2,282 research outputs found

    The Dzhungarian fault: Late Quaternary tectonics and slip rate of a major right-lateral strike-slip fault in the northern Tien Shan region

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    The Dzhungarian strike-slip fault of Central Asia is one of a series of long, NW-SE right-lateral strike-slip faults that are characteristic of the northern Tien Shan region and extends over 300 km from the high mountains into the Kazakh Platform. Our field-based and satellite observations reveal that the Dzhungarian fault can be characterized by three 100 km long sections based on variation in strike direction. Through morphological analysis of offset streams and alluvial fans, and through optically stimulated luminescence dating, we find that the Dzhungarian fault has a minimum average late Quaternary slip rate of 2.2 ± 0.8 mm/yr and accommodates N-S shortening related to the India-Eurasia collision. This shortening may also be partly accommodated by counterclockwise rotation about a vertical axis. Evidence for a possible paleo-earthquake rupture indicates that earthquakes up to at least Mw 7 can be associated with just the partitioned component of reverse slip on segments of the central section of the fault up to 30 km long. An event rupturing longer sections of the Dzhungarian fault has the potential to generate greater magnitude earthquakes (Mw 8); however, long time periods (e.g., thousands of years) are expected in order to accumulate enough strain to generate such earthquakes.We thank the Royal Society International Travel Grant, Mike Coward Fund of the Geological Society of London, Percy Sladen Fund of the Linnean Society, The Gilchrist Educational Trust, and the Earth and Space Foundation for their support in funding this project. GEC’s doctoral studentship is funded by the National Environmental Research Council through NCEO, COMET, and the NERC-ESRC funded Earthquakes without Frontiers (EWF) Project. RTW is supported by a University Research Fellowship awarded by the Royal Society.This is the final version of the article, originally published in the Journal of Geophysical Research: Solid Earth. It is also available from Wiley at http://onlinelibrary.wiley.com/doi/10.1002/jgrb.50367/abstract. © 2013. American Geophysical Unio

    Understanding and assessing the impact of treatment in diabetes: the Treatment-Related Impact Measures for Diabetes and Devices (TRIM-Diabetes and TRIM-Diabetes Device)

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    <p>Abstract</p> <p>Purpose</p> <p>Diabetes is a debilitating illness requiring lifelong management. Treatments can be varied in terms of mode of administration as well as type of agent. Unfortunately, most patient reported outcome measures currently available to assess the impact of treatment are specific to diabetes type, treatment modality or delivery systems and are designed to be either a HRQoL or treatment satisfaction measure. To address these gaps, the Treatment Related Impact Measure-Diabetes and Device measures were developed. This paper presents the item development and validation of the TRIM Diabetes/Device.</p> <p>Methods</p> <p>Patient interviews were conducted to collect the patient perspective and ensure high content validity. Interviews were hand coded and qualitatively analyzed to identify common themes. A conceptual model of the impact of diabetes medication was developed and preliminary items for the TRIM-Diabetes/Device were generated and cognitively debriefed. Validation data was collected via an on-line survey and analyzed according to an a priori statistical analysis plan to validate the overall score as well as each domain. Item level criteria were used to reduce the preliminary item pool. Next, factor analysis to identify structural domains was performed. Reliability and validity testing was then performed.</p> <p>Results</p> <p>One hundred and five patients were interviewed in focus groups, individual interviews and for cognitive debriefing. Five hundred seven patients participated in the validation study. Factor analysis identified seven domains: Treatment Burden, Daily Life; Diabetes Management; Psychological Health; Compliance and Device Function and Bother. Internal consistency reliability coefficients of the TRIM-Diabetes/Device ranged from 0.80 and 0.94. Test-retest reliability of the TRIM-Diabetes/Device ranged from 0.71 to 0.89. All convergent and known groups validity hypotheses were met for the TRIM-Diabetes/Device total scores and sub-scales.</p> <p>Conclusion</p> <p>Validation is an ongoing and iterative process. These findings are the first step in that process and have shown that both the TRIM-Diabetes and the TRIM-Diabetes Device have acceptable psychometric properties. Future research is needed to continue the validation process and examine responsiveness and the validity of the TRIM-Diabetes/Device in a clinical trial population.</p

    Interpersonal and affective dimensions of psychopathic traits in adolescents : development and validation of a self-report instrument

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    We report the development and psychometric evaluations of a self-report instrument designed to screen for psychopathic traits among mainstream community adolescents. Tests of item functioning were initially conducted with 26 adolescents. In a second study the new instrument was administered to 150 high school adolescents, 73 of who had school records of suspension for antisocial behavior. Exploratory factor analysis yielded a 4-factor structure (Impulsivity α = .73, Self-Centredness α = .70, Callous-Unemotional α = .69, and Manipulativeness α = .83). In a third study involving 328 high school adolescents, 130 with records of suspension for antisocial behaviour, competing measurement models were evaluated using confirmatory factor analysis. The superiority of a first-order model represented by four correlated factors that was invariant across gender and age was confirmed. The findings provide researchers and clinicians with a psychometrically strong, self-report instrument and a greater understanding of psychopathic traits in mainstream adolescents

    Which patients with heart failure should receive specialist palliative care?

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    AIMS: We investigated which patients with heart failure (HF) should receive specialist palliative care (SPC) by first creating a definition of need for SPC in patients hospitalised with HF using patient-reported outcome measures (PROMs) and then testing this definition using the outcome of days alive and out of hospital (DAOH). We also evaluated which baseline variables predicted need for SPC and whether those with this need received SPC. METHODS AND RESULTS: PROMs assessing quality of life (QoL), symptoms, and mood were administered at baseline and every 4 months. SPC need was defined as persistently severe impairment of any PROM without improvement (or severe impairment immediately preceding death). We then tested whether need for SPC, so defined, was reflected in DAOH, a measure which combines length of stay, days of hospital re-admission, and days lost due to death. Of 272 patients recruited, 74 (27%) met the definition of SPC needs. These patients lived one third fewer DAOH than those without SPC need (and less than a quarter of QoL-adjusted DAOH). A Kansas City Cardiomyopathy Questionnaire (KCCQ) summary score of <29 identified patients who subsequently had SPC needs (area under receiver operating characteristic curve 0.78). Twenty-four per cent of patients with SPC needs actually received SPC (n = 18). CONCLUSIONS: A quarter of patients hospitalised with HF had a need for SPC and were identified by a low KCCQ score on admission. Those with SPC need spent many fewer DAOH and their DAOH were of significantly worse quality. Very few patients with SPC needs accessed SPC services

    Osteonecrosis following resurfacing arthroplasty: A clinical positron emission tomography study of 14 cases

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    Background and purpose One of the main concerns regarding resurfacing arthroplasty is the viability of the remaining part of the femoral head, and the postoperative risk of a femoral neck fracture or collapse. In contrast to radiographic methods, positron emission tomography using the radiotracer [18F]-fluoride (Fluoride-PET) enables us to visualize the viability of bone in the remaining part of the head, despite the presence of the covering metal component
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