Optical pulse propagation in a switched-on photonic lattice: Rabi effect with the roles of light and matter interchanged

A light pulse propagating in a suddenly switched on photonic lattice, when the central frequency lies in the photonic band gap, is an analog of the Rabi model where the two-level system is the two resonant (i.e. Bragg-coupled) Fourier modes of the pulse, while the photonic lattice serves as a monochromatic external field. A simple theory of these Rabi oscillations is given and confirmed by the numerical solution of the corresponding Maxwell equations. This is a direct, i.e. temporal, analog of the Rabi effect, additionally to the spatial analog in optical beam propagation described in Opt. Lett. 32, 1920 (2007). An additional high-frequency modulation of the Rabi oscillations reflects the lattice-induced energy transfer between the electric and magnetic fields of the pulse.Comment: 3 pages, 5 figure

Victorian medical men and their understanding of the female condition, 1859-1900

Gender relations, particularly in the second half of the nineteenth century, were negotiated against the backdrop of a separate spheres ideology. The doctrine assumed a sexual identity for women based on their natural and distinctive biology. These so-called laws of nature asserted a specific female destiny making them peculiarly suited to a reproductive and domestic existence. This thesis sets out to explore why there were good reasons for medical men to welcome the idea of sexual difference, and by what means a number of them sought to frustrate the ambitions of many middle-class women who were questioning their allotted role and actively challenging the legal obstacles blocking their path in achieving equal status with men. Although many women subscribed to the idea of exclusion from the public arena, being quite content to run the domestic sphere, there were significant numbers who were openly demanding changes to their subordinate position. The passage of the Matrimonial Causes Act of 1857, the Married Women's Property Acts of 1870, 1882 and 1884 and the repeal of the Contagious Diseases Acts in 1886 confirmed that many feminists and their supporters were making steady inroads onto male territory. As the lot of middle-class women improved, albeit very slowly, accounting for their distinctive physiology became increasingly difficult to sustain on a rational level. To forestall further any ideas women entertained about moving from their dedicated sphere, some normal female functions were medicalized and many women found themselves directly implicated in the production of pathology. The thesis focuses on the scientific theories and discursive practices that lent support to the notion that women were naturally governed by their reproductive faculty. Their reproductive aptitude became the manifestation of developmental failure, explaining why they had been unable to keep pace with men on their evolutionary journey and achieve equal standing

The management of segmental tibial shaft fractures: A systematic review.

INTRODUCTION: Segmental tibial fractures are complex injuries associated with significant soft tissue damage that are difficult to treat. This study aimed to identify the most effective method of treating segmental tibial fractures. METHOD: A PRISMA compliant systematic review was conducted. Studies investigating the management of segmental tibial fractures with intramedullary nail fixation (IMN), open reduction and internal fixation (ORIF) or circular external fixation (CEF) were included for review. The primary outcome measure was time to fracture union. Secondary outcomes were complications and functional outcome. A narrative analysis was undertaken as meta-analysis was inappropriate due to heterogeneity of the data. RESULTS: Thirteen studies were eligible and included. No randomised controlled trials were identified. Fixation with an intramedullary nail provided the fastest time to union, followed by open reduction and internal fixation and then CEF. The rate of deep infection was highest after IMN (5/162 [3%]), followed by open reduction and internal fixation (2/78 [2.5%]) and CEF (1/54 [2%]). However, some studies reported particularly high rates of infection following IMN for open segmental tibial fractures. There was limited reporting of postoperative deformities. From the studies that did include such data, there was a higher rate of deformity following ORIF (8/53 [15%]), compared to IMN (13/138 [9%]), and CEF (4/44 [9%]). Three studies, not including IMN, described patient reported outcome measures with results ranging from 'excellent' to 'fair'. DISCUSSION: The available evidence was of poor quality, dominated by retrospective case series. This prevented statistical analysis, and precludes firm conclusions being drawn from the results available. CONCLUSION: IMN has the fastest time to fracture union, however there are concerns regarding an increased deep infection rate in open segmental tibial fractures. In this subgroup, the data suggests CEF provides the most satisfactory results. However, the available literature does not provide sufficient detail to make this statement with certainty. We recommend a randomised controlled study to further investigate this challenging problem

Tips and Tricks in Extracapsular Hip Fracture Fixation.

Aside from the decision-making in how to fix an extracapsular hip fracture, surgeons must be conversant with systems, implants and how to maximize their potential in the shortest operative time. We present a series of steps used in our unit when performing both DHS and intramedullary nail surgery to avoid the commonest problems and maximize our patients' recovery potential

An unclassified tibial plateau fracture: Reverse Schatzker type IV.

The most commonly accepted system of classification for tibia plateau fractures is that of Schatzker. Increasingly, both high energy injuries and atypical osteoporotic fragility failures have led to more complex, unusual and previously undescribed fracture patterns being recognized. We present a case of a patient with a previously unreported pattern of tibia plateau fracture and knee dislocation. We highlight the challenges confronted and present the management and the outcomes of his injury. A 28-year old male motorcyclist was involved in a head on collision with a truck and was transferred by helicopter to our level 1 major trauma centre emergency department. His injuries were a circumferential degloving injury to his left leg and a right lateral tibial plateau fracture/knee dislocation. The pattern of the lateral tibial plateau fracture was unique and did not fit any recognised classification system. The patient received a spanning external fixator initially and after latency of 12 days for soft tissue resuscitation he underwent definite fixation through an antero-lateral approach to the proximal tibia with two cannulated 6.5 mm partially threaded screws and an additional lateral proximal tibia plate in buttress mode. A hinged knee brace was applied with unrestricted range of motion post-operatively and free weight bearing were permitted post operatively. At the 6 months follow up, the patient walks without aids and with no limp. Examination revealed a stable joint and full range of motion. Plain radiographs revealed that the fracture healed with good alignment and the fixation remained stable. High energy injuries can lead to more complicated fracture patterns, which challenge the orthopaedic surgeons in their management. It is crucial to understand the individual fracture pattern and the possible challenges that may occur. This study reports a lateral tibia plateau fracture/dislocation which perhaps is best described as a reverse Schatzker IV type fracture

Temporary Fixation Using a Long Femoral-tibial Nail to Treat a Displaced Medial Tibial Plateau Fracture in a 90-year-old Patient: A Case Report.

Introduction: Tibial plateau fractures are complex injuries in the elderly population. When traditional methods of fixation are not suitable, an alternative method needs to be chosen for a favorable outcome. We demonstrate a previously undescribed treatment for displaced tibial plateau fractures in the very elderly with poor soft-tissue integrity. Case Report: A 90-year-old woman suffered an open, Gustilo Grade IIIA, displaced fracture of the tibial plateau. An intramedullary knee arthrodesis, the femoral-tibial nail was used to temporarily stabilize her fracture. She was able to weight bear immediately postfixation. Conclusion: A long femoral-tibial nail allows favorable fracture and soft tissue healing, ease of nursing and immediate full weight-bearing. It shows good promise and should be considered as a management option when traditional methods are not applicable in select patients

Heterotopic Ossification following Suprapatellar Intramedullary Nailing.

Introduction: Tibial shaft fractures are common fractures seen in trauma and orthopedic practice today. The majority of these fractures are treated with intramedullary nailing (IMN) which is rapidly becoming a gold standard. The procedure itself is performed by either a suprapatellar approach or infrapatellar approach. Suprapatellar approach is gaining popularity due to relative ease of insertion, decreased associated risk of anterior knee pain, and more accurate reduction. We report a case of heterotopic ossification noted in the knee following IMN of tibia performed using a suprapatellar approach. Case Report: A 27-year-old male, having sustained a left, Gustilo IIIB tibial shaft fracture following a motor vehicle accident, underwent a reamed intramedullary nail fixation performed through a suprapatellar approach. Two months later, he presented with intra-articular heterotopic ossification which was limiting his knee movement. He then underwent arthroscopic removal of the bony fragments which resolved his symptoms. Conclusion: An extensive search of literature did not yield any reported incidence of heterotopic ossification associated with IMN performed through a suprapatellar approach. We present this case report to raise awareness that although IMN through a suprapatellar approach is a safe approach, it does have associated risk of heterotopic ossification which needs to be included in the consent process

Pelvic fractures, helicopters and the injury severity score – Is there a correlation?

Edifici d'habitatges construït el 1875, aproximadament.Primer pla on es mostren dos edificis d'habitatges entre mitgeres amb dues façanes a la plaça Comercial i al carrer Rec. Els habitatges consten de planta baixa, entresòl, quatre pisos i terrat amb coberta a la catalana

Nonlinear localized modes at phase-slip defects in waveguide arrays

We study light localization at a phase-slip defect created by two semi-infinite mismatched identical arrays of coupled optical waveguides. We demonstrate that the nonlinear defect modes possess the specific properties of both nonlinear surface modes and discrete solitons. We analyze stability of the localized modes and their generation in both linear and nonlinear regimes.Comment: 3 pages, 6 figures, submitted to Opt. Let

Decision Making in the Management of Extracapsular Fractures of the Proximal Femur - is the Dynamic Hip Screw the Prevailing Gold Standard?

Currently, approximately half of all hip fractures are extracapsular, with an incidence as high as 50 in 100,000 in some countries. The common classification systems fail to explain the logistics of fracture classification and whether they all behave in the same manner. The Muller AO classification system is a useful platform to delineate stable and unstable fractures. The Dynamic hip screw (DHS) however, has remained the 'gold standard' implant of choice for application in all extracapsular fractures. The DHS relies on the integrity and strength of the lateral femoral wall as well as the postero-medial fragment. An analysis of several studies indicates significant improvements in design and techniques to ensure a better outcome with intramedullary nails. This article reviews the historical trends that helped to evolve the DHS implant as well as discussing if the surgeon should remain content with this implant. We suggest that the gold standard surgical management of extracapsular fractures can, and should, evolve