New evidence on palaeoenvironmental conditions in SW Cameroon since the Late Pleistocene derived from alluvial sediments of the Ntem River

An interior delta in the lower course of the Ntem River near the sub-prefecture Ma’an was identified after interpretation of satellite images, topographical maps of SW Cameroon and geological as well as hydrological references and a reconnaissance fieldtrip to the study area. Here neotectonic processes have initiated the establishment of a ‘sediment trap’ (step fault), which in combination with environmental changes strongly generated the fluvial morphology. It transitionally led to temporary lacustrine and palustrine conditions in parts of this river section. Inside the interior delta an anastomosing multi-branched river system has developed, which contains ‘stillwater locations', periodically inundated sections, islands and rapids. Following geomorphological, physiogeographical and sedimentological research approaches, the alluvial plain has been prospected and studied extensively. 91 hand-corings, including three NE–SW transects, were carried out on river benches, levees, cut-off and periodical branches, islands as well as terraces throughout the entire alluvial plain and have unveiled multi-layered, sandy to clayey alluvia reaching up to 440 cm depth. At many locations, fossil organic horizons and palaeosurfaces were discovered, containing valuable palaeoenvironmental proxy data. At these sites, through additional detailed stratigraphical analysis (close-meshed hand-coring and exposure digging) a comprehensive insight into the stratification (lamination) of the alluvia could be gained, clarifying processes and conditions that prevailed in the catchment area during the period of their deposition. 32 Radiocarbon data of macro-rests (leafs, wood), charcoal and organic sediment sampled from these horizons provided ages between 48.230 ± 6.411 and 217 ± 46 years BP (not calibrated). This constitutes the importance of the alluvia as an additional, innovative palaeoarchive for proxy data contributing to the reconstruction of palaeoenvironment and palaeoclimate in western Equatorial Africa. The further examination of the alluvia will not only provide additional information on the dynamics of vegetation, climate and hydrology (esp. fluvial morphology) in SW Cameroon since the ‘First Millennium BC Crisis’ (around 3.000 years BP), the main focus of the DFG-research project, but also on conditions prevailing since the Late Pleistocene, during the Last Glacial Maximum (~18.000 years BP), the Younger Dryas impact (~11.000 years BP) and the ‘Humid African Period’ (~9.000–6.000 years BP). Delta13C-values (–31,4 to –26,4‰) evidence that at the particular drilling sites rain forest has prevailed during the corresponding time period (rain forest refuge theory). The sampled macrorests all indicate rain forest dominated ecosystems, which were able to persist in fluvial habitats, even during arid periods

A paradigm shift in antithrombotic therapy

Ischemic heart disease is one of the most common causes of morbidity and mortality worldwide. Ischemic heart disease is usually a consequence of coronary atherosclerosis and acute coronary syndrome (ACS) is often the first clinical manifestation of this disease. Patients with ACS form a heterogeneous group with a varying risk of in-hospital and long-term mortality. Risk stratification is therefore important to identify patients who are at high risk and stand to benefit most from guideline-recommended therapies. In this thesis, we evaluate different risk stratification methods for patients with ACS. Antithrombotic therapy reduces the risk of recurrent ischemic events among patients presenting with ACS regardless of treatment strategy, but is also associated with increased bleeding risk. Current guidelines recommend 12 months of dual antiplatelet therapy (DAPT), consisting of aspirin and a P2Y12-inhibitor, following percutaneous coronary intervention (PCI) for ACS. However, given recent advances in stent technology and the high uptake of potent P2Y12-inhibitors, the risk of ischemic events, especially stent-related events, has been reduced. In this thesis, we discuss novel antithrombotic strategies, especially P2Y12-inhibitor monotherapy starting directly following PCI

THE EFFECT OF BRAND EQUITY ON PURCHASE DECISIONS AT BANJARMASIN ISLAMIC HOSPITAL, INDONESIA SERVICES

The tight competition in the hospital services industry requires each of these service providers to fix the services they provide to consumers. The hospital as a service provider must understand the expectations and desires of consumers well so that in the end the hospital will be able to provide services expected by consumers, this will certainly have an impact on the brand of the hospital itself. A brand makes it possible for hospitals to compete in the sale of products or services and shows the proportion of the value of its business strategy, therefore it is strategically very important to develop, filter and improve the brand of a product or service. This study focuses on analyzing the influence of brand equity variables on service purchase decisions, analyzing the influence of brand awareness on service purchase decisions, analyzing the influence of brand associations on service purchase decisions, analyzing the effect of perceived quality on service purchase decisions, and analyzing the effect of brand loyalty towards purchasing service decisions at Banjarmasin Islamic Hospital. This research is explanatory using survey research methods. The type of data used in this study is qualitative data and quantitative data. The data sources used in this study are primary data and secondary data, namely the results of interviews, questionnaires and data on the average number of days of care or Bed Occupancy Rate (BOR) of Banjarmasin Islamic Hospital. The sampling technique uses purposive sampling with multiple regression analysis with a total sample of 100 people. The results of regression coefficient show that all independent variables (Brand Equity, X) consist of Brand Awareness (X1), Brand Association (X2), Quality Perception (X3) and Brand Loyalty (X4) have a positive regression coefficient ie X1 = 0.691; X2 = 0.147; X3 = 0.067; X4 = 0.081 this shows that the independent variables are proportional to the dependent variable, namely the Purchase Decision. The degree of relationship between the independent variables and the dependent variable can be seen from the coefficient of determination (R Square) where it is known that the value of R Square in this study is 0.964 (96.4%). This shows that the magnitude of the influence of the independent variable (Brand Equity) on the dependent variable (Purchasing decision) is 96.4%. The results of the study show that the three sub-variables of brand equity affect the purchasing decisions of Banjarmasin Islamic Hospital services, namely brand awareness, brand association, and brand loyalty. While the perception of quality is considered to have no significant effect.  Article visualizations

Physiogeographical research on Pleistocene and Holocene palaeoenvironmental conditions in southern Cameroon derived from alluvia of the Ntem interior delta and alluvial sediments of the rivers Boumba, Ngoko, Nyong and Sanaga

Die Studie zur holozänen und pleistozänen Umweltgeschichte Süd-Kameruns betrachtet den Aussagewert alluvialer Ablagerungen der Flüsse Boumba, Dja, Nyong, Ntem und Sanaga für die Paläoumweltforschung. Die zugrundeliegende Forschungsarbeit fand im Rahmen des ReSaKo-Projektes, als Teil der interdisziplinären DFG-Forschergruppe 510 (“Ökologischer Wandel und kulturelle Umbrüche in West- und Zentralafrika”) statt, welches die zeitliche und räumliche Korrelation zwischen Klimawandel, Landnutzungsstrategien und kulturellen Innovationen während der “First Millennium BC Crisis” untersucht hat. Hierfür wurde der ökologisch sensitive Bereich des tropischen bis äquatorialen, immergrünen bis halb-immergrünen Guineisch-Kongolesischen Regenwaldes und dessen Übergangszone zur Savanne im Süden Kameruns ausgewählt. Als Hauptziele galten dabei zum einen der Nachweis und die Interpretation umweltgeschichtlich verwertbarer Alluvionen in einer diesbezüglich bisher unerforschten Region und zum anderen die Korrelation der Befunde mit bereits vorliegenden terrestrischen und hemi-pelagischen Paläoumweltarchiven zur weiteren Rekonstruktion der Paläoumweltbedingungen im westlichen (monsunalen) Äquatorialafrika. Nach der Identifizierung geeigneter Arbeitsgebiete entlang verzweigter, mäandrierender und verflochtener bis anastomosierender Flussabschnitte mittels Fernerkundung von Satellitenbildszenen (LANDSAT ETM+ und ASTER), wurden unter Verwendung physiogeographischer und geomorphologischer Arbeitsmethoden ausgedehnte Feldarbeiten während der Trockenzeiten der Jahre 2005-2008 durchgeführt. Zahlreiche Bohrarbeiten (161 Handbohrungen bis 550 cm Tiefe) zur Sedimentprobennahme (1093 Proben) innerhalb der Alluvial- und Auenbereiche der fluvialen Systeme lieferten einen umfassenden Einblick in die Stratigraphie und fluvial-morphologische als auch paläoökologische und –hydrologische Entwicklung der verschiedenen fluvialen Ökosysteme. Die mehrschichtigen, sandigen bis tonigen Alluvionen enthalten Paläooberflächen (z. B. Gyttjen, reliktische Sümpfe, fossile organische Lagen/Horizonte), die hervorragende zusätzliche Proxydaten-Archive für die Rekonstruierung umweltgeschichtlicher Bedingungen darstellen. Bohrtransekte und die Interpretation von Korngrößensequenzen (Verfeinerung, Vergröberung) und Paläooberflächen aus solchen alluvialen Sedimentarchiven stellen ein wichtiges, diagnostisches Instrument bei der Rekonstruktion paläoökologischer und paläohydrologischer Bedingungen und Veränderungen dar und belegen zeitweise einsetzende Austrocknung und Bodenbildung in den Auen sowie die Entstehung von Sümpfen, Mudden, Altarmen und Altwasserseen. Dies zeugt eindeutig von einer modifizierten Dynamik der fluvialen Systeme als Reaktion auf endogene Steuer-größen und (fluss-)interner Variabilität (equilibrium). Eine Vielzahl (76) von 14C (AMS)-Datierungen an organischem Sediment und Makroresten aus diesen Alluvionen lieferten spätpleistozäne bis rezente Alter (~48 – 0,2 ka BP). Die dazugehörigen δ13C-Werte (-35.5 bis -18.0 ‰) belegen für den Großteil der Untersuchungsstandorte (außer Oberläufe des Nyong und Sanaga) den Fortbestand von C3-Spezies dominierter Galleriewald-Ökosysteme entlang der Flusssysteme (“fluviale Regenwaldrefugien”) trotz einiger klimatischer Veränderungen/Aridisierungen (z. B. Letztes Glaziales Maximum um etwa 20.000 BP). Trotz der bestehenden Schwierigkeiten bei der Interpretation tropischer Sedimentarchive (z. B. Hiatusproblematik) und fluvialer Archive im Allgemeinen, unterstützen weitere sedimentologische und pedologische Analysen (bodenchemische und -physikalische Laboranalysen: Korngrößen, Kohlenstoff [Ctot], Stickstoff [N], Eisengehalt [Feo und Fed], pH, Munsell-Farben und C/N) und ausgewählte 14C (AMS)-Datierungen und δ13C-Bestimmungen diesen Beitrag zur hypothetischen Rekonstruktion der umweltgeschichtlichen und paläohydrologischen Entwicklung des Untersuchungsraumes. Die Interpretation des Alluvialarchivs liefert zusätzlich fundierte Informationen hinsichtlich der komplexen Zusammenhänge zwischen Klima, Ozean, fluvialen und ökologischen Systemen und anthropogener Einflussnahme in einem regional weitestgehend unerforschten Gebiet mit hoch-sensitiven tropischen Ökosystemen. Die Ergebnisse zeigen eine hohe Korrelation mit früheren Paläoumweltstudien, die über Untersuchungen an weiteren terrestrischen (lakustrin und palustrin) und hemi-pelagischen Archiven dieser Region gewonnen werden konnten. Sie bekräftigen Milanković- bis sub-Milanković-skalige Fluktuationen (bes. Präzession-Zyklus) der Intensität des westafrikanischen Monsuns und daraus resultierende klimatische, hydrologische und ökologische Modifikationen im Untersuchungsgebiet, was wiederum weitreichende Telekonnektionen und Reorganisationen impliziert. Insgesamt können im Liegenden grobkörnige, sandige sedimentäre Einheiten, welche turbulente fluvial-morphologische Bedingungen und geöffnete Landschaftsstrukturen während des Spätpleistozäns (48-30 ka BP) vermuten lassen, von fein-sandigen LGM-zeitlichen (22-16 ka BP) und mächtigen schluffigen bis tonigen, holozänen Sedimenteinheiten im Hangenden unterschieden werden, welche eher stabilisierte und saisonale Umweltverhältnisse widerspiegeln. Größere Um- und Verlagerungen innerhalb der Alluvialbereiche (v. a. Gerinnebettverlagerungen, Versumpfung) konnten für den Übergang vom Pleistozän zum Holozän (14-10 ka BP) nachgewiesen werden. Weitere einschneidende Veränderungen traten im Spätholozän auf (um 4, 2 und 0,8 ka BP), wahrscheinlich begünstigt durch die einsetzende Sesshaftwerdung Bantu sprechender Volksgruppen im tropischen Regenwald Zentralafrikas und die Einführung der Metallurgie um 3 ka BP. Die Informationen über regionale umweltgeschichtliche Oszillationen und Variationen im Prozess- und Landschaftsgefüge sind in den alluvialen Sedimenten gut dokumentiert und erhalten geblieben und ergänzen somit frühere Ergebnisse (z. B. ECOFIT Programm) zur spätquartären Umweltgeschichte des vom Monsun geprägten westlichen Äquatorialafrikas. Die Ergebnisse bestätigen vor allem die Bedeutung und Anwendbarkeit tropischer (afrikanischer) alluvialer Sedimente für die Paläoumweltforschung und belegen zudem, dass neben (neo-)tektonischen Impulsen das Klima die tragende Rolle in der Gestaltung der Landschaft und der Dynamik, sowie der Entwicklung der Flusseinzugsgebiete gespielt hat.This study on the Holocene and Pleistocene palaeoenvironment in southern Cameroon elucidates the value and relevance of mayor fluvial systems’ (Boumba, Dja, Nyong, Ntem and Sanaga) alluvial sediments for palaeoenvironmental research. It was realized within the framework of the “Regenwald-Savannen-Kontakt (ReSaKo)”-project, as part of the interdisciplinary DFG-research group 510 (“Ecological and cultural changes in West and Central Africa”). The latter focused on examining the temporal and spatial coherence of altering land-use strategies, cultural innovations and climate change during the so-called “First Millennium BC Crisis”. For this approach, study areas in the ecologically sensitive ecosystem of the equatorial and tropical evergreen to semi-deciduous Guinean-Congolian rain forest and its adjacent savanna margin in southern Cameroon were chosen. Mayor objectives of this study were the detection of palaeoenvironmentally interpretable alluvial sediments in a hitherto unexplored region and their subsequent interpretation and correlation with already existing terrestrial and hemi-pelagical sediment archives to further reconstruct palaeoenvironmental conditions in western (monsoonal) equatorial Africa. After remote-sensing of satellite imageries (LANDSAT ETM+, ASTER) to detect suitable study sites across braiding, meandering and anabranching to anastomosing river sections, extended fieldworks including physiogeographic and geomorphological research methods were carried out during dry seasons of 2005-2008. Numerous hand-corings (161 cores, up to depths of 550 cm) for sediment sampling (1093 samples) on alluvial ridges and floodplains of mayor fluvial systems provided a comprehensive insight into the stratigraphic record and fluvial-morphological as well as palaeoecological and -hydrological evolution of the fluvial ecosystems. The multilayered, sandy to clayey alluvia contain sedimentary form-units and palaeosurfaces (e.g. gyttja, relict swamp, fossil organic layers) which provide excellent additional proxy data archives for the reconstruction of palaeoenvironmental conditions. Coring transects and sedimentary profiles showing grain-size shifts and alternating sedimentary units in the stratigraphic records evidence temporal phases of desiccation and pedogenesis as well as formation of swamps, muds, oxbows and oxbow lakes (palaeochannels and palaeomeanders). This unequivocally indicates modified dynamics of the fluvial systems in response to external forcing and (river-)internal variability (equilibrium). Multiple (76) 14C-(AMS)-dated samples from organic sediment and macro-rests embedded in these sedimentary units indicate Late Pleistocene to recent ages (14C-ages: 48-0.2 ka BP). Corresponding δ13C-values (-35.5 to -18.0 ‰) for most study areas (except Nyong and Sanaga upper catchments) indicate the persistence of C3-dominated gallery forest ecosystems across the rivers (“fluvial rain forest refuges”) despite several climatic deteriorations/aridifications (e.g. Last Glacial Maximum [LGM], around approx. 20 ka BP). Regarding general problems and uncertainties of interpreting alluvial sediments (i.e. hiatus), additional sedimentological and pedological analysis (chemical and physical sediment analysis: texture, carbon [Ctot], nitrogen [N], organic material [OM], iron [Feo and Fed], pH and Munsell colour determination as well as C/N evaluation) and 14C (AMS) as well as δ13C data of selected samples substantiate this approach to hypothetically reconstruct the palaeoenvironmental and palaeohydrological conditions in the research area. The interpretation of the alluvial record offers excellent additional information on the complex feedbacks between climate, ocean, fluvial as well as ecological systems and human activity in a marginal studied region with high sensitive tropical ecosystems. The findings highly correlate with former palaeoenvironmental and palaeoclimatic reconstructions from additional terrestrial (lacustrine and palustrine) and hemi-pelagical archives from the region. They substantiate Milankovitch- to sub-Milankovitch-scale fluctuations (esp. precession cycle) of the western African monsoon intensity and inherited climatic, hydrological as well as ecological modifications in the study area, inducing large-scale teleconnections and reorganizations. Generally, several basal coarse-grained sandy units, representing turbulent fluvial-morphological conditions and instable landscape settings during the Late Pleistocene (48-30 ka BP), can be distinguished from more fine-grained sandy LGM-age (22-16 ka BP) and thick upper loamy to clayey Holocene units, indicating rather stable and seasonal environmental settings. Mayor reorganizations of the alluvial ridges (i.e. channel migration and wandering, swamp formation) have been allocated to the Pleistocene-Holocene transition around 14-10 ka BP. Further striking changes have been found for the Late Holocene (i.e. around 4, 2 and 0.8 ka BP), probably significantly enhanced by emerging sedentariness of Bantu speaking people in the tropical Central African rain forest and the inventory of metallurgy around 3 ka BP. However, the information on inherited regional oscillations, process and landscape variations have well been preserved in the alluvial sediment archives and thereby complement the earlier results (e.g. ECOFIT programme) on the Late Quaternary history of monsoonal western equatorial Africa. The results most of all corroborate the significance and applicability of tropical (African) alluvial sediment archives for palaeoenvironmental research and evidence that next to (neo-)tectonic impulses, climate may have played the mayor determining role in landscape and catchment dynamics and evolution

Probation Revocations as Delayed Dispositional Departures: Why Blakely v. Washington Requires Jury Trials at Probation Violation Hearings

status: publishe

EVALUASI PEMBANGUNAN DI BIDANG INFRASTRUKTUR DI KABUPATEN KUTAI TIMUR PASCA PEMEKARAN DAERAH

The purpose of this study is to evaluate the development of post-expansion infrastructure of the region in East Kutai Regency which is focused on the development of road infrastructure. The period of development that is evaluated is the period of 2011-2015. The results of research Infrastructure development in East Kutai Regency for the period of 2011-2015 shows that the development of road infrastructure is still uneven due to the vast area of East Kutai Regency, constrained by funding problems, land issues with residents and weather problems. Development is hampered because the distance between each sub-district is so far that the development so far has only focused on the development of the Capital district only Sangatta.Keyword : Evaluation of Development, Infrastructur