151 research outputs found
Reliability of movement control tests in the lumbar spine
<p>Abstract</p> <p>Background</p> <p>Movement control dysfunction [MCD] reduces active control of movements. Patients with MCD might form an important subgroup among patients with non specific low back pain. The diagnosis is based on the observation of active movements. Although widely used clinically, only a few studies have been performed to determine the test reliability. The aim of this study was to determine the inter- and intra-observer reliability of movement control dysfunction tests of the lumbar spine.</p> <p>Methods</p> <p>We videoed patients performing a standardized test battery consisting of 10 active movement tests for motor control in 27 patients with non specific low back pain and 13 patients with other diagnoses but without back pain. Four physiotherapists independently rated test performances as correct or incorrect per observation, blinded to all other patient information and to each other. The study was conducted in a private physiotherapy outpatient practice in Reinach, Switzerland. Kappa coefficients, percentage agreements and confidence intervals for inter- and intra-rater results were calculated.</p> <p>Results</p> <p>The kappa values for inter-tester reliability ranged between 0.24 – 0.71. Six tests out of ten showed a substantial reliability [k > 0.6]. Intra-tester reliability was between 0.51 – 0.96, all tests but one showed substantial reliability [k > 0.6].</p> <p>Conclusion</p> <p>Physiotherapists were able to reliably rate most of the tests in this series of motor control tasks as being performed correctly or not, by viewing films of patients with and without back pain performing the task.</p
A distortion of very--high--redshift galaxy number counts by gravitational lensing
The observed number counts of high-redshift galaxy candidates have been used
to build up a statistical description of star-forming activity at redshift z >~
7, when galaxies reionized the Universe. Standard models predict that a high
incidence of gravitational lensing will probably distort measurements of flux
and number of these earliest galaxies. The raw probability of this happening
has been estimated to be ~ 0.5 percent, but can be larger owing to
observational biases. Here we report that gravitational lensing is likely to
dominate the observed properties of galaxies with redshifts of z >~ 12, when
the instrumental limiting magnitude is expected to be brighter than the
characteristic magnitude of the galaxy sample. The number counts could be
modified by an order of magnitude, with most galaxies being part of multiply
imaged systems, located less than 1 arcsec from brighter foreground galaxies at
z ~ 2. This lens-induced association of high-redshift and foreground galaxies
has perhaps already been observed among a sample of galaxy candidates
identified at z ~ 10.6. Future surveys will need to be designed to account for
a significant gravitational lensing bias in high-redshift galaxy samples.Comment: Nature, Jan. 13, 2011 issue (in press
Inter-examiner reproducibility of tests for lumbar motor control
<p>Abstract</p> <p>Background</p> <p>Many studies show a relation between reduced lumbar motor control (LMC) and low back pain (LBP). However, test circumstances vary and during test performance, subjects may change position. In other words, the reliability - i.e. reproducibility and validity - of tests for LMC should be based on quantitative data. This has not been considered before. The aim was to analyse the reproducibility of five different quantitative tests for LMC commonly used in daily clinical practice.</p> <p>Methods</p> <p>The five tests for LMC were: repositioning (RPS), sitting forward lean (SFL), sitting knee extension (SKE), and bent knee fall out (BKFO), all measured in cm, and leg lowering (LL), measured in mm Hg. A total of 40 subjects (14 males, 26 females) 25 with and 15 without LBP, with a mean age of 46.5 years (SD 14.8), were examined independently and in random order by two examiners on the same day. LBP subjects were recruited from three physiotherapy clinics with a connection to the clinic's gym or back-school. Non-LBP subjects were recruited from the clinic's staff acquaintances, and from patients without LBP.</p> <p>Results</p> <p>The means and standard deviations for each of the tests were 0.36 (0.27) cm for RPS, 1.01 (0.62) cm for SFL, 0.40 (0.29) cm for SKE, 1.07 (0.52) cm for BKFO, and 32.9 (7.1) mm Hg for LL. All five tests for LMC had reproducibility with the following ICCs: 0.90 for RPS, 0.96 for SFL, 0.96 for SKE, 0.94 for BKFO, and 0.98 for LL. Bland and Altman plots showed that most of the differences between examiners A and B were less than 0.20 cm.</p> <p>Conclusion</p> <p>These five tests for LMC displayed excellent reproducibility. However, the diagnostic accuracy of these tests needs to be addressed in larger cohorts of subjects, establishing values for the normal population. Also cut-points between subjects with and without LBP must be determined, taking into account age, level of activity, degree of impairment and participation in sports. Whether reproducibility of these tests is as good in daily clinical practice when used by untrained examiners also needs to be examined.</p
The Formation of the First Massive Black Holes
Supermassive black holes (SMBHs) are common in local galactic nuclei, and
SMBHs as massive as several billion solar masses already exist at redshift z=6.
These earliest SMBHs may grow by the combination of radiation-pressure-limited
accretion and mergers of stellar-mass seed BHs, left behind by the first
generation of metal-free stars, or may be formed by more rapid direct collapse
of gas in rare special environments where dense gas can accumulate without
first fragmenting into stars. This chapter offers a review of these two
competing scenarios, as well as some more exotic alternative ideas. It also
briefly discusses how the different models may be distinguished in the future
by observations with JWST, (e)LISA and other instruments.Comment: 47 pages with 306 references; this review is a chapter in "The First
Galaxies - Theoretical Predictions and Observational Clues", Springer
Astrophysics and Space Science Library, Eds. T. Wiklind, V. Bromm & B.
Mobasher, in pres
The Formation and Evolution of the First Massive Black Holes
The first massive astrophysical black holes likely formed at high redshifts
(z>10) at the centers of low mass (~10^6 Msun) dark matter concentrations.
These black holes grow by mergers and gas accretion, evolve into the population
of bright quasars observed at lower redshifts, and eventually leave the
supermassive black hole remnants that are ubiquitous at the centers of galaxies
in the nearby universe. The astrophysical processes responsible for the
formation of the earliest seed black holes are poorly understood. The purpose
of this review is threefold: (1) to describe theoretical expectations for the
formation and growth of the earliest black holes within the general paradigm of
hierarchical cold dark matter cosmologies, (2) to summarize several relevant
recent observations that have implications for the formation of the earliest
black holes, and (3) to look into the future and assess the power of
forthcoming observations to probe the physics of the first active galactic
nuclei.Comment: 39 pages, review for "Supermassive Black Holes in the Distant
Universe", Ed. A. J. Barger, Kluwer Academic Publisher
The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain
<p>Abstract</p> <p>Background</p> <p>Shortening of the iliotibial band (ITB) has been considered to be associated with low back pain (LBP). It is theorized that ITB tightness in individuals with LBP is a compensatory mechanism following hip abductor muscle weakness. However, no study has clinically examined this theory. The purpose of this study was to investigate the muscle imbalance of hip abductor muscle weakness and ITB tightness in subjects with LBP.</p> <p>Methods</p> <p>A total of 300 subjects with and without LBP between the ages of 20 and 60 participated in this cross-sectional study. Subjects were categorized in three groups: LBP with ITB tightness (n = 100), LBP without ITB tightness (n = 100) and no LBP (n = 100). Hip abductor muscle strength was measured in all subjects.</p> <p>Results</p> <p>Analysis of Covariance (ANCOVA) with the body mass index (BMI) as the covariate revealed significant difference in hip abductor strength between three groups (P < 0.001). Post hoc analysis showed no significant difference in hip abductor muscle strength between the LBP subjects with and without ITB tightness (P = 0.59). However, subjects with no LBP had significantly stronger hip abductor muscle strength compared to subjects with LBP with ITB tightness (P < 0.001) and those with LBP without ITB tightness (P < 0.001).</p> <p>Conclusion</p> <p>The relationship between ITB tightness and hip abductor weakness in patients with LBP is not supported as assumed in theory. More clinical studies are needed to assess the theory of muscle imbalance of hip abductor weakness and ITB tightness in LBP.</p
Cluster Lenses
Clusters of galaxies are the most recently assembled, massive, bound
structures in the Universe. As predicted by General Relativity, given their
masses, clusters strongly deform space-time in their vicinity. Clusters act as
some of the most powerful gravitational lenses in the Universe. Light rays
traversing through clusters from distant sources are hence deflected, and the
resulting images of these distant objects therefore appear distorted and
magnified. Lensing by clusters occurs in two regimes, each with unique
observational signatures. The strong lensing regime is characterized by effects
readily seen by eye, namely, the production of giant arcs, multiple-images, and
arclets. The weak lensing regime is characterized by small deformations in the
shapes of background galaxies only detectable statistically. Cluster lenses
have been exploited successfully to address several important current questions
in cosmology: (i) the study of the lens(es) - understanding cluster mass
distributions and issues pertaining to cluster formation and evolution, as well
as constraining the nature of dark matter; (ii) the study of the lensed objects
- probing the properties of the background lensed galaxy population - which is
statistically at higher redshifts and of lower intrinsic luminosity thus
enabling the probing of galaxy formation at the earliest times right up to the
Dark Ages; and (iii) the study of the geometry of the Universe - as the
strength of lensing depends on the ratios of angular diameter distances between
the lens, source and observer, lens deflections are sensitive to the value of
cosmological parameters and offer a powerful geometric tool to probe Dark
Energy. In this review, we present the basics of cluster lensing and provide a
current status report of the field.Comment: About 120 pages - Published in Open Access at:
http://www.springerlink.com/content/j183018170485723/ . arXiv admin note:
text overlap with arXiv:astro-ph/0504478 and arXiv:1003.3674 by other author
Movement control exercise versus general exercise to reduce disability in patients with low back pain and movement control impairment. A randomised controlled trial
<p>Abstract</p> <p>Background</p> <p>Non-specific low back pain (NSLBP) in subacute and chronic stages can be treated effectively with exercise therapy. Research guidelines recommend evaluating different treatments in defined subgroups of patients with NSLBP. A subgroup of patients with movement control impairment (MCI) improved significantly on patient specific function and disability in a previous case series after movement control exercises.</p> <p>Methods/Design</p> <p>In a randomised controlled trial (RCT) we will compare the effectiveness of movement control and general exercise in patients with MCI. 106 participants aged 18 - 75 will be recruited in 5 outpatient hospital departments and 7 private practices.</p> <p>Patients randomly assigned to the movement control exercise group will be instructed to perform exercises according to their MCI. The general exercise group will follow an exercise protocol aimed at improving endurance and flexibility. Patients in both groups will receive 9 - 18 treatments and will be instructed to do additional exercises at home.</p> <p>The primary outcome is the level of disability assessed using the patient specific functional scale (PSFS) which links the perceived pain to functional situations and is measured before treatment and at 6 and 12 months follow-up. Secondary outcomes concern low back pain related disability (Roland Morris questionnaire, RMQ), graded chronic pain scale (GCPS), range of motion and tactile acuity.</p> <p>Discussion</p> <p>To our knowledge this study will be the first to compare two exercise programs for a specific subgroup of patients with NSLBP and MCI. Results of this study will provide insight into the effectiveness of movement control exercise and contribute to our understanding of the mechanisms behind MCI and its relation to NSLBP.</p> <p>Trial registration</p> <p>Current Controlled Trials <a href="http://www.controlled-trials.com/ISRCTN80064281">ISRCTN80064281</a></p
Space Telescope and Optical Reverberation Mapping Project. VII. Understanding the Ultraviolet Anomaly in NGC 5548 with X-Ray Spectroscopy
During the Space Telescope and Optical Reverberation Mapping Project observations of NGC 5548, the continuum and emission-line variability became decorrelated during the second half of the six-month-long observing campaign. Here we present Swift and Chandra X-ray spectra of NGC 5548 obtained as part of the campaign. The Swift spectra show that excess flux (relative to a power-law continuum) in the soft X-ray band appears before the start of the anomalous emission-line behavior, peaks during the period of the anomaly, and then declines. This is a model-independent result suggesting that the soft excess is related to the anomaly. We divide the Swift data into on- and off-anomaly spectra to characterize the soft excess via spectral fitting. The cause of the spectral differences is likely due to a change in the intrinsic spectrum rather than to variable obscuration or partial covering. The Chandra spectra have lower signal-to-noise ratios, but are consistent with the Swift data. Our preferred model of the soft excess is emission from an optically thick, warm Comptonizing corona, the effective optical depth of which increases during the anomaly. This model simultaneously explains all three observations: the UV emission-line flux decrease, the soft-excess increase, and the emission-line anomaly
Vasodilator Phosphostimulated Protein (VASP) Protects Endothelial Barrier Function During Hypoxia
The endothelial barrier controls the passage of solutes from the vascular space. This is achieved through active reorganization of the actin cytoskeleton. A central cytoskeletal protein involved into this is vasodilator-stimulated phosphoprotein (VASP). However, the functional role of endothelial VASP during hypoxia has not been thoroughly elucidated. We determined endothelial VASP expression through real-time PCR (Rt-PCR), immunhistochemistry, and Western blot analysis during hypoxia. VASP promoter studies were performed using a PGL3 firefly luciferase containing plasmid. Following approval by the local authorities, VASP−/− mice and littermate controls were subjected to normobaric hypoxia (8% O2, 92% N2) after intravenous injection of Evans blue dye. In in vitro studies, we found significant VASP repression in human microvascular and human umbilical vein endothelial cells through Rt-PCR, immunhistochemistry, and Western blot analysis. The VASP promoter construct demonstrated significant repression in response to hypoxia, which was abolished when the binding of hypoxia-inducible factor 1 alpha was excluded. Exposure of wild-type (WT) and VASP−/− animals to normobaric hypoxia for 4 h resulted in an increase in Evans blue tissue extravasation that was significantly increased in VASP−/− animals compared to WT controls. In summary, we demonstrate here that endothelial VASP holds significant importance for endothelial barrier properties during hypoxia
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