The surgical point of view of the geriatric patient — Urinary incontinence

Summary: Background: Urinary incontinence is one of the most frequent diseases in the ageing population. The aim of this manuscript is to present the current knowledge on urinary incontinence regarding (i) prevalence, (ii) pathogenesis, (iii) types, (iv) diagnostic assessment, and (v) treatment options. Methods: The current literature regarding urinary incontinence with special reference to the geriatric patient was reviewed. Results: According to a study performed recently in the Vienna area, 36.0% of women and 11.5% of men aged 70 years or older report urinary incontinence. Several factors, such as urodynamic changes, structural alterations of the lower urinary tract, increased sensory input, and impaired central control of the micturition reflex, contribute to the high prevalence of urinary incontinence with age. The four most common forms of urinary incontinence in the geriatric patient are combined stress/urge incontinence, pure urge incontinence, pure stress incontinence, and overflow incontinence. Diagnostic steps are classified into "mandatory”, "recommended”, and "indicated in selected cases only”. Particularly the "mandatory tests” are simple to perform and need no special equipment. Therapeutic options should be directed to the type of urinary incontinence as well as the physical and mental status of the patient. Conclusions: Urinary incontinence is highly prevalent with age. Conservative treatment is the therapy of choice for urge incontinence and mild to moderate forms of stress and overflow incontinence in the geriatric patien

Design and Characterization of an Ultrasonic Surgical Tool Using d₃₁ PMN-PT Plate

AbstractAn ultrasonic surgical tool for tissue incision and dissection has been designed and characterized. The surgical tool is based on a simple geometry to which PMN-PT d31 plates are bonded directly. The performance of the surgical tool has been defined numerically with the Abaqus finite element analysis (FEA) package and practically with laser vibrometer and impedance spectroscopy. The results show the ability of FEA to accurately predict the behaviors of an ultrasonic device as numerical and practical analysis were found to be in a good agreement. The design of the tool presented has the ability to generate displacement amplitude high enough to carry out soft tissue incision with relatively low driving voltage

Huge impact of compressive strain on phase transition temperatures in epitaxial ferroelectric KxNa1-xNbO3 thin films

We present a study in which ferroelectric phase transition temperatures in epitaxial KxNa1-xNbO3 films are altered systematically by choosing different (110)-oriented rare-earth scandate substrates and by variation of the potassium to sodium ratio. Our results prove the capability to continuously shift the ferroelectric-to-ferroelectric transition from the monoclinic MC to orthorhombic c-phase by about 400 °C via the application of anisotropic compressive strain. The phase transition was investigated in detail by monitoring the temperature dependence of ferroelectric domain patterns using piezoresponse force microscopy and upon analyzing structural changes by means of high resolution X-ray diffraction including X-ray reciprocal space mapping. Moreover, the temperature evolution of the effective piezoelectric coefficient d33,f was determined using double beam laser interferometry, which exhibits a significant dependence on the particular ferroelectric phase. © 2019 Author(s)

SU(2) symmetry in a Hubbard model with spin-orbit coupling

We study the underlying symmetry in a spin-orbit coupled tight-binding model with Hubbard interaction. It is shown that, in the absence of the on-site interaction, the system possesses the SU(2) symmetry arising from the timereversal symmetry. The influence of the on-site interaction on the symmetry depends on the topology of the networks: The SU(2) symmetry is shown to be the spin rotation symmetry of a simply-connected lattice, so it still holds in the presence of the Hubbard correlation. In contrary, the on-site interaction breaks the SU(2) symmetry of a multi-connected lattice.Comment: 5 pages, 2 figure

Molecular beam epitaxy of GaBiAs on (311) B GaAs substrates

We report the growth by molecular beam epitaxy of Ga Bix As1-x epilayers on (311) B GaAs substrates. We use high-resolution x-ray diffraction (HRXRD), transmission electron microscopy, and Z -contrast imaging to characterize the structural properties of the as-grown material. We find that the incorporation of Bi into the GaBiAs alloy, as determined by HRXRD, is sizably larger in the (311) B epilayers than in (001) epilayers, giving rise to reduced band-gap energies as obtained by optical transmission spectroscopy. © 2007 American Institute of Physics

Constraints on oceanic methane emissions west of Svalbard from atmospheric in situ measurements and Lagrangian transport modeling

Methane stored in seabed reservoirs such as methane hydrates can reach the atmosphere in the form of bubbles or dissolved in water. Hydrates could destabilize with rising temperature further increasing greenhouse gas emissions in a warming climate. To assess the impact of oceanic emissions from the area west of Svalbard, where methane hydrates are abundant, we used measurements collected with a research aircraft (Facility for Airborne Atmospheric Measurements) and a ship (Helmer Hansen) during the Summer 2014 and for Zeppelin Observatory for the full year. We present a model-supported analysis of the atmospheric CH$_{4}$mixing ratios measured by the different platforms. To address uncertainty about where CH$_{4}$ emissions actually occur, we explored three scenarios: areas with known seeps, a hydrate stability model, and an ocean depth criterion. We then used a budget analysis and a Lagrangian particle dispersion model to compare measurements taken upwind and downwind of the potential CH$_{4}$ emission areas. We found small differences between the CH$_{4}$ mixing ratios measured upwind and downwind of the potential emission areas during the campaign. By taking into account measurement and sampling uncertainties and by determining the sensitivity of the measured mixing ratios to potential oceanic emissions, we provide upper limits for the CH$_{4}$ fluxes. The CH$_{4}$ flux during the campaign was small, with an upper limit of 2.5 nmol m$^{-2}$ s$^{-1}$ in the stability model scenario. The Zeppelin Observatory data for 2014 suggest CH$_{4}$ fluxes from the Svalbard continental platform below 0.2 Tg yr$^{-1}$. All estimates are in the lower range of values previously reported.MOCA—Methane Emissions from the Arctic OCean to the Atmosphere: Present and Future Climate Effects is funded by the Research Council of Norway, grant 225814. CAGE—Centre for Arctic Gas Hydrate, Environment and Climate research work was supported by the Research Council of Norway through its Centres of Excellence funding scheme grant 223259. eSTICC—eScience Tools for Investigating Climate Change in northern high latitudes is supported by Nordforsk as Nordic Center of Excellence grant 57001. NERC grants NE/I029293/1 (PI. H. Coe) and NE/I02916/1 (PI J. Pyle) and Methane & Other Greenhouse Gases in the Arctic—Measurements, Process Studies and Modelling (MAMM). The ERC through the ACCI project, project number 267760. The biogenic methane emission data from the LPX-Bern v1.2 model were provided by Renato Spahni. The methane emission data from the GAINS model were provided by IIASA. GFED data are available from http://www.globalfiredata.org/index.html. Airborne data were obtained using the BAe-146-301 Atmospheric Research Aircraft (ARA) flown by Directflight Ltd. and managed by the Facility for Airborne Atmospheric Measurements (FAAM), which is a joint entity of the Natural Environment Research Council (NERC) and the Met Office. Zeppelin and Helmer Hansen atmospheric measurement data are archived in EBAS (http://ebas.nilu.no/) for long-term preservation, access and use. All Zeppelin data for 2014: http://ebas.nilu.no/DataSets.aspx?stations=NO0042G&fromDate=2014-01-01&toDate=2014-12-31. All atmospheric data from RV Helmer Hanssen: http://ebas.nilu.no/DataSets.aspx?stations=NO1000R&fromDate=2014-01-01&toDate=2014-12-31 (password is required until the end of 2017)

Predictive significance of the six-minute walk distance for long-term survival in chronic hypercapnic respiratory failure

Background: The 6-min walk distance ( 6-MWD) is a global marker of functional capacity and prognosis in chronic obstructive pulmonary disease ( COPD), but less explored in other chronic respiratory diseases. Objective: To study the role of 6-MWD in chronic hypercapnic respiratory failure ( CHRF). Methods: In 424 stable patients with CHRF and non-invasive ventilation ( NIV) comprising COPD ( n = 197), restrictive diseases ( RD; n = 112) and obesity-hypoventilation- syndrome ( OHS; n = 115), the prognostic value of 6-MWD for long- term survival was assessed in relation to that of body mass index (BMI), lung function, respiratory muscle function and laboratory parameters. Results: 6-MWD was reduced in patients with COPD ( median 280 m; quartiles 204/350 m) and RD ( 290 m; 204/362 m) compared to OHS ( 360 m; 275/440 m; p <0.001 each). Overall mortality during 24.9 (13.1/40.5) months was 22.9%. In the 424 patients with CHRF, 6-MWD independently predicted mortality in addition to BMI, leukocytes and forced expiratory volume in 1 s ( p <0.05 each). In COPD, 6-MWD was strongly associated with mortality using the median {[} p <0.001, hazard ratio ( HR) = 3.75, 95% confidence interval (CI): 2.24-6.38] or quartiles as cutoff levels. In contrast, 6-MWD was only significantly associated with impaired survival in RD patients when it was reduced to 204 m or less (1st quartile; p = 0.003, HR = 3.31, 95% CI: 1.73-14.10), while in OHS 6-MWD had not any prognostic value. Conclusions: In patients with CHRF and NIV, 6-MWD was predictive for long- term survival particularly in COPD. In RD only severely reduced 6-MWD predicted mortality, while in OHS 6-MWD was relatively high and had no prognostic value. These results support a disease-specific use of 6-MWD in the routine assessment of patients with CHRF. Copyright (C) 2007 S. Karger AG, Basel

Effect of Cd2+ on the Growth and Thermal Properties of K2SO4 crystal

Single crystals of pure and Cd2+ doped potassium sulfate were grown from aqueous solutions by the slow evaporation technique. From nutrient solutions with a CdSO4 concentration of 4wt.% crystals containing 0.014wt.% dopant concentration could be obtained. The X-ray diffraction patterns of powdered crystals confirmed their crystal structures for both cases. Thermal analysis of pure crystals shows that the alpha-beta phase transformation peak around 580 deg C is superimposed with spurious effects, while for Cd2+ doped crystals this is not the case. The thermal hysteresis of the phase transition is 8 K for undoped K2SO4 and is reduced to 3.5 K for K2SO4:Cd2+. Compared to undoped crystals, the optical transmittance of Cd2+ doped crystals is higher.Comment: 5 pages, 6 figure