Cerebral palsy with dislocated hip and scoliosis: what to deal with first?

PURPOSE:Hip dislocation and scoliosis are common in children with cerebral palsy (CP). Hip dislocation develops in 15% and 20% of children with CP, mainly between three and six years of age and especially in the spastic and dyskinetic subtypes. The risk of scoliosis increases with age and increasing disability as expressed by the Gross Motor Function Score.METHODS:A hip surveillance programme and early surgical treatment have been shown to reduce the hip dislocation, but it remains unclear if a similar programme could reduce the need for neuromuscular scoliosis. When hip dislocation and neuromuscular scoliosis are co-existent, there appears to be no clear guidelines as to which of these deformities should be addressed first: hip or spine.RESULTS:Hip dislocation or windswept deformity may cause pelvic obliquity and initiate scoliosis, while neuromuscular scoliosis itself leads to pelvic obliquity and may increase the risk of hip dislocation especially on the high side. It remains unclear if treating imminent hip dislocation can prevent development of scoliosis and vice versa, but they may present at the same time for surgery. Current expert opinion suggests that when hip dislocation and scoliosis present at the same time, scoliosis associated pelvic obliquity should be corrected before hip reconstruction. If the patient is not presenting with pelvic obliquity the more symptomatic condition should be addressed first.CONCLUSION:Early identification of hip displacement and neuromuscular scoliosis appears to be important for better surgical outcomes.</p

Mykorrhiza im ökologischen Landbau

The mycorrhizal symbiosis plays a major role in plant nutrient acquisition, pathogen control and soil stabilisation in land use systems with a low input of external resources. The use of inocula of mycorrhizal fungi for the development of sustainable agricultural production systems in Europe is still scarce. Since it was found that even in organically managed soils and particularly in substrates mycorrhizas can be limited, a set of recently introduced commercial inocula and 10 pre-selected strains of mycorrhizal fungi were multiplied and screened under farm conditions. Poinsettia, Pelargonium, leak and strawberry were used as test plants, which were inoculated in the seeding or potting substrates. There was a strong interaction between mycorrhizal fungi strains and crop. Mycorrhiza effects were found to be most pronounced in early seedling stages and, therefore, this phase of development should be investigated more intensively applying a combination of selected mycorrhizal fungal strains

Spectral Boundary of Positive Random Potential in a Strong Magnetic Field

We consider the problem of randomly distributed positive delta-function scatterers in a strong magnetic field and study the behavior of density of states close to the spectral boundary at $E=\hbar\omega_{c}/2$ in both two and three dimensions. Starting from dimensionally reduced expression of Brezin et al. and using the semiclassical approximation we show that the density of states in the Lifshitz tail at small energies is proportio- nal to $e^{f-2}$ in two dimensions and to $\exp(-3.14f\ln(3.14f/\pi e)/ \sqrt(2me))$ in three dimensions, where $e$ is the energy and $f$ is the density of scatterers in natural units.Comment: 12 pages, LaTex, 5 figures available upon request, to appear in Phys. Rev.

The Nature of the Hall Insulator

We have conducted an experimental study of the linear transport properties of the magnetic-field induced insulating phase which terminates the quantum Hall (QH) series in two dimensional electron systems. We found that a direct and simple relation exists between measurements of the longitudinal resistivity, $\rho_{xx}$, in this insulating phase and in the neighboring QH phase. In addition, we find that the Hall resistivity, $\rho_{xy}$, can be quantized in the insulating phase. Our results indicate that a close relation exists between the conduction mechanism in the insulator and in the QH liquid.Comment: RevTeX, 4 pages, 4 figure

Electron-Electron Interactions and the Hall-Insulator

Using the Kubo formula, we show explicitly that a non-interacting electron system can not behave like a Hall-insulator, {\it ie.,} a DC resistivity matrix $\rho_{xx}\rightarrow\infty$ and $\rho_{xy}=$finite in the zero temperature limit, as has been observed recently in experiment. For a strongly interacting electron system in a magnetic field, we illustrate, by constructing a specific form of correlations between mobile and localized electrons, that the Hall resistivity can approximately equal to its classical value. A Hall-insulator is realized in this model when the density of mobile electrons becomes vanishingly small. It is shown that in non-interacting electron systems, the zero-temperature frequency-dependent conductacnce generally does not give the DC conductance.Comment: 11 pages, RevTeX3.

Influence of clinical and gait analysis experience on reliability of observational gait analysis (Edinburgh Gait Score Reliability)

AbstractObjectivesTreatment complexity of cerebral palsy (CP) patients imposes outcome evaluation studies, which may include objective technical analysis and more subjective functional evaluation. The Edinburgh Gait Score (EGS) was proposed as an additive or alternative when complex instrumented three-dimensional gait analysis is not available. Our purposes were to apply a translated EGS to standard video recordings of independent walking spastic diplegic CP patients, to evaluate its intraobserver and interobserver reliability with respect to gait analysis familiar and not familiar observers.MethodsTen standard video recordings acquired during routine clinical gait analysis were examined by eight observers gait analysis interpretation experienced or not, out of various specialities, two times with a two weeks interval. Kappa statistics and intraclass correlation coefficient were calculated.ResultsBetter reliability was observed for foot and knee scores than in proximal segments with significant differences between stance and swing phase. Significantly better results in gait analysis trained observers underlines the importance to either be used to clinical gait analysis interpretation, or to benefit of video analysis training before observational scoring.ConclusionVisual evaluation may be used for outcome studies to explore clinical changes in CP patients over time and may be associated to other validated evaluation tools

The Quantized Hall Insulator: A New Insulator in Two-Dimensions

Quite generally, an insulator is theoretically defined by a vanishing conductivity tensor at the absolute zero of temperature. In classical insulators, such as band insulators, vanishing conductivities lead to diverging resistivities. In other insulators, in particular when a high magnetic field (B) is added, it is possible that while the magneto-resistance diverges, the Hall resistance remains finite, which is known as a Hall insulator. In this letter we demonstrate experimentally the existence of another, more exotic, insulator. This insulator, which terminates the quantum Hall effect series in a two-dimensional electron system, is characterized by a Hall resistance which is approximately quantized in the quantum unit of resistance h/e^2. This insulator is termed a quantized Hall insulator. In addition we show that for the same sample, the insulating state preceding the QHE series, at low-B, is of the HI kind.Comment: 4 page

Phenomenological Understanding of a Transport Regime with Reflection Symmetry in the Quantum Hall System in a Composite Fermion Picture

In this paper, we present a phenomenological picture based on the composite fermion theory, in responding to the recent discovery by Shahar et al. of a new transport regime near the transition from a $\nu=1$ quantum Hall liquid to a Hall insulator(ref[8]). In this picture, the seemingly unexpected reflection symmetry in the longitudinal resistivity $\rho_{xx}$ can be understood clearly as due to the symmetry of the gapful excitations which dominate $\sigma_{xx}$ across the transition, and the abrupt change in $\sigma_{xy}$ at the transition. The parameter $\alpha$ in the linear fit of $\nu_0(T)$ in ref[8] is also given a simple physical meaning and the effective mass can be calculated from $\alpha$, which gives a reasonable value of several electron band mass. When taking into account the result of network model, the almost invariant Hall resistivity $\rho_{xy}$ across the transition is also well-understood.Comment: 4 pages, RevTex, final version to appear in Phys.Rev.

Tail States in a Superconductor with Magnetic Impurities

A field theoretic approach is developed to investigate the profile and spectrum of sub-gap states in a superconductor subject to a weak magnetic impurity potential. Such states are found to be associated with inhomogeneous supersymmetry broken instanton configurations of the action.Comment: 4 pages, 2 eps figure

Sliding motion of a two-dimensional Wigner crystal in a strong magnetic field

We study the sliding state of a two-dimensional Wigner crystal in a strong magnetic field and a random impurity potential. Using a high-velocity perturbation theory, we compute the nonlinear conductivity, various correlation functions, and the interference effects arising in combined AC + DC electric effects, including the Shapiro anomaly and the linear response to an AC field. Disorder is found to induce mainly transverse distortions in the sliding state of the lattice. The Hall resistivity retains its classical value. We find that, within the large velocity perturbation theory, free carriers which affect the longitudinal phonon modes of the Wigner crystal do not change the form of the nonlinear conductivity. We compare the present sliding Wigner crystal in a strong magnetic field to the conventional sliding charge-density wave systems. Our result for the nonlinear conductivity agrees well with the $I-V$ characteristics measured in some experiments at low temperatures or large depinning fields, for the insulating phases near filling factor $\nu$ = 1/5. We summarize the available experimental data, and point out the differences among them.Comment: appeared in RPB vol. 50, 4600 (1994); LaTex file; 3 figures available from [email protected]