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We use Coulomb stress change (CSC) analyses and seismicity data to model the physical and statistical behavior of the multifault source of the 4 September 2010 Mw 7.1 Darfield earthquake in New Zealand. Geodetic and seismologic data indicate this earthquake initiated on a severely misoriented reverse fault and propagated across a structurally complex fault network including optimally oriented faults. The observed rupture sequence is most successfully modeled if maximum CSC imposed by rupture of the hypocentral fault on to receiver faults exceeds theoretical threshold values of 1 to 5 MPa that are assigned based on fault slip tendency and stress drop analyses. CSC modeling using the same criteria but initiating the earthquake on other faults in the network results in a multifault rupture cascade for five of seven scenarios. Analysis of earthquake frequency‐magnitude distributions indicates that a Gutenberg‐Richter frequency‐magnitude distribution for the near‐source region cannot be rejected in favor of a characteristic earthquake distribution. However, characteristic behavior is more favored probabilistically because ruptures initiating on individual source faults in the system are statistically more likely to cascade into multifault ruptures with larger amalgamated Mw (Mwmax = 7.1) than to remain confined to the hypocentral source fault (Mw = 6.3 to 6.8). Our favored hypothesis is that system rupture behavior is regulated by misoriented faults that occupy critical geometric positions within the network, as previously proposed for the 2010 El Mayor‐Cucapah earthquake in Baja California. Other fault networks globally may exhibit similar physical and statistical behaviors. Key Points: CSC and Mohr‐Coulomb fault slip tendency analyses are used to investigate multifault earthquakesThe fault system responsible for the 2010 Mw7.1 Darfield earthquake is probabilistically favored to rupture in multifault earthquakesFault network geometries and slip tendencies influence earthquake frequency‐magnitude distributions and maximum magnitude estimations [ABSTRACT FROM AUTHOR]

Background: Treatment of sexually-transmitted infections (STIs) and behavioural interventions are the main methods to prevent HIV in developing countries. We aimed to assess the effect of these interventions on incidence of HIV-1 and other sexually-transmitted infections.Methods: We randomly allocated all adults living in 18 communities in rural Uganda to receive behavioural interventions alone (group A), behavioural and STI interventions (group B), or routine government health services and community development activities (group C). The primary outcome was HIV-1 incidence. Secondary outcomes were incidence of herpes simplex virus type 2 (HSV2) and active syphilis and prevalence of gonorrhoea, chlamydia, reported genital ulcers, reported genital discharge, and markers of behavioural change. Analysis was per protocol.Findings: Compared with group C, the incidence rate ratio of HIV-1 was 0.94 (0.60-1.45, p=0.72) in group A and 1.00 (0.63-1.58, p=0.98) in group B, and the prevalence ratio of use of condoms with last casual partner was 1.12 (95% CI 0.99-1.25) in group A and 1.27 (1.02-1.56) in group B. Incidence of HSV2 was lower in group A than in group C (incidence rate ratio 0.65, 0.53-0.80) and incidence of active syphilis for high rapid plasma reagent test titre and prevalence of gonorrhoea were both lower in group B than in group C (active syphilis incidence rate ratio, 0.52, 0.27-0.98; gonorrhoea prevalence ratio, 0.25, 0.10-0.64).Interpretation: The interventions we used were insufficient to reduce HIV-1 incidence in rural Uganda, where secular changes are occurring. More effective STI and behavioural interventions need to be developed for HIV control in mature epidemics. [ABSTRACT FROM AUTHOR]

Rationale Studies suggest that increased breastfeeding rates can provide substantial financial savings, but the scale of such savings in the UK is not known. Objective To calculate potential cost savings attributable to increases in breastfeeding rates from the National Health Service perspective. Design: and settings Cost savings focussed on where evidence of health benefit is strongest: reductions in gastrointestinal and lower respiratory tract infections, acute otitis media in infants, necrotising enterocolitis in preterm babies and breast cancer (BC) in women. Savings were estimated using a seven-step framework in which an incidence-based disease model determined the number of cases that could have been avoided if breastfeeding rates were increased. Point estimates of cost savings were subject to a deterministic sensitivity analysis. Results: Treating the four acute diseases in children costs the UK at least £89 million annually. The 2009- 2010 value of lifetime costs of treating maternal BC is estimated at £959 million. Supporting mothers who are exclusively breast feeding at 1 week to continue breast feeding until 4 months can be expected to reduce the incidence of three childhood infectious diseases and save at least £11 million annually. Doubling the proportion of mothers currently breast feeding for 7 - 1 8 months in their lifetime is likely to reduce the incidence of maternal BC and save at least £31 million at 2009-2010 value. Conclusions: The economic impact of low breastfeeding rates is substantial. Investing in services that support women who want to breast feed for longer is potentially cost saving. [ABSTRACT FROM AUTHOR]

The previously unknown Greendale Fault ruptured in the September 2010 moment magnitude (M w ) 7.1 Darfield Earthquake. Surface rupture fracture patterns and displacements along the fault were measured with high precision using real time kinematic (RTK) GPS, tape and compass, airborne light detection and ranging (lidar), and aerial photos. No geomorphic evidence of a penultimate surface rupture was revealed from pre-2010 imagery. The fault zone is up to 300 m wide and comprises both distributed (folding) and discrete (faulting) deformation dominated by right-lateral displacement. Surface fracturing accommodates ~ 30% of the total right-lateral displacement in the central fault zone; the remainder is accommodated by distributed deformation. Ground penetrating radar and trenching investigations conducted across the central Greendale Fault reveal that most surface fractures are undetectable at depths exceeding 1 m; however, large, discrete Riedel shears continue to depths exceeding 3 m and displace interbedded gravels and sand-filled paleochannels. At one trench site, a Riedel shear displaces surface agricultural markers (e.g., fences and plow lines) and a subsurface (0.6 m deep) paleo-channel by 60 cm right-laterally and 10 cm vertically, indicating the paleochannel has been displaced only in the Darfield earthquake. Optically stimulated luminescence (OSL) dating of the displaced paleochannel yields an age of 21.6 ± 1.5 ka. Two additional paleochannels at ~ 2.5 m depth with OSL ages of 28.4 ± 2.4 ka and 33 ± 2 ka have been displaced ~ 120 cm right-laterally and ~ 20 cm vertically. The doubling of displacement at depth is interpreted to indicate that in the central section of the Greendale Fault the penultimate surface-rupturing event occurred between ca. 20 and 30 ka. The Greendale Fault remained undetected prior to the Darfield earthquake because the penultimate fault scarp was eroded and buried during Late Pleistocene alluvial activity. Similar active faults with low slip rates (i.e. lower than sedimentation/erosion rates) are likely to be concealed in alluvial settings globally. [ABSTRACT FROM AUTHOR]

The Upper Devonian to Carboniferous Mt Eclipse Sandstone is a basin-wide host to uranium mineralisation in the Ngalia Basin, NT. The fluvial depositional architecture and diagenesis of the Mt Eclipse Sandstone at the Bigrlyi uranium deposit on the northern margin of the basin are deduced from hyperspectral mineral results captured from 200 drill holes, combined with core and outcrop observations across a ~10 km strike length. The succession hosting the uranium mineralisation is interpreted to be deposited in the lower parts of a mature alluvial fan system with low slope angle and dominated by immature, kaolinised, medium-grained subarkosic sandstones and patchy calcite cement. This study reveals the fluvial channel sequence is estimated to be 3 km wide, 100–200 m thick and sourced from the north. This multidisciplinary study also uncovers the complex interaction and codependencies between fluvial/groundwater activity, evaporation, oxidation, fluctuating pH and detrital mineralogy controlling early diagenetic processes in the alluvial fan sediments. Carbon isotope data identify calcite cements as groundwater calcrete, while strontium isotope data suggest limited prolonged water–rock interaction prior and during calcite cementation. The petrographic data reveal the importance of early calcite cement occluding all pore space and preserving detrital minerals from later diagenetic processes. The hyperspectral results highlight the intermittent distribution of the calcite cement and the commonly repetitive mineralogical zonation throughout the 200 drill holes, including the inverse spatial correlation between kaolinite ± goethite ± gypsumvswhite mica ± hematite dominated zones. X-ray diffraction and the hyperspectral data reveal the scarcity of early diagenetic clay minerals such as montmorillonite. This paper is the first to report on a systematic mineralogical and sedimentological study for the Mt Eclipse Sandstone. By focusing on the diagenesis and fluvial architecture of this stratigraphic unit, a framework to support exploration for sediment-hosted uranium deposits is established. [ABSTRACT FROM AUTHOR]

Objective:To explore the long-term effects of women's childbearing patterns on their body mass index.Design:Cross-sectional analysis.Setting:Population-based study of UK women.Participants:740 628 postmenopausal participants in the Million Women Study who reported their height, weight, reproductive histories and other relevant factors.Main Outcome Measures:Standardized mean BMI (kg m−2) in groups defined by their parity and breastfeeding history.Results:Women were aged 57.5 (s.d. 4) years on average, and had a mean BMI of 26.2 kg m−2 (s.d. 5); 88% were parous, with 2.1 (s.d. 1.2) children on average. The standardised mean BMI increased progressively with the number of births from 25.6 kg m−2 (95% confidence interval (CI): 25.5-25.6) in nulliparous women up to 27.2 kg m−2 (CI: 27.2-27.3) for women with four or more births, a difference of 1.7 kg m−2 (CI: 1.6-1.7). Among the parous women 70% had ever breastfed and their average total duration of breastfeeding was 7.7 (s.d. 8.8) months. At every parity level the standardised mean BMI was significantly lower among women who had breastfed than those who had not, decreasing by 0.22 kg m−2 (CI: 0.21-0.22) for every 6 months of breastfeeding, that is, women's mean BMI was 1% lower for every 6 months that they had breastfed. These associations were highly statistically significant (P<0.0001) and independent of the effects of socioeconomic group, region of residence, smoking and physical activity.Conclusions:Childbearing patterns have a persistent effect on adiposity in this population. The reduction in BMI associated with just 6 months breastfeeding in UK women could importantly reduce their risk of obesity-related disease as they age. [ABSTRACT FROM AUTHOR]

An analysis of boulders displaced during the September 2010 MW 7.1 Darfield (Canterbury) earthquake provides non-instrumental constraints on the variability, distribution and origin of strong ground motion during major earthquakes. Boulders ranging in mass from 10 to 5000 kg were displaced 8–970 cm laterally from hosting soil sockets of <1 cm to 50 cm depth at several sites in the Port Hills, roughly 35 km southeast of the earthquake epicentre. Boulder displacement was observed on N-striking (000–015°) ridges above c. 400 m elevation but not on NE-, NW- and SE-striking ridges. The prevailing boulder horizontal displacement azimuth of 250±20° is subparallel with the direction of instrumentally recorded transient peak ground horizontal displacements. Boulder displacement distance has no correlation with displacement azimuth, boulder mass or soil socket depth and has a partial correlation with slope angle. The lateral displacement of many boulders from low slope (<10°) ground surfaces on ridge crests exceeds nearby instrumentally recorded peak ground displacements at lower elevations by up to an order of magnitude, implying that seismic waves were amplified at the study sites. Preliminary 2-D FLAC modelling suggests that topographic amplification may explain this observation. The co-existence of displaced and non-displaced boulders at proximal (<1 m spacing) sites also suggests small-scale ground motion variability and/or varying boulder-ground dynamic interactions relating to shallow phenomena such as variability in soil depth, bedrock fracture density and/or microtopography on the bedrock–soil interface. Remapping of boulders following the February 2011 MW 6.2 Christchurch earthquake reveals no subsequent relocation despite locally recorded horizontal and vertical ground accelerations well in excess of the Darfield earthquake and pervasive rockfalls and landslides elsewhere. This study successfully identifies some of the major controls on spatial ground motion variability at non-instrumented locations and highlights the complexity of ground response at different spatial scales and for different earthquake characteristics. [ABSTRACT FROM AUTHOR]

The September 2010 Mw 7.1 Darfield (Canterbury) earthquake in New Zealand is one of the best-recorded earthquakes of this magnitude. The earthquake occurred on a previously unidentified fault system and generated a 29.5 ± 0.5-km-long surface rupture across a low-relief agricultural landscape. High-accuracy measurements of coseismic displacements were obtained at over 100 localities along the Greendale fault. Maximum net displacement (Dmax) (5.3 ± 0.5 m) and average net displacement (Davg) (2.5 ± 0.1 m) are anomalously large for an earthquake of this Mw. Dmax / surface rupture length (SRL) and Davg/SRL ratios are among the largest ever recorded for a continental strike-slip earthquake. "Geologically derived" estimates of moment magnitude (Due to image rights restrictions, multiple line equation(s) cannot be graphically displayed) are less than the seismologically derived Mw, derived using widely employed SRL-Mw scaling regressions. Due to image rights restrictions, multiple line equation(s) cannot be graphically displayed is greater than Mw using Dmax- and Davg-Mw regressions. The "geologically derived" static stress drop of 13.9 ± 3.7 MPa provides a context with which to compare this earthquake rupture to interplate and intraplate ruptures of similar Mw. This data set provides fundamental information on fault rupture processes relevant to seismic-hazard modeling in this region and analogous settings globally. [ABSTRACT FROM AUTHOR]

Variations in the extent of Cenozoic marine inundation of Australia, as revealed by the distribution of marine and nearshore deposits, points to a tectonic regime involving three distinct modes of deformation. At the longest wavelengths (order 103 km), the continent has experienced southwest-up, northeast-down tilting with an amplitude of ∼300 m since the Late Eocene. We attribute this tilting to the dynamic topographic response to the northward motion of Australia towards the subduction realm of Indonesia and the western Pacific, as well as its passage across a complexly structured mantle. At short wavelengths (order 101 km), variations in elevation are associated with cumulative fault movements up to the order of 100 m. Fault-slip vectors are generally compatible with the prevailing in situ stress field and therefore can be allied to distant plate-boundary forcing. At intermediate wavelengths (order 102 km), undulations with amplitudes of the order of ∼100 m reflect, at least in part, lithospheric buckling due to relatively high levels of intraplate stress arising from plate-boundary forcing. Understanding the patterns of surface deformation associated with each of these deformation modes provides a tectonic framework against which the broader significance of the Australian Cenozoic record for such things as eustasy must be evaluated. [ABSTRACT FROM AUTHOR]

Geologic and chronometric studies of alluvial fan sequences in south-central Australia provide insights into the roles of tectonics and climate in continental landscape evolution. The most voluminous alluvial fans in the Flinders Ranges region have developed adjacent to catchments uplifted by Plio-Quaternary reverse faults, implying that young tectonic activity has exerted a first-order control on long-term sediment accumulation rates along the range front. However, optically stimulated luminescence (OSL) dating of alluvial fan sequences indicates that late Quaternary facies changes and intervals of sediment aggradation and dissection are not directly correlated with individual faulting events. Fan sequences record a transition from debris flow deposition and soil formation to clast-supported conglomeritic sedimentation by ∼30 ka. This transition is interpreted to reflect a landscape response to increasing climatic aridity, coupled with large flood events that episodically stripped previously weathered regolith from the landscape. Late Pleistocene to Holocene cycles of fan incision and aggradation post-date the youngest-dated surface ruptures and are interpreted to reflect changes in the frequency and magnitude of large floods. These datasets indicate that tectonic activity controlled long-term sediment supply but climate governed the spatial and temporal patterns of range-front sedimentation. Mild intraplate tectonism appears to have influenced Plio-Quaternary sedimentation patterns across much of the southern Australian continent, including the geometry and extent of alluvial fans and sea-level incursions. [ABSTRACT FROM AUTHOR]

Objective Two recent studies indicate an increased risk of stillbirth in the pregnancy that follows a pregnancy delivered by caesarean section. In this study, we report an analysis designed to test the hypothesis that delivery by caesarean section is a risk factor for explained or unexplained stillbirth in any subsequent pregnancy. We also report on the proportion of stillbirths in our study population, which may have been attributable to previous delivery by caesarean section. Design Retrospective cohort study. Population Linked statistical data set of 81 784 singleton deliveries registered in Oxfordshire and West Berkshire between 1968 and 1989. Methods The crude and adjusted hazard ratios for stillbirth in deliveries following a previous delivery by caesarean section, compared with no previous caesarean, were estimated using Cox regression. Main outcome measure Stillbirth. Results The unadjusted hazard ratios for all, explained, and unexplained stillbirths were 1.54 (95% CI 1.04–2.29); 2.13 (1.22–3.72); and 1.19 (0.68–2.09), respectively. After adjustment for maternal age, parity, social class, previous adverse outcome of pregnancy, body mass indexand smoking the hazard ratios were 1.58 (0.95–2.63), 2.08 (1.00–4.31) and 1.24 (0.60–2.56). Conclusions Pregnancies in women following a pregnancy delivered by caesarean section are at an increased risk of stillbirth. In our study, the risk appears to be mainly concentrated in the subgroup of explained stillbirths. However, there are sufficient inconsistencies in the developing literature about stillbirth risk that further research is needed. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to measure the agreement between hospital records and maternal reporting of mode of delivery in a representative UK sample. Design Population-based survey (Millennium Cohort Study). Setting UK. Population A total of 12 391 singleton infants born in 2000–2002. Methods Mothers were interviewed when infants were approximately 9 months old. Information was collected by interview on many obstetric and perinatal factors including mode of delivery. Record linkage to the mother’s delivery hospital records was undertaken in those who gave consent (90%). A matching record was found for 83%. Maternal report and hospital records were compared using mode of delivery classified into three (normal, assisted and caesarean) and six groups. Factors associated with disagreement between the two data sources were identified. Main outcome measure Proportion of records in which there was agreement between the two data sources. Results Agreement between maternal report and hospital records was at least 94% using six mode of delivery groups and 98% using three groups. Much of the disagreement (57–63%, depending on country) was between forceps and ventouse, and between planned and emergency caesarean. Disagreement was more common in women whose babies were first born and in women not born in the UK. Conclusion Our study confirms that maternal reporting of mode of delivery is highly reliable. This is important for clinical staff caring for women and those conducting epidemiological studies. Additional data sources may be necessary to gather reliable data from ethnic minority women, particularly those born outside the UK, or to distinguish forceps from ventouse, or planned from emergency caesarean section. [ABSTRACT FROM AUTHOR]

In the last 30 years, high-resolution computed tomography (HRCT) has been the major advance in diagnosis of diffuse parenchymal lung disease (DPLD). We review the diagnostic accuracy of HRCT and discuss how the gold standard in diagnosis of DPLD has shifted from histopathological diagnosis in isolation to a multidisciplinary approach. This latter process is now accepted as providing the highest levels of diagnostic accuracy in patients with DPLD and lung biopsy is primarily reserved for cases with atypical clinical or radiological presentations. [ABSTRACT FROM AUTHOR]

Cerebrospinal fluid (CSF) shunts carry a high risk of complications. Infections represent a major cause of shunt failure. Diagnosis and therapy of such infections are complicated by the formation of bacterial biofilms attached to shunt surfaces. This study correlated the pathophysiology and clinical course of biofilm infections with microscopical findings on the respective shunts. Surface irregularities, an important risk-factor for shunt colonisation with bacteria, were found to increase over time because of silicone degradation. Scanning electron-microscopy (SEM) documented residual biological material (dead biofilm), which can further promote extant bacterial adhesion, on newly manufactured shunts. Clinical course and SEM both documented bacterial dissemination against CSF flow and the monodirectional valve. In all cases, biofilms grew on both the inner and outer surfaces of the shunts. Microscopy and conventional culture detected all bacterial shunt infections. Analyses of 16S rDNA sequences using conserved primers identified bacteria in only one of three cases, probably because of previous formalin fixation of the samples. [ABSTRACT FROM AUTHOR]

Aims: To assess the effect of several measures of infant feeding on diarrhoeal disease, and whether these effects vary according to markers of social deprivation. Methods: Case-control study of diarrhoeal disease cases presenting to 34 general practices in England. Controls were stratified on age group, area deprivation index for the practice, and whether or not the practice was in London. Data were available on 304 infants (167 cases and 137 controls). Results: After adjustment for confounders, breast feeding was associated with significantly less diarrhoeal disease. Associations were striking even in infants aged ⩾ 6 months. They did not vary by social class, but were greater in those living in rented council accommodation and in more crowded households. The effect of receiving no breast milk was stronger in more deprived areas than in less deprived areas. The effect of not receiving exclusive breast milk was stronger in more deprived areas than in less deprived areas. In formula fed infants, there was significantly more diarrhoeal disease in those not sterilising bottles/teats with steam or chemicals. The protective effect of breast feeding did not persist beyond two months after breast feeding had stopped. Conclusions: Breast feeding protects against diarrhoeal disease in infants in England although the degree of protection may vary across infants and wear off after breast feeding cessation. Education about the benefits of breast feeding and the risks of inadequate sterilisation should be targeted at carers in deprived areas or households. [ABSTRACT FROM AUTHOR]

Background: Lateral ligament ankle sprains are the single most common sports injury. Objective: To determine the functional outcome of the ankle joint after a moderate or severe inversion injury, comparing standard treatment with an elastic support bandage against an Aircast ankle brace. Design: Prospective, randomised controlled trial. Selling: Two accident and emergency departments. Method: Fifty patients presenting consecutively were randomised into two equal groups: one group was treated with an elastic support bandage and the other with an Aircast ankle brace. All patients were given a standardised advice sheet referring to rest, ice, compression, and elevation. Patients were reviewed after 48-72 hours, 10 days, and one month. Primary outcome measure: Ankle joint function assessed at 10 days and one month using the modified Karlsson scoring method (maximum score 90). Secondary outcome measure: The difference in ankle girth (swelling) and pain score at 10 days. Results: Seventeen patients in the elastic support bandage group (six defaulted, two excluded) and 18 patients in the Aircast ankle brace group (six defaulted, one excluded) completed the study. There were no significant differences between the two groups at presentation in terms of age (mean 35.3 and 32.6 years respectively), sex, dominant leg, left or right ankle injured, previous injury, time to presentation (median three and four hours respectively), difference in ankle girth (mean 14.5 and 14.3 mm respectively), and pain scores (mean 6.2 and 5.8 respectively). The Karlsson score was significantly higher in the Aircast ankle cast group than in the elastic bandage group at 10 days (mean 50 v 35, p = 0.028, 95% confidence interval (CI) 1.7 to 27.7) and one month (mean 68 v 55, p = 0.029, 95% CI 1.4 to 24.8) (Student's t test). There was no difference between the groups in the secondary outcome measures (swelling, p = 0.09; pain, p = 0.07). When hierarchical multiple regression analysis was used to correct for possible baseline confounding factors, the Aircast ankle brace group was significantly associated with higher Karlsson scores at 10 days (p = 0.009) and one month (p = 0.024). Conclusion: The use of an Aircast ankle brace for the treatment of lateral ligament ankle sprains produces a significant improvement in ankle joint function at both 10 days and one month compared with standard management with an elastic support bandage. [ABSTRACT FROM AUTHOR]

Summary: Background: Treatment of sexually-transmitted infections (STIs) and behavioural interventions are the main methods to prevent HIV in developing countries. We aimed to assess the effect of these interventions on incidence of HIV-1 and other sexually-transmitted infections. Methods: We randomly allocated all adults living in 18 communities in rural Uganda to receive behavioural interventions alone (group A), behavioural and STI interventions (group B), or routine government health services and community development activities (group C). The primary outcome was HIV-1 incidence. Secondary outcomes were incidence of herpes simplex virus type 2 (HSV2) and active syphilis and prevalence of gonorrhoea, chlamydia, reported genital ulcers, reported genital discharge, and markers of behavioural change. Analysis was per protocol. Findings: Compared with group C, the incidence rate ratio of HIV-1 was 0.94 (0.60-1.45, p=0.72) in group A and 1.00 (0.63-1.58, p=0.98) in group B, and the prevalence ratio of use of condoms with last casual partner was 1.12 (95% CI 0.99-1.25) in group A and 1.27 (1.02-1.56) in group B. Incidence of HSV2 was lower in group A than in group C (incidence rate ratio 0.65, 0.53-0.80) and incidence of active syphilis for high rapid plasma reagent test titre and prevalence of gonorrhoea were both lower in group B than in group C (active syphilis incidence rate ratio, 0.52, 0.27-0.98; gonorrhoea prevalence ratio, 0.25, 0.10-0.64). Interpretation: The interventions we used were insufficient to reduce HIV-1 incidence in rural Uganda, where secular changes are occurring. More effective STI and behavioural interventions need to be developed for HIV control in mature epidemics. [ABSTRACT FROM AUTHOR]

The Nullarbor Plain is underlain by thick cratonic lithospheric mantle that is almost devoid of contemporary seismicity. Analysis of high‐resolution digital elevation models indicates neotectonic fault‐propagation fold traces on the nearly flat karst landscape that locally extend to lengths of >100 km, suggesting potential for hosting large (>7.3–7.5) moment magnitude earthquakes. Along‐strike maximum displacements are not proportional to neotectonic fold surface trace length but are spatially associated with crust‐scale electrical conductors identified in magnetotelluric surveys. Two major conductors penetrate from the upper crust to the uppermost mantle (at depths < 60 km) along crustal scale shear zones. Conductivity in the uppermost mantle shear zones is higher than conductivity at increased depth, suggesting fluid‐enhanced enrichment with hydrogen and/or carbon. Lithospheric fluid localization associated with ancient slab subduction and/or hydrothermal alteration may have weakened pre‐existing faults and enhanced neotectonic faulting in the Nullarbor Plain. Plain Language Summary: Stable cratons on the Earth are generally considered to be immune from large earthquakes. Historical seismic quiescence and a paucity of evidence for geologically recent activity on large intraplate faults can result in an absence or low level of seismic hazard awareness, though intraplate earthquakes have caused more fatalities than interplate earthquakes. Long recurrence intervals commonly obscure evidence for paleo‐earthquakes because surface erosional processes may erode or bury surface ruptures and other neotectonic deformational features. Finding an ideal place that can provide sufficient observations of intracontinental active faults is challenging but pivotal for unraveling intracontinental fault dynamics and seismic hazard assessment. The nearly flat Nullarbor Plain in South‐Central Australia is covered by 100s‐m‐thick limestone, which is cut by reactivated reverse faults propagating upward from the Precambrian basement. The limestone has been exposed to the surface since the mid‐Miocene. The arid climate in this region has helped preserve these neotectonic features from surface erosion. Fault traces with high displacements can be well correlated with patches with high electrical conductivities, which are sensitive to fluids in the lithosphere. With co‐located seismic reflection profiles, gravity, and magnetic maps, we propose that enhanced neotectonic activity is associated with fluids ascending from deeper parts of the lithosphere. Key Points: The Nullarbor Plain in Australia is a cratonic region with neotectonic fault (fold) traces of 7–150 km lengthFault displacement is not positively related to fault length but is spatially linked to high electrical conductors in the lithosphereLithospheric fluid localization is proposed to have weakened pre‐existing faults and enhanced neotectonic faulting in the Nullarbor Plain [ABSTRACT FROM AUTHOR]

Presents information on how to promote cardiac rehabilitation. Significance of taking part in an interdisciplinary program; Percentage increase in overall quality of life scores of elderly patients who had participated in cardiac rehabilitation; Information on the 2003 study on cardiac rehabilitation program.

Presents a letter to the editor about sports medicine clinics in Great Britain.

The article discusses various reports published within the issue, including one by J. K. Campbell and colleagues which offers structural and geomorphic evidence for the eastward propagation of kinematically linked east-striking transpressional dextral strike-slip faults and NE-striking thrust faults in northern Canterbury, another by R. Jongens and colleagues which describes the subsurface structure of the Canterbury plains and connect it with geomorphic expressions of active faults and another by G. H. Browne and colleagues which offers an assessment of the development of basement faults and the sedimentary sequence in the Canterbury region.

Statistical properties of the aftershock sequence of the MW 7.1 Darfield (Canterbury, New Zealand) earthquake are studied. The sequence exhibits rich scaling behaviour in magnitude and aftershock decay rates. In particular, we observe a marked variability in the frequency-magnitude statistics in space, between early and late times after the mainshock and over different magnitude ranges. The mainshock triggered two large earthquakes (22 February 2011 MW 6.2 Christchurch earthquake and 13 June 2011 MW 6.0 earthquake) that occurred later in the sequence and generated their own aftershock sequences. The frequency-magnitude statistics of the sequences are modelled using the Gutenberg–Richter scaling relation. We also study the difference between the magnitudes of the largest recorded aftershocks and the mainshock. This is analysed and discussed using the modified Båth law. In this context we consider the MW 6.2 Christchurch and 13 June 2011 MW 6.0 earthquakes as the largest aftershocks of the Darfield mainshock. It is also observed that the aftershock decay rates can be approximated by the modified Omori law. The obtained results indicate that the aftershock sequence exhibits self-similarity in both magnitude and time. [ABSTRACT FROM AUTHOR]

Objectives: Evidence about sociodemographic factors associated with late attendance for antenatal care in the UK is of poor quality. This study aimed to identify any social or ethnic differences in access to antenatal care, and to quantify the effect of any such differences using data collected in a survey of women's experiences of antenatal screening. Study design: Cross-sectional survey using a postal questionnaire. Methods: A stratified clustered random sampling strategy was used. Hospitals in England were stratified according to ethnic mix. In order to ensure inclusion of an adequate number of women from Black and Minority Ethnic (BME) backgrounds, hospitals with >15% of women of BME origin were oversampled. Pregnant women aged ≥16 years, receiving care in 15 participating hospitals, were sent a postal questionnaire at 27-31 weeks of gestation. Logistic regression was used to estimate odds ratios (ORs) comparing social and ethnic groups for attendance for antenatal care, adjusting for sociodemographic and clinical factors. Results: In total, 839 women (57%) returned completed questionnaires. Compared with all women giving birth in 2005 in England and Wales, the survey sample contained fewer women aged <20 years (5.8% vs 6.9%), more women aged >35 years (24.1% vs 19.6%) and fewer women who were born outside the UK (14.8% vs 20.8%). Five percent of responders were late attenders for their first antenatal appointment. The odds of late initiation of antenatal care were higher for women born outside the UK [OR 4.37, 95% confidence interval (CI) 2.25-8.52; P= 0.0004] and for women living without a husband/partner (OR 2.74, 95% Cl 1.81-4.16; P= 0.0002). In total, 2.5% of women were late attenders for their booking appointment. The odds of late booking were higher for Black women (OR 5.92, 95% CI 2.97-11.83) and women living without a husband/partner (OR 1.95, 95% CI 0.97-3.93; P = 0.06). Conclusions: A small proportion of women initiate and/or book late for antenatal care. This study provides recent, good-quality evidence that women born outside the UK and those living without a husband/partner may be at particular risk of late attendance for antenatal care. [ABSTRACT FROM AUTHOR]

The objective of the study was to determine if negative multidetector computed tomography (MDCT) and lateral radiography of the cervical spine effectively excludes patients with unstable cervical spine injuries. Over a period of 40 months, 6558 people were admitted to our trauma service with blunt injury and 447 (6.8%) were found to have cervical fractures. Fractures were identified by CT and/or lateral radiography. In order to rule out clinically significant instability in the absence of fracture, we identified nine patients who required any type of stabilization of the cervical spine including anterior fusion, posterior fusion and external orthosis. These patients also underwent MR of the cervical spine. Radiography, CT, and MR images and reports of these nine patients were reviewed. Nine patients without a fracture required cervical stabilization. These patients had the following abnormalities: disc herniation with canal stenosis in three, unilateral jumped facet in three, and various other soft tissue abnormalities in three, all of which were evident on CT or radiography. All nine patients had evidence for cervical spine injury or instability by MDCT. Normal MDCT and radiography appears adequate to 'clear' the cervical spine. We recommend that patients requiring cervical spine clearance undergo a complete MDCT and lateral radiograph of the cervical spine. If these studies are entirely normal, then the cervical spine may be cleared. If any abnormalities, including disc herniation, soft tissue swelling and bony malalignments are noted by radiography and/or MDCT, further studies, including MR, are indicated prior to clearance of the cervical spine. [ABSTRACT FROM AUTHOR]

To understand the increase in age-related incidence and frequency of absence seizures in the rat brain, we investigated the effect of these seizures on brain dynamics. This paper puts forward the hypothesis that age-related differences in the expression of absence seizures are associated with the ability of the seizures to reset brain dynamics. [ABSTRACT FROM AUTHOR]

Summary This paper reports the validation of a ‘best-judgement’ standardised questionnaire using guidelines and algorithms developed by an expert working group conducted in Nicaragua between 1995 and 1997. Prospective hospital data, including standardised medical recording of selected signs and symptoms, laboratory and radiographic test results and physician diagnoses were collected for children < 5 years admitted with any serious life-threatening condition in 3 study hospitals. The mothers or caregivers of the children were later traced and interviewed using the ‘best-judgement’ questionnaire. Interviews were completed 1–22 months after admission to hospital for 1115 children (400 who died during the stay in hospital and 715 who were discharged alive). The cause of death or admission to hospital was determined by an expert algorithm applied to hospital data. A similar procedure was used to derive the cause using the answers to questions from interviews. Hospital causes were compared with interview causes and sensitivity and specificity calculated, together with the estimated cause-specific fraction for diarrhoea and pneumonia. Multiple diagnoses were allowed; 378 children in the sample (104 deaths, 274 survivors) had a reference diagnosis of diarrhoeal illness, and 506 (168 deaths, 338 survivors) a reference diagnosis of pneumonia. When results for deaths and survivors in all age groups were combined, the expert algorithms had sensitivity between 86% and 88% and specificity between 81% and 83% for any diarrhoeal illness; and sensitivity between 74% and 87% and specificity between 37% and 72% for pneumonia. Algorithms tested in previous validation studies were also applied to data obtained in this study, and the results are compared. Despite less than perfect sensitivity and specificity, reasonably accurate estimates of the cause-specific mortality and morbidity fractions for diarrhoea were obtained, although the accuracy of estimates in other settings using the same instrument will depend on the true cause-specific fraction in those settings. The algorithms tested for pneumonia did not produce accurate estimates of the cause-specific fraction, and are not recommended for use in community settings. [ABSTRACT FROM AUTHOR]

Background: Studies on prevalence and factors associated with postpartum posttraumatic stress (PTS) typically do not distinguish between PTS related to childbirth (PTS-C) and PTS related to other stressors (PTS-O). This study aimed to describe the prevalence, clinical characteristics, and factors associated with PTS-C and PTS-O in postpartum women.Methods: The study was a cross-sectional population-based survey of 16,000 postpartum women, selected at random from birth registrations in England to receive a postal questionnaire, including the Primary Care Posttraumatic Stress Disorder Screen.Results: Questionnaires were returned by 4,509 women. The median age was 32 years (IQR=29-36), 64% were married, 77% were UK-born, and 76% were White-British. Prevalence of PTS-C was 2.5% (95%CI:2.0-3.0) and prevalence of PTS-O was 6.8% (95%CI:6.0-7.8). Women with PTS-C were significantly more likely to report re-experiencing symptoms (Chi-Square=7.69,p<0.01). Factors associated with PTS-C were: higher level of deprivation, not having a health professional to talk to about sensitive issues during pregnancy, and the baby being admitted for neonatal intensive care. Factors associated with PTS-O were: age ≤24 years, depression during pregnancy, and having a pregnancy affected by long-term health problems. Factors associated with both were: living without a partner, anxiety during pregnancy, pregnancy-specific health problems, and lower birth satisfaction.Conclusions: PTS during the postpartum period is relatively common and, for many women, unrelated to childbirth. Increased awareness among health professionals of prevalence, clinical characteristics and factors associated with postpartum PTS-C and PTS-O will aid the development of appropriate management protocols to identify and support women during the perinatal period. Posttraumatic stress, posttraumatic stress disorder, postpartum PTSD/PTS, birth-related PTSD/PTS, birth trauma, perinatal mental health. [ABSTRACT FROM AUTHOR]

Studies CD4 counts in HIV-seropositive patients in Zambia, using a fluorescence-activated cell sorters. Comparison with CD4 counts obtained using the immunoalkaline phosphatase method; Correlation with neopterin, beta-2-microglobulin, hemoglobin and total lymphocyte count; Comparison of progression markers with clinical parameters.

Over a quarter of UK births are to women who were born outside of the UK. Black and Minority Ethnic (BME) women are disproportionately affected by poor mental health and inequitable access to mental health care in the perinatal period, yet the influence of the migrant status (mothers' UK vs. non-UK birth) is poorly understood. This study aimed to explore the relationship between ethnicity, migration and mental health indicators among mothers participating in a large nationally representative cohort study. This is a secondary analysis of data from the Millennium Cohort Study. Logistic regression quantified the crude and adjusted effects of self-reported ethnicity and migrant status on prevalence of psychological distress and treatment for anxiety/depression at 9-month and 5-year postpartum. We found substantial variation in the prevalence of distress according to ethnicity and migrant status, with Indian and Pakistani women at greatest risk. Despite equal or greater risk, BME and migrant women were less likely to report treatment for anxiety/depression. Mutually adjusted analyses showed ethnicity to be a stronger predictor of both outcomes than migrant status; however, at 5 years, being a migrant independently predicted lower odds of treatment, for a statistically similar level of distress. Migrant women are likely to be at high risk of poor mental health in the perinatal period and beyond, yet may face significant barriers to accessing mental health care. A better understanding of ethnicity and migration as interrelated risk factors for perinatal mental ill-health is needed to help National Health Service organisations develop policy and practice that is flexible and responsive to diversity. • Migrant and ethnic minority mothers are at increased risk of psychological distress. • But are less likely than non-migrant/white British women to be treated for anxiety/depression. • Ethnicity was a stronger predictor than migrant status of these differences. [ABSTRACT FROM AUTHOR]

Background: Preclinical studies suggest that bb2121, a chimeric antigen receptor (CAR) T-cell therapy that targets B-cell maturation antigen (BCMA), has potential for the treatment of multiple myeloma.Methods: In this phase 1 study involving patients with relapsed or refractory multiple myeloma, we administered bb2121 as a single infusion at doses of 50×106, 150×106, 450×106, or 800×106 CAR-positive (CAR+) T cells in the dose-escalation phase and 150×106 to 450×106 CAR+ T cells in the expansion phase. Patients had received at least three previous lines of therapy, including a proteasome inhibitor and an immunomodulatory agent, or were refractory to both drug classes. The primary end point was safety.Results: Results for the first 33 consecutive patients who received a bb2121 infusion are reported. The data-cutoff date was 6.2 months after the last infusion date. Hematologic toxic effects were the most common events of grade 3 or higher, including neutropenia (in 85% of the patients), leukopenia (in 58%), anemia (in 45%), and thrombocytopenia (in 45%). A total of 25 patients (76%) had cytokine release syndrome, which was of grade 1 or 2 in 23 patients (70%) and grade 3 in 2 patients (6%). Neurologic toxic effects occurred in 14 patients (42%) and were of grade 1 or 2 in 13 patients (39%). One patient (3%) had a reversible grade 4 neurologic toxic effect. The objective response rate was 85%, including 15 patients (45%) with complete responses. Six of the 15 patients who had a complete response have had a relapse. The median progression-free survival was 11.8 months (95% confidence interval, 6.2 to 17.8). All 16 patients who had a response (partial response or better) and who could be evaluated for minimal residual disease (MRD) had MRD-negative status (≤10-4 nucleated cells). CAR T-cell expansion was associated with responses, and CAR T cells persisted up to 1 year after the infusion.Conclusions: We report the initial toxicity profile of a BCMA-directed cellular immunotherapy for patients with relapsed or refractory multiple myeloma. Antitumor activity was documented. (Funded by Bluebird Bio and Celgene; CRB-401 ClinicalTrials.gov number, NCT02658929.). [ABSTRACT FROM AUTHOR]

Macroaggregates are of interest because of their fast response to land management and their role in the loss or restoration of soil organic carbon (SOC). The study included two experiments. In Experiment I, we investigated the effect of long-term (27 years) land management on the chemical composition of organic matter (OM) of macroaggregates. Macroaggregates were sampled from topsoil under conventional cropping, cover cropping and natural succession systems. The OM of macroaggregates from conventional cropping was more decomposed than that of cover cropping and especially natural succession, based on larger δ15N values and decomposition indices determined by multiple magic-angle spinning nuclear magnetic resonance (13C CP/MAS NMR) and Fourier transform infrared (FTIR) spectroscopy. Previous research at the sites studied suggested that this was mainly because of reduced diversity and activity of the decomposer community, change in nutrient stoichiometry from fertilization and contrasting formation pathways of macroaggregates in conventional cropping compared with cover cropping and, specifically, natural succession. In Experiment II, we investigated the relation between OM composition and pore characteristics of macroaggregates. Macroaggregates from the natural succession system only were studied. We determined 3-D pore-size distribution of macroaggregates with X-ray microtomography, for which we cut the macroaggregates into sections that had contrasting dominant pore sizes. Then, we characterized the OM of macroaggregate sections with FTIR and δ15N methods. The results showed that within a macroaggregate, the OM was less decomposed in areas where the small (13-32 µm) or large (136-260 µm) pores were abundant. This was attributed to the role of large pores in supplying fresh OM and small pores in the effective protection of OM in macroaggregates. Previous research at the site studied had shown increased abundance of large and small intra-aggregate pores following adoption of less intensive management systems. It appears that land management can alter the OM composition of macroaggregates, partly by the regulation of OM turnover at the intra-aggregate scale. Highlights OM and pore characteristics were studied in soil macroaggregates under different land management., Long-term intensive land management increased degree of OM decomposition in macroaggregates., Abundance of < 32 and > 136 µm pores was positively related to less decomposed OM., Land management may affect rate of SOM turnover by changing intra-aggregate pore-size distribution. [ABSTRACT FROM AUTHOR]

The article focuses on a symposium on the association between surgical treatment of cervical intraepithelial neoplasia (CIN) and subsequent preterm birth held on February 16, 2015 in London, Great Britain. It is stated that CIN grades 2 and 3 that have been managed surgically were the main focus of the meeting.

Background Children born before full term (39-41 weeks' gestation) are at increased risk of adverse cognitive outcomes. Risk quantification is important as late-preterm (LPT; 34-36 weeks) and early-term (ET; 37-38 weeks) births are common. Method This review analyses the effect of LPT and ET births on long-term cognitive and educational outcomes. The primary outcome was general cognitive ability. Secondary outcomes included verbal/non-verbal intelligence quotient, subject-specific school performance and special educational needs. The search strategy included Medline and Embase from January 1975 to June 2013. Eligible studies investigated specified outcomes and included suitable gestational age participants assessed at 2 years and older. Outcome measures and socio-demographic descriptors were extracted, and data meta-analysed where possible. Results Eight studies compared ET birth with full-term birth. Fourteen studies compared LPT birth with either term birth (>37 weeks, n = 12 studies) or full-term birth (39-41 weeks, n = 2 studies). Substantial between-study heterogeneity existed. LPT and ET children underperformed in most outcomes compared with their term/full-term counterparts, respectively. For example, LPT children had an increased risk of lower general cognitive ability (adjusted risk ratio 1.38 [95% confidence interval 1.06-1.79]), and full-term children performed 5% of a standard deviation higher ( z-score 0.05 [0.02, 0.08]) than ET children. Poorer outcomes persist into adulthood; term cohorts performed 5% of a standard deviation higher than LPT cohorts ( z-score 0.05 [0.04, 0.07]), and full-term cohorts performed 3% of a standard deviation higher than ET cohorts ( z-score 0.03 [0.02, 0.04]). Conclusion This review critically examines the knowledge around long-term cognitive outcomes of LPT and ET births, demonstrating multiple, small, adverse differences between LPT/ET and term/full-term births. [ABSTRACT FROM AUTHOR]

Unfractionated heparin (UFH), low molecular weight heparin or fondaparinux are recommended for venous thromboembolism (VTE) prophylaxis in acutely ill medical patients. There are limited data on the safety of fondaparinux for VTE prophylaxis in ischemic stroke. We examined adverse event frequency in hospitalized patients with ischemic stroke who received VTE prophylaxis with fondaparinux versus UFH. Materials and Methods We performed a propensity score matched analysis on a retrospective cohort of 644 consecutive patients with acute ischemic stroke receiving fondaparinux (n=322) or UFH (n=322) for VTE prophylaxis. Patients who received intravenous tPA and continuous intravenous infusions of UFH were excluded. The primary outcome was major hemorrhage (intracranial or extracranial) and the secondary outcome was total hemorrhage (major and minor hemorrhage) during hospitalization. We also examined the rate of symptomatic VTE. Results Mean age of the matched cohort was 71.3±14.1years, median NIHSS score was 4 (IQR 1-11), median duration of anticoagulant exposure was 5 (IQR 3-8) days, and 98.1% received antiplatelet medications. In the matched cohort, there were less observed major hemorrhages in the fondaparinux group 1.2% (4/322) compared to UFH 3.7% (12/322), but this difference was not significant (OR=0.33, 95% CI 0.08-1.10, p=0.08). There were also no significant differences in total hemorrhage (p=0.15), intracranial hemorrhage (p=0.48), major extracranial hemorrhage (p=0.18) and symptomatic VTE (p=1.00) between the groups. Conclusions Fondaparinux is not associated with increased hemorrhagic complications compared with UFH in patients with ischemic stroke. There were low rates of symptomatic VTE in both groups. [ABSTRACT FROM AUTHOR]

Palynology of exhumed Pliocene marine turbidites and marl beds on the island of Timor provide insights into crustal deformation in the Indonesian region. Between ca. 4.5 and ca. 3 Ma, palynomorphs were sourced primarily from Australia and New Guinea, with increasing swamp and mangrove elements sourced from an emerging proto-Timor. Following ca. 3.1 Ma, pollen and charcoal evidence track the rapid uplift of Timor to a high island, with the progressive appearance of montane and dry, lee-side floristic elements. Early- to mid-Pliocene uplift rates of 0.5-0.6 mm yr-1 increased to 2-5 mm yr-1 in the latest Pliocene. The rapid topographic development of Timor-Leste initiated earlier but followed a pattern similar to that of more westerly localities in the Timor sector of the Banda Arc. Timor's emergence from the marine environment is closely correlated with the timing of closure of the Indonesian seaway to deep-dwelling foraminfera. [ABSTRACT FROM AUTHOR]

A correction to the article "Absence Seizures as Resetting Mechanisms of Brain Dynamics" that was published in the September-October 2008 issue is presented.

Rupture of the Greendale Fault during the 4 September 2010, M W7.1 Darfield (Canterbury) earthquake produced a zone of ground-surface rupture that severely damaged several houses, buildings and lifelines. Immediately after the earthquake, surface rupture features were mapped in the field and from digital terrain models developed from airborne Light Detection and Ranging (lidar) data. To enable rebuild decisions to be made and for future land use planning, a fault avoidance zone was defined for the Greendale Fault following the Ministry for the Environment guidelines on ‘Planning for the Development of Land on or Close to Active Faults’. We present here the most detailed map to date of the fault trace and describe how this was used to define and characterise the fault avoidance zone for land use planning purposes. [ABSTRACT FROM PUBLISHER]

Pulmonary lymphoproliferative disorders (LPD) are characterised by abnormal proliferation of indigenous cell lines or infiltration of lung parenchyma by lymphoid cells. They encompass a wide spectrum of focal or diffuse abnormalities, which may be classified as reactive or neoplastic on the basis of cellular morphology and clonality. The spectrum of reactive disorders results primarily from antigenic stimulation of bronchial mucosa-associated lymphoid tissue (MALT) and comprises three main entities: follicular bronchiolitis, lymphoid interstitial pneumonia and (more rarely) nodular lymphoid hyperplasia. Primary parenchymal neoplasms are most commonly extranodal marginal zone lymphomas of MALT origin (MALT lymphomas), followed by diffuse large B-cell lymphomas (DLBCLs) and lymphomatoid granulomatosis (LYG). Secondary lymphomatous parenchymal neoplasms (both Hodgkin and non-Hodgkin lymphomas) are far more prevalent than primary neoplasms. Acquired immune deficiency syndrome (AIDS)-related lymphoma (ARL) and post-transplantation lymphoproliferative disorder (PTLD) may also primarily affect the lung parenchyma. Modern advances in treatments for AIDS and transplant medicine are associated with an increase in the incidence of LPD and have heightened the need to understand the range of imaging appearance of these diseases. The multidetector CT (MDCT) findings of LPD are heterogeneous, thereby reflecting the wide spectrum of clinical manifestations of these entities. Understanding the spectrum of LPD and the various imaging manifestations is crucial because the radiologist is often the first one to suggest the diagnosis and has a pivotal role in differentiating these diseases. The current concepts of LPD are discussed together with a demonstration of the breadth of MDCT patterns within this disease spectrum. [ABSTRACT FROM AUTHOR]

Background: Epidemiological studies have examined the health of children born after assisted reproductive technology (ART), with contradictory results. In this article, we address the question 'Do singletons born after ART have a poorer cognitive developmental outcome at 3 years of age?' We assess the implications of using different comparison groups, and discuss appropriate analytical approaches for the control of confounding and mediating variables.Methods: Data were drawn from the Millennium Cohort Study. Interviews captured sociodemographic, behavioural and pregnancy information. Developmental assessments conducted at age three included the British Ability Scales II Naming Vocabulary (BAS-NV) instrument. We compared ART infants (born after IVF or ICSI) to four comparison groups: a 'matched' group; a 'subfertile' group (time to conception >12 months); a 'fertile' group (time to conception <12 months); and an 'any spontaneous conceptions' group. Linear regression provided estimates of the difference in mean BAS-NV scores in the ART and comparison groups; both unadjusted estimates and those adjusted for confounding and mediating factors are presented.Results: In the unadjusted analyses, ART children gained significantly better BAS-NV test results than did the comparison group children. When converted to an estimate of developmental age gap, ART children were 2.5, 2.7, 3.6 and 4.5 months ahead of the 'matched', 'subfertile', 'fertile' and 'spontaneous conception' children, respectively. After adjusting for confounding and mediating factors, the differences were reduced, and were not statistically significant.Conclusions: ART is not associated with poorer cognitive development at 3 years. We have highlighted methodological considerations for researchers planning to study the effect of infertility and ART on childhood outcomes. [ABSTRACT FROM AUTHOR]

Objectives: A study of men with genital ulcer disease (GUD) in Durban, South Africa, at the start of the local HIV epidemic in 1988/1989 found that 36% of men with GUD continued with sexual intercourse despite symptoms. The aim of this study was to determine whether this high-risk behaviour was still prevalent and to enquire about similar risk behaviours with other sexually transmitted infection (STI)-related problems. Methods: 650 Men attending the main Durban STI clinic with a new complaint were enrolled. A standard questionnaire was administered. Polymerase chain reaction (PCR) tests were performed to diagnose genital herpes from ulcer specimens and gonorrhoea and chlamydia from those with urethral discharge and/or dysuria. Serology tests were performed for HIV, herpes simplex virus type 2 (HSV-2) and syphilis. Results: Sex since the start of symptoms was reported by between 33.3% and 43.9% of men with GUD, herpetic ulcers, gonorrhoea and/or chlamydia or dysuria. The incidence of condom use was very low in all groups having sex despite symptoms. In 87 men with genital ulcers confirmed positive for genital herpes by PCR testing, 30 (34.4%) had had sex since the start of symptoms, 28 (93.3%) of whom had had unprotected sex. Conclusions: There is a high level of risk behaviour in this group of men in whom genital herpes is the most common cause of GUD. This risky sexual behaviour could reflect disinhibition, possibly because so many have already been infected with HSV-2, lack of education or other unknown factors. Syndromic STI management should be strengthened with intensive health education to promote community awareness of both genital ulceration and genital herpes and their role in facilitating HIV transmission. The low level of condom use indicates that condom promotion programmes still have much to achieve. [ABSTRACT FROM AUTHOR]