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

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)

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

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

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

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

Extensive release of methane from Arctic seabed west of Svalbard during summer 2014 does not influence the atmosphere

© 2016. American Geophysical Union. All Rights Reserved. We find that summer methane (CH4) release from seabed sediments west of Svalbard substantially increases CH4 concentrations in the ocean but has limited influence on the atmospheric CH4 levels. Our conclusion stems from complementary measurements at the seafloor, in the ocean, and in the atmosphere from land-based, ship and aircraft platforms during a summer campaign in 2014. We detected high concentrations of dissolved CH4 in the ocean above the seafloor with a sharp decrease above the pycnocline. Model approaches taking potential CH4 emissions from both dissolved and bubble-released CH4 from a larger region into account reveal a maximum flux compatible with the observed atmospheric CH4 mixing ratios of 2.4-3.8 nmol m-2 s-1. This is too low to have an impact on the atmospheric summer CH4 budget in the year 2014. Long-term ocean observatories may shed light on the complex variations of Arctic CH4 cycles throughout the year.The project MOCA- Methane Emissions from the Arctic OCean to the Atmosphere: Present and Future Climate Effects is funded by the Research Council of Norway, grant no.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 no. 223259. Nordic Center of Excellence eSTICC (eScience Tool for Investigating Climate Change in northern high latitudes) funded by Nordforsk, grant no. 57001

Psychotherapy in historical perspective

This article will briefly explore some of the ways in which the past has been used as a means to talk about psychotherapy as a practice and as a profession, its impact on individuals and society, and the ethical debates at stake. It will show how, despite the multiple and competing claims about psychotherapy’s history and its meanings, historians themselves have, to a large degree, not attended to the intellectual and cultural development of many therapeutic approaches. This absence has the potential consequence of implying that therapies have emerged as value-free techniques, outside of a social, economic and political context. The relative neglect of psychotherapy, by contrast with the attention historians have paid to other professions, particularly psychiatry, has also underplayed its societal impact. This article will foreground some of the instances where psychotherapy has become an object of emerging historical interest, including the new research that forms the substance of this special issue of History of the Human Sciences