ICF core sets for low back pain: do they include what matters to patients?

To investigate whether the International Classification of Functioning Disability and Health (ICF) Core Sets for low back pain encompass the key functional problems of patients

The 3D soft X-ray cluster-AGN cross-correlation function in the ROSAT NEP survey

X-ray surveys facilitate investigations of the environment of AGNs. Deep Chandra observations revealed that the AGNs source surface density rises near clusters of galaxies. The natural extension of these works is the measurement of spatial clustering of AGNs around clusters and the investigation of relative biasing between active galactic nuclei and galaxies near clusters.The major aims of this work are to obtain a measurement of the correlation length of AGNs around clusters and a measure of the averaged clustering properties of a complete sample of AGNs in dense environments. We present the first measurement of the soft X-ray cluster-AGN cross-correlation function in redshift space using the data of the ROSAT-NEP survey. The survey covers 9x9 deg^2 around the North Ecliptic Pole where 442 X-ray sources were detected and almost completely spectroscopically identified. We detected a >3sigma significant clustering signal on scales s<50 h70^-1 Mpc. We performed a classical maximum-likelihood power-law fit to the data and obtained a correlation length s_0=8.7+1.2-0.3 h_70-1 Mpc and a slope gamma=1.7$^+0.2_-0.7 (1sigma errors). This is a strong evidence that AGNs are good tracers of the large scale structure of the Universe. Our data were compared to the results obtained by cross-correlating X-ray clusters and galaxies. We observe, with a large uncertainty, that the bias factor of AGN is similar to that of galaxies.Comment: 4 pages, 2 figure, proceedings of the Conference "At the edge of the Universe", Sintra Portugal, October 2006. To be published on the Astronomical Society of the Pacific Conference Series (ASPCS

Spontaneous deterministic side-branching behavior in phase-field simulations of equiaxed dendritic growth

The accepted view on dendritic side-branching is that side-branches grow as the result of selective amplification of thermal noise and that in the absence of such noise dendrites would grow without the development of side-arms. However, recently there has been renewed speculation about dendrites displaying deterministic side-branching [see, e.g., M. E. Glicksman, Metall. Mater. Trans A 43, 391 (2012)]. Generally, numerical models of dendritic growth, such as phase-field simulation, have tended to display behaviour which is commensurate with the former view, in that simulated dendrites do not develop side-branches unless noise is introduced into the simulation. However, here, we present simulations that show that under certain conditions deterministic side-branching may occur. We use a model formulated in the thin interface limit and a range of advanced numerical techniques to minimise the numerical noise introduced into the solution, including a multigrid solver. Spontaneous side-branching seems to be favoured by high undercoolings and by intermediate values of the capillary anisotropy, with the most branched structures being obtained for an anisotropy strength of 0.03. From an analysis of the tangential thermal gradients on the solid-liquid interface, the mechanism for side-branching appears to have some similarities with the deterministic model proposed by Glicksman

Impairment-targeted exercises for older adults with knee pain: protocol for a proof-of-principle study.

BACKGROUND: Exercise therapy for knee pain and osteoarthritis remains a key element of conservative treatment, recommended in clinical guidelines. Yet systematic reviews point to only modest benefits from exercise interventions.One reason for this might be that clinical trials tend to use a one-size-fits-all approach to exercise, effectively disregarding the details of their participants' clinical presentations. This uncontrolled before-after study (TargET-Knee-Pain) aims to test the principle that exercises targeted at the specific physical impairments of older adults with knee pain may be able to significantly improve those impairments. It is a first step towards testing the effectiveness of this more individually-tailored approach. METHODS/DESIGN: We aim to recruit 60 participants from an existing observational cohort of community-dwelling older adults with knee pain. Participants will all have at least one of the three physical impairments of weak quadriceps, a reduced range of knee flexion and poor standing balance. Each participant will be asked to undertake a programme of exercises, targeted at their particular combination and degree of impairment(s), over the course of twelve weeks. The exercises will be taught and progressed by an experienced physiotherapist, with reference to a "menu" of agreed exercises for each of the impairments, over the course of six fortnightly home visits, alternating with six fortnightly telephone calls. Primary outcome measures will be isometric quadriceps strength, knee flexion range of motion, timed single-leg standing balance and the "Four Balance Test Scale" at 12 weeks. Key secondary outcome measures will be self-reported levels of pain, stiffness and difficulties with day-to-day functional tasks (WOMAC). Outcome measures will be taken at three time-points (baseline, six weeks and twelve weeks) by a study nurse blinded to the exercise status of the participants. DISCUSSION: This study (TargET-Knee-Pain) is the first step towards exploring whether an impairment-targeted approach to exercise prescription for older adults with knee pain may have sufficient efficacy to warrant further testing. If warranted, future randomised clinical trials may compare this approach with more traditional one-size-fits-all exercise approaches. TRIAL REGISTRATION: Current Controlled Trials ISRCTN61638364.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Simulations of three-dimensional dendritic growth using a coupled thermo-solutal phase-field model

Using a phase field model, which fully couples the thermal and solute concentration field, we present simulation results in three dimensions of the rapid dendritic solidification of a class of dilute alloys at the meso scale. The key results are the prediction of steady state tip velocity and radius at varying undercooling and thermal diffusivities. Less computationally demanding 2-dimensional results are directly compared with the corresponding 3-dimensional results, where significant quantitative differences emerge. The simulations provide quantitative predictions for the range of thermal and solutal diffusivities considered and show the effectiveness and potential of the computational techniques employed. These results thus provide benchmark 3-dimensional computations, allow direct comparison with underlying analytical theory, and pave the way for further quantitative results

The soft X-ray Cluster-AGN spatial cross-correlation function in the ROSAT-NEP survey

X-ray surveys facilitate investigations of the environment of AGNs. Deep Chandra observations revealed that the AGNs source surface density rises near clusters of galaxies. The natural extension of these works is the measurement of spatial clustering of AGNs around clusters and the investigation of relative biasing between active galactic nuclei and galaxies near clusters. The major aims of this work are to obtain a measurement of the correlation length of AGNs around clusters and a measure of the averaged clustering properties of a complete sample of AGNs in dense environments. We present the first measurement of the soft X-ray cluster-AGN cross-correlation function in redshift space using the data of the ROSAT-NEP survey. The survey covers 9x9 deg^2 around the North Ecliptic Pole where 442 X-ray sources were detected and almost completely spectroscopically identified. We detected a > 3 sigma significant clustering signal on scales s<50 h_70^-1 Mpc. We performed a classical maximum-likelihood power-law fit to the data and obtained a correlation length s_0=8.7^+1.2_-0.3 h70^-1 Mpc and a slope gamma=1.7^+0.2_-0.7 (1 sigma errors). This is a strong evidence that AGNs are good tracers of the large scale structure of the Universe. Our data were compared to the results obtained by cross-correlating X-ray clusters and galaxies. We observe, with a large uncertainty, a similar behaviour of the AGNs clustering around clusters similar to the clustering of galaxies around clusters.Comment: 7 pages, 6 figures, Accepted by A&

The WARPS survey: III. The discovery of an X-ray luminous galaxy cluster at z=0.833 and the impact of X-ray substructure on cluster abundance measurements

The WARPS team reviews the properties and history of discovery of ClJ0152.7-1357, an X-ray luminous, rich cluster of galaxies at z=0.833. At L_X = 8 x 10^44 h^(-2) erg/s (0.5-2.0 keV) ClJ0152.7-1357 is the most X-ray luminous cluster known at redshifts z>0.55. The high X-ray luminosity of the system suggests that massive clusters may begin to form at redshifts considerably greater than unity. This scenario is supported by the high degree of optical and X-ray substructure in ClJ0152.7-1357, which is similarly complex as that of other X-ray selected distant clusters and consistent with the picture of cluster formation by mass infall along large-scale filaments. X-ray emission from ClJ0152.7-1357 was detected already in 1980 with the EINSTEIN IPC. However, because the complex morphology of the emission caused its significance to be underestimated, the corresponding source was not included in the EMSS cluster sample and hence not previously identified. Simulations of the EMSS source detection and selection procedure suggest a general bias of the EMSS against X-ray luminous clusters with pronounced substructure. If highly unrelaxed, merging clusters are common at high redshift, they could create a bias in some samples as the morphological complexity of mergers may cause them to fall below the flux limit of surveys that assume a unimodal spatial source geometry. Conversely, the enhanced X-ray luminosity of mergers might cause them to, temporarily, rise above the flux limit. Either effect could lead to erroneous conclusions about the evolution of the comoving cluster space density. A high fraction of morphologically complex clusters at high redshift would also call into question the validity of cosmological studies that assume that the systems under investigation are virialized.Comment: 17 pages, 7 figures; revised to focus on possible detection biases caused by substructure in clusters; accepted for publication in ApJ; uses emulateapj.sty; eps files of figures 1 and 2 can be obtained from ftp://hubble.ifa.hawaii.edu/pub/ebeling/warp

IMPaCT Back study protocol. Implementation of subgrouping for targeted treatment systems for low back pain patients in primary care: a prospective population-based sequential comparison.

BACKGROUND: Prognostic assessment tools to identify subgroups of patients at risk of persistent low back pain who may benefit from targeted treatments have been developed and validated in primary care. The IMPaCT Back study is investigating the effects of introducing and supporting a subgrouping for targeted treatment system in primary care. METHODS/DESIGN: A prospective, population-based, quality improvement study in one Primary Care Trust in England with a before and after design. Phases 1 and 3 collect data on current practice, attitudes and behaviour of health care practitioners, patients' outcomes and health care costs. Phase 2 introduces and supports the subgrouping for targeted treatment system, via a multi-component, quality improvement intervention that includes educational courses and outreach visits led by opinion leaders, audit/feedback, mentoring and organisational support to embed the subgrouping tools within IT and clinical management systems.We aim to recruit 1000 low back pain patients aged 18 years and over consulting 7 GP practices within one Primary Care Trust in England, UK. The study includes GPs in participating practices and physiotherapists in associated services. The primary objective is to determine the effect of the subgrouping for targeted treatment system on back pain related disability and catastrophising at 2 and 6 months, comparing data from phase 1 with phase 3. Key secondary objectives are to determine the impact on: a) GPs' and physiotherapists' attitudes and behaviour regarding low back pain; b) The process of care that patients receive; c) The cost-effectiveness and sustainability of the new clinical system. DISCUSSION: This paper details the rationale, design, methods, planned analysis and operational aspects of the IMPaCT Back study. We aim to determine whether the new subgrouping for targeted treatment system is implemented and sustained in primary care, and evaluate its impact on clinical decision-making, patient outcomes and costs. STUDY REGISTRATION: International Standard Randomised Controlled Trial Number Register ISRCTN55174281.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

The 160 Square Degree ROSAT Survey: the Revised Catalog of 201 Clusters with Spectroscopic Redshifts

We present the revised catalog of galaxy clusters detected as extended X-ray sources in the 160 Square Degree ROSAT Survey, including spectroscopic redshifts and X-ray luminosities for 200 of the 201 members. The median redshift is z~0.25 and the median X-ray luminosity is 4.2e+43 erg/s/h50^2 (0.5-2.0 keV). This is the largest high-redshift sample of X-ray selected clusters published to date. There are 73 objects at z>0.3 and 22 objects at z>0.5 drawn from a statistically complete flux-limited survey with a median object flux of 1.4d-13 erg/cm^2/s. We describe the optical follow-up of these clusters with an emphasis on our spectroscopy which has yielded 155 cluster redshifts, 110 of which are presented here for the first time. These measurements combined with 45 from the literature and other sources provide near-complete spectroscopic coverage for our survey. We discuss the final optical identifications for the extended X-ray sources in the survey region and compare our results to similar X-ray cluster searches.Comment: 17 pages, 7 figs, accepted for publication in ApJ, a version with full resolution images is available at http://www.eso.org/~cmullis/papers/160sd-catalog.ps.gz, machine-readable versions of the catalog are available at http://www.eso.org/~cmullis/research/160sd-catalog.htm