Generating Surface Geometry in Higher Dimensions using Local Cell Tilers

In two dimensions contour elements surround two dimensional objects, in three dimensions surfaces surround three dimensional objects and in four dimensions hypersurfaces surround hyperobjects. These surfaces can be represented by a collection of connected simplices, hence, continuous n dimensional surfaces can be represented by a lattice of connected n-1 dimensional simplices. The lattice of connected simplices can be calculated over a set of adjacent n-dimensional cubes, via for example the Marching Cubes Algorithm. These algorithms are often named local cell tilers. We propose that the local-cell tiling method can be usefully-applied to four dimensions and potentially to N-dimensions. We present an algorithm for the generation of major cases (cases that are topologically invariant under standard geometrical transformations) and introduce the notion of a sub-case which simplifies their representations. Each sub-case can be easily subdivided into simplices for rendering and we describe a backtracking tetrahedronization algorithm for the four dimensional case. An implementation for surfaces from the fourth dimension is presented and we describe and discuss ambiguities inherent within this and related algorithms

An Open Framework for Integrating Widely Distributed Hypermedia Resources

The success of the WWW has served as an illustration of how hypermedia functionality can enhance access to large amounts of distributed information. However, the WWW and many other distributed hypermedia systems offer very simple forms of hypermedia functionality which are not easily applied to existing applications and data formats, and cannot easily incorporate alternative functions which would aid hypermedia navigation to and from existing documents that have not been developed with hypermedia access in mind. This paper describes the extension to a distributed environment of the open hypermedia functionality of the Microcosm system, which is designed to support the provision of hypermedia access to a wide range of source material and application, and to offer straightforward extension of the system to incorporate new forms of information access

Unifying Distributed Processing and Open Hypertext through a Heterogeneous Communication Model

A successful distributed open hypermedia system can be characterised by a scaleable architecture which is inherently distributed. While the architects of distributed hypermedia systems have addressed the issues of providing and retrieving distributed resources, they have often neglected to design systems with the inherent capability to exploit the distributed processing of this information. The research presented in this paper describes the construction and use of an open hypermedia system concerned equally with both of these facets

Cross-cultural adaptation and validation of the STarT Back Tool for Arabic speaking adults with low back pain in Saudi Arabia

BACKGROUND:The STarT Back Tool (Subgrouping for Targeted Treatment; SBT) was developed and validated in the United Kingdom for adults with non-specific low back pain (LBP) to provide risk stratification groups. An Arabic version has not yet been developed. Consequently, our objectives were: First, to cross-culturally adapt the SBT for use in Arabic speaking adults (SBT-Ar) with LBP. Second, to assess the face, content and construct validity of SBT-Ar against relevant reference standards.METHODS: This was a prospective, cross-sectional study carried out in the outpatient department in a tertiary care hospital. A total of 59 participants (aged 18-60) with LBP able to read Arabic completed the questionnaire. SBT cross-cultural adaptation was performed according to published guidelines. Face and content validity were explored by individual interviews. Construct validity was assessed using pre-hypothesized correlations with relevant reference standards.RESULTS: Following 48 individual interviews the SBT final version was reached and demonstrated face and content validity. The SBT-Ar total score and psychosocial sub-scale had acceptable internal consistency and no redundancy (Cronbach a = 0.7). Moderate Spearman's correlations were found between the SBT-Ar total score and reference standards (Arabic Pain Numeric Rating Scale NRS-Ar r = 0.50 and Arabic Oswestry Disability Index ODI-ar r = 0.51). As expected the SBT-Ar psychosocial subscale had medium to high correlations with the psychosocial reference measures (Arabic Fear-Avoidance Beliefs Questionnaire Physical Activity FABQPA-Ar r = 0.41, Arabic Hospital Anxiety and Depression Scale-Anxiety HADSA-Ar r = 0.58, Arabic Hospital Anxiety and Depression Scale-Depression HADSD-Ar r = 0.45 and Arabic Pain Catastrophizing Scale PCSAr r = 0.69).The SBT-Ar showed no significant floor or ceiling effects. CONCLUSION: This study culturally adapted and preliminary validated SBT into Arabic.STUDY DESIGN: Prospective, Cross-sectional

Development of an optimised physiotherapist-led treatment protocol for lateral elbow tendinopathy:a consensus study using an online nominal group technique

OBJECTIVES: There are a wide range of physiotherapy treatment options for people with lateral elbow tendinopathy (LET); however, previous studies have reported inconsistent approaches to treatment and a lack of evidence demonstrating clinical effectiveness. This study aimed to combine the best available research evidence with stakeholder perspectives to develop key components of an optimised physiotherapist-led treatment protocol for testing in a future randomised controlled trial (RCT). DESIGN: Online consensus groups using nominal group technique (NGT), a systematic approach to building consensus using structured multistage meetings. SETTING: UK National Health Service (NHS). PARTICIPANTS: 10 physiotherapists with special interest in LET, 2 physiotherapy service managers and 3 patients who had experienced LET. INTERVENTIONS: Two consensus groups were conducted; the first meeting focused on agreeing the types of interventions to be included in the optimised treatment protocol; the second meeting focused on specific details of intervention delivery. Participants were sent an evidence summary of available treatments for LET prior to the first meeting. All treatment options were discussed before anonymous voting and ranking of priority. Consensus for inclusion of each treatment option was set at ≥70% based on OMERACT guidelines. Options with 30%-69% agreement were discussed again, and a second vote was held, allowing for a change of opinion. RESULTS: The optimised physiotherapist-led treatment package included: advice and education, exercise therapy and orthotics. Specific components for each of these interventions were also agreed such as: condition-specific advice, health-promotion advice, exercise types, exercise into 'acceptable' levels of pain, exercise dosage and type of orthoses. Other treatment options including electrotherapy, acupuncture and manual therapy were excluded. CONCLUSION: An optimised physiotherapist-led treatment protocol for people with LET was successfully developed using an online NGT consensus approach. This intervention is now ready for testing in a future pilot/feasibility RCT to contribute much needed evidence about the treatment of LET. TRIAL REGISTRATION NUMBER: This is the pre-cursor to the OPTimisE Pilot and Feasibility Randomised Controlled Trial. Registration: https://www.isrctn.com/ISRCTN64444585

The Lived Experience of People with Lateral Elbow Tendinopathy – a Qualitative Study from the OPTimisE Pilot & Feasibility Trial.

Objectives: To explore the lived experience of people with lateral elbow tendinopathy (LET) and its impact on everyday life. Design: Qualitative semi-structured interviews, analysed using thematic analysis. Setting: Conducted as part of the mixed-methods OPTimisE pilot and feasibility randomised controlled trial of outpatient physiotherapy patients in the UK. Participants: 17 participants with LET, purposively sampled from the trial to provide representativeness based on age, sex, ethnicity, deprivation index and treatment allocation. Results: Four themes were identified from the participants’ responses: (1) cause of onset—typically symptoms were attributed to: sudden changes in activity, repetitive work or compensating for other musculoskeletal conditions; (2) impact on everyday life—which included substantial impacts on quality-of-life, particularly due to pain disturbing sleep and difficulties performing daily tasks (related to work and hobbies) due to pain, although most reported being able to persevere with work; (3) self-help and understanding of the condition—with uncertainty about the appropriateness and potential harm of online advice and confusion from the diagnostic term ‘Tennis Elbow’ that non-sporting individuals struggled to relate to; (4) healthcare experiences—the treatments received were highly variable and often perceived as ineffectual. Conclusions: For the first time, the lived experience of people from a range of backgrounds suffering from LET has been explored. Findings suggest that people frequently related the cause to a specific activity. They reported substantial impacts on daily tasks, sleep, work and hobbies. People also reported hesitancy to trust online information without formal healthcare advice, were confused by the common label of ‘Tennis Elbow’, and perceived the wide array of healthcare treatment options they had received to offer false hope and be largely ineffective. This study provides stimulus for clinicians to consider the advice and treatment provided, and whether the messages conveyed reflect the favourable natural history of the condition. Trial registration number: ISRCTN6444458