Impact of Earthquakes on the Transportation Infrastructure of Indonesia: A Preliminary Study

Indonesia is a high seismic region and one of the most vulnerable countries prone to experiencing damaging earthquakes. It is critical that lifeline infrastructure remain operational or is quickly remediated after an earthquake to minimise physical, social, and economical losses. Not much work has been carried out in understanding the effect of earthquakes on transportation infrastructure systems. This study aims to gain a better understanding of the impact of earthquakes on the transportation infrastructure in Indonesia. This is achieved by firstly reviewing the frameworks and tools for conducting seismic risk assessment of lifeline infrastructure. The critical components of the transportation system are then identified. Various forms of transportation infrastructure damage caused by earthquakes are discussed. An overview of the damaging earthquakes for the past 20 years is presented. Finally, conclusions and recommendations are provided about the future work required for conducting risk assessment of the transportation infrastructure in Indonesia

Tear Film, Lacrimal Drainage System, and Eyelid Findings in Subjects with Anophthalmic Socket Discharge

Purpose To compare the results of tear film and lacrimal drainage system tests between anophthalmic socket and normal eye and assess discharge characteristics and frequency of prosthesis removal (questionnaire), eyelid function, and meibomian glad dysfunction (MGD). Design Prospective masked case control. Methods Subjects (�6 years and �6 months of wearing prosthesis) with unilateral acquired anophthalmic socket discharge were included. Excluded was ocular adnexal abnormality of any reason and incomplete tests. The subjective questionnaire was completed. Blinking rate, lagophthalmos, eyelid laxity, MGD, Schirmer test, tear meniscus height, and dye disappearance test were assessed by a masked examiner. Another masked examiner performed an irrigation test 1 week later and interpreted the scintigraphy images at the end of the study. Results Included were 50 subjects (mean age: 31.3 years, mean prosthesis wear: 96.1 months). Discharge was frequent or very frequent in 85, mucoid or mucopurulent in 90, and moderate to severe in 86 of the subjects. MGD in 58, lagophthalmos in 80, and eyelid laxity in 46 were observed. Anophthalmic socket sides showed a significantly lower tear production and higher tear drainage obstruction. Subjects with frequent prosthesis removal had a significantly (P =.02) greater lagophthalmos and blinking rate (P =.04). The blinking rate was also significantly greater in subjects with higher frequency of discharge (P =.04). Conclusion Tear film impairment (aqueous and lipid) and lacrimal drainage obstruction should be considered in subjects with anophthalmic socket discharge. A significantly higher blinking rate and lagophthalmos were found in subjects with higher frequency of prosthesis removal. © 2016 Elsevier Inc. All rights reserved

Echocardiographic Evaluation of Hemodynamic Changes in Left-Sided Heart Valves in Pregnant Women With Valvular Heart Disease

Physiologic changes during pregnancy can deteriorate or improve patients' hemodynamic status in the setting of valvular heart disease. There are sparse data regarding the effect of pregnancy on valve hemodynamics in normal pregnant women with known valvular heart disease. In a prospective study from July 2014 to January 2016, a total of 52 normal pregnant women who had mitral stenosis, aortic stenosis, or a history of mitral valve or aortic valve replacements were assessed. All patients underwent echocardiographic examinations and hemodynamic parameters were measured for both the mitral valve and aortic valve at first, second, and third trimesters. The parameters included mean gradient, peak gradient, mean gradient/heart rate, peak gradient/heart rate, pressure halftime, dimensionless velocity index, and valve area. Although most hemodynamic parameters (i.e., mean gradient, peak gradient, mean gradient/heart rate, and peak gradient/heart rate) increased approximately 50 from first to second trimester and first to third trimester (p 0.05). The ratio of changes between trimesters for valve area and dimensionless velocity index were comparable. No clinical decompensations were observed except for 3 and 7 cases of deterioration to functional class II at second and third trimesters, respectively. In conclusion, during a full-term and uncomplicated pregnancy, mitral and aortic valve gradients increase without significant changes in valve area that are more marked between the second and first trimester than between the third and second trimester. © 2016 Elsevier Inc