Management of Humeral Shaft Fractures; Non-Operative Versus Operative

Context: Functional humeral bracing remains the gold standard for treatment of humeral shaft fractures. There is an increasing trend in the literature to perform operative fixation of these fractures. Evidence Acquisition: The aim of this systematic review was to compare the level one evidence for the outcome of non-operative with operative management of humeral shaft fractures in adults. A comprehensive electronic literature search of Medline and PubMed was performed with specific inclusion criteria to identify randomized controlled trials. Results: In total, seventeen different studies were identified from the search terms and combinations used. Only one study met the inclusion criteria; however, this was a published study protocol of an ongoing trial currently being conducted. One additional published protocol for an ongoing trial was also identified, but this was for a prospective comparative observational study. Although this latter study may not be level one evidence, it would offer great insight into the functional outcome of humeral shaft fractures and economic implications of operative management, which is currently not addressed in the literature. Two retrospective comparative studies were also identified, one of which demonstrated a significantly lower rate of nonunion and malunion in those patients undergoing operative management. Conclusions: This systematic review demonstrated a deficiency in the current literature of level one evidence available for the management of humeral shaft fractures. The current ongoing randomized control trail would offer a greater insight into the management of humeral shaft fractures and help confirm or refute the current literature. If this randomized control trial affirms the reduction in the rate of nonunion with operative fixation, a cost economic analysis is essential. As it would seem to offer operative management to all patients may be over treatment and not to offer this at all would undertreat

Multi-band spectroscopy of inhomogeneous Mott-insulator states of ultracold bosons

In this work, we use inelastic scattering of light to study the response of inhomogeneous Mott-insulator gases to external excitations. The experimental setup and procedure to probe the atomic Mott states are presented in detail. We discuss the link between the energy absorbed by the gases and accessible experimental parameters as well as the linearity of the response to the scattering of light. We investigate the excitations of the system in multiple energy bands and a band-mapping technique allows us to identify band and momentum of the excited atoms. In addition the momentum distribution in the Mott states which is spread over the entire first Brillouin zone enables us to reconstruct the dispersion relation in the high energy bands using a single Bragg excitation with a fixed momentum transfer.Comment: 19 pages, 7 figure

Visualizing probabilistic models: Intensive Principal Component Analysis

Unsupervised learning makes manifest the underlying structure of data without curated training and specific problem definitions. However, the inference of relationships between data points is frustrated by the `curse of dimensionality' in high-dimensions. Inspired by replica theory from statistical mechanics, we consider replicas of the system to tune the dimensionality and take the limit as the number of replicas goes to zero. The result is the intensive embedding, which is not only isometric (preserving local distances) but allows global structure to be more transparently visualized. We develop the Intensive Principal Component Analysis (InPCA) and demonstrate clear improvements in visualizations of the Ising model of magnetic spins, a neural network, and the dark energy cold dark matter ({\Lambda}CDM) model as applied to the Cosmic Microwave Background.Comment: 6 pages, 5 figure

Killing Vector Fields in Three Dimensions: A Method to Solve Massive Gravity Field Equations

Killing vector fields in three dimensions play important role in the construction of the related spacetime geometry. In this work we show that when a three dimensional geometry admits a Killing vector field then the Ricci tensor of the geometry is determined in terms of the Killing vector field and its scalars. In this way we can generate all products and covariant derivatives at any order of the ricci tensor. Using this property we give ways of solving the field equations of Topologically Massive Gravity (TMG) and New Massive Gravity (NMG) introduced recently. In particular when the scalars of the Killing vector field (timelike, spacelike and null cases) are constants then all three dimensional symmetric tensors of the geometry, the ricci and einstein tensors, their covariant derivatives at all orders, their products of all orders are completely determined by the Killing vector field and the metric. Hence the corresponding three dimensional metrics are strong candidates of solving all higher derivative gravitational field equations in three dimensions.Comment: 25 pages, some changes made and some references added, to be published in Classical and Quantum Gravit

X-ray diffraction from bone employing annular and semi-annular beams

This is the final version of the article. Available from the publisher via the DOI in this record.There is a compelling need for accurate, low cost diagnostics to identify osteo-tissues that are associated with a high risk of fracture within an individual. To satisfy this requirement the quantification of bone characteristics such as 'bone quality' need to exceed that provided currently by densitometry. Bone mineral chemistry and microstructure can be determined from coherent x-ray scatter signatures of bone specimens. Therefore, if these signatures can be measured, in vivo, to an appropriate accuracy it should be possible by extending terms within a fracture risk model to improve fracture risk prediction.In this preliminary study we present an examination of a new x-ray diffraction technique that employs hollow annular and semi-annular beams to measure aspects of 'bone quality'. We present diffractograms obtained with our approach from ex vivo bone specimens at Mo Kα and W Kα energies. Primary data is parameterized to provide estimates of bone characteristics and to indicate the precision with which these can be determined.We acknowledge gratefully the funding provided by the UK Engineering and Physical Sciences Research Council (EPSRC) grant number EP/K020196/

All stationary axi-symmetric local solutions of topologically massive gravity

We classify all stationary axi-symmetric solutions of topologically massive gravity into Einstein, Schr\"odinger, warped and generic solutions. We construct explicitly all local solutions in the first three sectors and present an algorithm for the numerical construction of all local solutions in the generic sector. The only input for this algorithm is the value of one constant of motion if the solution has an analytic centre, and three constants of motion otherwise. We present several examples, including soliton solutions that asymptote to warped AdS.Comment: 42 pages, 9 figures. v2: Changed potentially confusing labelling of one sector, added references. v3: Minor changes, matches published versio