Transitional Care for Patients with Congenital Colorectal Diseases: An EUPSA Network Office, ERNICA, and eUROGEN Joint Venture

Background: Transition of care (TOC; from childhood into adulthood) of patients with anorectal malformations (ARM) and Hirschsprung disease (HD) ensures continuation of care for these patients. The aim of this international study was to assess the current status of TOC and adult care (AC) programs for patients with ARM and HD. Methods: A survey was developed by members of EUPSA, ERN eUROGEN, and ERNICA, including patient representatives (ePAGs), comprising of four domains: general information, general questions about transition to adulthood, and disease-specific questions regarding TOC and AC programs. Recruitment of centres was done by the ERNs and EUPSA, using mailing lists and social media accounts. Only descriptive statistics were reported. Results: In total, 82 centres from 21 different countries entered the survey. Approximately half of them were ERN network members. Seventy-two centres (87.8%) had a self-reported area of expertise for both ARM and HD. Specific TOC programs were installed in 44% of the centres and AC programs in 31% of these centres. When comparing centres, wide variation was observed in the content of the programs. Conclusion: Despite the awareness of the importance of TOC and AC programs, these programs were installed in less than 50% of the participating centres. Various transition and AC programs were applied, with considerable heterogeneity in implementation, content and responsible caregivers involved. Sharing best practice examples and taking into account local and National Health Care Programs might lead to a better continuation of care in the future. Level of Evidence: III

Vertical leakage in GaN-on-Si stacks investigated by a buffer decomposition experiment

We investigated the origin of vertical leakage and breakdown in GaN-on-Si epitaxial structures. In order to understand the role of the nucleation layer, AlGaN buffer, and C-doped GaN, we designed a sequential growth experiment. Specifically, we analyzed three different structures grown on silicon substrates: AlN/Si, AlGaN/AlN/Si, C:GaN/AlGaN/AlN/Si. The results demonstrate that: (i) the AlN layer grown on silicon has a breakdown field of 3.25 MV/cm, which further decreases with temperature. This value is much lower than that of highly-crystalline AlN, and the difference can be ascribed to the high density of vertical leakage paths like V-pits or threading dislocations. (ii) the AlN/Si structures show negative charge trapping, due to the injection of electrons from silicon to deep traps in AlN. (iii) adding AlGaN on top of AlN significantly reduces the defect density, thus resulting in a more uniform sample-to-sample leakage. (iv) a substantial increase in breakdown voltage is obtained only in the C:GaN/AlGaN/AlN/Si structure, that allows it to reach VBD > 800 V. (v) remarkably, during a vertical I-V sweep, the C:GaN/AlGaN/AlN/Si stack shows evidence for positive charge trapping. Holes from C:GaN are trapped at the GaN/AlGaN interface, thus bringing a positive charge storage in the buffer. For the first time, the results summarized in this paper clarify the contribution of each buffer layer to vertical leakage and breakdown