Rates of knee arthroplasty within one-year of undergoing arthroscopic partial meniscectomy in England:temporal trends, regional and age-group variation in conversion rates

Objective The aim of this study was to determine the proportion of patients undergoing arthroscopic partial meniscectomy (APM) then subsequently receiving a knee arthroplasty within one or two years, with focus on patients over the age of 60 years and regional variation. Methods Patients undergoing APM in England over 20-years (01-April-1997 to 31-March 2017) were identified in the national Hospital Episode Statistics (HES). The proportion of patients undergoing arthroplasty in the same knee within one or two years of APM was determined and trends were analysed over time nationally and by NHS Clinical Commissioning Group (CCG) region. Results 806,195 APM patients were eligible for analysis with at least one-year of follow up and 746,630 with two-years. The odds of arthroplasty conversion within one year increased over the study period (odds ratio [OR] 3.10 within 1-year in 2014 vs 2000; 95% confidence interval [CI] 2.75–3.50). For patients undergoing APM aged 60 years or older in 2015–16, 9.9% (1689/17,043; 95% CI 9.5–10.4) underwent arthroplasty within 1-year and, in 2014–15, 16.6% (3100/18,734; 95% CI 16.0–17.1) underwent arthroplasty within 2-years. There was greater than 10-fold variation by CCG. Conclusions Over the study period, the proportion of patients undergoing arthroplasty within one-year of APM increased. In 2015–16, of patients aged 60 years or older who underwent APM, 10% subsequently underwent knee arthroplasty within one year (17% within two years in 2014–15) and there was a high level of regional variation in this outcome. The development and adoption of national treatment guidance is recommended to improve and standardise treatment selection.</p

Ab initio dynamics study of poly-para-phenylene vinylene

We present an ab initio dynamics investigation within a density-functional perturbation theory framework of the properties of the conjugated polymer poly-para-phenylene vinylene (PPV) in both the isolated chain and crystalline states. The calculated results show that for an isolated chain, most of the vibrational modes correspond to experimentally observed modes in crystalline PPV. However, additional hitherto unidentified modes have been observed in experiment and our calculations on crystalline material have allowed us to assign these. We also present the results of calculations of the polarizability and permittivity tensors of the material, which are in reasonable agreement with the typical values for conjugated polymers. Dynamical Born effective charges [ S. Baroni, S. de Gironcoli, A. Dal Corso, and P. Giannozzi, Rev. Mod. Phys. 73, 515 (2001) ] are calculated and compared with atomic charges obtained from Mulliken population analysis [ M. D. Segall, C. J. Pickard, R. Shah, and M. C. Payne, Mol. Phys. 89, 571 (1996) ] and we conclude that effective charges are more appropriate for use in the study of the dynamics of the system. Notable differences are found in the infrared-absorption spectra obtained for the isolated chain and crystalline states, which can be attributed to the differences in the crystalline packing effects, which clearly play a key role in influencing the lattice dynamics of PPV

Exploring the psychological rewards of a familiar semirural landscape: connecting to local nature through a mindful approach

This study analyses a 53,000 word diary of a year engaging with nature through over 200 trips to a semi-rural landscape. Thematic analysis revealed two themes; the transition from observer to nature connectedness and the ways in which the natural environment was experienced once a connection was made. These themes are discussed in relation to theories that seek to explain the positive effect of nature and nature connectedness. The findings are important as they suggest that repeated engagement with local semi-rural countryside can lead to a mindful approach and psychological rewards that do not require travel into the wilderness. The work informs further research into outcomes and processes of nature based interventions such as: trip frequency, duration and diary keeping

Alternative approach to electromagnetic field quantization in nonlinear and inhomogeneous media

A simple approach is proposed for the quantization of the electromagnetic field in nonlinear and inhomogeneous media. Given the dielectric function and nonlinear susceptibilities, the Hamiltonian of the electromagnetic field is determined completely by this quantization method. From Heisenberg's equations we derive Maxwell's equations for the field operators. When the nonlinearity goes to zero, this quantization method returns to the generalized canonical quantization procedure for linear inhomogeneous media [Phys. Rev. A, 43, 467, 1991]. The explicit Hamiltonians for the second-order and third-order nonlinear quasi-steady-state processes are obtained based on this quantization procedure.Comment: Corrections in references and introductio

Is there still a place for the concept of therapeutic regression in psychoanalysis?

The author uses his own failure to find a place for the idea of therapeutic regression in his clinical thinking or practice as the basis for an investigation into its meaning and usefulness. He makes a distinction between three ways the term ‘regression’ is used in psychoanalytic discourse: as a way of evoking a primitive level of experience; as a reminder in some clinical situations of the value of non-intervention on the part of the analyst; and as a description of a phase of an analytic treatment with some patients where the analyst needs to put aside normal analytic technique in order to foster a regression in the patient. It is this third meaning, which the author terms “therapeutic regression” that this paper examines, principally by means of an extended discussion of two clinical examples of a patient making a so-called therapeutic regression, one given by Winnicott and the other by Masud Khan. The author argues that in these examples the introduction of the concept of therapeutic regression obscures rather than clarifies the clinical process. He concludes that, as a substantial clinical concept, the idea of therapeutic regression has outlived its usefulness. However he also notes that many psychoanalytic writers continue to find a use for the more generic concept of regression, and that the very engagement with the more particular idea of therapeutic regression has value in provoking questions as to what is truly therapeutic in psychoanalytic treatment

Nonclassical correlations in damped quantum solitons

Using cumulant expansion in Gaussian approximation, the internal quantum statistics of damped soliton-like pulses in Kerr media are studied numerically, considering both narrow and finite bandwidth spectral pulse components. It is shown that the sub-Poissonian statistics can be enhanced, under certain circumstances, by absorption, which damps out some destructive interferences. Further, it is shown that both the photon-number correlation and the correlation of the photon-number variance between different pulse components can be highly nonclassical even for an absorbing fiber. Optimum frequency windows are determined in order to realize strong nonclassical behavior, which offers novel possibilities of using solitons in optical fibers as a source of nonclassically correlated light beams.Comment: 15 pages, 11 PS figures (color

Return to Hanging Rock: Lost Children in a Gothic Landscape

Using the philosophical position of phenomenology this article examines the ways in which ideas of wildness combine with Australian Gothic tropes such as the white colonial lost child and the bush as a haunted locale to compose key features of an Australian Ecogothic. Joan Lindsay’s enigmatic novel Picnic at Hanging Rock (1967) has prompted scholars such as Lesley Kathryn Hawkes to describe how in Australian literature for both adults and children ‘the environment is far more than a setting or backdrop against which the plot takes place’ (Hawkes, 2011,67). On St Valentine’s Day in 1900 three young Australian girls and their teacher disappear from a school picnic at the ancient site of Mount Macedon in Victoria. The analysis, which focuses on Lindsay’s posthumously published chapter eighteen (1987) examines how elements of the material, sensing world combine with the mythological or sacred to connect the human protagonists with the gothic landscape they inhabit. The resulting intersubjectivity problematizes colonial ideology and unsettles notions of national identity. Using the philosophical position of phenomenology this article examines the ways in which ideas of wildness combine with Australian Gothic tropes such as the white colonial lost child and the bush as a haunted locale to compose key features of an Australian Ecogothic. Joan Lindsay’s enigmatic novel Picnic at Hanging Rock (1967) has prompted scholars such as Lesley Kathryn Hawkes to describe how in Australian literature for both adults and children ‘the environment is far more than a setting or backdrop against which the plot takes place’ (Hawkes, 2011,67). On St Valentine’s Day in 1900 three young Australian girls and their teacher disappear from a school picnic at the ancient site of Mount Macedon in Victoria. The analysis, which focuses on Lindsay’s posthumously published chapter eighteen (1987) examines how elements of the material, sensing world combine with the mythological or sacred to connect the human protagonists with the gothic landscape they inhabit. The resulting intersubjectivity problematizes colonial ideology and unsettles notions of national identity

Interaction of the quantized electromagnetic field with atoms in the presence of dispersing and absorbing dielectric bodies

A general theory of the interaction of the quantized electromagnetic field with atoms in the presence of dispersing and absorbing dielectric bodies of given Kramers--Kronig consistent permittivities is developed. It is based on a source-quantity representation of the electromagnetic field, in which the electromagnetic-field operators are expressed in terms of a continuous set of fundamental bosonic fields via the Green tensor of the classical problem. Introducing scalar and vector potentials, the formalism is extended in order to include in the theory the interaction of the quantized electromagnetic field with additional atoms. Both the minimal-coupling scheme and the multipolar-coupling scheme are considered. The theory replaces the standard concept of mode decomposition which fails for complex permittivities. It enables us to treat the effects of dispersion and absorption in a consistent way and to give a unified approach to the atom-field interaction, without any restriction to a particular interaction regime in a particular frequency range. All relevant information about the dielectric bodies such as form and intrinsic dispersion and absorption is contained in the Green tensor. The application of the theory to the spontaneous decay of an excited atom in the presence of dispersing and absorbing bodies is addressed.Comment: Paper presented at the International Conference on Quantum Optics and VIII Seminar on Quantum Optics, Raubichi, Belarus, May 28-31, 2000, 14 pages, LaTeX2e, no figure

Cumulant expansion for studying damped quantum solitons

The quantum statistics of damped optical solitons is studied using cumulant-expansion techniques. The effect of absorption is described in terms of ordinary Markovian relaxation theory, by coupling the optical field to a continuum of reservoir modes. After introduction of local bosonic field operators and spatial discretization pseudo-Fokker-Planck equations for multidimensional s-parameterized phase-space functions are derived. These partial differential equations are equivalent to an infinite set of ordinary differential equations for the cumulants of the phase-space functions. Introducing an appropriate truncation condition, the resulting finite set of cumulant evolution equations can be solved numerically. Solutions are presented in Gaussian approximation and the quantum noise is calculated, with special emphasis on squeezing and the recently measured spectral photon-number correlations [Spaelter et al., Phys. Rev. Lett. 81, 786 (1998)].Comment: 17 pages, 13 figures, revtex, psfig, multicols, published in Phys.Rev.