Geomorphic and geological constraints on the active normal faulting of the Gediz (Alaşehir) Graben, Western Turkey.

The Gediz (Alaşehir) Graben is located in the highly tectonically active region of Western Turkey. Extension due to regional geodynamic controls has resulted in a broadly two-phase evolution of the graben; firstly, low-angle normal faulting relating to the exhumation of the Menderes Massif metamorphic core complex took place between 16 - 2.6 Ma. Secondly, high-angle normal faulting initiated ~ 2 Ma forming the Gediz and other E-W trending grabens in the region. Here we quantify the throw rate along the fault array over the last 2.6, 2 and 0.7 Ma using structural and geological constraints, along with analysis of topographic relief as a proxy for footwall uplift. We derive, for the first time, time averaged rates of fault motion from 0.4 mm/yr to 1.3 mm/yr along the strike of the Gediz Graben, with variation in throw-rate associated with the geometry of individual fault strands. Patterns in throw-rate along strike of the graben bounding fault array also suggest that the fault segments have become linked during the last 2.6 - 2 Ma, possibly at 0.8 – 0.7 Ma. Furthermore, these data suggest that an earthquake occurring along the graben bounding fault could have a maximum predicted Mw of 6.3 - 7.6

Normal fault growth and linkage in the Gediz (Alasehir) Graben, Western Turkey, revealed by transient river long-profiles and slope-break knickpoints

The Gediz (Alaşehir) Graben is located in the highly tectonically active and seismogenic region of Western Turkey. The rivers upstream of the normal fault-bounded graben each contain a non-lithologic knickpoint, including those that drain through inferred fault segment boundaries. Knickpoint heights measured vertically from the fault scale with footwall relief and documented fault throw (vertical displacement). Consequently, we deduce these knickpoints were initiated by an increase in slip rate on the basin-bounding fault, driven by linkage of the three main fault segments of the high-angle graben bounding fault array. Fault interaction theory and ratios of channel steepness suggest that the slip rate enhancement factor on linkage was a factor of 3. We combine this information with geomorphic and structural constraints to estimate that linkage took place between 0.6 Ma and 1 Ma. Calculated pre- and post-linkage throw rates are 0.6 and 2 mm/yr respectively. Maximum knickpoint retreat rates upstream of the faults range from 4.5 to 28 mm/yr, faster than for similar catchments upstream of normal faults in the Central Apennines and the Hatay Graben of Turkey, and implying a fluvial landscape response time of 1.6 to 2.7 Myr. We explore the relative controls of drainage area and precipitation on these retreat rates, and conclude that while climate variation and fault throw rate partially explain the variations seen, lithology remains a potentially important but poorly characterised variable

Using exclusion rate to unify niche and neutral perspectives on coexistence

The competitive exclusion principle is one of the most influential concepts in ecology. The classical formulation suggests a correlation between competitor species similarity and competition severity, leading to rapid competitive exclusion where species are very similar; yet neutral models show that identical species can persist in competition for long periods. Here, we resolve the conflict by examining two components of similarity – niche overlap and competitive similarity – and modeling the effects of each on exclusion rate (defined as the inverse of time to exclusion). Studying exclusion rate, rather than the traditional focus on binary outcomes (coexistence vs exclusion), allows us to examine classical niche and neutral perspectives using the same currency. High niche overlap speeds exclusion, but high similarity in competitive ability slows it. These predictions are confirmed by a well-known model of two species competing for two resources. Under ecologically plausible scenarios of correlation between these two factors, the strongest exclusion rates may be among moderately similar species, while very similar and highly dissimilar competitors have very low exclusion rates. Adding even small amounts of demographic stochasticity to the model blurs the line between deterministic and probabilistic coexistence still further. Thus, focusing on exclusion rate, instead of on the binary outcome of coexistence versus exclusion, allows a variety of outcomes to result from competitive interactions. This approach may help explain species coexistence in diverse competitive communities and raises novel issues for future work

Predicting vaccine effectiveness against severe COVID-19 over time and against variants: a meta-analysis

Vaccine protection from symptomatic SARS-CoV-2 infection has been shown to be strongly correlated with neutralising antibody titres; however, this has not yet been demonstrated for severe COVID-19. To explore whether this relationship also holds for severe COVID-19, we performed a systematic search for studies reporting on protection against different SARS-CoV-2 clinical endpoints and extracted data from 15 studies. Since matched neutralising antibody titres were not available, we used the vaccine regimen, time since vaccination and variant of concern to predict corresponding neutralising antibody titres. We then compared the observed vaccine effectiveness reported in these studies to the protection predicted by a previously published model of the relationship between neutralising antibody titre and vaccine effectiveness against severe COVID-19. We find that predicted neutralising antibody titres are strongly correlated with observed vaccine effectiveness against symptomatic (Spearman ρ = 0.95, p < 0.001) and severe (Spearman ρ = 0.72, p < 0.001 for both) COVID-19 and that the loss of neutralising antibodies over time and to new variants are strongly predictive of observed vaccine protection against severe COVID-19

Do MRI findings identify patients with chronic low back pain and Modic changes who respond best to rest or exercise: A subgroup analysis of a randomised controlled trial

Background: No previous clinical trials have investigated MRI findings as effect modifiers for conservative treatment of low back pain. This hypothesis-setting study investigated if MRI findings modified response to rest compared with exercise in patients with chronic low back pain and Modic changes. Methods: This study is a secondary analysis of a randomised controlled trial comparing rest with exercise. Patients were recruited from a specialised outpatient spine clinic and included in a clinical trial if they had chronic low back pain and an MRI showing Modic changes. All patients received conservative treatment while participating in the trial. Five baseline MRI findings were investigated as effect modifiers: Modic changes Type 1 (any size), large Modic changes (any type), large Modic changes Type 1, severe disc degeneration and large disc herniation. The outcome measure was change in low back pain intensity measured on a 0-10 point numerical rating scale at 14-month follow-up (n = 96). An interaction = 1.0 point (0-10 scale) between treatment group and MRI findings in linear regression was considered clinically important. Results: The interactions for Modic Type 1, with large Modic changes or with large Modic changes Type 1 were all potentially important in size (-0.99 (95% CI -3.28 to 1.29), -1.49 (-3.73 to 0.75), -1.49 (-3.57 to 0.58), respectively) but the direction of the effect was the opposite to what we had hypothesized-that people with these findings would benefit more from rest than from exercise. The interactions for severe disc degeneration (0.74 (-1.40 to 2.88)) and large disc herniation (-0.92 (3.15 to 1.31)) were less than the 1.0-point threshold for clinical importance. As expected, because of the lack of statistical power, no interaction term for any of the MRI findings was statistically significant. Conclusions: Three of the five MRI predictors showed potentially important effect modification, although the direction of the effect was surprising and confidence intervals were wide so very cautious interpretation is required. Further studies with adequate power are warranted to study these and additional MRI findings as potential effect modifiers for common interventions

Prognostic implications of the Quebec Task Force classification of back-related leg pain: An analysis of longitudinal routine clinical data

Background: Low back pain (LBP) patients with related leg pain have a more severe profile than those with local LBP and a worse prognosis. Pain location above or below the knee and the presence of neurological signs differentiate patients with different profiles, but knowledge about the prognostic value of these subgroups is sparse. The objectives of this study were (1) to investigate whether subgroups consisting of patients with Local LBP only, LBP + leg pain above the knee, LBP + leg pain below the knee, and LBP + leg pain and neurological signs had different prognoses, and (2) to determine if this was explained by measured baseline factors. Methods. Routine clinical data were collected during the first visit to an outpatient department and follow-ups were performed after 3 and 12 months. Patients were divided into the four subgroups and associations between subgroups and the outcomes of activity limitation, global perceived effect (GPE) after 3 months, and sick leave after 3 months were tested by means of generalised estimating equations. Models were univariate (I), adjusted for duration (II), and adjusted for all baseline differences (III). Results: A total of 1,752 patients were included, with a 76% 3-month and 70% 12-month follow-up. Subgroups were associated with activity limitation in all models (p &lt; 0.001). Local LBP had the least and LBP + neurological signs the most severe limitations at all time-points, although patients with neurological signs improved the most. Associations with GPE after 3 months were only significant in Model I. Subgroups were associated with sick leave after 3 months in model I and II, with sick leave being most frequent in the subgroup with neurological signs. No significant differences were found in any pairwise comparisons of patients with leg pain above or below the knee. Conclusions: Subgrouping LBP patients, based on pain location and neurological signs, was associated with activity limitation and sick leave, but not with GPE. The presence of neurological signs and pain in the leg both have prognostic implications but whether that leg pain without neurological signs is above or below the knee does not