Does early intervention improve outcomes in physiotherapy management of lumbar radicular syndrome? A mixed-methods study protocol.

INTRODUCTION: Lumbar radicular syndrome (LRS) can be a painful and debilitating condition. The optimum management strategies and their timing remain elusive despite extensive research. Surgery provides good short-term outcomes but has concomitant risks and costs. Physiotherapy is commonly practised for patients with LRS but its effects remain equivocal and there is a lack of consensus on the type, duration and timing of physiotherapy intervention. There is a lack of high-quality evidence into new and innovative management strategies and the timings of those strategies for LRS. This pilot trial is an essential preliminary to a definitive randomised controlled trial (RCT) assessing the effectiveness and cost-effectiveness of early physiotherapy intervention for patients with LRS. The study will test the protocol, the intervention, the use of outcome measures and the ability to set-up and run the trial to enable refinement of a future definitive RCT. METHODS AND ANALYSIS: This is a mixed-methods study encompassing an external pilot RCT with integrated qualitative interviews with patients, clinicians and other key stakeholders. 80 patients will be recruited from primary care and randomised, after consent into 1 of 2 groups. Both groups will receive individually tailored, goal orientated physiotherapy. The usual care group will begin their physiotherapy 6 weeks after randomisation and the intervention group at 2 weeks after randomisation. Outcome measures will primarily be feasibility parameters including the ability to recruit and retain patients and to deliver the intervention. Data will be collected at baseline, and 6, 12 and 26 weeks following randomisation. ETHICS AND DISSEMINATION: The study has received favourable ethical review from the East of Scotland Research Ethics Service (EoSRES) on the 20 August 2015 (15/ES/0130). Recruitment began on the 1 March 2016 and is expected to close in January 2017. Data collection is anticipated to be complete in July 2017. The study results will be made available to participants, clinicians involved in the study and the wider clinical community through publication in a peer reviewed journal and at conference presentations. TRIAL REGISTRATION NUMBER: ISRCTN: 25018352, Pre-results; Clinical Trials.Gov: NCT02618278 Document version V1.1 23.9.2016

Small punch fatigue testing of a nickel superalloy

Miniaturised mechanical test approaches, specifically small punch testing, are now widely recognised as a means of obtaining useful mechanical properties to characterise the creep, tensile and fracture characteristics of numerous material systems from a range of industrial applications. Limited success has been found in replicating fatigue properties through the use of a small punch disc. This paper will discuss the ongoing research and progress in developing a novel small punch fatigue testing facility at the Institute of Structural Materials at Swansea University. Experiments have been performed on the nickel superalloy C263 at ambient room temperature, investigating three different alloy variants; two orientations produced through additive manufacturing and the cast equivalent. Fractographic analysis has been completed to interpret the complex damage mechanisms in the test method along with the differences in performance amongst the alloy variants

Does early intervention improve outcomes in the physiotherapy management of lumbar radicular syndrome? Results of the POLAR pilot randomised controlled trial

OBJECTIVE: To investigate the feasibility of undertaking a definitive randomised controlled trial (RCT). SETTING: This was a pilot, pragmatic superiority RCT with a qualitative element, recruiting from 14 general practitioner (GP) practices in England. PARTICIPANTS: Patients over 18 years of age presenting to their GP with unilateral lumbar radicular syndrome (LRS), defined as radicular pain and/or neurological symptoms originating from lumbar nerve roots, were eligible to participate in the study, those who did not have a clear understanding of the English language or had comorbidities preventing rehabilitation were ineligible. INTERVENTIONS: Participants were randomised into early intervention physiotherapy or usual care with the former receiving their treatment within 2 weeks after randomisation and the latter 6 weeks postrandomisation. Both groups received a patient-centred, goal-orientated physiotherapy programme specific to their needs. Participants received up to six treatment sessions over an 8-week period. OUTCOME MEASURES: Process outcomes to determine the feasibility of the study and an exploratory analysis of patient-reported outcomes, including self-rated disability, pain and general health, these were collected at baseline, 6, 12 and 26 weeks postrandomisation. RESULTS: 80 participants were recruited in 10 GP practices over 34 weeks and randomised to (early intervention physiotherapy n=42, usual care n=38). Follow-up rates at 26 weeks were 32 (84%) in the usual care and 36 (86%) in the early intervention physiotherapy group. The mean area under the curve (larger values indicating more disability) for the Oswestry Disability Index over the 26 weeks was 16.6 (SD 11.4) in the usual care group and 16.0 (SD 14.0) in the intervention group. A difference of -0.6 (95% CI -0.68 to 5.6) in favour of the intervention group. CONCLUSIONS: The results of the study suggest a full RCT is feasible and will provide evidence as to the optimal timing of physiotherapy for patients with LRS. TRIAL REGISTRATION NUMBER: NCT02618278, ISRCTN25018352

High-Temperature Hall Effect in Ga(1-x)Mn(x)As

The temperature dependence of the Hall coefficient of a series of ferromagnetic Ga(1-x)Mn(x)As samples is measured in the temperature range 80K < T < 500K. We model the Hall coefficient assuming a magnetic susceptibility given by the Curie-Weiss law, a spontaneous Hall coefficient proportional to rho_xx^2(T), and including a constant diamagnetic contribution in the susceptibility. For all low resistivity samples this model provides excellent fits to the measured data up to T=380K and allows extraction of the hole concentration (p). The calculated p are compared to alternative methods of determining hole densities in these materials: pulsed high magnetic field (up to 55 Tesla) technique at low temperatures (less than the Curie temperature), and electrochemical capacitance- voltage profiling. We find that the Anomalous Hall Effect (AHE) contribution to rho_xy is substantial even well above the Curie temperature. Measurements of the Hall effect in this temperature regime can be used as a testing ground for theoretical descriptions of transport in these materials. We find that our data are consistent with recently published theories of the AHE, but they are inconsistent with theoretical models previously used to describe the AHE in conventional magnetic materials.Comment: 6 pages, 5 figures, 1 table. Accepted to Phys.Rev.

Molecular basis for bacterial peptidoglycan recognition by LysM domains.

Carbohydrate recognition is essential for growth, cell adhesion and signalling in all living organisms. A highly conserved carbohydrate binding module, LysM, is found in proteins from viruses, bacteria, fungi, plants and mammals. LysM modules recognize polysaccharides containing N-acetylglucosamine (GlcNAc) residues including peptidoglycan, an essential component of the bacterial cell wall. However, the molecular mechanism underpinning LysM-peptidoglycan interactions remains unclear. Here we describe the molecular basis for peptidoglycan recognition by a multimodular LysM domain from AtlA, an autolysin involved in cell division in the opportunistic bacterial pathogen Enterococcus faecalis. We explore the contribution of individual modules to the binding, identify the peptidoglycan motif recognized, determine the structures of free and bound modules and reveal the residues involved in binding. Our results suggest that peptide stems modulate LysM binding to peptidoglycan. Using these results, we reveal how the LysM module recognizes the GlcNAc-X-GlcNAc motif present in polysaccharides across kingdoms

Solid-state processing of surplus aluminium alloy powders through a combination of field-assisted sintering technology and hot rolling

Metal additive manufacturing techniques typically operate using powders with limited particle size ranges, but atomisation processes produce significant amounts of particles outside these ranges, resulting in an accumulation of out-of-size specification metal powders without a clear use case. Field-assisted sintering technology (FAST) can provide an alternative, solid-state processing route to consolidate these powders into billets for subsequent processing, or directly into near-net shape components. In this study, surplus powders of A20X, an aerospace approved aluminium alloy developed by Aluminium Materials Technologies (ECKART GmbH), were processed using FAST and subsequently hot rolled to produce sheet material. Tensile properties were similar to hot rolled conventional cast material and comparable to additively manufactured product. This indicates that FAST is an effective option for converting surplus metal powders into useful products, while improving sustainability in the additive supply chain

Transfer Matrices and Partition-Function Zeros for Antiferromagnetic Potts Models. V. Further Results for the Square-Lattice Chromatic Polynomial

We derive some new structural results for the transfer matrix of square-lattice Potts models with free and cylindrical boundary conditions. In particular, we obtain explicit closed-form expressions for the dominant (at large |q|) diagonal entry in the transfer matrix, for arbitrary widths m, as the solution of a special one-dimensional polymer model. We also obtain the large-q expansion of the bulk and surface (resp. corner) free energies for the zero-temperature antiferromagnet (= chromatic polynomial) through order q^{-47} (resp. q^{-46}). Finally, we compute chromatic roots for strips of widths 9 <= m <= 12 with free boundary conditions and locate roughly the limiting curves.Comment: 111 pages (LaTeX2e). Includes tex file, three sty files, and 19 Postscript figures. Also included are Mathematica files data_CYL.m and data_FREE.m. Many changes from version 1: new material on series expansions and their analysis, and several proofs of previously conjectured results. Final version to be published in J. Stat. Phy

Spanning forests and the q-state Potts model in the limit q \to 0

We study the q-state Potts model with nearest-neighbor coupling v=e^{\beta J}-1 in the limit q,v \to 0 with the ratio w = v/q held fixed. Combinatorially, this limit gives rise to the generating polynomial of spanning forests; physically, it provides information about the Potts-model phase diagram in the neighborhood of (q,v) = (0,0). We have studied this model on the square and triangular lattices, using a transfer-matrix approach at both real and complex values of w. For both lattices, we have computed the symbolic transfer matrices for cylindrical strips of widths 2 \le L \le 10, as well as the limiting curves of partition-function zeros in the complex w-plane. For real w, we find two distinct phases separated by a transition point w=w_0, where w_0 = -1/4 (resp. w_0 = -0.1753 \pm 0.0002) for the square (resp. triangular) lattice. For w > w_0 we find a non-critical disordered phase, while for w < w_0 our results are compatible with a massless Berker-Kadanoff phase with conformal charge c = -2 and leading thermal scaling dimension x_{T,1} = 2 (marginal operator). At w = w_0 we find a "first-order critical point": the first derivative of the free energy is discontinuous at w_0, while the correlation length diverges as w \downarrow w_0 (and is infinite at w = w_0). The critical behavior at w = w_0 seems to be the same for both lattices and it differs from that of the Berker-Kadanoff phase: our results suggest that the conformal charge is c = -1, the leading thermal scaling dimension is x_{T,1} = 0, and the critical exponents are \nu = 1/d = 1/2 and \alpha = 1.Comment: 131 pages (LaTeX2e). Includes tex file, three sty files, and 65 Postscript figures. Also included are Mathematica files forests_sq_2-9P.m and forests_tri_2-9P.m. Final journal versio

Powder production, FAST processing and properties of a Nb-silicide based alloy for high temperature aerospace applications

A Nb-silicide based alloy with nominal composition Nb–18Ti–22Si–6Mo-1.5Cr–2Sn-1Hf (at. %), designed for high temperature aerospace applications, was produced via a powder metallurgy (PM) route. The raw elements were arc melted, crushed, and milled to powder, then consolidated using Field Assisted Sintering Technology (FAST). The compressive creep of the alloy was evaluated using electro-thermal mechanical testing (ETMT). The study demonstrated the production of larger 60 mm diameter samples, with potential for further scale up. The microstructure of the FAST alloy, which is comprised of bcc Nbss and tetragonal αNb5Si3 was more homogenous compared with the cast alloy, with some interstitial contamination that occurred during powder production. The FAST alloy had lower density than state of the art Ni-based superalloys and refractory metal complex concentrated alloys (RCCAs) and high entropy alloys (RHEAs), and its yield strength and specific yield strength was higher than those of the latter metallic Ultra high temperature materials (UHTMs) and comparable to those of Nb-silicide based alloys with B addition. The stress exponent n in compressive creep was in the range 1.7–2.6, similar to that of binary Nb–10Si and Nb–16Si alloys and its creep rate at 1200 °C and 100 MPa was similar to that of the MASC alloy (Nb–25Ti–16Si-8Hf-2Al–2Cr (at.%)). Like the latter, the creep of the FAST alloy did not meet the creep goal