Tibial Tubercle Osteotomy and Medial Patellofemoral Ligament Imbrication for Patellar Instability Due to Trochlear Dysplasia.

BackgroundThe treatment of patellar instability in the setting of trochlear dysplasia is challenging.Purpose/hypothesisThe purpose of this study was to evaluate outcomes for the treatment of recurrent patellar dislocations due to trochlear dysplasia using anteromedialization tibial tubercle osteotomy combined with medial patellofemoral ligament (MPFL) imbrication. We hypothesized that the treatment of patellar instability with tibial tubercle osteotomy and MPFL imbrication would result in improved patient satisfaction and decrease patellar instability events in patients with prior instability and trochlear dysplasia.Study designCase series; Level of evidence, 4.MethodsWe performed a retrospective analysis of patients who underwent MPFL imbrication and concomitant anteromedialization tibial tubercle osteotomy for recurrent patellofemoral instability at a single institution. The minimum follow-up was 1 year. Patient demographic information including age at the time of surgery, sex, body mass index (BMI), tibial tubercle-trochlear groove (TT-TG) distance, and grade of trochlear dysplasia was collected along with relevant operative data. Postoperatively, recurrent dislocation events as well as Knee injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index, and Kujala scores were collected, and satisfaction was ascertained by asking patients whether they would undergo the procedure again.ResultsA total of 37 knees from 31 patients (23 female) with a mean follow-up of 3.8 years (range, 1-8.9 years) were included. The mean patient age was 28.8 years (range, 14-45 years), the mean BMI was 24 kg/m2 (range, 20-38 kg/m2), and the mean preoperative TT-TG distance was 18.9 mm (range, 8.4-32.4 mm). Two knees were classified as low-grade trochlear dysplasia (Dejour A) and 35 as high-grade trochlear dysplasia (Dejour B-D). At final follow-up, patients reported mean KOOS subscale scores of 86.5 (Pain), 79.8 (Symptoms), 93.9 (Activities of Daily Living), 74.3 (Sports/Recreation), and 61.9 (Quality of Life), as well as a mean Kujala score of 81.3. Mean patient satisfaction was 8.3 of 10. The majority of knees (86.5%; 32/37) remained stable without recurrent instability after this procedure, while 13.5% (5 knees) suffered a recurrent dislocation, with 2 requiring revision surgery. Eight knees (21.6%) underwent subsequent hardware removal.ConclusionAnteromedialization tibial tubercle osteotomy with MPFL imbrication can improve recurrent patellofemoral instability and provide significant clinical benefit to patients with trochlear dysplasia

Curvature Dependence of Surface Free Energy of Liquid Drops and Bubbles: A Simulation Study

We study the excess free energy due to phase coexistence of fluids by Monte Carlo simulations using successive umbrella sampling in finite LxLxL boxes with periodic boundary conditions. Both the vapor-liquid phase coexistence of a simple Lennard-Jones fluid and the coexistence between A-rich and B-rich phases of a symmetric binary (AB) Lennard-Jones mixture are studied, varying the density rho in the simple fluid or the relative concentration x_A of A in the binary mixture, respectively. The character of phase coexistence changes from a spherical droplet (or bubble) of the minority phase (near the coexistence curve) to a cylindrical droplet (or bubble) and finally (in the center of the miscibility gap) to a slab-like configuration of two parallel flat interfaces. Extending the analysis of M. Schrader, P. Virnau, and K. Binder [Phys. Rev. E 79, 061104 (2009)], we extract the surface free energy gamma (R) of both spherical and cylindrical droplets and bubbles in the vapor-liquid case, and present evidence that for R -> Infinity the leading order (Tolman) correction for droplets has sign opposite to the case of bubbles, consistent with the Tolman length being independent on the sign of curvature. For the symmetric binary mixture the expected non-existence of the Tolman length is confirmed. In all cases {and for a range of radii} R relevant for nucleation theory, gamma(R) deviates strongly from gamma (Infinity) which can be accounted for by a term of order gamma(Infinity)/gamma(R)-1 ~ 1/R^2. Our results for the simple Lennard-Jones fluid are also compared to results from density functional theory and we find qualitative agreement in the behavior of gamma(R) as well as in the sign and magnitude of the Tolman length.Comment: 25 pages, submitted to J. Chem. Phy

Towards a Critique of Educative Violence: Walter Benjamin and ‘Second Education’

Although modern systems of mass education are typically defined in their opposition to violence, it has been argued that it is only through an insistent and critical focus upon violence that radical thought can be sustained. This article seeks to take up this challenge in relation to Walter Benjamin’s lesser-known writings on education. Benjamin retained throughout his life a deep suspicion about academic institutions and about the pedagogic, social and economic violence implicated in the idea of cultural transmission. He nonetheless remained committed to the possibility of another kind of revolutionary potential inherent to true education and, when he comes to speak of this in his Critique of Violence, it is remarkable that he describes it as manifesting an educative violence. This article argues that Benjamin’s philosophy works toward a critique of educative violence that results in a distinction between a ‘first’ and ‘second’ kind of education and asks whether destruction might have a positive role to play within pedagogical theories in contrast to current valorisations of creativity and productivity

Rapid hydrolysis of tertiary isoprene nitrate efficiently removes NO_x from the atmosphere

The formation of a suite of isoprene-derived hydroxy nitrate (IHN) isomers during the OH-initiated oxidation of isoprene affects both the concentration and distribution of nitrogen oxide free radicals (NO_x). Experiments performed in an atmospheric simulation chamber suggest that the lifetime of the most abundant isomer, 1,2-IHN, is shortened significantly by a water-mediated process (leading to nitric acid formation), while the lifetime of a similar isomer, 4,3-IHN, is not. Consistent with these chamber studies, NMR kinetic experiments constrain the 1,2-IHN hydrolysis lifetime to less than 10 s in deuterium oxide (D₂O) at 298 K, whereas the 4,3-IHN isomer has been observed to hydrolyze much less efficiently. These laboratory findings are used to interpret observations of the IHN isomer distribution in ambient air. The IHN isomer ratio (1,2-IHN to 4,3-IHN) in a high NO_x environment decreases rapidly in the afternoon, which is not explained using known gas-phase chemistry. When simulated with an observationally constrained model, we find that an additional loss process for the 1,2-IHN isomer with a time constant of about 6 h best explains our atmospheric measurements. Using estimates for 1,2-IHN Henry’s law constant and atmospheric liquid water volume, we show that condensed-phase hydrolysis of 1,2-IHN can account for this loss process. Simulations from a global chemistry transport model show that the hydrolysis of 1,2-IHN accounts for a substantial fraction of NO_x lost (and HNO₃ produced), resulting in large impacts on oxidant formation, especially over forested regions

Morally Respectful Listening and its Epistemic Consequences

What does it mean to listen to someone respectfully, that is, insofar as they are due recognition respect? This paper addresses that question and gives the following answer: it is to listen in such a way that you are open to being surprised. A specific interpretation of this openness to surprise is then defended

The Bubbling Galactic Disk

A visual examination of the images from the Galactic Legacy Infrared Mid-Plane Survey Extraordinaire (GLIMPSE) has revealed 322 partial and closed rings that we propose represent partially or fully enclosed three-dimensional bubbles. We argue that the bubbles are primarily formed by hot young stars in massive star formation regions. We have found an average of about 1.5 bubbles per square degree. About 25% of the bubbles coincide with known radio H II regions, and about 13% enclose known star clusters. It appears that B4-B9 stars (too cool to produce detectable radio H II regions) probably produce about three-quarters of the bubbles in our sample, and the remainder are produced by young O-B3 stars that produce detectable radio H II regions. Some of the bubbles may be the outer edges of H II regions where PAH spectral features are excited and may not be dynamically formed by stellar winds. Only three of the bubbles are identified as known SNRs. No bubbles coincide with known planetary nebulae or W-R stars in the GLIMPSE survey area. The bubbles are small. The distribution of angular diameters peaks between 1' and 3' with over 98% having angular diameters less than 10' and 88% less than 4'. Almost 90% have shell thicknesses between 0.2 and 0.4 of their outer radii. Bubble shell thickness increases approximately linearly with shell radius. The eccentricities are rather large, peaking between 0.6 and 0.7; about 65% have eccentricities between 0.55 and 0.85

Quantum principle of sensing gravitational waves: From the zero-point fluctuations to the cosmological stochastic background of spacetime

We carry out a theoretical investigation on the collective dynamics of an ensemble of correlated atoms, subject to both vacuum fluctuations of spacetime and stochastic gravitational waves. A general approach is taken with the derivation of a quantum master equation capable of describing arbitrary confined nonrelativistic matter systems in an open quantum gravitational environment. It enables us to relate the spectral function for gravitational waves and the distribution function for quantum gravitational fluctuations and to indeed introduce a new spectral function for the zero-point fluctuations of spacetime. The formulation is applied to two-level identical bosonic atoms in an off-resonant high-Q cavity that effectively inhibits undesirable electromagnetic delays, leading to a gravitational transition mechanism through certain quadrupole moment operators. The overall relaxation rate before reaching equilibrium is found to generally scale collectively with the number N of atoms. However, we are also able to identify certain states of which the decay and excitation rates with stochastic gravitational waves and vacuum spacetime fluctuations amplify more significantly with a factor of N². Using such favorable states as a means of measuring both conventional stochastic gravitational waves and novel zero-point spacetime fluctuations, we determine the theoretical lower bounds for the respective spectral functions. Finally, we discuss the implications of our findings on future observations of gravitational waves of a wider spectral window than currently accessible. Especially, the possible sensing of the zero-point fluctuations of spacetime could provide an opportunity to generate initial evidence and further guidance of quantum gravity

Using Apollo Sites and Soils to Compositionally Ground Truth Diviner Lunar Radiometer Observations

Apollo landing sites and returned soils afford us a unique opportunity to "ground truth" Diviner Lunar Radiometer compositional observations, which are the first global, high resolution , thermal infrared measurements of an airless body. The Moon is the most accessible member of the most abundant class of solar system objects, which includes Mercury, asteroids, and icy satellites. And the Apollo samples returned from the Moon are the only extraterrestrial samples with known spatial context. Here we compare Diviner observations of Apollo landing sites and compositional and spectral laboratory measurements of returned Apollo soils. Diviner, onboard NASA's Lunar Reconnaissance Orbiter, has three spectral channels near 8 micron that were designed to characterize the mid-infrared emissivity maximum known as the Christiansen feature (CF), a well-studied indicator of silicate mineralogy. It has been observed that thermal infrared spectra measured in simulated lunar environment (SLE) are significantly altered from spectra measured under terrestrial or martian conditions, with enhanced CF contrast and shifted CF position relative to other spectral features. Therefore only thermal emission experiments conducted in SLE are directly comparable to Diviner data. With known compositions, Apollo landing sites and soils are important calibration points for the Diviner dataset, which includes all six Apollo sites at approximately 200 m spatial resolution. Differences in measured CFs caused by composition and space weathering are apparent in Diviner data. Analyses of Diviner observations and SLE measurements for a range of Apollo soils show good agreement, while comparisons to thermal reflectance measurements under ambient conditions do not agree well, which underscores the need for SLE measurements and validates our measurement technique. Diviner observations of Apollo landing sites are also correlated with geochemical measurements of Apollo soils from the Lunar Sample Compendium. In particular, the correlations between CF and FeO and AI203 are very strong, owing to the dependence on the feldspar-mafic ratio. Our analyses suggest that Diviner data may offer an independent measure of soil iron content from the existing optical and gamma-ray spectrometer datasets

The distribution and density of water mice (Xeromys myoides) in the Maroochy River of Southeast Queensland, Australia

The water mouse is a small and vulnerable rodent present in coastal areas of south-west Papua New Guinea, and eastern Queensland and the Northern Territory of Australia. Current knowledge regarding the distribution of the water mouse is incomplete and the loss of one local population has been documented in southeast Queensland, a region where pressures from urban and industrial development are increasing. Water mouse populations have not been studied intensively enough to enable the primary factors responsible for the local decline to be identified. We surveyed the distribution and density of the water mouse along the Maroochy River of southeast Queensland, near the southern extent of the species’ range, to gather baseline data that may prove valuable for detecting any future decline in this population’s size or health. All areas of suitable habitat were surveyed on foot or by kayak or boat over a three-year period. We found 180 water mouse nests, of which ~94% were active. Permanent camera monitoring of one nest and limited supplementary live trapping suggested that up to three individual mice occupied active nests. Water mouse density was estimated to be 0.44 per hectare of suitable habitat along the Maroochy River. Should future monitoring reveal an adverse change in the water mouse population on the Maroochy River, a concerted effort should be made to identify contributing factors and address proximate reasons for the decline

Pyroclastic Deposits in Floor-Fractured Craters: A Unique Style or Lunar Basaltic Volcanism?

The lunar maria were formed by effusive fissure flows of low-viscosity basalt. Regional pyroclastic deposits were formed by deep-sourced fire-fountain eruptions dominated by basaltic glass. Basaltic material is also erupted from small vents within floor-fractured impact craters. These craters are characterized by shallow, flat floors cut by radial, concentric and/or polygonal fractures. Schultz [1] identified and classified over 200 examples. Low albedo pyroclastic deposits originate from depressions along the fractures in many of these craters