The Paleo-Orientations of Northwestern Borneo and Adjacent South China Sea Basins

DOI: 10.17014/ijog.v7i2.136Limited paleomagnetic data from West Kalimantan and southwestern Sarawak appear to indicate counter-clockwise (CCW) rotation of over 50 degrees during Cenozoic. On the other hand, similar studies from Sabah show conflicting results in terms of paleo-positions. This CCW information and other plate tectonic considerations have formed the base of Southeast Asia\u27s plate reconstructions that have seen print in a number of updated versions. The existing publications on extensive field and exploration data, including geological stress fields from wellbore breakouts, on northwestern Borneo and basins of South China Sea have not been taken into account. The latter wealth of information already established that the region under discussion consists of a mosaic-like assemblage of diverse tectono-stratigraphic terranes, each with separate tectonic development. Stress fields changed in different ways in the different terranes indicating definitively that regional, progressive CCW rotation of Borneo is not possible

Wrench-Slip Reversals and Structural Inversions: Cenozoic Slide-Rule Tectonics in Sundaland

DOI: 10.17014/ijog.v1i1.174Most of continental Southeast Asia, that is, Sundaland and Indosinia, achieved a relative tectonic stability by the beginning of the Cenozoic. Since then a strong tectonic activity in Sundaland has been restricted to existing regional fault zones and to regional slow, vertical crustal movements elsewhere that produced small to very large sedimentary basins. On the other hand, regional deformation of Indosinia as a consequence of ductile shearing has continued into the Paleogene. Since the Oligocene, the northern part of Sundaland and Indosinia have been extruded differentially towards southeast along the Red River, Wang Chao (or Mae Ping, or Tonle Sap), and Three Pagodas - Axial Malay fault zones. The initial cause has been attributed to hard collision between Subplate India with Megaplate Eurasia. Plate dynamics in the region have changed substantially since Mid-Miocene as to force wrench-slip reversals along the major fault zones in Sundaland as well as in Indosinia. Concomitant structural inversions are demonstrated on seismic sections. In the core of Sundaland, earlier transtensional wrenching was succeeded by transpressive strike-slip faulting that on major faults of the Malay Basin manifested in reversals of sense. From the Hinge-line fault eastward, the transtensional left wrench slip was succeeded by transpressional dextral slip, while in the region to its west the wrench-slip kinematics was an earlier transtensional right slip followed by transpressional left slip. In the Strait of Malacca and eastern margin of Sumatra, right-lateral wrenching in the Neogene has been common. In certain places it could be established a wrench-slip of transtensional character in Oligocene-Early Miocene, and the transpressional wrench movement occurred mainly during the Middle to Late Miocene. The remarkable coincidence of termination of spreading of the South China Basin in Langhian, and that of the West Philippine and Caroline basins during Mid-Miocene invites further study

OUTLINE OF QUATERNARY TECTONICS OF INDONESIA

Quaternary teetonics in fndonesia is conveniently grouped into four types comprising ( 1) uplift and subsidence, Q)warping and folding, (3) horizontal displacements, and (4) volcanotectonic deformations. Quaternary age of the various deformations is mostly inferred from horizontal to subhorizontal attitudes of strata or erosion surfaces, percentage of living mollusc and/or coral species in fossil assemblages, mammalian fauna, imglements, incomplete recrystallization or compaction of sediments, and incomplete devellopment of post Glacial "Daly levels". Radiometric dates for fndonesian Quaternary deposits are rare. Uplift is generally intermittentas is indicated by the presence of multfple coral reef terraces and other types of marine phenomena. The maximum uplift has exceeded 750 meter during the Quaternary. Subsidence implies similar rates of displacement but results in greater depths through absence of denudation. Quaternary folding has raised the land to about 300 meter elevation. Warping has even affected the "stable" regions like e.g. the Sunda Shelf. Horizontal displacements are important along transcurrent faults; e.g. the Lembang Fault near Bandurg, Java, displays a mean horizontal shift of L40 m in the last 6,000 years or even shorter. Vertical displacement through volcanotectonic collapse of the volcanoes and resulting folding through gravity tectonics of the bases are common features and has continued into subhistorical time. Contemporary tectonic diastrophism such as uplift and faulting is especially apparent in the Moluccas. 

Sifat Optik Film Disperse Red-1 Yang Dibuat Dengan Metode Efa-pvd

Tujuan dilakukannya penelitian ini adalah untuk mengkaji efek permukaan substrat ITO dan medan listrik luar dalam mengatur orientasi molekul film DR-1; dan juga mengkaji sifat optik film DR-1 untuk aplikasi divais fotonik. Metode fabrikasi yang digunakan adalah metode EFA-PVD (Electric Field Assisted Physical Vapor Deposition,). Metode tersebut adalah modifikasi dari metodekonvensional PVD (Physical Vapor Deposition) yang dilengkapi dengan penambahan medan listrik luar (E) dalam chamber. Film dibuat di atas permukaan substrat ITO (Indium Tin Oxide) dengan deposisi molekul-molekul DR-1 oleh variasi medan listrik luar. Film dianalisis dan dikarakterisasidengan menggunakan spektroskopi SEM, difraksi sinar-X, dan reflektometer. Hasil analisis pengukuran SEM, dan difraksi sinar-X memperlihatkan bahwa molekul-molekul DR-1 tersusun teratur (stacking) tegak lurus permukaan substrat, yang menunjukkan suatu indikasi efek permukaan (surfactant effect) substrat yang kuat dari ikatan hidrogen (hydrogen bonding) molekul DR-1 dengan substrat. Hasil pengukuran sifat optik menunjukkan bahwa dengan peningkatan medan listrik luar, terjadi peningkatan konsentrasi molekul-molekul DR-1 yang terdeposisi teratur paralel (stacking) tegak lurus permukaan substrat yang ditandai dengan peningkatan indeks bias film

Technological Resources and Personnel Costs Required to Implement an Automated Alert System for Primary Care Physicians When Patients Transition from Hospitals to Home

Background With the adoption of electronic medical records by medical group practices, there are opportunities to improve the quality of care for patients discharged from hospitals. However, there is little guidance for medical groups outside of integrated hospital systems to automate the flow of patient information during transitions in care. Objective To describe the technological resources, expertise and time needed to develop an automated system providing information to primary care physicians when their patients transition from hospitals to home. Development Within a medical group practice, we developed an automated alert system that provides notification of discharges, reminders of the need for follow-up visits, drugs added during in-patient stays, and recommendations for laboratory monitoring of high risk drugs. We tracked components of the information system required and the time spent by team members. We used US national averages of hourly wages to estimate personnel costs. Application Critical components of the information system are notifications of hospital discharges through an admission, discharge and transfer registration (ADT) interface, linkage to the practice’s scheduling system, access to information on pharmacy dispensing and lab tests, and an interface engine. Total personnel cost was $76,314. Nearly half (47%) was for 614 hours by physicians who developed content, provided overall project management, and reviewed alerts to ensure that only “actionable” alerts would be sent. Conclusion Implementing a system to provide information about patient transitions requires strong internal informatics expertise, cooperation between facilities and ambulatory providers, development of electronic linkages, and extensive commitment of physician time

Intervention to Reduce Adverse Outcomes among Older Adults Discharged from Skilled Nursing Facilities to Home

Background: Older adults may be at risk for adverse outcomes after discharge from skilled nursing facilities (SNF), but little research has focused on this transition. Objective: To assess the impact of an alert system on the rates of adverse outcomes among older adults discharged from SNFs to home. Methods: Within a multispecialty group practice, we tracked 30-day re-hospitalizations after SNF discharges during an intervention that provided discharge alerts to primary care physicians. We compared them to discharges from the pre-intervention period matched on age, gender and SNF. For the first 100 intervention discharges and their matches, we performed chart reviews to identify adverse drug events (ADEs). Multivariate analyses controlled for age, gender and intervention status. Results: We matched 313 intervention SNF discharges to 313 previous discharges. There was a slight reduction in the rate of 30-day re-hospitalization (30% vs. 31%) adjusted. Within the ADE study, 30% of the discharges during the intervention period and 30% of matched discharges had ADEs within 45 days. Among the 83 ADEs identified, 28% were deemed preventable; 69% resulted in symptom duration more than one day; 69% occurred within the first 14 days after discharge. This was a highly vulnerable population: mean age 82.5 (standard deviation (SD) 6.7); mean number of prescribed medications 11.9 (SD 8); 17% had Charlson Comorbidity Scores of ≥4. Common clinical conditions included myocardial infarction (24%), heart failure (22%), COPD (23%), and major depression (28%). Patients with scores of ≥4 were more likely to experience an ADE than those with lower scores (adjusted OR 2.5 (CI 1.2, 5.5), RD 0.21). Conclusion: Simply providing alerts when these vulnerable patients are discharged from SNFs is not sufficient to lower rates of adverse outcomes. Further research is required to track trajectories and identify additional points for interventions

Reducing Rehospitalizations through Automated Alerts to Primary Care Providers and Staff When Older Patients are Discharged from the Hospital: A Randomized Trial

Background: Inadequate continuity of care places older patients at very high risk during transitions from the hospital to ambulatory setting. Methods: We conducted a randomized controlled trial of an HIT-based transitional care intervention in patients aged 65 and older discharged from hospital to home. All patients were senior plan members of a Massachusetts-based health plan, and cared for by a multispecialty medical group using the EpicCare Ambulatory Medical Record. In addition to notifying providers about the patient’s recent transition, the system provided information about new drugs added during the inpatient stay, warnings about drug-drug interactions, recommendations for dose changes and laboratory monitoring of high-risk medications, and reminded the primary care provider’s support staff to schedule a post-hospitalization office visit. Randomization occurred at the time of hospital discharge during a one-year intervention period beginning in August 2010. Alerts were automatically delivered to the provider and staff in-basket within the EMR. The primary outcomes were: 1) having an outpatient office visit with the primary care provider within 30 days following discharge; and 2) having a rehospitalization within 30 days following discharge. Results: The study included 3667 discharges of which 1877 discharges were randomly assigned to the intervention arm. Forty-nine percent of discharges in the intervention arm were followed by office visits with the primary care provider within 30 days, compared to 51% in the comparison arm (RR 0.96, 95% CI 0.90, 1.03). Eighteen percent of discharges in the intervention arm were followed by a rehospitalization within 30 days compared to 20% in the comparison arm (RR 0.92, 95% CI 0.80, 1.05). Conclusions: This HIT-based intervention was not effective in increasing the percentage of hospital discharges of older patients that were followed by timely office visits to primary care providers or reducing the percentage with rehospitalization

Adverse Drug Events Post-Hospital Discharge in Older Patients: Types, Severity, and Involvement of Beers Criteria Medications

Objective: To characterize adverse drug events (ADEs) occurring within the high-risk 45-day period post-hospitalization in older adults. Design: Clinical pharmacists reviewed the ambulatory records of 1000 consecutive discharges. Setting: A large multispecialty group practice closely aligned with a Massachusetts-based health plan. Participants: Hospitalized patients aged 65 years and older who were discharged to home. Measurements: Possible drug-related incidents occurring during the 45-day period post-hospitalization were identified and presented to a pair of physician-reviewers who classified incidents as to whether an ADE was present, whether the event was preventable, and the severity of the event. Medications implicated in ADEs were further characterized according to their inclusion in the 2012 Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Results: At least one ADE was identified during the 45-day period in 18.7% (187) of the 1000 discharges. Of the 242 ADEs identified, 35% (n=84) were deemed preventable, of which 32% (n=27) were characterized as serious, and 5% (n=4) as life threatening. Over half of all ADEs occurred within the first 14 days post-hospitalization. The percentage of ADEs in which Beers Criteria medications were implicated was 16.5% (n=40). Beers Criteria medications with both a high quality of evidence and strong strength of recommendation were implicated in 6.6% (n=16) of the ADEs. Conclusion: ADEs are common and often preventable among older adults following hospital discharge, underscoring the need to address medication safety during this high-risk period in this vulnerable population. Beers Criteria medications played a small role in these events suggesting that efforts to improve the quality and safety of medication use during this critical transition period must extend beyond a singular focus on Beers criteria medications

Osteopontin Impairs Host Defense during Established Gram-Negative Sepsis Caused by Burkholderia pseudomallei (Melioidosis)

Melioidosis is a severe tropical disease caused by infection with the bacterium Burkholderia (B.) pseudomallei. In northeast Thailand infection with this bacterium is the major cause of community-acquired septicemia with a mortality rate up to 40%. Extending the knowledge on the mechanisms of host defense against B. pseudomallei infection would be helpful to improve treatment of this severe illness. Osteopontin (OPN) is a cytokine that is involved in several immune responses that occur during bacterial infection. In this study, we investigated levels of OPN in patients with melioidosis, and studied the function of OPN during experimental melioidosis in mice. We found that OPN concentrations were elevated in patients with severe melioidosis, and that high OPN concentrations are associated with poor outcome in patients with melioidosis. In experimental melioidosis in mice plasma and lung OPN levels were also increased. Moreover, mice with melioidosis that were deficient for OPN demonstrated reduced bacterial numbers in their lungs, diminished pulmonary tissue injury, and decreased neutrophil infiltration into the lungs during established melioidosis. Moreover, these mice displayed a delayed mortality as compared to control mice. In conclusion, sustained production of OPN impairs host defense during melioidosis