Optimizing the Composition and Delivery of Assessment and Treatment Following Distal Radius Fracture

Distal radius fracture (DRF) is the most common fracture.1 The most recent Cochrane review indicated “The available evidence from randomized controlled trials is insufficient to establish the relative effectiveness of the various interventions used in the rehabilitation of adults with fractures of the distal radius”.2 Since the relative effectiveness of the various interventions used for rehabilitation after DRF is unknown, the main goal of this thesis is to focus on one aspect of both assessment and treatment to add to the current literature base. The first paper (Chapter 2) describes a new method using a modified finger goniometer (MFG) for measuring forearm rotation, and suggests some potential benefits for using this technique over the currently accepted method. The second paper (Chapter 3) investigates the inter-rater reliability of the MFG method. The MFG method demonstrated excellent inter-rater reliability and compared favorably to the currently accepted method for measuring the forearm. In addition to investigating a new method to optimize assessment following DRF, this thesis also studies common modalities used for treatment. The third paper (Chapter 4) investigates the volumetric changes that occur in the hand with the use of hot packs and whirlpool, which are often used for preconditioning the wrist prior to treatment. The effect of these modalities for improving range of motion (ROM) of the wrist and forearm are reviewed in Chapter 5. Overall, whirlpool was shown to temporarily increase swelling in the hand more than hot pack, but this difference was not evident at the end of each therapy visit. Whirlpool was shown to be more effective for improving ROM of the wrist than hot pack during therapy. In summary, this thesis provides a valuable contribution to the current literature base for rehabilitation after DRF by proposing a new method for measuring forearm rotation, investigating this method’s reliability, and comparing the volumetric and ROM effects of two heat modalities commonly used for treatment. This information can be used as a building block for future research to determine best practice for the treatment of patients with DRF. References 1. JJ FD. Fractures of the Distal Radius. A Practical Approach to Management. 2nd ed. New York: Springer; 2002. 2. Handoll HH, Madhok R, Howe TE. Rehabilitation for distal radial fractures in adults. Cochrane Database Syst Rev. 2006:CD003324

Newtonian and Post-Newtonian approximations of the k = 0 Friedmann Robertson Walker Cosmology

In a previous paper we derived a post-Newtonian approximation to cosmology which, in contrast to former Newtonian and post-Newtonian cosmological theories, has a well-posed initial value problem. In this paper, this new post-Newtonian theory is compared with the fully general relativistic theory, in the context of the k = 0 Friedmann Robertson Walker cosmologies. It is found that the post-Newtonian theory reproduces the results of its general relativistic counterpart, whilst the Newtonian theory does not.Comment: 11 pages, Latex, corrected typo

Some notes on the Kruskal - Szekeres completion

The Kruskal - Szekeres (KS) completion of the Schwarzschild spacetime is open to Synge's methodological criticism that the KS procedure generates "good" coordinates from "bad". This is addressed here in two ways: First I generate the KS coordinates from Israel coordinates, which are also "good", and then I generate the KS coordinates directly from a streamlined integration of the Einstein equations.Comment: One typo correcte

Post-Newtonian Cosmology

Newtonian Cosmology is commonly used in astrophysical problems, because of its obvious simplicity when compared with general relativity. However it has inherent difficulties, the most obvious of which is the non-existence of a well-posed initial value problem. In this paper we investigate how far these problems are met by using the post-Newtonian approximation in cosmology.Comment: 12 pages, Late

Remodeling of Wall Mechanics and the Myogenic Mechanism of Rat Intramural Coronary Arterioles in Response to a Short-Term Daily Exercise Program: Role of Endothelial Factors

PURPOSE: Exercise elicits early adaptation of coronary vessels enabling the coronary circulation to respond adequately to higher flow demands. We hypothesized that short-term daily exercise induces biomechanical and functional remodeling of the coronary resistance arteries related to pressure. METHODS: Male rats were subjected to a progressively increasing 4-week treadmill exercise program (over 60 min/day, 1 mph in the final step). In vitro pressure-diameter measurements were performed on coronary segments (119 +/- 5 mum in diameter at 50 mm Hg) with microarteriography. The magnitude of the myogenic response and contribution of endogenous nitric oxide and prostanoid production to the wall mechanics and pressure-diameter relationship were assessed. RESULTS: Arterioles isolated from exercised ani mals - compared to the sedentary group - had thicker walls, increased distensibility, and a decreased elastic modulus as a result of reduced wall stress in the low pressure range. The arterioles of exercised rats exhibited a more powerful myogenic response and less endogenous vasoconstrictor prostanoid modulation at higher pressures, while vasodilator nitric oxide modulation of diameter was augmented at low pressures (\u3c 60 mm Hg). CONCLUSIONS: A short-term daily exercise program induces remodeling of rat intramural coronary arterioles, likely resulting in a greater range of coronary autoregulatory function (constrictor and dilator reserves) and more effective protection against great changes in intraluminal pressure, contributing thereby to the optimization of coronary blood flow during exercise

A Conserved Bach Current

The Bach tensor and a vector which generates conformal symmetries allow a conserved four-current to be defined. The Bach four-current gives rise to a quasilocal two-surface expression for power per luminosity distance in the Vaidya exterior of collapsing fluid interiors. This is interpreted in terms of entropy generation.Comment: to appear in Class. Quantum Gra

The Embedding of Schwarzschild in Braneworld

The braneworlds models were inspired partly by Kaluza-Klein's theory, where both the gravitational and the gauge fields are obtained from the geometry of a higher dimensional space. The positive aspects of these models consist in perspectives of modifications it could bring in to particle physics, such as: unification in a TeV scale, quantum gravity in this scale and deviation of Newton's law for small distances. One of the principles of these models is to suppose that all space-times can be embedded in a bulk of higher dimension. The main result in these notes is a theorem showing a mathematical inconsistency of the Randall-Sundrum braneworld model, namely that the Schwarzschild space-time cannot be embedded locally and isometrically in a five dimensional bulk with constant curvature,(for example AdS-5). From the point of view of semi-Riemannian geometry this last result represents a serious restriction to the Randall-Sundrum's braneworld model.Comment: Published in the Int. J. Theor. Phys, 200

Ideally embedded space-times

Due to the growing interest in embeddings of space-time in higher-dimensional spaces we consider a specific type of embedding. After proving an inequality between intrinsically defined curvature invariants and the squared mean curvature, we extend the notion of ideal embeddings from Riemannian geometry to the indefinite case. Ideal embeddings are such that the embedded manifold receives the least amount of tension from the surrounding space. Then it is shown that the de Sitter spaces, a Robertson-Walker space-time and some anisotropic perfect fluid metrics can be ideally embedded in a five-dimensional pseudo-Euclidean space.Comment: layout changed and typos corrected; uses revtex