Cenozoic epeirogeny of the Indian peninsula

Peninsular India is a cratonic region with asymmetric relief manifest by eastward tilting from the 1.5 km high Western Ghats escarpment toward the flood-plains of eastward-draining rivers. Oceanic residual depth measurements on either side of India show that this west-east asymmetry is broader scale, occurring over distances of >2,000 km. Admittance analysis of free-air gravity and topography shows that the elastic thickness is 10 ± 3 km, suggesting that regional uplift is not solely caused by flexural loading. To investigate how Indian physiography is generated, we have jointly inverted 530 river profiles to determine rock uplift rate as a function of space and time. Key erosional parameters are calibrated using independent geologic constraints (e.g. emergent marine deposits, elevated paleosurfaces, uplifted lignite deposits). Our results suggest that regional tilt grew at rates of up to 0.1 mm a‾¹ between 25 Ma and the present day. Neogene uplift initiated in the south and propagated northward along the western margin. This calculated history is corroborated by low-temperature ther- mochronologic observations, by sedimentary flux of clastic deposits into the Krishna- Godavari delta, and by sequence stratigraphic architecture along adjacent rifted margins. Onset of regional uplift predates intensification of the Indian monsoon at 8 Ma, suggesting that rock uplift rather than climatic change is responsible for modern-day relief. A positive correlation between residual depth measure- ments and shear wave velocities beneath the lithosphere suggests that regional uplift is generated and maintained by temperature anomalies of ±100 ⁰C within a 200 ± 25 km thick asthenospheric channel

Cost-Effectiveness of Collaborative Care for Depression in UK Primary Care: Economic Evaluation of a Randomised Controlled Trial (CADET)

Background: Collaborative care is an effective treatment for the management of depression but evidence on its cost-effectiveness in the UK is lacking. Aims: To assess the cost-effectiveness of collaborative care in a UK primary care setting. Methods: An economic evaluation alongside a multi-centre cluster randomised controlled trial comparing collaborative care with usual primary care for adults with depression (n = 581). Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICER) were calculated over a 12-month follow-up, from the perspective of the UK National Health Service and Personal Social Services (i.e. Third Party Payer). Sensitivity analyses are reported, and uncertainty is presented using the cost-effectiveness acceptability curve (CEAC) and the cost-effectiveness plane. Results: The collaborative care intervention had a mean cost of £272.50 per participant. Health and social care service use, excluding collaborative care, indicated a similar profile of resource use between collaborative care and usual care participants. Collaborative care offered a mean incremental gain of 0.02 (95% CI: –0.02, 0.06) quality-adjusted life-years over 12 months, at a mean incremental cost of £270.72 (95% CI: –202.98, 886.04), and resulted in an estimated mean cost per QALY of £14,248. Where costs associated with informal care are considered in sensitivity analyses collaborative care is expected to be less costly and more effective, thereby dominating treatment as usual. Conclusion: Collaborative care offers health gains at a relatively low cost, and is cost-effective compared with usual care against a decision-maker willingness to pay threshold of £20,000 per QALY gained. Results here support the commissioning of collaborative care in a UK primary care setting

Search for astronomical neutrinos from blazar TXS 0506+056 in super-kamiokande

We report a search for astronomical neutrinos in the energy region from several GeV to TeV in the direction of the blazar TXS 0506+056 using the Super-Kamiokande detector following the detection of a 100 TeV neutrinos from the same location by the IceCube collaboration. Using Super-Kamiokande neutrino data across several data samples observed from 1996 April to 2018 February we have searched for both a total excess above known backgrounds across the entire period as well as localized excesses on smaller timescales in that interval. No significant excess nor significant variation in the observed event rate are found in the blazar direction. Upper limits are placed on the electron- and muon-neutrino fluxes at the 90% confidence level as 6.0 × 10−7 and 4.5 × 10−7–9.3 × 10−10 [erg cm−2 s−1], respectively

Reduced engagement with social stimuli in 6-month-old infants with later Autism Spectrum Disorder: a longitudinal prospective study of infants at high familial risk

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects more than 1% of the population, and close to 20% of prospectively studied infants with an older sibling with ASD. Although significant progress has been made in characterizing the emergence of behavioral symptoms of ASD, far less is known about the underlying disruptions to early learning. Recent models suggest that core aspects of the causal path to ASD may only be apparent in early infancy. Here, we investigated social attention in 6- and 12-month-old infants who did and did not meet criteria for ASD at 24 months using both cognitive and electrophysiological methods. We hypothesized that a reduction in attention engagement to faces would be associated with later ASD. Methods: In a prospective longitudinal design, we used measures of both visual attention (habituation) and brain function (event-related potentials to faces and objects) at 6 and 12 months, and investigated the relationship to ASD outcome at 24 months. Results: High-risk infants who met criteria for ASD at 24 months showed shorter epochs of visual attention, faster but less prolonged neural activation to faces, and delayed sensitization responses (increases in looking) to faces at 6 months; these differences were less apparent at 12 months. These findings are consistent with disrupted engagement of sustained attention to social stimuli. Conclusions: These findings suggest that there may be fundamental early disruptions to attention engagement that may have cascading consequences for later social functioning

The precession constant and its long-term variation

The dynamical flattening of the Earth, H, related to the precession constant, is a fundamental astro-geodetic parameter that appears in studies of the Earth's rotation and orbital evolution. We present numerical predictions and observations of the variation in H over time scales ranging from tens of millions of years to decades. The geophysical processes controlling this variation include solid-state convection in the rocky mantle of the Earth that drives plate tectonics, isostatic adjustments due to ice age loading, and ice-ocean mass transfer linked to modern global climate change. The time dependence of H is complex and non-linear, and thus, in contrast to previous suggestions, cannot be captured by a constant rate parameter

The effect of lateral variations in Earth structure on Last Interglacial sea level

It is generally agreed that the Last Interglacial (LIG; ∼130–115 ka) was a time when global average temperatures and global mean sea level were higher than they are today. However, the exact timing, magnitude and spatial pattern of ice melt is much debated. One difficulty in extracting past global mean sea level from local observations is that their elevations need to be corrected for glacial isostatic adjustment (GIA), which requires knowledge of Earth’s internal viscoelastic structure. While this structure is generally assumed to be radially symmetric, evidence from seismology, geodynamics and mineral physics indicates that large lateral variations in viscosity exist within the mantle. In this study, we construct a new model of Earth’s internal structure by converting shear wave speed into viscosity using parametrizations from mineral physics experiments and geodynamic constraints on Earth’s thermal structure. We use this 3-D Earth structure, which includes both variations in lithospheric thickness and lateral variations in viscosity, to calculate the first 3-D GIA prediction for LIG sea level. We find that the difference between predictions with and without lateral Earth structure can be metres to 10s of metres in the near field of former ice sheets, and up to a few metres in their far field. We demonstrate how forebulge dynamics and continental levering are affected by laterally varying Earth structure, with a particular focus on those sites with prominent LIG sea level records. Results from four 3-D GIA calculations show that accounting for lateral structure can act to increase local sea level by up to ∼1.5 m at the Seychelles and minimally decrease it in Western Australia. We acknowledge that this result is only based on a few simulations, but if robust, this shift brings estimates of global mean sea level from these two sites into closer agreement with each other. We further demonstrate that simulations with a suitable radial viscosity profile can be used to locally approximate the 3-D GIA result, but that these radial profiles cannot be found by simply averaging viscosity below the sea level indicator site

TITUS: the Tokai Intermediate Tank for the Unoscillated Spectrum

68 pages.38 figures68 pages.38 figures68 pages.38 figures70 pages, 41 figuresThe TITUS, Tokai Intermediate Tank for Unoscillated Spectrum, detector, is a proposed Gd-doped Water Cherenkov tank with a magnetised muon range detector downstream. It is located at J-PARC at about 2 km from the neutrino target and it is proposed as a potential near detector for the Hyper-Kamiokande experiment. Assuming a beam power of 1.3 MW and 27.05 x 10^{21} protons-on-target the sensitivity to CP and mixing parameters achieved by Hyper-Kamiokande with TITUS as a near detector is presented. Also, the potential of the detector for cross sections and Standard Model parameter determination, supernova neutrino and dark matter are shown

Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety

Objective: Computerised therapies play an integral role in efforts to improve access to psychological treatment for patients with depression and anxiety. However, despite recognised problems with uptake, there has been a lack of investigation into the barriers and facilitators of engagement. We aimed to systematically review and synthesise findings from qualitative studies of computerised therapies, in order to identify factors impacting on engagement. Method: Systematic review and meta-synthesis of qualitative studies of user experiences of computer delivered therapy for depression and/or anxiety. Results: 8 studies were included in the review. All except one were of desktop based cognitive behavioural treatments. Black and minority ethnic and older participants were underrepresented, and only one study addressed users with a comorbid physical health problem. Through synthesis, we identified two key overarching concepts, regarding the need for treatments to be sensitive to the individual, and the dialectal nature of user experience, with different degrees of support and anonymity experienced as both positive and negative. We propose that these factors can be conceptually understood as the ‘non-specific’ or ‘common’ factors of computerised therapy, analogous to but distinct from the common factors of traditional face-to-face therapies. Conclusion: Experience of computerised therapy could be improved through personalisation and sensitisation of content to individual users, recognising the need for users to experience a sense of ‘self’ in the treatment which is currently absent. Exploiting the common factors of computerised therapy, through enhancing perceived connection and collaboration, could offer a way of reconciling tensions due to the dialectal nature of user experience. Future research should explore whether the findings are generalisable to other patient groups, to other delivery formats (such as mobile technology) and other treatment modalities beyond cognitive behaviour therapy. The proposed model could aid the development of enhancements to current packages to improve uptake and support engagement

Community-based management induces rapid recovery of a high-value tropical freshwater fishery

Tropical wetlands are highly threatened socio-ecological systems, where local communities rely heavily on aquatic animal protein, such as fish, to meet food security. Here, we quantify how a ‘win-win’ community-based resource management program induced stock recovery of the world’s largest scaled freshwater fish (Arapaima gigas), providing both food and income. We analyzed stock assessment data over eight years and examined the effects of protected areas, community-based management, and landscape and limnological variables across 83 oxbow lakes monitored along a ~500-km section of the Juruá River of Western Brazilian Amazonia. Patterns of community management explained 71.8% of the variation in arapaima population sizes. Annual population counts showed that protected lakes on average contained 304.8 (±332.5) arapaimas, compared to only 9.2 (±9.8) in open-access lakes. Protected lakes have become analogous to a high-interest savings account, ensuring an average annual revenue of US$10,601 per community and US$1046.6 per household, greatly improving socioeconomic welfare. Arapaima management is a superb window of opportunity in harmonizing the co-delivery of sustainable resource management and poverty alleviation. We show that arapaima management deserves greater attention from policy makers across Amazonian countries, and highlight the need to include local stakeholders in conservation planning of Amazonian floodplains

Bezlotoxumab for Prevention of Recurrent Clostridium difficile Infection

BACKGROUND Clostridium difficile is the most common cause of infectious diarrhea in hospitalized patients. Recurrences are common after antibiotic therapy. Actoxumab and bezlotoxumab are human monoclonal antibodies against C. difficile toxins A and B, respectively. METHODS We conducted two double-blind, randomized, placebo-controlled, phase 3 trials, MODIFY I and MODIFY II, involving 2655 adults receiving oral standard-of-care antibiotics for primary or recurrent C. difficile infection. Participants received an infusion of bezlotoxumab (10 mg per kilogram of body weight), actoxumab plus bezlotoxumab (10 mg per kilogram each), or placebo; actoxumab alone (10 mg per kilogram) was given in MODIFY I but discontinued after a planned interim analysis. The primary end point was recurrent infection (new episode after initial clinical cure) within 12 weeks after infusion in the modified intention-to-treat population. RESULTS In both trials, the rate of recurrent C. difficile infection was significantly lower with bezlotoxumab alone than with placebo (MODIFY I: 17% [67 of 386] vs. 28% [109 of 395]; adjusted difference, −10.1 percentage points; 95% confidence interval [CI], −15.9 to −4.3; P<0.001; MODIFY II: 16% [62 of 395] vs. 26% [97 of 378]; adjusted difference, −9.9 percentage points; 95% CI, −15.5 to −4.3; P<0.001) and was significantly lower with actoxumab plus bezlotoxumab than with placebo (MODIFY I: 16% [61 of 383] vs. 28% [109 of 395]; adjusted difference, −11.6 percentage points; 95% CI, −17.4 to −5.9; P<0.001; MODIFY II: 15% [58 of 390] vs. 26% [97 of 378]; adjusted difference, −10.7 percentage points; 95% CI, −16.4 to −5.1; P<0.001). In prespecified subgroup analyses (combined data set), rates of recurrent infection were lower in both groups that received bezlotoxumab than in the placebo group in subpopulations at high risk for recurrent infection or for an adverse outcome. The rates of initial clinical cure were 80% with bezlotoxumab alone, 73% with actoxumab plus bezlotoxumab, and 80% with placebo; the rates of sustained cure (initial clinical cure without recurrent infection in 12 weeks) were 64%, 58%, and 54%, respectively. The rates of adverse events were similar among these groups; the most common events were diarrhea and nausea. CONCLUSIONS Among participants receiving antibiotic treatment for primary or recurrent C. difficile infection, bezlotoxumab was associated with a substantially lower rate of recurrent infection than placebo and had a safety profile similar to that of placebo. The addition of actoxumab did not improve efficacy. (Funded by Merck; MODIFY I and MODIFY II ClinicalTrials.gov numbers, NCT01241552 and NCT01513239.