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

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

Structural and optical investigation of non-polar (1-100) GaN grown by the ammonothermal method

We studied the structural and optical properties of state-of-the-art non-polar bulk GaN grown by the ammonothermal method. The investigated samples have an extremely low dislocation density (DD) of less than 5 × 104cm-2, which results in very narrow high-resolution x-ray rocking curves. The a and c lattice parameters of these stress-free GaN samples were precisely determined by using an x-ray diffraction technique based on the modified Bond method. The obtained values are compared to the lattice parameters of free-standing GaN from different methods and sources. The observed differences are discussed in terms of free-electron concentrations, point defects, and DD. Micro Raman spectroscopy revealed a very narrow phonon linewidth and negligible built-in strain in accordance with the high-resolution x-ray diffraction data. The optical transitions were investigated by cathodoluminescence measurements. The analysis of the experimental data clearly demonstrates the excellent crystalline perfection of ammonothermal GaN material and its potential for fabrication of non-polar substrates for homoepitaxial growth of GaN based device structures. © 2013 AIP Publishing LLC

Strain and localization effects in InGaAs(N) quantum wells: Tuning the magnetic response

We investigated effects of localization and strain on the optical and magneto-optical properties of diluted nitrogen III-V quantum wells theoretically and experimentally. High-resolution x-ray diffraction, photoluminescence (PL), and magneto-PL measurements under high magnetic fields up to 15 T were performed at low temperatures. Bir-Pikus Hamiltonian formalism was used to study the influence of strain, confinement, and localization effects. The circularly polarized magneto-PL was interpreted considering localization aspects in the valence band ground state. An anomalous behavior of the electron-hole pair magnetic shift was observed at low magnetic fields, ascribed to the increase in the exciton reduced mass due to the negative effective mass of the valence band ground state

An analytical inversion method for determining regional and global emissions of greenhouse gases: Sensitivity studies and application to halocarbons

A new analytical inversion method has been developed to determine the regional and global emissions of long-lived atmospheric trace gases. It exploits in situ measurement data from three global networks and builds on backward simulations with a Lagrangian particle dispersion model. The emission information is extracted from the observed concentration increases over a baseline that is itself objectively determined by the inversion algorithm. The method was applied to two hydrofluorocarbons (HFC-134a, HFC-152a) and a hydrochlorofluorocarbon (HCFC-22) for the period January 2005 until March 2007. Detailed sensitivity studies with synthetic as well as with real measurement data were done to quantify the influence on the results of the a priori emissions and their uncertainties as well as of the observation and model errors. It was found that the global a posteriori emissions of HFC-134a, HFC-152a and HCFC-22 all increased from 2005 to 2006. Large increases (21%, 16%, 18%, respectively) from 2005 to 2006 were found for China, whereas the emission changes in North America (−9%, 23%, 17%, respectively) and Europe (11%, 11%, −4%, respectively) were mostly smaller and less systematic. For Europe, the a posteriori emissions of HFC-134a and HFC-152a were slightly higher than the a priori emissions reported to the United Nations Framework Convention on Climate Change (UNFCCC). For HCFC-22, the a posteriori emissions for Europe were substantially (by almost a factor 2) higher than the a priori emissions used, which were based on HCFC consumption data reported to the United Nations Environment Programme (UNEP). Combined with the reported strongly decreasing HCFC consumption in Europe, this suggests a substantial time lag between the reported time of the HCFC-22 consumption and the actual time of the HCFC-22 emission. Conversely, in China where HCFC consumption is increasing rapidly according to the UNEP data, the a posteriori emissions are only about 40% of the a priori emissions. This reveals a substantial storage of HCFC-22 and potential for future emissions in China. Deficiencies in the geographical distribution of stations measuring halocarbons in relation to estimating regional emissions are also discussed in the paper. Applications of the inversion algorithm to other greenhouse gases such as methane, nitrous oxide or carbon dioxide are foreseen for the future

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)

Ability of a urine gene expression classifier to reduce the number of follow up cystoscopies in bladder cancer patients

This study aimed to improve our previous urine gene expression classifiers focusing on the detection of non-high-risk non-muscle-invasive bladder cancer (NMIBC), and develop a new classifier able to decrease the frequency of cystoscopies during bladder cancer (BC) patients' surveillance. A total of 597 urines from BC patients, controls and patients in follow-up for BC (PFBC) were included. The study has 3 phases. In the urinary biomarker discovery phase, 84 urines from BC and control patients were retrospectively included and analyzed by Ribonucleic Acid (RNA) sequencing. In the classifier development phase, a total of 132 selected genes from previous phase were evaluated by nCounter in 214 prospectively collected urines from PFBC (98 with tumor). A diagnostic classifier was generated by logistic regression. Finally, in the classifier validation phase, a multicentric and international cohort of 248 urines (134 BC and 114 nonrecurrent PFBC) was used to validate classifier performance. A total of 521 genes were found differentially expressed between non-high-risk NMIBC samples and all other groups (P < 0.05). An 8-gene diagnostic classifier with an area under curve (AUC) of 0.893 was developed. Validation of this classifier in a cohort of PFBC achieved an overall sensitivity (SN) and a negative predictive value (NPV) of 96% and 97%, respectively (AUC = 0.823). Notably, this accuracy was maintained in non-high-risk NMIBC group (SN = 94%; NPV = 98%). In conclusion, this 8-gene expression classifier has high SN and NPV in a real clinical scenario. The use of this classifier can reduce the number of follow-up cystoscopies in PFBC, although assessing its final place in clinical setting is necessary

Multilayers of InGaAs Nanostructures Grown on GaAs(210) Substrates

Multilayers of InGaAs nanostructures are grown on GaAs(210) by molecular beam epitaxy. With reducing the thickness of GaAs interlayer spacer, a transition from InGaAs quantum dashes to arrow-like nanostructures is observed by atomic force microscopy. Photoluminescence measurements reveal all the samples of different spacers with good optical properties. By adjusting the InGaAs coverage, both one-dimensional and two-dimensional lateral ordering of InGaAs/GaAs(210) nanostructures are achieved