The objective of this study was to evaluate effects of extracorporeal shockwave therapy (ESWT) on spinal mechanical nociceptive threshold (MNT) and multifidus muscle cross-sectional area (CSA) in horses with thoracolumbar pain. We hypothesized that ESWT would increase MNT and multifidus CSA. Twelve horses with thoracolumbar pain were included. Prior to treatment, each thoracolumbar spine was radiographed to document existing pathology. Horses received 3 ESWT treatments, 2 weeks apart (days 0, 14, 28). Palpation scores were documented (days 0, 45, 65) and ultrasonographic CSA of left and right multifidus was recorded at T12, T14, T16, T18, L3 and L5 (days 0, 45, 65). MNT was measured at T12, T14, T16, T18, L3 and L5 every 7 days (day 0-56). Change in MNT in 10/12 horses was significant at each timepoint compared to day 0 (P<0.05). MNT increased at all timepoints at 6 sites in 2/12, at 5 sites in 3/12, at 4 sites in 4/12 and at 1 site in 1/12 (P<0.05). MNT average percent increase from day 0-56 was 64% for T12-T18 and 29% for L3-L5. There was no statistical difference in MNT from day 35-56 (P=0.25). A bimodal analgesic trend was observed following ESWT. Degree of radiographic change was not associated with response to treatment and no significant change in multifidus CSA was observed. In conclusion, 3 treatments of ESWT 2 weeks apart raised MNT over a 56-day period in horses with back pain, but did not influence change in CSA of the multifidus. / Master of Science / Back pain in the horse is a frequently diagnosed and treated cause of back stiffness, lameness, poor performance and/or avoidance behavior under saddle. Treatment is focused on reducing pain and inflammation and on strengthening and promoting proper muscle development to maintain long term results. Recently, rehabilitation of the deep spinal stabilizer multifidus muscle, particularly with regard to increased cross-sectional area (CSA), has become a focus of targeted physiotherapy. Assessment of the degree of pain is subjective due to individual interpretation and palpation technique. In an attempt to standardize quantification of pain, pressure algometry has become a validated, objective and repeatable measure of axial skeleton mechanical nociceptive threshold (MNT), which is defined as the minimum pressure required to induce a pain response. Although many treatment options for back pain exist, there is limited research documenting the efficacy of these treatments in horses. Extracorporeal shockwave therapy (ESWT), which consists of focused, high velocity acoustic waves, is one type of non-invasive, well-tolerated treatment for back pain. Despite its popularity, there is no research documenting the effects of ESWT on equine spinal MNT or multifidus muscle CSA. This is the first study to document the effects of ESWT on spinal MNT and multifidus muscle CSA in horses with back pain. We hope that the results of this study will help guide treatment decisions for horses with back pain.

A population based cross-sectional time series analysis was conducted using three Ontario administrative databases, to assess trends over time in the surgical management of kidney stone disease. All kidney stone treatments performed with extracorporeal shockwave lithotripsy (SWL), ureteroscopy (URS) and percutaneous nephrolithotomy between July 1, 1991 and December 31, 2010, were included. Time series modeling with exponential smoothing and autoregressive integrated moving average models demonstrated a significant increase in the utilization of URS over time (23.69% to 59.98%, p<0.0001), with a reciprocal significant decrease in the utilization of SWL (68.77% to 33.36%, p<0.0001). As a result of this shift in treatment paradigm, time series modeling also demonstrated an associated significant decrease in the need for ancillary treatment over time (22.12% to 16.01%, p<0.0001) and a significant increase in the need for hospital readmission (8.01% to 10.85%, p<0.0001) or emergency room visit (7.58% to 9.95%, p=0.0024) within 7 days following treatment.

A population based cross-sectional time series analysis was conducted using three Ontario administrative databases, to assess trends over time in the surgical management of kidney stone disease. All kidney stone treatments performed with extracorporeal shockwave lithotripsy (SWL), ureteroscopy (URS) and percutaneous nephrolithotomy between July 1, 1991 and December 31, 2010, were included. Time series modeling with exponential smoothing and autoregressive integrated moving average models demonstrated a significant increase in the utilization of URS over time (23.69% to 59.98%, p<0.0001), with a reciprocal significant decrease in the utilization of SWL (68.77% to 33.36%, p<0.0001). As a result of this shift in treatment paradigm, time series modeling also demonstrated an associated significant decrease in the need for ancillary treatment over time (22.12% to 16.01%, p<0.0001) and a significant increase in the need for hospital readmission (8.01% to 10.85%, p<0.0001) or emergency room visit (7.58% to 9.95%, p=0.0024) within 7 days following treatment.

Author: Bc. Kateřina Průchová Title: The effectiveness of shock wave therapy for plantar fasciitis Objectives: The main goal of this work is to assess the effect of the radial and focused shock wave therapy for plantar fasciitis compared with therapeutic ultrasound. Methods: The study included 55 patients with diagnose of heel spur syndrome. Patients were divided into three groups according to undergoing therapy. Group A (n = 20) received 6 applications of radial shock wave, group B (n = 20) obtained 3 applications of focused shock wave and group C received 8 applications of therapeutic ultrasound. Intensity and character of the pain were assessed before and after therapeutic intervention using non-standardized questionnaire. For the assessment and description of the results were used standard statistical indicators and methods. Results: Radial and focused shockwave therapy had according to the obtained results in the selected treatment protocol positive effect on the clinical course of the disease and was markedly more effective than therapeutic ultrasound. Almost all parameters reached the highest percentage improvement in the group treated with 6 applications of radial shock waves. There were no complications and side effects during the experiment. Keywords: heel spur, plantar fasciitis,...

OBJETIVOS: Comparar o tratamento por ondas de choque radiais com a fisioterapia convencional na fasciite plantar. MATERIAL E MÉTODOS: Foram tratados 40 pacientes com diagnóstico de fasciite plantar. Os pacientes foram divididos, de forma aleatória em dois grupos. Grupo 1 - constituído de 20 pacientes, que fizeram 10 sessões de fisioterapia com ultra-som, cinesioterapia e orientação domiciliar de alongamentos. Grupo 2 constituído de 20 pacientes, que fizeram três aplicações, uma vez por semana, com ondas de choque radial e orientação domiciliar de alongamentos. Todos os pacientes passaram por uma avaliação de dor e função antes, depois e após 3 meses do tratamento. A média de idade foi 49,6 ± 11,8 (25-68) anos, 85% gênero feminino, 88% estavam acima do peso, 63% tinham comprometimento bilateral e 83% usavam analgésicos regularmente. RESULTADOS: Os dois tratamentos foram eficazes na melhora da dor e função dos pacientes com fasciite plantar. O efeito das ondas de choque foi observado em tempo menor. CONCLUSÃO: O tratamento com ondas de choque não foi mais efetivo que o tratamento de fisioterapia convencional, quando avaliado três meses após o final do tratamento / OBJECTIVE: To compare radial shockwave treatment and conventional physiotherapy for plantar fasciitis. MATERIALS AND METHODS: Forty patients with plantar fasciitis were included in this study. They were randomly divided into two groups. Group 1 - was composed of 20 patients who underwent 10 physiotherapy sessions each, consisting of ultrasound, kinesiotherapy and instruction for stretching exercises at home. Group 2 - was composed of 20 patients who underwent three applications of radial shockwaves (once a week) and received instruction for stretching exercises at home. Pain and function were evaluated before treatment, immediately afterwards, and three months later. The mean age of the patients was 49.6 ± 11.8 years (range 25-68); 85% were female, 88% were overweight, 63% had bilateral impairment, and 83% used analgesics regularly. RESULTS: Both treatments were effective for pain reduction and for improving the functional abilities of patients with plantar fasciitis. The effect of the shockwaves was apparent sooner than physiotherapy after the onset of treatment. CONCLUSION: Shockwave treatment was no more effective than conventional physiotherapy treatment when evaluated three months after the end of treatment

It is widely agreed that estimates of freeway segment travel times are more highly valued by motorists than other forms of traveller information. The provision of real-time estimates of travel times is becoming relatively common in many of the large urban centres in the US and overseas. Presently, most traveler information systems are operating based on estimated travel time rather than predicted travel time. However, traveler information systems are most beneficial when they are built upon predicted traffic information (e.g. predicted travel time). A number of researchers have proposed different models to predict travel time. One of these techniques is based on traffic flow theory and the concept of shockwaves. Most of the past efforts at identifying shockwaves have been focused on performing shockwave analysis based on fixed sensors such as loop detectors which are commonly used in many jurisdictions. However, latest advances in wireless communications have provided an opportunity to obtain vehicle trajectory data that potentially could be used to derive traffic conditions over a wide spatial area. This research proposes a new methodology to detect and analyze shockwaves based on vehicle trajectory data and will use this information to predict travel time for freeway sections. The main idea behind this methodology is that average speed on a section of roadway is constant unless a shockwave is created due to change in flow rate or density of traffic. In the proposed methodology first the road section is discretized into a number of smaller road segments and the average speed of each segment is calculated based on the available information obtained from probe vehicles during the current time interval. If a new shockwave is detected, the average speed of the road segment is adjusted to account for the change in the traffic conditions. In order to detect shockwaves, first, a two phase piecewise linear regression is used to find the points at which a vehicle has changed its speed. Then, the points that correspond to the intersection of shockwaves and trajectories of probe vehicles are identified using a data filtering procedure and a linear clustering algorithm is employed to group different shockwaves. Finally, a linear regression model is applied to find propagation speed and spatial and temporal extent of each shockwave. The performance of this methodology was tested using one simulated signalized intersection, trajectories obtained from video processing of a section of freeway in California, and trajectories obtained from two freeway sections in Ontario. The results of this thesis show that the proposed methodology is able to detect shockwaves and predict travel time even with a small sample of vehicles. These results show that traffic data acquisition systems which are based on anonymously tracking of vehicles are a viable substitution to the tradition traffic data collection systems especially in relatively rural areas.

Der Begriff der Virtualität von Bankdienstleistungen wird unterschiedlich interpretiert. Während eine Vielzahl der Veröffentlichungen in den Kontext von Virtuellen Unternehmen und Intermediären einzuordnen ist, kann konstatiert werden, dass die Virtualisierung des Bankgeschäfts im Rahmen dreidimensionaler Technologien weniger Beachtung findet. Die vorliegenden Studie soll einen Beitrag dazu leisten, diese Erkenntnislücke zu schließen, indem die Eignung aktueller Technologien zur Realisierung einer virtuellen Bankfiliale im Sinn der virtuellen Realität untersucht wird. Ziel der Studie ist die Implementierung einer dreidimensionalen Bankfiliale mit verschiedenen Internet-basierten Technologien. Mit den Technologien Adobe Atmosphere, Shockwave 3D, VRML und Java 3D wurden Prototypimplementierungen durchgeführt, um deren Eignung für das Bankgeschäft anhand unterschiedlicher Kriterien zu bewerten.

Bone mechanotransduction is a fundamental process underlying the remarkable ability of bones to perceive surrounding physical cues and adapt their mass, structure and overall strength to their mechanical environment. Therefore, it is central to many aspects of bone biology and disease. The key to a mechanistic understanding of this process lies in better knowledge of critical signaling molecules that relay the mechanical information inside bone cells. In this thesis, we investigate the role of polycystin-1 (PC1), a proposed fluid flow sensor in kidney epithelial cells, in transducing mechanical signals in bone cells. Loss of PC1 in osteoblast lineage cells using osterix-Cre (Osx-Cre) causes mild osteopenia in mice with reduced calvarial and trabecular bone formation, and markedly attenuated anabolic bone formation responses to in vivo mechanical loading of long bones. Loss of PC1 in limb bud mesenchymal cells at an early stage causes mildly increased bone formation and a tendency to exhibit enhanced anabolic responses to in vivo mechanical loading of long bones. These findings suggest that PC1 has a complex role in different bone cell populations both during development and in bone mechanotransduction. PC1 has been shown to mediate tensile force-induced proliferation in osteoprogenitor cells (OPCs) in craniofacial sutures. To investigate the role of PC1 in periosteal osteoprogenitor mechanotransduction, we establish a shockwave-induced periosteum mechanical stress model. Shockwave treatment triggers dramatically increased cell proliferation, potent osteogenic activity, and intramembranous new bone formation in the periosteum. We show that loss of PC1 in periosteal cells (Prx1-Cre) does not affect periosteal mechanoresponsiveness to shockwave mechanical stress. These findings suggest that the role of PC1 in OPCs is likely tissue or force dependent. Fluid shear stress (FSS) in the lacunar-canalicular network is a major force element that osteocytes experience and respond to in vivo. To study the role of PC1 in FSS-mediated osteocyte/osteoblast mechanotransduction, we establish a laminar FSS system with custom-made flow chambers and a PC1-deficient osteoblast cell line. Our data show that PC1 is essential for regulation of FSS-induced initial \(Ca^{2+}\) influx in osteoblasts and mediates osteoblast FSS responses in a COX-2 and AP-1 independent manner.

It is widely agreed that estimates of freeway segment travel times are more highly valued by motorists than other forms of traveller information. The provision of real-time estimates of travel times is becoming relatively common in many of the large urban centres in the US and overseas. Presently, most traveler information systems are operating based on estimated travel time rather than predicted travel time. However, traveler information systems are most beneficial when they are built upon predicted traffic information (e.g. predicted travel time). A number of researchers have proposed different models to predict travel time. One of these techniques is based on traffic flow theory and the concept of shockwaves. Most of the past efforts at identifying shockwaves have been focused on performing shockwave analysis based on fixed sensors such as loop detectors which are commonly used in many jurisdictions. However, latest advances in wireless communications have provided an opportunity to obtain vehicle trajectory data that potentially could be used to derive traffic conditions over a wide spatial area. This research proposes a new methodology to detect and analyze shockwaves based on vehicle trajectory data and will use this information to predict travel time for freeway sections. The main idea behind this methodology is that average speed on a section of roadway is constant unless a shockwave is created due to change in flow rate or density of traffic. In the proposed methodology first the road section is discretized into a number of smaller road segments and the average speed of each segment is calculated based on the available information obtained from probe vehicles during the current time interval. If a new shockwave is detected, the average speed of the road segment is adjusted to account for the change in the traffic conditions. In order to detect shockwaves, first, a two phase piecewise linear regression is used to find the points at which a vehicle has changed its speed. Then, the points that correspond to the intersection of shockwaves and trajectories of probe vehicles are identified using a data filtering procedure and a linear clustering algorithm is employed to group different shockwaves. Finally, a linear regression model is applied to find propagation speed and spatial and temporal extent of each shockwave. The performance of this methodology was tested using one simulated signalized intersection, trajectories obtained from video processing of a section of freeway in California, and trajectories obtained from two freeway sections in Ontario. The results of this thesis show that the proposed methodology is able to detect shockwaves and predict travel time even with a small sample of vehicles. These results show that traffic data acquisition systems which are based on anonymously tracking of vehicles are a viable substitution to the tradition traffic data collection systems especially in relatively rural areas.

OBJETIVOS: Comparar o tratamento por ondas de choque radiais com a fisioterapia convencional na fasciite plantar. MATERIAL E MÉTODOS: Foram tratados 40 pacientes com diagnóstico de fasciite plantar. Os pacientes foram divididos, de forma aleatória em dois grupos. Grupo 1 - constituído de 20 pacientes, que fizeram 10 sessões de fisioterapia com ultra-som, cinesioterapia e orientação domiciliar de alongamentos. Grupo 2 constituído de 20 pacientes, que fizeram três aplicações, uma vez por semana, com ondas de choque radial e orientação domiciliar de alongamentos. Todos os pacientes passaram por uma avaliação de dor e função antes, depois e após 3 meses do tratamento. A média de idade foi 49,6 ± 11,8 (25-68) anos, 85% gênero feminino, 88% estavam acima do peso, 63% tinham comprometimento bilateral e 83% usavam analgésicos regularmente. RESULTADOS: Os dois tratamentos foram eficazes na melhora da dor e função dos pacientes com fasciite plantar. O efeito das ondas de choque foi observado em tempo menor. CONCLUSÃO: O tratamento com ondas de choque não foi mais efetivo que o tratamento de fisioterapia convencional, quando avaliado três meses após o final do tratamento / OBJECTIVE: To compare radial shockwave treatment and conventional physiotherapy for plantar fasciitis. MATERIALS AND METHODS: Forty patients with plantar fasciitis were included in this study. They were randomly divided into two groups. Group 1 - was composed of 20 patients who underwent 10 physiotherapy sessions each, consisting of ultrasound, kinesiotherapy and instruction for stretching exercises at home. Group 2 - was composed of 20 patients who underwent three applications of radial shockwaves (once a week) and received instruction for stretching exercises at home. Pain and function were evaluated before treatment, immediately afterwards, and three months later. The mean age of the patients was 49.6 ± 11.8 years (range 25-68); 85% were female, 88% were overweight, 63% had bilateral impairment, and 83% used analgesics regularly. RESULTS: Both treatments were effective for pain reduction and for improving the functional abilities of patients with plantar fasciitis. The effect of the shockwaves was apparent sooner than physiotherapy after the onset of treatment. CONCLUSION: Shockwave treatment was no more effective than conventional physiotherapy treatment when evaluated three months after the end of treatment