bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pseudotachylyte increases the post-slip strength of faults
Authors: Proctor B. , Lockner D.A. 
Published: October 2016

Abstract
Solidified frictional melts, or pseudotachylytes, are observed in exhumed faults from across the seismogenic zone. These unique fault rocks, and many experimental studies, suggest that frictional melting can be an important process during earthquakes. However, it remains unknown how melting affects the post-slip strength of the fault and why many exhumed faults do not contain pseudotachylyte. Analyses of triaxial stick-slip events on Westerly Granite (Rhode Island, USA) sawcuts at confining pressures from 50 to 400 MPa show evidence for frictional heating, including some events energetic enough to generate surface melt. Total and partial stress drops were observed with slip as high as 6.5 mm. We find that in dry samples following melt-producing stick slip, the shear failure strength increased as much as 50 MPa, while wet samples had &lt;10 MPa strengthening. Microstructural analysis indicates that the strengthening is caused by welding of the slip surface during melt quenching, suggesting that natural pseudotachylytes may also strengthen faults after earthquakes. These results predict that natural pseudotachylyte will inhibit slip reactivation and possibly generate stress heterogeneities along faults. Wet samples do not exhibit melt welding, possibly because of thermal pressurization of water reducing frictional heating during slip.
Transitions in coral reef accretion rates linked to intrinsic ecological shifts on turbid-zone nearshore reefs
Authors: Morgan Kyle M. , Perry Chris T. , Smithers Scott G. , Johnson Jamie A. , Gulliver Pauline 
Published: October 2016

Abstract
Nearshore coral communities within turbid settings are typically perceived to have limited reef-building capacity. However, several recent studies have reported reef growth over millennial time scales within such environments and have hypothesized that depth-variable community assemblages may act as equally important controls on reef growth as they do in clear-water settings. Here, we explicitly test this idea using a newly compiled chronostratigraphic record (31 cores, 142 radiometric dates) from seven proximal (but discrete) nearshore coral reefs located along the central Great Barrier Reef (Australia). Uniquely, these reefs span distinct stages of geomorphological maturity, as reflected in their elevations below sea level. Integrated age-depth and ecological data sets indicate that contemporary coral assemblage shifts, associated with changing light availability and wave exposure as reefs shallowed, coincided with transitions in accretion rates at equivalent core depths. Reef initiation followed a regional ∼1 m drop in sea level (1200–800 calibrated yr B.P.) which would have lowered the photic floor and exposed new substrate for coral recruitment by winnowing away fine seafloor sediments. We propose that a two-way feedback mechanism exists where past growth history influences current reef morphology and ecology, ultimately driving future reef accumulation and morphological change. These findings provide the first empirical evidence that nearshore reef growth trajectories are intrinsically driven by changes in coral community structure as reefs move toward sea level, a finding of direct significance for predicting the impacts of extrinsically driven ecological change (e.g., coral-algal phase shifts) on reef growth potential within the wider coastal zone on the Great Barrier Reef.
‘Women and babies are dying but not of Ebola’: the effect of the Ebola virus epidemic on the availability, uptake and outcomes of maternal and newborn health services in Sierra Leone
Authors: Jones Susan A , Gopalakrishnan Somasundari , Ameh Charles A , White Sarah , van den Broek Nynke R 
Published: October 2016

BackgroundWe sought to determine the impact of the Ebola virus epidemic on the availability, uptake and outcome of routine maternity services in Sierra Leone.MethodsThe number of antenatal and postnatal visits, institutional births, availability of emergency obstetric care (EmOC), maternal deaths and stillbirths were assessed by month, by districts and by level of healthcare for 10 months during, and 12 months prior to, the Ebola virus disease (EVD) epidemic. All healthcare facilities designated to provide comprehensive (n=13) or basic (n=67) EmOC across the 13 districts of Sierra Leone were included.ResultsPreservice students were not deployed during the EVD epidemic. The number of healthcare providers in facilities remained constant (incidence rate ratio (IRR) 1.03, 95% CI 1.00 to 1.07). Availability of antibiotics, oxytocics, anticonvulsants, manual removal of placenta, removal of retained products of conception, blood transfusion and caesarean section were not affected by the EVD epidemic. Across Sierra Leone, following the onset of the EVD epidemic, there was a 18% decrease in the number of women attending for antenatal (IRR 0.82, 95% CI 0.79 to 0.84); 22% decrease in postnatal attendance (IRR 0.78, 95% CI 0.75 to 0.80) visits and 11% decrease in the number of women attending for birth at a healthcare facility (IRR 0.89, 95% CI 0.87 to 0.91). There was a corresponding 34% increase in the facility maternal mortality ratio (IRR 1.34, 95% CI 1.07 to 1.69) and 24% increase in the stillbirth rate (IRR 1.24, 95% CI 1.14 to 1.35).ConclusionsDuring the EVD epidemic, fewer pregnant women accessed healthcare. For those who did, an increase in maternal mortality and stillbirth was observed. In the post-Ebola phase, ‘readiness’ (or not) of the global partners for large-scale epidemics has been the focus of debate. The level of functioning of the health system with regard to ability to continue to provide high-quality effective routine care needs more attention.
What shape do UK trainees want their training to be? Results of a cross-sectional study
Authors: Harries Rhiannon L , Rashid Mustafa , Smitham Peter , Vesey Alex , McGregor Richard , Scheeres Karl , Bailey Jon , Sohaib Syed Mohammed Afzal , Prior Matthew , Frost Jonathan , Al-Deeb Walid , Kugathasan Gana , Gokani Vimal J 
Published: October 2016

ObjectivesThe British Government is acting on recommendations to overhaul postgraduate training to meet the needs of the changing population, to produce generalist doctors undergoing shorter broad-based training (Greenaway Review). Only 45 doctors in training were involved in the consultation process. This study aims to obtain a focused perspective on the proposed reforms by doctors in training from across specialities.DesignProspective, questionnaire-based cross-sectional study.Setting/participantsFollowing validation, a 31-item electronic questionnaire was distributed via trainee organisations and Postgraduate Local Education and Training Board (LETB) mailing lists. Throughout the 10-week study period, the survey was publicised on several social media platforms.ResultsOf the 3603 demographically representative respondents, 69% knew about proposed changes. Of the respondents, 73% expressed a desire to specialise, with 54% keen to provide general emergency cover. A small proportion (12%) stated that current training pathway length is too long, although 86% felt that it is impossible to achieve independent practitioner-level proficiency in a shorter period of time than is currently required. Opinions regarding credentialing were mixed, but tended towards disagreement. The vast majority (97%) felt credentialing should not be funded by doctors in training. Respondents preferred longer placement lengths with increasing career progression. Doctors in training value early generalised training (65%), with suggestions for further improvement.ConclusionsThis is the first large-scale cross-specialty study regarding the Shape of Training Review. Although there are recommendations which trainees support, it is clear that one size does not fit all. Most trainees are keen to provide a specialist service on an emergency generalist background. Credentialing is a contentious issue; however, we believe removing aspects from curricula into post-Certificate of Completion of Training (CCT) credentialing programmes with shortened specialty training routes only degrades the current consultant expertise, and does not serve the population. Educational needs, not political winds, should drive changes in postgraduate medical education and all stakeholders should be involved.
Comparison of acupuncture pretreatment followed by letrozole versus letrozole alone on live birth in anovulatory infertile women with polycystic ovary syndrome: a study protocol for a randomised controlled trial
Authors: Li Juan , Ng Ernest Hung Yu , Stener-Victorin Elisabet , Hu Zhenxing , Wu Wanting , Lai Maohua , Wu Taixiang , Ma Hongxia 
Published: October 2016

IntroductionThe high prevalence of insulin resistance in women with polycystic ovary syndrome (PCOS) is considered to be one of the major pathophysiological changes in PCOS that leads to anovulatory infertility. We hypothesise that electroacupuncture pretreatment improves insulin sensitivity and leads to a higher ovulation rate and greater chances of live birth after the induction of ovulation. The effect of electroacupuncture pretreatment followed by ovulation induction in women with anovulatory PCOS has not been investigated before, and we present here a randomised controlled trial to test this hypothesis by comparing electroacupuncture pretreatment followed by letrozole versus letrozole alone in anovulatory women with PCOS.Methods/analysisThis is a multicentre, randomised,and controlled trial. A total of 384 patients will be enrolled in this study and will be randomly allocated by a central randomisation system to the treatment group or the control group in a 1:1 ratio. The treatment group will undergo 16 weeks of electroacupuncture pretreatment followed by 4 cycles of letrozole, and the control group will only undergo 4 cycles of letrozole. The primary outcome will be the live birth rate. All statistical analyses will be performed using the SPSS program V.21.0 (SPSS, Chicago, Illinois, USA), and a p value <0.05 will be considered statistically significant.Ethics/disseminationThis study has been approved by the ethics committees of each participating centre. Written consent will be obtained from each patient and her husband before any study procedure is performed. Adverse events will be categorised, and the percentage of patients experiencing adverse events or serious adverse events during the treatment period will be documented. The results of this trial will be disseminated in peer-reviewed journals and presented at international meetings.Trial registration numberNCT02491333.
Educational disparities in the intention to quit smoking among male smokers in China: a cross-sectional survey on the explanations provided by the theory of planned behaviour
Authors: Droomers Mariël , Huang Xinyuan , Fu Wenjie , Yang Yong , Li Hong , Zheng Pinpin 
Published: October 2016

ObjectivesWe aim to describe the intention to quit smoking among Chinese male smokers from different educational backgrounds and to explain this intention from their attitude, perceived social norms and self-efficacy regarding smoking cessation.SettingParticipants were recruited from workplaces and communities to reflect the occupational distribution in three cities (Shanghai, Nanning and Mudanjiang) in China.Design and participantsIn 2013 interviews were conducted with 3676 male smokers aged 18 years and older.Outcome measuresMultivariate logistic regression analyses calculated educational differences in the intention to quit smoking as well as the association between the intention to quit smoking and attitude, subjective norms, and self-efficacy. Bootstrapping estimated to what extent the educational disparities in the intention to quit smoking were mediated by these three determinants.ResultsNo educational disparities in the intention to quit smoking within 1 or 6 months were observed among male Chinese smokers (p=0.623 and p=0.153, respectively). A less negative attitude, a higher perceived subjective norm towards smoking cessation, and a higher perceived self-efficacy to quit smoking were all associated with intention to quit (all p values <0.001). Perceived subjective norms were the only component of the theory of planned behaviour that statistically significantly mediated the differences in the intention to quit smoking (within 1 or 6 months) between the lowest educated Chinese men and the groups with lower (β=0.039, 95% CI 0.017 to 0.071 and β=0.043, 95% CI 0.019 to 0.073), higher (β=0.041, 95% CI 0.017 to 0.075 and β=0.045, 95% CI 0.019 to 0.077) and the highest education (β=0.045, 95% CI 0.019 to 0.080 and β=0.050, 95% CI 0.023 to 0.083).ConclusionsIn order to prevent future socioeconomic disparities in smoking cessation, investment in a more stimulating social environment and norms towards smoking cessation among particularly the lowest educated Chinese men is warranted.
Does the UKCAT predict performance on exit from medical school? A national cohort study
Authors: MacKenzie R K , Cleland J A , Ayansina D , Nicholson S 
Published: October 2016

ObjectivesMost UK medical programmes use aptitude tests during student selection, but large-scale studies of predictive validity are rare. This study assesses the UK Clinical Aptitude Test (UKCAT:http://www.ukcat.ac.uk), and 4 of its subscales, along with individual and contextual socioeconomic background factors, as predictors of performance during, and on exit from, medical school.MethodsThis was an observational study of 6294 medical students from 30 UK medical programmes who took the UKCAT from 2006 to 2008, for whom selection data from the UK Foundation Programme (UKFPO), the next stage of UK medical education training, were available in 2013. We included candidate demographics, UKCAT (cognitive domains; total scores), UKFPO Educational Performance Measure (EPM) and national exit situational judgement test (SJT). Multilevel modelling was used to assess relationships between variables, adjusting for confounders.ResultsThe UKCAT—as a total score and in terms of the subtest scores—has significant predictive validity for performance on the UKFPO EPM and SJT. UKFPO performance was also affected positively by female gender, maturity, white ethnicity and coming from a higher social class area at the time of application to medical school An inverse pattern was seen for a contextual measure of school, with those attending fee-paying schools performing significantly more weakly on the EPM decile, the EPM total and the total UKFPO score, but not the SJT, than those attending other types of school.ConclusionsThis large-scale study, the first to link 2 national databases—UKCAT and UKFPO, has shown that UKCAT is a predictor of medical school outcome. The data provide modest supportive evidence for the UKCAT's role in student selection. The conflicting relationships of socioeconomic contextual measures (area and school) with outcome adds to wider debates about the limitations of these measures, and indicates the need for further research.
Healthcare costs in chronic kidney disease and renal replacement therapy: a population-based cohort study in Sweden
Authors: Eriksson Jonas K , Neovius Martin , Jacobson Stefan H , Elinder Carl-Gustaf , Hylander Britta 
Published: October 2016

ObjectiveTo compare healthcare costs in chronic kidney disease (CKD) stage 4 or 5 not on dialysis (estimated glomerular filtration rate <30 mL/min/1.73m2), peritoneal dialysis, haemodialysis and in transplanted patients with matched general population comparators.DesignPopulation-based cohort study.SettingSwedish national healthcare system.ParticipantsPrevalent adult patients with CKD 4 or 5 (n=1046, mean age 68 years), on peritoneal dialysis (n=101; 64 years), on haemodialysis (n=460; 65 years) and with renal transplants (n=825; 52 years) were identified in Stockholm County clinical quality registers for renal disease on 1 January 2010. 5 general population comparators from the same county were matched to each patient by age, sex and index year.Primary and secondary outcome measuresAnnual healthcare costs in 2009 incurred through inpatient and hospital-based outpatient care and dispensed prescription drugs ascertained from nationwide healthcare registers. Secondary outcomes were annual number of hospital days and outpatient care visits.ResultsPatients on haemodialysis had the highest mean annual cost (€87 600), which was 1.49 (95% CI 1.38 to 1.60) times that observed in peritoneal dialysis (€58 600). The mean annual cost was considerably lower in transplanted patients (€15 500) and in the CKD group (€9600). In patients on haemodialysis, outpatient care costs made up more than two-thirds (€62 500) of the total, while costs related to fluids ($29 900) was the largest cost component in patients on peritoneal dialysis (51%). Compared with their matched general population comparators, the mean annual cost (95% CI) in patients on haemodialysis, peritoneal dialysis, transplanted patients and patients with CKD was 45 (39 to 51), 29 (22 to 37), 11 (10 to 13) and 4.0 (3.6 to 4.5) times higher, respectively.ConclusionsThe mean annual costs were ∼50% higher in patients on haemodialysis than in those on peritoneal dialysis. Compared with the general population, costs were substantially elevated in all groups, from 4-fold in patients with CKD to 11, 29 and 45 times higher in transplanted patients and patients on peritoneal dialysis and haemodialysis, respectively.
Combination with intravenous iron supplementation or doubling erythropoietin dose for patients with chemotherapy-induced anaemia inadequately responsive to initial erythropoietin treatment alone: study protocol for a randomised controlled trial
Authors: Chen Lin , Jiang Hong , Gao Wei , Tu Ye , Zhou Ying , Li Xi , Zhu Zhe , Jiang Qixin , Zhan Haifeng , Yu Jiangming , Fu Chuangang , Gao Yong 
Published: October 2016

IntroductionErythropoietin (EPO) is a commonly used option in the treatment of chemotherapy-induced anaemia (CIA). However, ∼30–50% of patients fail to achieve an adequate response after initial treatment. Prior studies have demonstrated that intravenous iron might synergistically improve therapeutic response to EPO treatment in this patient population.Methods and analysisWe will perform this multicentre, randomised, open-label, parallel-group, active controlled non-inferiority study to compare the two combination therapies of EPO plus intravenous iron regimen versus doubling the dose of EPO in patients with CIA who have an inadequate response to initial EPO treatment at a routine dose. A total of 603 patients with an increase in haemoglobin (Hb) <1 g/dL will be enrolled and randomised to one of the three study treatment groups at a 1:1:1 ratioGroup 1: EPO treatment at the original dose plus intravenous iron dextran 200 mg every 3 weeks (Q3W) for 15 weeks;Group 2: EPO treatment at the original dose plus intravenous iron dextran 100 mg, twice a week for 5 weeks;Group 3: the control group, doubling the EPO dose without preplanned iron supplementation. The primary outcome measure to compare is the Hb response rate at week 15 and the secondary end points involve therapeutic blood transfusions. Time-to-progression, adverse events and quality of life will also be evaluated.Ethics and disseminationAll participants will provide informed consent; the study protocol has been approved by the independent ethics committee of Shanghai East Hospital. This study would clearly demonstrate the potential benefit of combining epoetin treatment with intravenous iron supplementation. Findings will be shared with participating hospitals, policymakers and the academic community to promote the clinical management of CIA in China.Trial registration numberNCT02731378.
Long-term cost-effectiveness of collaborative care (vs usual care) for people with depression and comorbid diabetes or cardiovascular disease: a Markov model informed by the COINCIDE randomised controlled trial
Authors: Camacho Elizabeth M , Ntais Dionysios , Coventry Peter , Bower Peter , Lovell Karina , Chew-Graham Carolyn , Baguley Clare , Gask Linda , Dickens Chris , Davies Linda M 
Published: October 2016

ObjectivesTo evaluate the long-term cost-effectiveness of collaborative care (vs usual care) for treating depression in patients with diabetes and/or coronary heart disease (CHD).Setting36 primary care general practices in North West England.Participants387 participants completed baseline assessment (collaborative care: 191; usual care: 196) and full or partial 4-month follow-up data were captured for 350 (collaborative care: 170; usual care: 180). 62% of participants were male, 14% were non-white. Participants were aged ≥18 years, listed on a Quality and Outcomes Framework register for CHD and/or type 1 or 2 diabetes mellitus, with persistent depressive symptoms. Patients with psychosis or type I/II bipolar disorder, actively suicidal, in receipt of services for substance misuse, or already in receipt of psychological therapy for depression were excluded.InterventionCollaborative care consisted of evidence-based low-intensity psychological treatments, delivered over 3 months and case management by a practice nurse and a Psychological Well Being Practitioner.Outcome measuresAs planned, the primary measure of cost-effectiveness was the incremental cost-effectiveness ratio (cost per quality-adjusted life year (QALY)). A Markov model was constructed to extrapolate the trial results from short-term to long-term (24 months).ResultsThe mean cost per participant of collaborative care was £317 (95% CI 284 to 350). Over 24 months, it was estimated that collaborative care was associated with greater healthcare usage costs (net cost £674 (95% CI −30 953 to 38 853)) and QALYs (net QALY gain 0.04 (95% CI −0.46 to 0.54)) than usual care, resulting in a cost per QALY gained of £16 123, and a likelihood of being cost-effective of 0.54 (willingness to pay threshold of £20 000).ConclusionsCollaborative care is a potentially cost-effective long-term treatment for depression in patients with comorbid physical and mental illness. The estimated cost per QALY gained was below the threshold recommended by English decision-makers. Further, long-term primary research is needed to address uncertainty associated with estimates of cost-effectiveness.Trial registration numberISRCTN80309252; Post-results.