeneration. For example, undifferentiated stem cells are attracting intense interest because of their capacity to be transformed into almost any cell type that may be needed, and even fat cells can be directed to produce appropriate tissues. In addition, promising artificial nerve grafts or nerve guidance channels are being developed for nerve regeneration. In the future, efforts will likely increasingly focus on the development of tissueengineered products under consensus safety and efficacy standards, including sourcing of cells and tissues, characterization and testing of the materials, quality assurance and control, and preclinical and clinical evaluation. The FDAhas already provided some regulatory guidance concerning specific materials, such as certain marketed artificial skin products; in the next few years, these guidelines will likely be increasingly formalized
VII
and structured, ensuring that tissue engineering products not only work but are also safe. Significant future developments will include the continued development of artificial organs that use cells embedded into appropriate support structures. A recent report describes the use of polyurethane foam as a good matrix into which liver cells grew as spheroids, the system showing promise as an artificial liver. The future will also see significant efforts to develop engineered vascular grafts. An approach that will see increasing attention is that of taking a scaffold that is a structurally intact xenogeneic vessel, such as a pig aorta, removing all cells, and repopulating this with human autologous cells. A recent report showed how this could be done in 2–3 weeks, opening up the way for a good alternative to vascular engineering. The range of human tissue that can be engineered will also increase dramatically in the future, so in addition to the traditional targets, such as skin and liver, other tissues and organs will see their day. A great deal of excitement in clinical circles is that of developing artificial human thyroid tissues which are capable of producing T cells, and this will be a major area for continued R&D. Finally, stem cells and their manipulation for therapeutic purposes will continue to be a major area of development, because of the pluripotency of these cells. For example, bone marrow stem cells contained in resorbable artificial tubes have been shown to lead to effective healing of non-union defects in rabbit radii, and this opens up significant surgical alternatives to organ and tissue damage. Conclusions Tissue engineering is emerging as a vibrant industry with a huge potential market. The biomaterials, scaffolds, artificial organs, and differentiating cells that are combined to create a tissue engineering product address significant medical needs, such as major tissue and organ damage or failure. The industry faces numerous technical challenges, not the least of which is the establishment of a consensus quality control program to ensure that tissue engineering products work and are safe to use. Efforts to address these issues are underway, and if past success is any indication, this technology is certainly one that will have a major impact in future health care practice.
VIII
I-C What? An iconic medical city in Egypt that seeks to be a role model globally in health care, education and scientific research. Presenting a marginalized medical field in Egypt (Biological and Tissue engineering) that will solve one of the main health problems related to organ transplantation and making Egypt a pioneer of it in the Middle East. Providing scientific facilities for doctors and students instead of travelling abroad to learn more about this field. A medical city that can be a beacon for holding international medical conferences. The city consists of five buildings: Cardiac Hospital For heart diseases and also repair of injured and damaged blood vessels, valves, and cardiac tissue using stem cells and tissue engineering.
Orthopaedic and Dermatology Hospital for skin and bone diseases and using tissue engineering in constructing new skin using stem cells of the patient and induce new functional bones. Research Centre specializing in the biological and tissue engineering and introducing new techniques to be used in future surgeries for the patients who need heart, bone, or skin transplant. Biomedical Institute specialized in the tissue engineering to teach this new medical field to the future students and doctors without the need to travel abroad and also be pioneered in the Middle East in this field to attract all these countries students to learn it in Egypt. Medical Mall (Mixed Use) that have a large Conference hall to facilitate holding international medical conferences from all around the world. Also will have the central administration of the whole city that will organise the medical and research movement
IX
from the research centre to the hospital and from the research centre to the institute and all be connected to and controlled by the medical mall. Why Borg Al-Arab?? The process of the tissue engineering and Bio printing needs a bio-ink that can be extracted from Sea weeds and Brown Alga which can be found along the Mediterranean Coast. And the medical aspect of the project needs clean and calm area away from the pollution and dense zones, applying the patient satisfactions. Different seaweed species of different classes including, red (Jania rubens, Gracilaria compressa, Gracilaria verrucosa, Pterocladia capillacea, and Hypnea musciformis), green (Ulva lactuca, Codium tomentosum, and Enteromorpha intestinalis), and brown ones (Colpomenia sinuosa and Sargassum linifolium) were collected from seven locations (Abu Qir Bay, El Montazah, Sidi Bishir, El Shatby, Eastern Harbor, El Mex Bay, and 21 km) along Egyptian Mediterranean coast (Alexandria). For these previous points Few Alternatives were available some of them were refused leading only to Borg Al Arab as it is discussed in the “site selection� section.
X
Ain Shams Univeristy Bio-neering Medical City Introduction
I-D Why?
XI
I-E How?
XII
Table of contents
XIII
Ain Shams Univeristy Bio-neering Medical City Introduction Table of Content (I) Introduction
I
(I-A) What is the problem?
II
(I-B) What is tissue engineering?
IV
(I-C) What?
IX
(I-D) Why?
XI
(I-E) How?
XII
(1) Executive Report
1
(1-1) Research and Studies
1
(1-2) Research and Studies Conclusions
1
(1-3) Design Approach
1
(1-4) Design Progress
2
(1-5) Key Recommendations
2
(1-6) Conclusion
2
(2) Site Analysis
3
(2-1) Site Selection
4
(2-2) Background on Borg Al Arab
4
(2-3) SWOT Analysis
5
(2-4) Site Location
7
(2-5) Nearby Airports
7
(2-6) Neighbourhood Context
8
(2-7) Man Made Environment
9
(2-8) Accessibility and Circulation
10
(2-9) Topography
11
(2-9-1) Natural Physical Features
11 XIV
(2-9-2) Site Contour
11
(2-10) Sensory
12
(2-11) Points of Interests on Site
13
(2-12) Noise Sources
13
(2-13) Size and Zoning
14
(2-13-1) Dimensions
14
(2-13-2) Areas
14
(2-13-3) Zoning and Setbacks
15
(2-13-4) Building Height Limit
15
(2-14) Legal Covenants
15
(2-15) Ownership and Jurisdiction
15
(2-16) Vehicular Circulation
15
(2-17) Climate
16
(2-17-1) Solar Radiation
16
(2-17-2) Sun-path
17
(2-17-3) Wind Analysis
18
(2-17-4) Precipitation Analysis
19
(2-17-5) Temperature Analysis
20
(2-18) Design Decisions
21
(2-18-1) Main Spaces
21
(2-18-2) Secondary Spaces
22
(2-18-3) Circulation
23
(3) Similar Projects Analysis (3-1) Manazel Medical City, Abou Dhabi
24 25
XV
(3-1-1) Introduction
25
(3-1-2) What is the problem?
25
(3-1-3) What?
25
(3-1-4) Site Location
26
(3-1-5) Climate Analysis
26
(3-1-6) Space Program
27
(3-1-7) Design Concept
29
(3-1-8) Circulation Studies
30
(3-2) Sheikh khalifa Medical city
31
(3-2-1) What
31
(3-2-2) What is the problem
31
(3-2-3) The design Decision
32
(4) Architectural Program
35
(4-1) Orthopaedics and Cardiac Hospitals Space program
36
(4-2) Research centre Space Program
44
(4-3) Medical Mall and Convention Centre Space Program
46
(4-4) Bio-Medical Institute Space Program
48
(5) Programmatic Concept
51
(5-1) Project Site Zoning
52
(5-2) Buildings 3D Zoning
53
(5-1) Priority
57
(5-2) Hierarchy
57
(5-3) Character
57
(5-4) Density
58
(5-5) Service Grouping
58
XVI
(5-6) Activity Grouping
58
(5-7) People Grouping
59
(5-8) Relationships
59
(5-9) Communications
60
(5-10) Neighbours
60
(5-11) Accessibility
60
(5-12) Separated/Mixed Flow
61
(5-13) Circulation Path
61
(5-14) Flexibility
61
(5-15) Environmental Control
62
(5-16) Orientation
62
(5-17) Safety
63
(5-18) Security Control
63
(6) Design Concept
63
(6-1) Concept
64
(6-2) Visual Connection & Layers
65
(6-3) Solid and Void Study
66
(6-4) Vehicular and Pedestrian Paths
66
(7) Design Development
68
(7-1) First Sketch
69
(7-2) Comments on First Sketch
70
(7-3) Second Sketch
71
(7-4) Comments on Second Sketch
72
(7-5) Third Sketch (7-6) Comments on Third Sketch
XVII
(8) Lessons Learnt and Recommendations
concept
73
(8-1) Lessons Learnt Regarding The Project
74
(8-2) Lessons Learnt Regarding The Site Analysis
74
(8-3) Lessons Learnt Regarding the project zoning and programmatic (8-4) Recommendations To other Architects
(8-4) Recommendations To the government (9) References
74 75 75 76
XVIII
Table of Figures
XIX
Table of Figures Code
Title
(1-1)
WHO annual report of Egypt
(1-2)
Egypt’s health rating
(1-3)
An article shows the rating of burn accidents
(1-4)
Tissue Engineering Process
(1-5)
3D Bioprinitng Process
(1-6)
Bio-printed Ear
(2-1)
Locations of Seaweeds
(2-2)
Location Alternatives
Google Earth
4
(2-3)
Nearby Transportation
Google Earth
5
Distance from Mediterranean Sea Google Earth
5
(2-4)
Reference WHO Official Site, http://www.who. int/countries/egy/en/ , Last accessed 3/2017 http://www.who.int/countries/egy/ en/, Last Accessed, June 2017 Al Ahram Journal May 2016
Page II II II IV
h t t p s : / / w w w. s l i d e s h a r e . n e t / lrq3000/3d-printers-bioprinters-and-physibles-15451337 h t t p : / / w w w. 3 d e r s . o r g / a r t i cles/20160221-watch-this-epic-science-video-compilation-of-3d-bioprinting-in-action.html https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC3667364/
IV
V
4
(2-5)
Zoomed in Map
Google Earth
7
(2-6)
Zoomed Out Map
Google Earth
7
(2-7)
Nearby Cities Map
Google Earth
7
(2-8)
Nearby Airports Map
Google Earth
7
(2-9)
Borg Al Arab Planning
http://newcities.gov.eg/know_cities/ Borg_%20Arab/default.aspx , Last accessed 16/3/17
8
(2-10)
Macro Zoning
By the designer
8
(2-11)
Micro Zoning
By the designer
8
(2-12)
Salamlek Palace
http://raseef22.com/culture/
9
(2-13)
Antoniadis Palace
http://raseef22.com/culture/
9
XX
(2-14)
Site Map
(2-15)
Residential Zone
Google Earth
9
www.newcities.gov.eg
9
technology Applica- Google Earth (2-16) Research & tion City
9
(2-17)
Smooha Sporting Club
Google Earth
9
(2-18)
Ways of Transportation
Google Earth
10
(2-19)
Circulation Map
Google Earth
10
to project Site form Google Earth (2-20) CirculationMain Roads Site & related Google Earth (2-21) Distance from locations http://solargis.com/products/maps(2-22) Geographical Map of Egypt and-gis-data/free/download/egypt Map of Borg Al (2-23) Geographical Arab (2-24)
Site Map
10 10 11 11
Google Earth
11
ArcGIS, https://www.arcgis. com/home/webmap/viewer.html?webmap=a72b0766aea04b48bf7a0e8c27ccc007
11
(2-25)
Contour Map
(2-26)
Section 1-1
Google Earth
11
(2-27)
Section 2-2
Google Earth
11
(2-28)
Section 3-3
Google Earth
11
(2-29)
Smooha Sporting Club
Google Images
12
(2-30)
Sporting Clubs area
Google Images
12
p : / / w w w. a l a r a b y a n e w s . Borg Al Arab University Hospital hc ot tm /32476 & technological Google Images (2-32) City for Research Application (2-31)
12 12
(2-33)
Points of Interest
By the designer
13
(2-34)
Noise Source Map
By the designer
13
(2-35)
Site Boundaries & Dimensions
By the designer
14
XXI
roads & (2-36) Surrounding dimensions
their By the designer
14
(2-37)
Site Area
By the designer
14
(2-38)
Site Buildable Area
By the designer
14
(2-39)
Site Setbacks
By the designer
15
(2-40)
Height Limit
By the designer
15
(2-41)
Circulation
By the designer
15
http://solargis.com/products/mapsRadiation Map of and-gis-data/free/download/afri(2-42) Climatic SolarAfrica ca-and-middle-east http://solargis.com/prodRadiation Map of SolarGIS, (2-43) Climatic SolarEgypt ucts/maps-and-gis-data/free/download/egypt http://solargis.com/prodRadiation Map of SolarGIS, (2-44) Detailed SolarEgypt ucts/maps-and-gis-data/free/download/egypt SunCalc, http://suncalc.net/#/30.871 (2-45) Sun path diagram 1,29.5702,13/2017.03.15/23:52 Sunearthtools, https://www. (2-46) Sun path diagram sunearthtools.com/dp/tools/pos_sun. php#top Sunearthtools, https://www. (2-47) Sun path diagram sunearthtools.com/dp/tools/pos_sun. php#top MeteoBlue, https://www.meteoblue. (2-48) WindRose of Borg Al Arab com/en/weather/forecast/ MeteoBlue, https://www.meteoblue. (2-49) Average Wind com/en/weather/forecast/ MeteoBlue, https://www.meteoblue. (2-50) Average Wind Speed com/en/weather/forecast/ MeteoBlue, https://www.meteoblue. (2-51) Precipitation Rate com/en/weather/forecast/ MeteoBlue, https://www.meteoblue. (2-52) Precipitation Rate com/en/weather/forecast/ MeteoBlue, https://www.meteoblue. (2-53) Precipitation Rate com/en/weather/forecast/ MeteoBlue, https://www.meteoblue. (2-54) Average Temperature com/en/weather/forecast/
16
16
16 17 17
17 18 18 18 19 19 19 20
XXII
MeteoBlue, https://www.meteoblue. com/en/weather/forecast/ MeteoBlue, https://www.meteoblue. com/en/weather/forecast/ MeteoBlue, https://www.meteoblue. com/en/weather/forecast/
(2-55)
Max. & Min. Temperature
(2-56)
Temperature Analysis
(2-57)
Average Humidity
(2-58)
Main Spaces
By the designer
21
(2-59)
Secondary Spaces
By the designer
22
(2-60)
Rush University Hospital Atrium Arch daily,
20 20 20
22
(2-61)
Entrances
By the designer
23
(2-62)
Circulation
By the designer
23
(3-1)
Manazel Project Overview
(3-2)
Project Site
(3-3)
Project Components
(3-4)
Manazel Location
(3-5)
Manazel Location
(3-6)
Climatic Charts
(3-7)
Climatic Charts
(3-8)
Climatic Charts
(3-9)
Manazel Space Program
(3-10)
Manazel Space Program
(3-11)
Manazel Space Program
(3-12)
Competition three Proposals
(3-13)
Manazel Concept
Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com
25 25 25 26 26 27 27 28 28 29 29 29 29
XXIII
Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com Manazel Official Site, http://manazelmedical-city.squarespace.com Archdaily, http://www.archdaily. com/225153/sheikh-khalifamedical-city-in-abu-dhabi-som Archdaily, http://www.archdaily. com/225153/sheikh-khalifamedical-city-in-abu-dhabi-som Archdaily, http://www.archdaily. com/225153/sheikh-khalifamedical-city-in-abu-dhabi-som Archdaily, http://www.archdaily. com/225153/sheikh-khalifamedical-city-in-abu-dhabi-som Archdaily, http://www.archdaily. com/225153/sheikh-khalifamedical-city-in-abu-dhabi-som Archdaily, http://www.archdaily. com/225153/sheikh-khalifamedical-city-in-abu-dhabi-som Archdaily, http://www.archdaily. com/225153/sheikh-khalifamedical-city-in-abu-dhabi-som Archdaily, http://www.archdaily. com/225153/sheikh-khalifamedical-city-in-abu-dhabi-som
(3-14)
Circulation Studies
(3-15)
Circulation Studies
(3-16)
Circulation Studies
(3-17)
Sheikh khalifa city
(3-18)
Sheikh khalifa city perspective
(3-19)
Sheikh khalifa city Architecture
(3-20)
Hanging Garden
(3-21)
General Lobby
(3-22)
Cafeteria Terrace
(3-23)
Paediatric Lobby
(3-24)
Project zoning
(4-1)
Hospital zoning pie chart
By the designer
36
(4-2)
Research zoning pie chart
By the designer
44
(4-3)
Medical Mall zoning pie chart
By the designer
46
By the designer
48
By the designer
49
By the designer
51
(4-4) (4-5) (4-6)
Convention center zoning pie chart Bio-medical Institute zoning pie chart Site Zoning
30 30 30 31
31
32
33
33
34
34
34
XXIV
(4-7)
Two Hospitals common zones
By the designer
52
(4-8)
Two Hospitals 3D Zoning
By the designer
52
(4-9)
Research centre 3D Zoning
By the designer
52
(4-10)
Medical Mall/Mixed Use 3D Zoning
By the designer
54
Bio-Medical Institute 3D Zoning By the designer
55
(4-11) (5-1)
Priority in the buildings
By the designer
57
(5-2)
Hierarchy Path
By the designer
57
(5-3)
Connections
By the designer
57
(5-4)
Horizontal Character
By the designer
57
(5-5)
Density
By the designer
58
(5-6)
Service Grouping
By the designer
58
(5-7)
Activity Grouping
By the designer
58
(5-8)
People Grouping
By the designer
59
(5-9)
Relationships
By the designer
59
(5-10)
Communications
By the designer
60
(5-11)
Neighbours
By the designer
60
(5-12)
Accessibility
By the designer
60
(5-13)
Separated/Mixed Flow
By the designer
61
(5-14)
Circulation
By the designer
61
(5-15)
Flexibility in Hospitals
By the designer
61
(5-16)
Environmental Control
By the designer
62
(5-17)
Atrium & Court Location
By the designer
62
(5-18)
Roof Algae
By the designer
62
(5-19)
Algae Panels
By the designer
62
(5-20)
Orientation
By the designer
62 XXV
(5-21)
Safety
By the designer
63
(5-22)
Security Control
By the designer
63
By the designer
65
By the designer
65
By the designer
65
By the designer
65
By the designer
65
By the designer
66
(6-1) (6-2) (6-3) (6-4) (6-5) (6-6) (6-7) (6-8)
Inspirational Images for regeneration Creating a continuous spine that has no visual end Creating a continuous spine that has no visual end The spine generating the building masses within enclosure The spine generating the building masses within enclosure Solid & Void Analysis
The Bridge Connecting between By the designer the Institute & the Medical Mall Connection between the hospital By the designer & medical mall
66 66
(6-9)
Layout - Suitable Scale
By the designer
67
(7-1)
First Sketch
By the designer
69
(7-2)
First Sketch
By the designer
69
(7-3)
First Sketch
By the designer
69
(7-4)
Second Sketch
By the designer
71
(7-5)
Second Sketch
By the designer
71
(7-6)
Second Sketch
By the designer
72
(7-7)
Second Sketch
By the designer
72
(7-8)
Second Sketch
By the designer
72
(7-9)
Second Sketch
By the designer
72
(7-10)
Third Sketch, Group board
By the designer
73
(7-11)
Third Sketch, hospitals board
By the designer
74
XXVI
(7-12)
Third Sketch, hospitals board
By the designer
75
(7-13)
Third Sketch, hospitals board
By the designer
76
(7-14) Third Sketch, Research Center board By the designer
77
(7-15) Third Sketch, Research Center board By the designer
78
(7-16) (7-17) (7-18) (7-19)
Third Sketch, Convention Center board Third Sketch, Convention Center board Third Sketch, Bio-Medical Institute board Third Sketch, Bio-Medical Institute board
By the designer
79
By the designer
80
By the designer
81
By the designer
82
XXVII
Table of Tables
XXVIII
Table of Tables Table
Title
Reference
(4-1)
Orthopaedic & Cardiac Hospitals
By the designer
(4-2)
Research Centre
By the designer
(4-3)
Medical Mall & Mixed Use
By the designer
(4-4)
Bio-Medical Institute
By the designer
Page
XXIX
Executive Report
XXX
(1) Executive Report
(1-2) Research & Studies Conclusions
This is a Report Submitted as a Partial Requirement of Graduation Project Fulfilment, and it provides an analysis of the design process through the graduation project starting from site analysis till the design development and the final product . It contains a summary of all the studied data , all the researches done and all the previous assignments that contributed to the production of the final project.
After gathering and analysing all the studies, A 2D zoning was done to locate each building and deciding the best orientation for each one according to its uses. The zoning helped in making a conceptual physical model where the design and programmatic concept were studied, and how they affected the form generation.
(1-1) Research & Studies
(1-3) Design approach
The research process started with gathering all the needed data about the site, its potentials, the studying the site analysis, knowing the site’s threats, opportunities, strengths and weakness. Studying the surrounding context and whether It will affect the design theme & concept or not. Then gathering data about site climate, and analysing it on the site, where it will help in Orientation decisions.
After several trials on the physical model, the resulted model led to the masterplan phase, many attempts were done to reach a masterplan integrating all the five buildings as a one whole project. The programmatic and design concepts were analysed and affected the masterplan.
Studying previous similar projects, analysing them and gathering notes and decisions from them. Setting the space program of the whole project, and the space program within each project.
For the programmatic concept: The five buildings had connections between each other according to the users and the function. A connection between the two hospitals and the research centre to facilitate the continuous movement of the doctors back and forth between them. A connection between the clinics in the medical mall and the hospitals clinics’ administration. A connection between the research centre and the institute that secure and make it easier for the doctors and students to move between them.
1
Bio-neering Medical City Executive Report (1-5) Key Recommendations Also the programmatic concept affected the flexibility needed for the two hospitals, where they have one podium of two floors containing the common public departments and one service basement, and are separate in the inpatient department in the two towers. It also affected the circulation and other points that will be explained in detail in the programmatic concept section. For the design concept: While our project focuses mainly on the tissue engineering a lot of ideas were inspired from this field and the process of the bioprinting, that led to some keywords as Layering, Continuity and No dead ends helped in making the design the concept that will also is explained in the design concept section .
A project where each building is connected functionally and visually with the other one needs to be studied micro and macro scale at each phase from the concept, and form generation to the plans and landscape.
(1-6) Conclusion As the healthcare and the medical field in Egypt is at low rate and not continuously updated. It’s Important to focus more on the medical and research architecture, and make use of good climate conditions of some new cities with great future potentials as Borg Al Arab.
(1-4) Design Progress The concept phase was followed by setting the project plans and studying each project functions and their relations within the same project and the other five buildings. Studying the landscape and designing them according to the building functions.
2
Site Analysis
3
Bio-neering Medical City Site Analysis (2-1) Site Selection 1
As It is mentioned int the introduction the site selection is based on some targeted points: •The Bio-printing process needs bio-ink which is extracted from sea weeds and Brown Alga which ca be found along the mediterranean sea at the locations shown in Fig ( ). •The Site needs to be close to an international airport as one of our main targeted groups are foregin doctors, researchers and students. •Fulfilling Patient statisfaction where the hospitals need clean area, away from dense and polluted zones.
Fig. (2-1) Locations of Seaweeds
So According to these reasons that led to some Locations some in Alexandria like El Dekheila close to El-max bay where seaweeds can be found and close to an airport. Refused as It is an industrial area with high pollution
Fig. (2-2) Locations Alternatives
Sidi Krer close to the Mediterranean cost refused due to the presence of many Fish Farms. Borg Al Arab close to the Mediterranean coast (only 21 Kms) ,so Close to an international airport (Borg Al Arab international airport) and also can be considered of clean air and calm quiet area. Making it the best location for an international medical city.
(2-2) Background on Borg Al Arab New Borg El Arab is located in Alexandria Governorate, Egypt, at latitude 30° 50’ 56” North, longitude 29° 36’ 42” East. Bounded on the north by Borg El Arab city, on the east Borg El Arab Airport, on the west El Hamam in the Matrouh Governorate
(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3667364/
4
and on the south Amreya. The city lies 60 kms away from Alexandria and 7kms from North Coast. Total Area 47.5 thousands Feddan, 26.7 thousands for building. 8 hospitals, 9 schools, The city population is 150,000 Health New Borg El Arab city includes many of hospitals and medical centers such as: Al Salam Royal Hospital. Borg El Arab General Hospital. Borg El Arab University Hospital. Juweili medical center Education New Borg El Arab city includes many of the nurseries, schools and universities such as: Egypt-Japan University of Science and Technology. Scientific Research and Technological Applications City. Higher Institute of Engineering and Technology.
(2-3) SWOT Analysis Points of Strength •East of the site there is medical service zone. •20 km (28 min) from Borg El-Arab international airport. •It can be reached from Cairo - Borg El-Arab desert road. New Borg El-Arab - Marsa Matrouh road Cairo - Alexandria desert road. •Away from the densed areas of Alexandria and borg El-Arab.
Fig. (2-3) Nearby Transportations
Points of Weakness •The presence of the residential area may affect the research center. •The building regulations in the city are limiting. Fig. (2-4) Distance from Mediterranean Coast
5
Bio-neering Medical City Site Analysis Points of Opportunity •Close to the Mediterranean sea coast, where •Seaweeds and Brown alga can be found (the main sources of bio-prinitng process) •Presence of the entertainment Sport clubs zone north of the site, may have a good effect to the medical mall and institutes buildings. Points of Threat •The crowdedness of the city in the future constructions may affect the privacy needed to the project, if not planned well •Heavy rains ,and in some cases, floods in winter season.
6
(2-4) Site Location 1. The Site lies in the northern western part of the Nile Delta. 2. Close to Alexandria and the North coast. 3. Can be accessed from New Borg El-Arab Marsa Matrouh road and Alexandria - Marsa Matrouh road. Distance from site to nearby cities From New Borg Al Arab to: •Alexandria 60.7km, 1h.3min •Cairo 224 km, 2h.33min •El Alamen 72km, 1h.13min •Ismailia 357km, 4h.8min
Fig. (2-7) Nearby Cities Map
Fig. (2-5) Zoomed in Map
Fig. (2-6) Zoomed Out Map
(2-5) Nearby Airports •Al Alamen International Airport •Borg El-arb International Airport •Alexandria El-Nozha Airport •Cairo International Airport
Fig. (2-8) Nearby Airports Map
7
Bio-neering Medical City Site Analysis (2-6) Neighbourhood Context The map (Fig.2-9 ) Shows the planning of Borg Al Arab city, where the service zone is represented with the red colour, the Yellow is the residential zones, and the blue is the educational zone.
Fig(2-10) represent a macro zoning for the neighbourhood context of the site. The first residential zones already been planned and constructed. An entertainment zone in the north direction of the site. And a university zone in the south of the site. The medical service zone in the east of the site. Fig() represent a micro zoning for the neighbourhood context. For the Entertainment zone, there are 4 sport clubs: •”Smooha Sports Club, Sporting sports club, United sports club, and El-seed sports club.” For the medical service zone there are many hospital one of them is the “Borg Al Arab University hospital.” For the educational zone: “Mubarak city for scientific research & tecnology application” And there is “Egypt Japan University of Science and Technology” close to the third residential zone.
Fig. (2-9) Borg Al Arab Planning
Fig. (2-10) Macro Zoning
Fig. (2-11) Micro Zoning
Conclusion The neighbourhood context will be part of the project as the entertainment zone will service on the research center and the institute (for the researchers and students) also the medical service zone with the hospitals may be connected to the clinics in the our project medical mall’s clinics. 8
(2-7) Man Made Environment Borg Al Arab is part of Alexandria Environment, however it hasn’t been affected by its architecture. For Borg Al Arab’s architecture can be considered as modern architecture.
Fig. (2-12) salamlek palace
Fig. (2-13) Antoniadis palace
Fig. (2-15) Residential Zone Fig. (2-14) Site Map
Fig. (2-16) Research and Technical Applications City
Fig. (2-17) Smooha Sporting Club
9
Bio-neering Medical City Site Analysis (2-8) Accessibility & Circulation
Fig.(2-18) Ways of transportation to project site
Airport (Borg Al Arab International airport) Train Station Bus Stop
Fig.(2-20) Circulation to our project site from main roads
Alex - Matrouh road Cairo - Alex road Borg Al Arb - Cairo road
Fig.(2-19) Circulation map
Roads leading to Borg Al Arab.
Fig.(2-21) Distance from our site and related locations
2.2km, 4min to Borg Al Arab University hospital 3.okm, 5min to Somoha sports club 4.8km, 9min to El Gewaily medical center
10
(2-9) Topography (2-9-1) Natural Physical Features
Fig.(2-22) Geographical map for Egypt
Fig. (2-23) Geographical map for Borg Al Arab
Our project site lies on 59 to 79 m above sea level
(2-9-2) Site contours The site topography is variable. contoring will be studied and used in our project to create leveling among the project 5 buildings. However this variable contour won’t have main effect on the project design.
Fig. (2-25) Contour Map
Fig. (2-26) Section 1-1
Fig.(2-27) Section 2-2
Fig.(2-24 ) Site Map
Fig.(2-28) Section 3-3
11
Bio-neering Medical City Site Analysis (2-10) Sensory The sensory surrounding the site are mostly building areas in the south of the site where there is the universities zone, And the north there’s the green spacious area of the sports clubs however some of them are still under construction as “Smoooha Sporting Club”.
Fig.(2-29) Smooha Sporting Club
Fig. (2-31)Borg Al Arab University Hospital
Fig.(2-30) Sporting Clubs area
Fig.(2-32) city for scientific research & technology
12
(2-11) Points of interest on site The East place is best place for the medical mall as it is close to the public residential area the two main roads are in the eastern area The west direction of the site is good choice for the hospital as it is calm and away from the dense zones. Good for hospital as it will be a good opportunity for the hospital extension the future. It can be a good choice for the privacy need for the research center.
Fig.(2-33) Points of Interest
(2-12) Noise sources to the site Some of the surrounding building may affect the quietness needed to the site due to its medical aspect (especially to the two hospitals), Firstly, the sporting clubs may cause some noise especially during festival times. Secondly the universities may cause some noises as it’s a public zone, and these points will affect the macro and micro zoning of the site.
3 Fig. (2-34) Noise Sources map
13
Bio-neering Medical City Site Analysis 1) Smooha Sporting Club 2) University teaching hospital 3) Universities zone
(2-13) Size & Zoning (2-13-1) Dimensions
Fig. (2-35) Site boundaries and dimensions.
Fig. (2-36) Surrounding roads and their dimensions. The site is surrounded by three main roads the largest on the east is 15m , 12 in the south and 9m in the north of the site.
(2-13-2) Areas
Fig. (2-37) Site Area.
Fig. (2-38) Site buildable area.
The site area is 630,000 sqm (150 Feddan) with building area of 30% equals to 189,000 (45 Feddan).
14
(2-13-3) Zoning and Setbacks
Fig. (2-39) Site setbacks
(2-13-4) Building height limit
Fig. (2-40) The height limit is an average of 30m. High.
(2-14) Legal and Covenants No special design restrictions. Height doesn’t exceed 30m.
(2-15) Ownership & Jurisdiction Ownership: Jurisdiction: -City of Borg Al Arab, Alexandria. Design Review: -
(2-16) Vehicular Circulation Main roads. Secondary road. Intersection of roads (high traffic). Pedestrian path. The two intersection of roads may cause hight traffic, so it’s better for the location of the hospital to be away from them, and they are better locations for the public buildings as the Institute and the medical mall.
High traffic point
Fig. (2-41) Circulation
15
Bio-neering Medical City Site Analysis (2-17) Climate (2-17-1) Solar Radiation
Fig. (2-42) Climatic solar radiation map of Africa
Fig. (2-43) Climatic solar radiation map of Egypt
Fig. (2-44) Detailed solar radiation map of Egypt
Borg El-Arab average radiation is less than 5.5 KWh/m2/day.
16
(2-17) Climate (2-17-2) Sun Path
Fig. (2-45) Sun Path Diagram
Fig. (2-46) Sun Path Diagram
Fig. (2-47) Sun Path Diagram
17
Bio-neering Medical City Site Analysis
(2-17) Climate (2-17-3) Wind Analysis
Fig. (2-48) Windrose For Borg El Arab
Fig. (2-49) Average wind
Prevailing wind is mostly from North west direction with speed of average from 5 to 28 km/h.
A Diagram for Borg El Arab shows how many days within one month can be expected to reach certain wind speeds.
Fig. (2-50) Average Wind speed through the year for Borg El Arab.
18
(2-17) Climate (2-17-4) Precipitation Analysis
Fig. (2-51 ) Precipitation rate
Fig. (2-52) Precipitation rate
The graph shows the monthly number of sunny, partly cloudy, overcast and precipitation days. Days with less than 20% cloud cover are considered as sunny, with 20-80% cloud cover as partly cloudy and with more than 80% as overcast.
The precipitation diagram for Borg El Arab shows on how many days per month, certain precipitation amounts are reached.
Fig. (2-53) The average precipitation diagram for Borg El Arab through the year.
19
Bio-neering Medical City Site Analysis
(2-17) Climate (2-17-5) Temperature Analysis
Fig. (2-54) Average temperature degrees all over the year.
Fig. (2-55) Max & Min Temperatures.
Fig. (2-56) Temp., Precipitation, & wind analysis.
Fig. (2-57) Average humidity. The average annual relative humidity is 67.9% and average monthly relative humidity ranges from 65% in April to 71% in July. Humidity in Borg Al Arab is high which will be considered in our design decisions.
20
(2-18) Design Decisions (2-18-1) Main Spaces
Fig. (2-58) Main Spaces
21
Bio-neering Medical City Site Analysis
(2-18) Design Decisions (2-18-2) Secondary Spaces 1) Institute theatre. 2) Atrium. 3) Cafeteria. 4) Library. 5) Teaching offices. 6) Seminars. 7)Conference hall. 8) Medical mall clinics.(2nd floor) 9) Offices 10 9 10) Reception. 11 12
13
5
1 4 6
19 15 14
11) Atrium. 12) Library. 13) Seminars. 14) Physiotherapy. 15) ER. 16) Radiology &
2 3 5
8
7
15 16 17 18
Fig. (2-59) Secondary Spaces For Research centre and Institute: Both offices close to each other to ease the flow of doctors in the research centre who are also the teaching staff of the institute.
Labs. 17) Clinics. 18) Pharmacy. 19) Labs.
For the research centre: To reach daylight to dark spaces, and connect inside to the outside.
For the conference hall: Close to the corner of the two main roads as it’s the approach of the project, also close to the public zone of the residential area. For Medical Mall & Two Hospitals: Both Clinics have adjacency where they can have easy access to the hospital services and Administration. For the Two Hospitals: ER close to a main road with separated access from the hospital access
Fig. (2-60) Rush University Hospital Atriums. 22
(2-18) Design Decisions (2-18-3) Circulation
Fig. (2-61) Entrances
Fig. (2-62) Circulation
23
Similar project samples
24
(3) Similar Projects (3-1) Manazel Medical city, Abou Dhabi (3-1-1) Introduction The Proposed design is set to achieve the highest possible quality for the lowest possible cost. The result is a beautiful and operationally cost-effective plan for a hospital building for a new era of Healthcare.
(3-1-2) What is the problem Healthcare demand in the UAE is rising due to shifting demographics, higher income, steady population growth, and lifestyle choices. Abu Dhabi leaders want to reduce the number of Emiratis going abroad for healthcare, most notably for cancer treatment. In a recent report, the Health Authority of Abu Dhabi (HAAD) projected a demand for 1,300 additional acute care hospital beds by 2021.
(3-1-3) What The Manazel Medical City is a 132,788 square meter comprehensive medical centre master planned and designed by “SmithGroupJJR”. It comprises five distinct components: acutecare hospital, medical office building (MOB), cancer centre, rehabilitation hospital, and children’s learning and disability center. Each of the five components is integrated into a six-level building running north and south, with three “fingers” projecting from the west side.
Fig. (3-1) Project Overview
Fig. (3-2) Project Site
Fig. (3-3) Project Components 25
Bio-neering Medical City Similar Project Samples
(3-1-4) Site Location
Fig. (3-4) Manazel Location The Site is located in Abou Dhabi UAE. Is the capital and the second most populous city of the United Arab Emirates. Climate : Abu Dhabi has a hot desert climate. Sunny blue skies can be expected throughout the year. The months of June through September are generally extremely hot and humid with maximum temperatures averaging above 38 °C. During this time, sandstorms occur intermittently, in some cases reducing visibility to a few meters. The cooler season is from November to March, which ranges between moderately hot to mild. This period also sees dense fog on some days. On average, January is the coolest month in the year, while August is the hottest
Fig. (3-5) Manazel Location
26
(3-1-5) Climatic Analysis
Fig. (3-6) Climatic Charts
Fig. (3-7) Climatic Charts 27
Bio-neering Medical City Similar Project Samples
Fig. (3-8) Climatic Charts
(3-1-6) Space Program
Fig. (3-9) Space Program 28
(3-1-6) Space Program
Fig. (3-10) Space Program
Fig. (3-11) Space Program
(3-1-7) Design Concept The Design was first held by a competition where three proposals were presented. The Sabre, The River and The GEODE. Each proposal was focused on a unique concept. One in a continuous functional form, Other flexibility and the last is connectivity.
Sabre. This concept was the most rational of the three. The Sabre was inspired by precision, technical excellence, skill and fine craft, and beauty. This concept included a classic orthogonal hospital plan, with multiple patient wings sharing a diagnostic and treatment block. It provides flexibility, and, a structural grid coordinated with the parking garage beneath, with minimal transfer beams.
Fig. (3-12) Three Competition Proposals
Fig. (3-13) Concept 29
Bio-neering Medical City Similar Project Samples (3-1-8) Circulation Studies
Fig. (3-14) Circulation Studies
Fig. (3-15) Circulation Studies
Fig. (3-16) Circulation Studies
30
(3) Similar Projects (3-2) Sheikh khalifa Medical city (3-2-1) What Conceived as three hospitals in of Abu Dhabi combines a general hospital with medical centers for women and children. This sharedservices model enhances patient care while improving efficiency. Once complete, the Sheikh Khalifa Medical City will be the largest hospital in the United o ne, this massive complex in the heart Arab Emirates. Fig. (3-17) Sheikh khalifa city Location: Abu Dhabi, United Arab Emirates Anticipated Completion: 2018 Project Area: 279,000 m2 Building Height: 57 m Market: Health + Science
(3-2-2) What is the problem Sheikh Khalifa Medical City will combine a general hospital with a level-one trauma center and women’s and pediatric hospitals. Given the massive scale of this project, creating a hospitable sense of character and overall unity for the entire facility – while conveying a sense of identity for each individual hospital – is one of the primary design challenges. Fig. (3-18) Sheikh khalifa city perspective
31
Bio-neering Medical City Similar Project Samples
(3-2-3) The design Decision The architecture of the bed towers communicates the identity of each hospital within a common vocabulary. The exterior sun screens, which characterize the bed tower facades, will vary from the simple rhythm of the general hospital to playful colors and patterns of the children’s hospital to the intricate mashrabiya-inspired geometries of the women’s hospital.
Fig. (3-19) Sheikh khalifa city Architecture
The new Sheikh Khalifa Medical City balances the technical demands of a world-class medical center with the psychological well being of its visitors. The design allows for the flexible integration of next generation medical technologies, while the incorporation of amenities, such as trees and hanging gardens coupled with restaurants and retail, provides tranquility, relief and a sense of normalcy for patients and their families.”
32
Like the exterior architecture, which expresses distinct identities developed from a common language, the interiors will be unified yet uniquely branded. The shared public spaces within the plinth will serve as connective tissue, while the lobbies and bed tower interiors of General, Women’s and Pediatric hospitals will express their own similar yet distinct identities.
From the landscaped entry drives to the main garden level and the light-filled courtyards that perforate the plinth, the medical city’s gardens will create a calm and healing environment. The diverse network of open spaces is considered essential in establishing a tranquil atmosphere and in crafting the campus-like environment that will help to distinguish this medical campus.
This shaded garden, on the roof of the building’s plinth, is accessed from below by gracious interior and exterior stairs and activated by adjacent cafes, conference areas, and family waiting areas. Within the plinth, itself, a series of courtyards serves to bring light and nature into these large floor plates, thereby mitigating the sense of distance, assisting in way-finding and creating a more tranquil atmosphere in this medically intense setting
Fig. (3-20) Hanging Garden
Fig. (3-21) General Lobby
33
Bio-neering Medical City Similar Project Samples
Fig. (3-22) Cafeteria Terrace
Fig. (3-23) Paediatric Lobby
The design of the medical city is based on the belief that patients are guests and everything about the facility supports that notion of hospitality. The patient and visitor experience is carefully controlled to minimize exposure to the back-of-house components of the facility. Lobbies and other public spaces convey a sense of serenity through spaciousness, natural materials and diffused natural light, while courtyards and terraces engage building interiors with the outdoors.
Fig. (3-24) Project zoning 34
Architectural program
35
Bio-neering Medical City Architectural Program
(4) Space Program (4-1) Cardiac & Orthopedic Hospitals
Orthopaedics and Cardiac Hospitals
Fig. (4-1) Hospital zoning pie chart Name of zone
Space
Number
Area/m2
Total Area
Outpatient clinics
Reception and registration Waiting area
1
1.25 per person
1
1.25 per person 20 chairs
WCs
1
Clinics: examination rooms
3 Cardio
12
108
3 Skin 3 Bones
Emergency
Splinting room
1
6
6
Nurse station
1
18
18
Medical storage
2
8
16
Cleaning storage
2
5
10
Waste storage
2
6
12
Chair wheel storage
2
3 chairs
6 chairs
Administration office
1
9
9
Police reports
1
9
9
Receiving cases
1
40
Preparation room
2
For 12 beds 16
Examination room
2
12
24
32
36
Orthopaedics and Cardiac Hospitals
Administration
Small surgery room
2
25
50
Recovery room
2
16
32
Splinting room
1
18
18
Doctor’s room
1
20
20
Nurses room
1
15
15
Medical storage
1
16
16
Cleaning storage
1
10
10
Waste storage
1
12
12
Chair wheel storage
2
Reception hall
1
3 chairs 3 Trolleys 25
25
Manager office
1
20
20
Vice manager office
1
10
10
Managing team
1
12
12
Financial manager office Financial records office Secretary
1
10
10
1
8
8
1
9
9
Public relations office
1
20
20
Procurement office
1
12
12
Treasury and accounts
1
12
12
Staff offices
1
20
20
Medical records office
2
8
16
Nursing head office
1
14
14
37
Orthopaedics and Cardiac Hospitals
Bio-neering Medical City Architectural Program
physiotherapy
Nursing manager office Engineering office
1
10
10
1
12
12
Staff Lounge
1
50
50
WCs
2
Cleaning storage
2
5
5
Storages
2
6
12
Reception & waiting area Changing rooms
1
30
30
10
10
Treatment rooms Staff office WCs Patient care
Stay patient rooms
Single -double
Patients break area
1
Nursing station
Doctors rooms
1 per 30 bed 1 per 60 bed 1
Nurses rooms
1
Staff lounge
1
kitchenette Medical storage
Treatment rooms
Depends on bed size 0.7 m.sq per bed 18 Oct-15 20
20
15
15
1
12
12
2
8
16 38
Orthopaedics and Cardiac Hospitals
Cleaning storage
2
5
10
Waste storage
2
6
12
Clean sheets storage
2
12
24
Dirty sheets storage
2
12
24
Chair wheel storage
2 per station
3 chairs 3 trolleys
Intensive care
40
40
Visitors lounges
1
Visitors WCs
1
Care units
6 – 10 bed 1 per 12 bed
18 each bed 18
Operation room
4
36 – 50
200
Anesthesia
4
18
72
Sterilization
4
18
72
Sterilization storage (dirty) Sterilization storage (clean) Operating room lab
1 per OR
10 – 30
10 – 30
1 per OR
10 – 30
10 – 30
1
12
12
Scrub area
1 per OR
8
8
Nursing unit Nursing services Records room Visitors area Surgical department
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Orthopaedics and Cardiac Hospitals
Bio-neering Medical City Architectural Program
Radiology
Supplies equipment storage Clean up area
1
20 – 40
20 – 40
1 per OR
6
6
Patient waiting area
1
Patient’s care after anesthesia Resuscitation
4
18
72
Beds 1.5/ OR
8
Recovery room
8
Nursing station
18
18
Head surgeon’s office
1
30
30
Doctors room
1
20
20
Nurses room
1
15
15
Medication storage
1
8
8
Cleaning room storage Waiting and reception
2
5
10
1
20
20
WCs
1
Changing rooms X-ray room
2 per radiology room 3
18
54
CT scan room
2
30
60
MRI room
2
50
100
Atomic scan room
1
30
30
4
40
Orthopaedics and Cardiac Hospitals
Laboratories
Ultrasound (echo) room ECG and drawing heart room Physician's room
2
30
60
2
30
60
1
20
20
Technicians room
1
15
15
Watching and recording room Acidification
2
8
16
2
10
20
Film storages
1
7
7
Control room
1
10
10
Staff WCs
1
Waiting and reception
1
20
20
WCs
1
Records rooms
1
12
12
Rooms for taking samples Blood bank
3
8
24
1
25
25
12 – 45
12 – 45
20
20
10
10
Specialized labs
Central sterilization
Physicians rooms
1
Staff WCs
1
Storages
1
Receiving room
1
Decontamination
1
41
Orthopaedics and Cardiac Hospitals
Bio-neering Medical City Architectural Program Inspection and packing Sterilization
1
Sterile storage
1
Dispatch
1
Waste disposal
1
Changing rooms
1
Staff rest rooms
1
kitchenette
1
12
12
Supervisor office
1
8
8
Storage
1
10
10
Pharmacy
1
Laundry
1
300
300
Kitchen
1
400
400
The morgue
1
65
65
Waste treatment
1 200
200
1
Maintenance room
Public services
Storages Worker’s services Control room
1
Generator room
1
42
Transformer room
1
HVAC
1
Maintenance
1
Cleaning department
1
40
40
Table (4-1) Orthopaedic & Cardiac Hospitals
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Bio-neering Medical City Architectural Program
(4) Space Program (4-2) Research Centre
Fig. (4-2) Research zoning pie chart Building
Name of zone
Space
Number 3
Area/m2 80
Total Area 240
Wet Labs
Stem cells bioengineering lab Cardiovascular biomechanics lab Scaffolds engineering lab Biomaterials lab
3
55
165
2
55
110
2
55
110
2
55
110
Stem cell bank
1
28
28
Animal holding Area
1
30
30
Lab support
1 each lab
20
40
2
85
170
2
96
192
2
100
200
Research Centre
Clinical research lab Total Area = 735 sqm Lab Support
Total Area = 98 sqm Dry Lab
3D Printing lab Total Area = 170 sqm
Public spaces
Seminar room (80person) Conference room (30person)
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Video Conference room Library Break rooms Public toilets
1
30
30
1
120
120
1/3 Labs 1 / 50 person
20
40
40
500
15
15-25
375
Total Area = 1082 sqm Admin.
Offices Total Area = 375 sqm
Table (4-2) Research Centre
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Bio-neering Medical City Architectural Program
(4) Space Program (4-3) Medical Mall & Convention Centre
Fig. (4-3) Medical Mall zoning pie chart Name of zone
Space
Area/m2
Waiting lounges
Number 1
120
Total Area 120
Waiting areas
reception
1
60
60
1
200
200
2
100
200
diagnostic clinics
12
60-100
1200
Consultant room
1
100
100
shops
15
60-100
1500
Pharmacy
2
100
200
1
100
100
Total Area = 180 sqm
Medical Mall
Lab Support
Diagnostic testing facilities (MRI, CT scan, X-Ray) Laboratory facilities Total Area = 400 sqm
Examining area
Total Area = 1300 sqm Additional spaces
Total Area = 1700 sqm Staff and manager
Consumer health education center.
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Medical Mall
Offices of major hospitals and clinics in the County Offices of County boards Private nurse placement office . Nurse station
4
100
400
2
200
400
5
60
300
1
270
270
Manager Office
1
100
100
Child care facility for employees Break rooms
1
60
60
1
60
60
Staff toilet
2
50
100
Patient toilets
2
50
100
Public toilets
2
52
104
storages
2
100
200
Total Area = 1570 sqm Service
Total Area = 642 sqm Table (4-3) Medical Mall & Mixed Use
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Bio-neering Medical City Architectural Program
(4) Space Program (4-3) Medical Mall & Convention Centre
Fig. (4-4) convention center zoning pie chart Name of zone
Space
Number
Area/m2
Total Area
Waiting areas
lobby
1
150
150
reception
1
80
80
Retail area
1
80
80
Total Area = 310 sqm Main auditorium(800seat) Seminar rooms
1
2400
2400
4
120
480
Back stage support
1
800
800
Meeting room
1
140
140
Backstage Operation Total Area = 3920 sqm Equipment storage
1
100
100
1
200
200
Public toilets
2
50
100
offices
5
60
300
Exhibition rooms
2
400
800
Convention Centre
Lab Support
Offices and service
Total Area = 1400 sqm
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(4) Space Program (4-4) Biomedical Institute
Fig. (4-5) Bio-medical Institute zoning pie chart Name of zone Space
Bio-Medical Institute
Teaching spaces
Area/m2
Classrooms
Number 6
80
Total Area 480
Preparation
6
60
360
Laboratories
6
80
480
Seminar rooms
2
80
160
Reading spaces
1
300
300
Computer spaces
1
200
200
Offices
5
20
100
Meeting rooms
2
30
60
Archive
2
60
120
Offices
5
20
100
Meeting rooms
2
30
60
Storages
1
30
30
Total Area = 1480 sqm Library
Total Area = 500 sqm Staff offices
Total Area = 280 Admin
Total Area = 190 sqm
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Bio-neering Medical City Architectural Program
Cafeteria
Kitchen
1
300
300
Restaurant
1
200
200
Cleaning rooms
4
15
60
Students Toilets
6
40
240
Staff toilets
4
40
160
Storages
2
50
100
Electric rooms
2
16
32
Mechanical rooms
1
14
14
Generator rooms
1
16
16
Bio-Medical Institute
Total Area = 500 sqm Public spaces
Total Area = 622 Table (4-4) Bio-medical Institute
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(5-1) Project Site Zoning
Fig. (4-6) Site Zoning
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Bio-neering Medical City Architectural Program (4-2) Buildings 3D Zoning
Fig. (4-7) Two Hospitals common zones
Fig. (4-8) Two Hospitals 3D Zoning
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Fig. (4-9) Research centre 3D Zoning
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Bio-neering Medical City Architectural Program
Fig. (4-10) Medical Mall/Mixed Use 3D Zoning 54
Fig. (4-11) Bio-Medical Institute 3D Zoning
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Programmatic concept
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(5) Programmatic Concept (5-1) Priority The zone that has the priority is the two hospitals zone. It has the priority of the master plan layout.
(5-2) Hierarchy The project is divided into 3 main zones the health zone , commercial zone , Research and studying zone. The hierarchy of the buildings is obvious through heights. Creating a spine that starts at its peak point creating the hospital. Leaning near the ground to form the research centre. It rises up to form the mixed-zone building, connecting the institute to form a continuous spine that has no visual end to end back again forming the hospitals towers creating a loop shape like spine
(5-3) Character
Fig. (5-1) Priority for the buildings
Fig. (5-2) Hierarchy Path
Fig. (5-3) Connections
The dominant character is horizontal except for the two towers of the hospitals, which create a slide difference in height.
Fig. (5-4) Horizontal Character
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Bio-neering Medical City Programmatic Concept
(5-4) Density The part of the high density is the hospital zone linked to it the mixed used zone. While the institute creates a medium density zone , and the research centre is of the lowest density . Fig. (5-5) Density
(5-5) Service grouping The whole services of the city is connected by a grid of roads located underground. The main services of the buildings is mostly located in the basement floor, Eg. the service floor of the two hospitals, and the storages needed for the research centre. Fig. (5-6) Service Grouping
(5-6) Activity grouping Each building has it’s own zone in which a certain activity occurs that serves the needs of the building and the capacity of the people doing the activity. Medical Mall: contains outdoor exhibitions and open theatre. Institute: contains play-fields, cafeterias and other activities.
Fig. (5-7) Activity Grouping
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(5-7) People grouping The medical city is adopting a new field of medicine “ tissue engineering � , thus the approach must be expresses a wonderful landmark for the new science as it will be the main gathering point of the project. The open theatre and the outdoor exhibitions will host large events which will attract large number of visitors.
Fig. (5-8) People Grouping
(5-8) Relationships This sketch (Fig.1) represents the zoning of the project elements showing the relationships in their assembling. Where the elements are divided into 4 zones, hospitals zone, research zone, institute zone and mixed zone which is composed of a medical mall, a convention centre and the administration of the city. The research centre is inaccessible from the medical mall because it has high security levels and needs secrecy.
Fig. (5-9) Relationships
The medical mall in the mixed use zone is placed near the hospital providing access to the clinics of both the hospitals and the medical mall. Access to the research centre is provided from both the medical institute and the hospitals for the doctors to pass through.
Access is provided for doctors and students between the convention centre in the mixed use zone and the medical institute.
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Bio-neering Medical City Programmatic Concept
(5-9) Communications 1) A Pedestrian bridge for doctors connecting between hospital and research centre. 2) Ramped road for hospital emergency. 3) A service road ramped underground making a grid of service roads connecting all buildings together. 4) A Pedestrian path connecting research centre to medical mall. 5) A Pedestrian bridge for doctors from clinics of the medical mall to clinics of the hospital. 6) Ramped path from podium roof to the ground creating an escape emergency to the two inpatient towers.
(5-10) Neighbours
3 4 1 2
6
5
Fig. (5-10) Communications
Sports Club area
Sport Clubs area serves as an entertainment area for students at the institute. Residential area to ease the access to the clinics. University Zones where any medical university might need the service of the hospital.
Residential Area
Universities Zone
(5-11) Accessibility
Fig. (5-11) Neighbours
Fig. (5-12) Accessibility
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(5-12) Separated/Mixed Flow This picture represents the vehicle paths in the project where each zone has its entrance, drop off, parking and exit parts. There is also the ring road which makes moving between zones easier. The service paths are mostly under ground for less traffic in the project and less pollution because clean air is needed for the patients environment.
Fig. (5-13) Separated/Mixed Flow
(5-13) Circulation Path Bridges are designed on different levels for doctors movement between the medical mall, convention centre, hospitals, research centre and the medical institute. A path was designed for doctors and students to go from the medical institute to the convention centre and medical mall and vice versa. Pedestrian paths are designed on the ground to ease the movement of visitors in the city.
(5-14) Flexibility
Fig. (5-14) Circulation
One Podium for the two hospitals, combining their Er, Surgical departments, Radiology, Laboratories, Clinics, and the general services.
Fig. (5-15) Flexibility in hospitals
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Bio-neering Medical City Programmatic Concept (5-15) Environmental Control Using roof algae ponds to generate biofuel reduce electricity consumption. Using bioreactor on the south and south west facade to reduce environmental impact. Ventilation and lighting courts to dark research spaces.
Fig. (5-16) Environmental Control
Fig. (5-18) Roof Algae
Fig. (5-17) Atrium and Court Locations Fig. (5-19) Algae Panels
(5-16) Orientation Hospitals zone catches The North and The South viewing on the Healing park.
Fig. (5-20) Orientation
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(5-17) Safety High security zone contains The Research Centre Medium Security zone contains The Biomedical Institute Low Security zone contains The two hospitals and Mixed-use Building Research centre consists of two underground floors have the labs and two upper floors have the public services It’s location is in the remote part of our medical city
Fig. (5-21) Safety
(5-18) Security Control Ring road vehicle’s circulation totally separated from pedestrian circulation through bridges,ramps and roads
Fig. (5-22) Security Control
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design concept
64
(6) Design Concept (6-1) Concept Regeneration as a process is a renewable, continuous recreating process. Layering as appeared in the project taken from the bio-printing process concept which is based mainly on layering of cells. Endless main spine forming the buildings representing the continuity of regenerating cells and tissues of organs Regeneration - continuity - No deadends No end points visually
(6-2) Visual connection & Layers
Fig. (6-1) Inspirational Images for regeneration
Fig. (6-2) Creating a continuous spine that has no visual end
Fig. (6-3) Creating a continuous spine that has no visual end
Fig. (6-4) The spine generating the building masses within enclosure
Fig. (6-5) The spine generating the building masses within enclosure
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Bio-neering Medical City Design Concept (6-3) Solid and Void Study The Relation between Solids and voids creates suitable urban spaces and enhances the enclosure of each building, which makes all the project Elements act together as one homogeneous unit. Buildings Pedestrian bridges Pedestrian landscape paths Landscape
Fig. (6-6) Solid & Void Analysis
(6-4) Vehicular & Pedestrian Paths - The City is Surrounded by a ring road with width 9 meters connected to the main roads of the site to ease the accessibility of the buildings. - The whole services of the city is connected by a grid of roads located underground. - Integrating the pedestrian and vehicular routes with minimum intersections.
Fig. (6-7) The Bridge Connecting between the Institute & the Medical Mall
- Achieving walk-ability enhancement and visual perceptions of the buildings. - Creating continuous pedestrian paths between the buildings, In landscape between hospital, research centre & institute, and through bridges with tension cables between the institute & the medical mall.
Fig. (6-8) Connection between the hospital & medical mall
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Fig. (6-9) Layout - Suitable Scale
Main Entrance Service Entrance
67
design development
68
(7) Design Development (7-1) First Sketch
Fig. (7-1) First Sketch
Fig. (7-2) First Sketch
Fig. (7-3) First Sketch
69
Bio-neering Medical City Design Development
(7-2) Comments on First Sketch Explain: At this phase we focused on the layout design and the relations between the buildings and how to be presented as one whole integrated project. Advantages: The Spine is well presented. The project buildings are connected between each other. Urban spaces of each building can be defined. Disadvantages: Architectural functions are not studied well. No clear function for the connections in the landscape that connects between each building.
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(7-3) Second Sketch
Fig. (7-4) Second Sketch
Fig. (7-5) Second Sketch
71
Bio-neering Medical City Design Development
Fig. (7-6) Second Sketch
Fig. (7-7) Second Sketch
Fig. (7-8) Second Sketch
Fig. (7-9) Second Sketch
(7-4) Comments on First Sketch Explain: At this phase we focused on the functions of each project and the function of the connections between the buildings. Advantages: The architecture function is studied and shown with some needed modifications and progress. Disadvantages: The forms of the buildings lacked details. The projects facade lacked details and not presented well.
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(7-5) Third Sketch
Fig. (7-10) Third Sketch, Group board
73
Fig. (7-11) Third Sketch, hospitals board
74
Fig. (7-12) Third Sketch, hospitals board
75
Fig. (7-13) Third Sketch, hospitals board
76
Fig. (7-14) Third Sketch, Research Center board
77
Fig. (7-15) Third Sketch, Research Center board
78
Fig. (7-16) Third Sketch, Convention Center board
79
Fig. (7-17) Third Sketch, Convention Center board
80
Fig. (7-18) Third Sketch, Bio-Medical Institute board
81
Fig. (7-19) Third Sketch, Bio-Medical Institute board
82
Lessons learnt & recommendatiosn
83
Bio-neering Medical City Lesson Learnt & Recommendations Lesson Learnt & Recommendations Lesson Learnt : Regarding the Project 1. Introducing and studying a new field of medicine that’s been spread around the world. 2. Increasing our self knowledge with the deep study that was done to understand the whole field with all its aspects and how it’s been performed, what materials and environment does it need. 3. All the gathered knowledge and data helped in setting the team minds to form the concept and the design theme that connects the whole five projects together. Regarding the site analysis 1. It is important to study the site climate conditions especially when designing a project with medical aspect and whether it will be a good zone for patients and doctors or not. 2. SWOT Analysis can be helpful to study the site strength and weakness points and taking them into consideration while designing. 3. Studying the neighbourhood context helps in knowing how the project can be a complementary to these buildings and not a threat. Regarding the project zoning and programmatic concept 1. Studying the relationships within the one building. 2. Connecting between the different buildings functionally and how each project of the five projects depends and serves the other one. 3. Creating exterior functional connections between the buildings to represent the project as one whole building and so to facilitate the movement of the users from one building to the other.
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Recommendations: To other Architects 1. Gathering a lot of data about the site of the project,its strength and weakness and if there are any dangers that will affect the project in the future. 2. Studying many case studies that have similarities with the project. 3. Studying the climate and environmental conditions that will help in directing and choosing the best location of the project. 4. With project of multiple buildings, Studying the relations between all the buildings is important, and how each building will benefit the other, so to make it a one whole integrated project. 5. Always have a quick look on all the project phases as each phase affects the other. 6. Introducing sustainable technologies to the project as much as possible as the future needs to solve the global warming problem, so the future architecture is based on recycling, and how the building can have positive effect to the surrounding environment. 7. Make use of the natural elements of the site and the surrounding areas. 8. Studying how the project will benefit the country or the location designed on it. To the government 1. Completion with concern the planning of Borg Al Arab city as it’s a city with many potentials. 2. The city is of a good location to investments and projects with foreign target groups as it’s close to an international airport and close to the Mediterranean coast without having so humid climate like cities on the Mediterranean coast. 3. Giving more concern to the planned medical zone in Borg Al Arab as it will be a good medical beacon if it’ll be designed creatively and with sustainable aspect.
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References
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References Journals Al Ahram Journal, May 2016 Papers Rannan-Eliya, Ravi P., Blanco-Vidal, Claudia, and Nandakumar, A. K., “The Distribution of Health Care Resources in Egypt: Implications for Equity”, Mooneya, David J., and Maoa, Angelo S., “Regenerative medicine: Current therapies and future directions”, 2015 Websites http://www.worldlifeexwpectancy.com/egypt-coronary-heart-disease WHO Egypt Statistical Profile, http://www.who.int/countries/egy/en/, Last Accessed, June 2017 Telegraph, “Organ donation crisis threatens hundreds of lives”, http://www.telegraph. co.uk/news/health/news/11749503/Organ-donation-crisis-threatens-hundreds-of-lives. html, Last Accessed, 4/2017 Nature biotechnology, “3D bioprinting of tissues and organs”, http://www.nature.com/ nbt/journal/v32/n8/full/nbt.2958.html, Last Accessed 5/5/2016 Nature biotechnology, “Selected companies with tissue engineering programs”, http:// www.nature.com/nbt/journal/v18/n10s/fig_tab/nbt1000_IT56_T1.html , Last Accessed 5/2017 محافظة االسكندريةhttp://www.alexandria.gov.eg/Government/districts/alborg/Map.aspx هيئة المجتمعات العمرانية الجديدةwww.newcities.gov.eg SolarGIS, http://solargis.com/products/maps-and-gis-data/free/download/africa-and-middle-east SolarGIS, http://solargis.com/products/maps-and-gis-data/free/download/egypt SunCalc, http://suncalc.net/#/30.8711,29.5702,13/2017.03.15/23:52 Sunearthtools, https://www.sunearthtools.com/dp/tools/pos_sun.php#top MeteoBlue, https://www.meteoblue.com/en/weather/forecast/ Topograpgic map, http://en-ca.topographic-map.com/places/Egypt-7855099/ ArcGIS, https://www.arcgis.com/home/webmap/viewer.html?webmap=a72b0766aea04b48bf7a0e8c27ccc007
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Archdaily, http://www.archdaily.com/225153/sheikh-khalifa-medical-city-in-abu-dhabisom http://www.som.com/projects/sheikh_khalifa_medical_city www.Slideshare.com
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