Revitalizing missions on the cusp of change : complex systems science mazeways for mission theory amid twenty-first century realities

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Surgical Fixation of Bilateral Simultaneous Avulsion Fractures of the Proximal Tibia in a 12-Year-Old with History of Conservatively Managed Unilateral Tibial Avulsion Fracture

Fractures of the proximal tibial epiphysis are rare, representing less than 3% of all epiphyseal and 1% of all physeal injuries in adolescents. Bilateral injuries are extremely rare. The specific anatomical and histological features of the proximal tibial epiphysis make it vulnerable to a specific fracture pattern that occurs when the tensile force of the quadriceps is greater than the fibrocartilaginous tissue underlying the tibial tuberosity. We report the first case to our knowledge of a 12-year-old boy who sustained simultaneous bilateral tibial avulsion fractures on the background of a previous conservatively managed unilateral tibial tuberosity avulsion fracture. We report this case for its uniqueness and as an educational review of the anatomy, the mechanism of injury, and the development of classifying these fractures and discussion of the stages of the growing physis that determine the treatment approach

Season of the year influences infection rates following total hip arthroplasty

To research the influence of season of the year on periprosthetic joint infections. METHODS We conducted a retrospective review of the entire Medicare files from 2005 to 2014. Seasons were classified as spring, summer, fall or winter. Regional variations were accounted for by dividing patients into four geographic regions as per the United States Census Bureau (Northeast, Midwest, West and South). Acute postoperative infection and deep periprosthetic infections within 90 d after surgery were tracked. RESULTS In all regions, winter had the highest incidence of periprosthetic infections (mean 0.98%, SD 0.1%) and was significantly higher than other seasons in the Midwest, South and West (P \u3c 0.05 for all) but not the Northeast (P = 0.358). Acute postoperative infection rates were more frequent in the summer and were significantly affected by season of the year in the West. CONCLUSION Season of the year is a risk factor for periprosthetic joint infection following total hip arthroplasty (THA). Understanding the influence of season on outcomes following THA is essential when risk-stratifying patients to optimize outcomes and reduce episode of care costs. © The Author(s) 2017

AI and Democracy's Digital Identity Crisis

AI-enabled tools have become sophisticated enough to allow a small number of individuals to run disinformation campaigns of an unprecedented scale. Privacy-preserving identity attestations can drastically reduce instances of impersonation and make disinformation easy to identify and potentially hinder. By understanding how identity attestations are positioned across the spectrum of decentralization, we can gain a better understanding of the costs and benefits of various attestations. In this paper, we discuss attestation types, including governmental, biometric, federated, and web of trust-based, and include examples such as e-Estonia, China's social credit system, Worldcoin, OAuth, X (formerly Twitter), Gitcoin Passport, and EAS. We believe that the most resilient systems create an identity that evolves and is connected to a network of similarly evolving identities that verify one another. In this type of system, each entity contributes its respective credibility to the attestation process, creating a larger, more comprehensive set of attestations. We believe these systems could be the best approach to authenticating identity and protecting against some of the threats to democracy that AI can pose in the hands of malicious actors. However, governments will likely attempt to mitigate these risks by implementing centralized identity authentication systems; these centralized systems could themselves pose risks to the democratic processes they are built to defend. We therefore recommend that policymakers support the development of standards-setting organizations for identity, provide legal clarity for builders of decentralized tooling, and fund research critical to effective identity authentication systems

Tapped Out: Threats to the Human Right to Water in the Urban United States

In the United States today, the goal of universal water service is slipping out of reach. Water costs are rising across the country, forcing many individuals to forgo running water or sanitation, or to sacrifice other essential human rights. The fixed costs of water systems have increased in recent years, driven in part by underinvestment in infrastructure. In many cities, this has been exacerbated by population shifts and the economic downturn. In this era of increasing costs and limited financial resources, water providers struggle to balance the competing priorities of modernization and universal access. This report, researched and written by students of Georgetown Law’s Human Rights Institute in the winter of 2013, details the causes, effects, and solutions to the affordability crisis affecting water in the urban United States

Opening a door between PRC and Hong Kong in insolvency proceedings: insight from Re Samson Paper Limited

Having recently marked the 25-year anniversary of 'One Country Two Systems' between the People's Republic of China ('PRC') and the Hong Kong Special Administrative Region of the People's Republic of China ('Hong Kong'), under which Hong Kong is able to maintain a separate Common law based legal system, there is now an increasing focus on how to facilitate interaction between the two distinct legal systems. How questions about these two legal systems interact and provide judicial assistance to each other will not only be of interest to local practitioners, but practitioners and scholars everywhere as it foreshadows how the PRC legal system will ultimately cooperate with other foreign jurisdictions around the world. Given the inbound and outbound investment into and out of China over the last 40 years, often through Hong Kong, the ever-growing number of bilateral ties has created increasing demand for legal certainty and transparency from the PRC courts, not least if and when those investments run into trouble. In a landmark move recently, a mutual recognition framework has been established between Hong Kong and PRC to allow the Hong Kong courts to recognise and grant assistance to insolvency practitioners in corporate insolvencies appointed by certain PRC Courts, and vice versa. This is a significant step towards resolving one of the longstanding issues arising from Hong Kong's role, as an international financial centre, being used to raise funds by PRC companies whose main assets and operations are in PRC resulting in 'offshore' creditors not having recourse to 'onshore' assets or security and vice versa, if insolvency ensues. This raises as many questions as there are opportunities to innovate given the lack of a detailed legal framework in the new arrangement, especially from the PRC courts. In search of a more concrete framework following the new arrangement, this article analyses the first PRC court case, Samson Paper Company Limited, that granted recognition and assistance to Hong Kong insolvency practitioners. It sheds the first light for foreign practitioners on the PRC court's attitude and how they intend to play a more facilitative role among parties whilst safeguarding the local public interest. It is unveiled that the practice and standard adopted by the PRC courts which should be incorporated into existing treaty or supra-national law to better fit the needs of key stakeholders in cross-jurisdictional situations, including an important clarification in terms of the scope of the powers the PRC court will grant to the Hong Kong liquidators and provides a pointer as to the future possible ways that the PRC will deal with issues of judicial comity in the increasing important area of cross-border insolvency

Fate of radium on the discharge of oil and gas produced water to the marine environment

Understanding the speciation and fate of radium during operational discharge from the offshore oil and gas industry into the marine environment is important in assessing its long term environmental impact. In the current work, Ra-226 concentrations in marine sediments contaminated by produced water discharge from a site in the UK were analysed using gamma spectroscopy. Radium was present in field samples (0.1-0.3 Bq g(-1)) within International Atomic Energy Agency activity thresholds and was found to be primarily associated with micron sized radiobarite particles (Peer reviewe

Neptunium Reactivity During Co-Precipitation and Oxidation of Fe(II)/Fe(III) (Oxyhydr)oxides

Fe(II) bearing iron (oxyhydr)oxides were directly co-precipitated with Np(V)O2+ under anaerobic conditions to form Np doped magnetite and green rust. These environmentally relevant mineral phases were then characterised using geochemical and spectroscopic analyses. The Np doped mineral phases were then oxidised in air over 224 days with solution chemistry and end-point oxidation solid samples collected for further characterisation. Analysis using chemical extractions and X-ray absorption spectroscopy (XAS) techniques confirmed that Np(V) was initially reduced to Np(IV) during co-precipitation of both magnetite and green rust. Extended X-Ray Absorption Fine Structure (EXAFS) modelling suggested the Np(IV) formed a bidentate binuclear sorption complex to both minerals. Furthermore, following oxidation in air over several months, the sorbed Np(IV) was partially oxidised to Np(V), but very little remobilisation to solution occurred during oxidation. Here, linear combination fitting of the X-Ray Absorption Near Edge Structure (XANES) for the end-point oxidation samples for both mineral phases suggested approximately 50% oxidation to Np(V) had occurred over 7 months of oxidation in air. Both the reduction of Np(V) to Np(IV) and inner sphere sorption in association with iron (oxyhydr)oxides, and the strong retention of Np(IV) and Np(V) species with these phases under robust oxidation conditions, have important implications in understanding the mobility of neptunium in a range of engineered and natural environments

Neptunium Reactivity During Co-Precipitation and Oxidation of Fe(II)/Fe(III) (Oxyhydr)oxides

Fe(II) bearing iron (oxyhydr)oxides were directly co-precipitated with Np(V)O2+ under anaerobic conditions to form Np doped magnetite and green rust. These environmentally relevant mineral phases were then characterised using geochemical and spectroscopic analyses. The Np doped mineral phases were then oxidised in air over 224 days with solution chemistry and end-point oxidation solid samples collected for further characterisation. Analysis using chemical extractions and X-ray absorption spectroscopy (XAS) techniques confirmed that Np(V) was initially reduced to Np(IV) during co-precipitation of both magnetite and green rust. Extended X-Ray Absorption Fine Structure (EXAFS) modelling suggested the Np(IV) formed a bidentate binuclear sorption complex to both minerals. Furthermore, following oxidation in air over several months, the sorbed Np(IV) was partially oxidised to Np(V), but very little remobilisation to solution occurred during oxidation. Here, linear combination fitting of the X-Ray Absorption Near Edge Structure (XANES) for the end-point oxidation samples for both mineral phases suggested approximately 50% oxidation to Np(V) had occurred over 7 months of oxidation in air. Both the reduction of Np(V) to Np(IV) and inner sphere sorption in association with iron (oxyhydr)oxides, and the strong retention of Np(IV) and Np(V) species with these phases under robust oxidation conditions, have important implications in understanding the mobility of neptunium in a range of engineered and natural environments