[Comparison of Modifications of Femoral and Tibial Lengthening in Children]. / Srovnání modifikací prolongace femuru a bérce u detí.

PURPOSE OF THE STUDY Limb lengthening has always belonged to the most complex surgical techniques in paediatric orthopaedics. In our study, we compared the results of femoral and tibial lengthening using three different surgical techniques. The presented study aimed to shorten the duration of external fixation to a minimum and to reduce the complication rate. MATERIAL AND METHODS The retrospective study compared 74 patients (38 boys, 36 girls) who had undergone stepwise progressive lengthening of the femur or tibia between the years 2007 and 2019. The most frequent indication was the proximal focal femoral deficiency (PFFD, 33 patients). The total number of lengthening procedures was 130 (femur 72, tibia 58), the follow-up period was 2-14 years. The following modifications of surgical techniques were used: (i) standard approach, i.e. corticotomy with a two-stage removal of the fixator, (ii) preventive fixation with elastic stable intramedullary nails (ESIN) and also with a two-stage removal of the fixator, and (iii) standard approach with an early removal of the external fixator and plate osteosynthesis. RESULTS The mean lengthening achieved was 56 ± 18 (27-114) mm in femur and 54 ± 16 (25-110) mm in tibia. There was no statistical difference in the lengthening achieved by different modifications. The mean duration of external fixation in femur and tibia lengthening was comparable (166 and 164 days). The complications were observed in 60% of lengthening procedures, the most frequent being the pin release or axial malalignment of the lengthening (33 cases, 25%). The patients with ESIN displayed statistically the lowest complication rate (26%), the highest complication rate was seen in children with osteosynthesis using a plate (80%). CONCLUSIONS It follows from our results that fixation with intramedullary nails in comparison with the standard approach and plate osteosynthesis helped decrease the number of complications by more than 50%. The plate osteosynthesis is indicated in patients with repeated lengthening (achondroplasia, hypochondroplasia or PFFD with pronounced shortening) since it significantly reduces the duration of external fixation. Key words: limb lengthening, femur, tibia, surgical techniques, complications.

[Correction of Valgus Knee Deformity by Hemiepiphyseodesis: a Restrospective Analysis]. / Korekce valgózní deformity kolena u detí pomocí hemiepifyzeodézy: retrospektivní analýza.

PURPOSE OF THE STUDY Hemiepiphyseodesis is commonly used to correct a coronal plane knee deformity during childhood. Since 2007 Blount staple method has been replaced by the eight-Plate Guided Growth System. We retrospectively analysed the indications, results and complications of the older Blount staple method so as to compare them with the newer eight-Plate Guided Growth system. MATERIAL AND METHODS In the period from 2009 to 2019, a total of 98 lower extremities of 54 patients were treated by hemiepiphyseodesis. Lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA) and mechanical axis deviation (MAD) were measured before and after the correction. We focused on the location of hemiepiphyseodesis (distal femur/proximal tibia/both), the operative time and compared the results of implanting 2 or 3 Blount staples. RESULTS The primary correction of valgus knee deformity was achieved in 97%, of which only partial correction was observed in 9.2% and slight overcorrection in 6.1%. A total of 4 patients (4.1%) underwent subsequent corrective osteotomy. The mean LDFA increased from 80° to 86°, while the mean MPTA decreased from 94° to 92°. The mean MAD decreased from 23 mm to 3 mm. The reported complication rate was 5.1%, including four cases of loosening of staples and one case of superficial infection. DISCUSSION It has been verified that the LDFA reduction correlates with staple implantation into the distal femur, conversely the increase in the MPTA correlated with the implantation of staples into the proximal tibia or into both locations. The number of implanted staples (2 or 3) did not affect the size of the resulting correction, but the operative time was statistically significantly shorter when 2 instead of 3 staples were implanted. CONCLUSIONS Blount staple hemiepiphyseodesis is an older method, but it still gives very good results with a low rate of complications. The operating time can be shortened by using 2 staples only, with the same correction effect. The LDFA and MPTA parameters are helpful in identifying the location of hemiepiphyseodesis. The key to success of treatment still remains in correct timing of the implantation of staples with sufficient growth potential. Key words: hemiepiphyseodesis, guided growth, valgus knee deformity, Blount staple.

Nonlinear lattice dynamics as a basis for enhanced superconductivity in YBa2Cu3O6.5.

Terahertz-frequency optical pulses can resonantly drive selected vibrational modes in solids and deform their crystal structures. In complex oxides, this method has been used to melt electronic order, drive insulator-to-metal transitions and induce superconductivity. Strikingly, coherent interlayer transport strongly reminiscent of superconductivity can be transiently induced up to room temperature (300 kelvin) in YBa2Cu3O6+x (refs 9, 10). Here we report the crystal structure of this exotic non-equilibrium state, determined by femtosecond X-ray diffraction and ab initio density functional theory calculations. We find that nonlinear lattice excitation in normal-state YBa2Cu3O6+x at above the transition temperature of 52 kelvin causes a simultaneous increase and decrease in the Cu-O2 intra-bilayer and, respectively, inter-bilayer distances, accompanied by anisotropic changes in the in-plane O-Cu-O bond buckling. Density functional theory calculations indicate that these motions cause drastic changes in the electronic structure. Among these, the enhancement in the character of the in-plane electronic structure is likely to favour superconductivity.

Spectral Evidence for Emergent Order in Ba_{1-x}Na_{x}Fe_{2}As_{2}.

We report an angle-resolved photoemission spectroscopy study of the iron-based superconductor family, Ba_{1-x}Na_{x}Fe_{2}As_{2}. This system harbors the recently discovered double-Q magnetic order appearing in a reentrant C_{4} phase deep within the underdoped regime of the phase diagram that is otherwise dominated by the coupled nematic phase and collinear antiferromagnetic order. From a detailed temperature-dependence study, we identify the electronic response to the nematic phase in an orbital-dependent band shift that strictly follows the rotational symmetry of the lattice and disappears when the system restores C_{4} symmetry in the low temperature phase. In addition, we report the observation of a distinct electronic reconstruction that cannot be explained by the known electronic orders in the system.

Long-range charge-density-wave proximity effect at cuprate/manganate interfaces.

The interplay between charge density waves (CDWs) and high-temperature superconductivity is currently under intense investigation. Experimental research on this issue is difficult because CDW formation in bulk copper oxides is strongly influenced by random disorder, and a long-range-ordered CDW state in high magnetic fields is difficult to access with spectroscopic and diffraction probes. Here we use resonant X-ray scattering in zero magnetic field to show that interfaces with the metallic ferromagnet La2/3Ca1/3MnO3 greatly enhance CDW formation in the optimally doped high-temperature superconductor YBa2Cu3O6+δ (δ ∼ 1), and that this effect persists over several tens of nanometres. The wavevector of the incommensurate CDW serves as an internal calibration standard of the charge carrier concentration, which allows us to rule out any significant influence of oxygen non-stoichiometry, and to attribute the observed phenomenon to a genuine electronic proximity effect. Long-range proximity effects induced by heterointerfaces thus offer a powerful method to stabilize the charge-density-wave state in the cuprates and, more generally, to manipulate the interplay between different collective phenomena in metal oxides.

Transfer of Magnetic Order and Anisotropy through Epitaxial Integration of 3d and 4f Spin Systems.

Resonant x-ray scattering at the Dy M_{5} and Ni L_{3} absorption edges was used to probe the temperature and magnetic field dependence of magnetic order in epitaxial LaNiO_{3}-DyScO_{3} superlattices. For superlattices with 2 unit cell thick LaNiO_{3} layers, a commensurate spiral state develops in the Ni spin system below 100 K. Upon cooling below T_{ind}=18 K, Dy-Ni exchange interactions across the LaNiO_{3}-DyScO_{3} interfaces induce collinear magnetic order of interfacial Dy moments as well as a reorientation of the Ni spins to a direction dictated by the strong magnetocrystalline anisotropy of Dy. This transition is reversible by an external magnetic field of 3 T. Tailored exchange interactions between rare-earth and transition-metal ions thus open up new perspectives for the manipulation of spin structures in metal-oxide heterostructures and devices.

Multiple Supersonic Phase Fronts Launched at a Complex-Oxide Heterointerface.

Selective optical excitation of a substrate lattice can drive phase changes across heterointerfaces. This phenomenon is a nonequilibrium analogue of static strain control in heterostructures and may lead to new applications in optically controlled phase change devices. Here, we make use of time-resolved nonresonant and resonant x-ray diffraction to clarify the underlying physics and to separate different microscopic degrees of freedom in space and time. We measure the dynamics of the lattice and that of the charge disproportionation in NdNiO_{3}, when an insulator-metal transition is driven by coherent lattice distortions in the LaAlO_{3} substrate. We find that charge redistribution propagates at supersonic speeds from the interface into the NdNiO_{3} film, followed by a sonic lattice wave. When combined with measurements of magnetic disordering and of the metal-insulator transition, these results establish a hierarchy of events for ultrafast control at complex-oxide heterointerfaces.

Methods to increase reporting of childhood sexual abuse in surveys: the sensitivity and specificity of face-to-face interviews versus a sealed envelope method in Ugandan primary school children.

BACKGROUND: Underreporting of childhood sexual abuse is a major barrier to obtaining reliable prevalence estimates. We tested the sensitivity and specificity of the face-to-face-interview (FTFI) method by comparing the number of disclosures of forced sex against a more confidential mode of data collection, the sealed-envelope method (SEM). We also report on characteristics of individuals associated with non-disclosure in FTFIs. METHODS: Secondary analysis of data from a cross-sectional survey conducted in 2014, with n = 3843 children attending primary school in Luwero District, Uganda. Sensitivity and specificity were calculated, and mixed effects logistic regression models tested factors associated with disclosure in one or both modes. RESULTS: In the FTFI, 1.1% (n = 42) of children reported ever experiencing forced sex, compared to 7.0% (n = 268) in the SEM. The FTFI method demonstrated low sensitivity (13.1%, 95%CI 9.3-17.7%) and high specificity (99.8%, 95%CI 99.6-99.9%) in detecting cases of forced sex, when compared to the SEM. Boys were less likely than girls to disclose in the FTFI, however there was no difference in prevalence by sex using the SEM (aOR = 0.91, 95%CI 0.7-1.2; P = 0.532). Disclosing experience of other forms of sexual violence was associated with experience of forced sex for both modes of disclosure. CONCLUSIONS: The SEM method was superior to FTFIs in identifying cases of forced sex amongst primary school children, particularly for boys. Reporting of other forms of sexual violence in FTFIs may indicate experience of forced sex. Future survey research, and efforts to estimate prevalence of sexual violence, should make use of more confidential disclosure methods to detect childhood sexual abuse.

Symmetry of charge order in cuprates.

Charge-ordered ground states permeate the phenomenology of 3d-based transition metal oxides, and more generally represent a distinctive hallmark of strongly correlated states of matter. The recent discovery of charge order in various cuprate families has fuelled new interest into the role played by this incipient broken symmetry within the complex phase diagram of high-T(c) superconductors. Here, we use resonant X-ray scattering to resolve the main characteristics of the charge-modulated state in two cuprate families: Bi2Sr(2-x)La(x)CuO(6+δ) (Bi2201) and YBa2Cu3O(6+y) (YBCO). We detect no signatures of spatial modulations along the nodal direction in Bi2201, thus clarifying the inter-unit-cell momentum structure of charge order. We also resolve the intra-unit-cell symmetry of the charge-ordered state, which is revealed to be best represented by a bond order with modulated charges on the O-2p orbitals and a prominent d-wave character. These results provide insights into the origin and microscopic description of charge order in cuprates, and its interplay with superconductivity.

Tunable Charge and Spin Order in PrNiO_{3} Thin Films and Superlattices.

We use polarized Raman scattering to probe lattice vibrations and charge ordering in 12 nm thick, epitaxially strained PrNiO_{3} films, and in superlattices of PrNiO_{3} with the band insulator PrAlO_{3}. A carefully adjusted confocal geometry is used to eliminate the substrate contribution to the Raman spectra. In films and superlattices under tensile strain which undergo a metal-insulator transition upon cooling, the Raman spectra reveal phonon modes characteristic of charge ordering. These anomalous phonons do not appear in compressively strained films, which remain metallic at all temperatures. For superlattices under compressive strain, the Raman spectra show no evidence of anomalous phonons indicative of charge ordering, while complementary resonant x-ray scattering experiments reveal antiferromagnetic order associated with a modest increase in resistivity upon cooling. This confirms theoretical predictions of a spin density wave phase driven by spatial confinement of the conduction electrons.

Orbital control of noncollinear magnetic order in nickel oxide heterostructures.

We have used resonant x-ray diffraction to develop a detailed description of antiferromagnetic ordering in epitaxial superlattices based on two-unit-cell thick layers of the strongly correlated metal LaNiO3. We also report reference experiments on thin films of PrNiO3 and NdNiO3. The resulting data indicate a spiral state whose polarization plane can be controlled by adjusting the Ni d-orbital occupation via two independent mechanisms: epitaxial strain and spatial confinement of the valence electrons. The data are discussed in light of recent theoretical predictions.

Momentum-dependent charge correlations in YBa2Cu3O6+δ superconductors probed by resonant X-ray scattering: evidence for three competing phases.

We use resonant x-ray scattering to determine the momentum-dependent charge correlations in YBa(2)Cu(3) O(6.55) samples with highly ordered chain arrays of oxygen acceptors (ortho-II structure). The results reveal nearly critical, biaxial charge density wave (CDW) correlations at in-plane wave vectors (0.315, 0) and (0, 0.325). The corresponding scattering intensity exhibits a strong uniaxial anisotropy. The CDW amplitude and correlation length are enhanced as superconductivity is weakened by an external magnetic field. Analogous experiments are carried out on a YBa(2)Cu(3)O(6.6) crystal with a dilute concentration of spinless (Zn) impurities, which had earlier been shown to nucleate incommensurate magnetic order. Compared to pristine crystals with the same doping level, the CDW amplitude and correlation length are found to be strongly reduced. These results indicate a three-phase competition between spin-modulated, charge-modulated, and superconducting states in underdoped YBa(2)Cu(3)O(6+δ).

Electric-field-induced polar order and localization of the confined electrons in LaAlO3/SrTiO3 heterostructures.

With ellipsometry, x-ray diffraction, and resistance measurements we investigated the electric-field effect on the confined electrons at the LaAlO3/SrTiO3 interface. We obtained evidence that the localization of the electrons at negative gate voltage is induced, or at least enhanced, by a polar phase transition in SrTiO3 which strongly reduces the lattice polarizability and the subsequent screening. In particular, we show that the charge localization and the polar order of SrTiO3 both develop below ∼50 K and exhibit similar, unipolar hysteresis loops as a function of the gate voltage.

Distinct charge orders in the planes and chains of ortho-III-ordered YBa2Cu3O(6+δ) superconductors identified by resonant elastic x-ray scattering.

Recently, charge density wave (CDW) order in the CuO(2) planes of underdoped YBa(2)Cu(3)O(6+δ) was detected using resonant soft x-ray scattering. An important question remains: is the chain layer responsible for this charge ordering? Here, we explore the energy and polarization dependence of the resonant scattering intensity in a detwinned sample of YBa(2)Cu(3)O(6.75) with ortho-III oxygen ordering in the chain layer. We show that the ortho-III CDW order in the chains is distinct from the CDW order in the planes. The ortho-III structure gives rise to a commensurate superlattice reflection at Q=[0.33 0 L] whose energy and polarization dependence agrees with expectations for oxygen ordering and a spatial modulation of the Cu valence in the chains. Incommensurate peaks at [0.30 0 L] and [0 0.30 L] from the CDW order in the planes are shown to be distinct in Q as well as their temperature, energy, and polarization dependence, and are thus unrelated to the structure of the chain layer. Moreover, the energy dependence of the CDW order in the planes is shown to result from a spatial modulation of energies of the Cu 2p to 3d(x(2)-y(2)) transition, similar to stripe-ordered 214 cuprates.

Magnetic proximity effect in YBa2Cu3O7/La(2/3)Ca(1/3)MnO3 and YBa2Cu3O7/LaMnO(3+δ) superlattices.

Using neutron reflectometry and resonant x-ray techniques we studied the magnetic proximity effect (MPE) in superlattices composed of superconducting YBa2Cu3O7 and ferromagnetic-metallic La0.67Ca0.33MnO3 or ferromagnetic-insulating LaMnO(3+δ). We find that the MPE strongly depends on the electronic state of the manganite layers, being pronounced for the ferromagnetic-metallic La0.67Ca0.33MnO3 and almost absent for ferromagnetic-insulating LaMnO(3+δ). We also detail the change of the magnetic depth profile due to the MPE and provide evidence for its intrinsic nature.

Dynamic electron correlations with charge order wavelength along all directions in the copper oxide plane.

In strongly correlated systems the strength of Coulomb interactions between electrons, relative to their kinetic energy, plays a central role in determining their emergent quantum mechanical phases. We perform resonant x-ray scattering on Bi2Sr2CaCu2O8+δ, a prototypical cuprate superconductor, to probe electronic correlations within the CuO2 plane. We discover a dynamic quasi-circular pattern in the x-y scattering plane with a radius that matches the wave vector magnitude of the well-known static charge order. Along with doping- and temperature-dependent measurements, our experiments reveal a picture of charge order competing with superconductivity where short-range domains along x and y can dynamically rotate into any other in-plane direction. This quasi-circular spectrum, a hallmark of Brazovskii-type fluctuations, has immediate consequences to our understanding of rotational and translational symmetry breaking in the cuprates. We discuss how the combination of short- and long-range Coulomb interactions results in an effective non-monotonic potential that may determine the quasi-circular pattern.

Stabilization of three-dimensional charge order in YBa2Cu3O6+x via epitaxial growth.

Incommensurate charge order (CO) has been identified as the leading competitor of high-temperature superconductivity in all major families of layered copper oxides, but the perplexing variety of CO states in different cuprates has confounded investigations of its impact on the transport and thermodynamic properties. The three-dimensional (3D) CO observed in YBa2Cu3O6+x in high magnetic fields is of particular interest, because quantum transport measurements have revealed detailed information about the corresponding Fermi surface. Here we use resonant X-ray scattering to demonstrate 3D-CO in underdoped YBa2Cu3O6+x films grown epitaxially on SrTiO3 in the absence of magnetic fields. The resonance profiles indicate that Cu sites in the charge-reservoir layers participate in the CO state, and thus efficiently transmit CO correlations between adjacent CuO2 bilayer units. The results offer fresh perspectives for experiments elucidating the influence of 3D-CO on the electronic properties of cuprates without the need to apply high magnetic fields.

Charge order driven by Fermi-arc instability in Bi2Sr(2-x)La(x)CuO(6+δ).

The understanding of the origin of superconductivity in cuprates has been hindered by the apparent diversity of intertwining electronic orders in these materials. We combined resonant x-ray scattering (REXS), scanning-tunneling microscopy (STM), and angle-resolved photoemission spectroscopy (ARPES) to observe a charge order that appears consistently in surface and bulk, and in momentum and real space within one cuprate family, Bi2Sr(2-x)La(x)CuO(6+δ). The observed wave vectors rule out simple antinodal nesting in the single-particle limit but match well with a phenomenological model of a many-body instability of the Fermi arcs. Combined with earlier observations of electronic order in other cuprate families, these findings suggest the existence of a generic charge-ordered state in underdoped cuprates and uncover its intimate connection to the pseudogap regime.

Long-range incommensurate charge fluctuations in (Y,Nd)Ba2Cu3O(6+x).

The concept that superconductivity competes with other orders in cuprate superconductors has become increasingly apparent, but obtaining direct evidence with bulk-sensitive probes is challenging. We have used resonant soft x-ray scattering to identify two-dimensional charge fluctuations with an incommensurate periodicity of ~3.2 lattice units in the copper-oxide planes of the superconductors (Y,Nd)Ba(2)Cu(3)O(6+)(x), with hole concentrations of 0.09 to 0.13 per planar Cu ion. The intensity and correlation length of the fluctuation signal increase strongly upon cooling down to the superconducting transition temperature (T(c)); further cooling below T(c) abruptly reverses the divergence of the charge correlations. In combination with earlier observations of a large gap in the spin excitation spectrum, these data indicate an incipient charge density wave instability that competes with superconductivity.

Dimensionality control of electronic phase transitions in nickel-oxide superlattices.

The competition between collective quantum phases in materials with strongly correlated electrons depends sensitively on the dimensionality of the electron system, which is difficult to control by standard solid-state chemistry. We have fabricated superlattices of the paramagnetic metal lanthanum nickelate (LaNiO(3)) and the wide-gap insulator lanthanum aluminate (LaAlO(3)) with atomically precise layer sequences. We used optical ellipsometry and low-energy muon spin rotation to show that superlattices with LaNiO(3) as thin as two unit cells undergo a sequence of collective metal-insulator and antiferromagnetic transitions as a function of decreasing temperature, whereas samples with thicker LaNiO(3) layers remain metallic and paramagnetic at all temperatures. Metal-oxide superlattices thus allow control of the dimensionality and collective phase behavior of correlated-electron systems.