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PURPOSE: This study aims to report on functional outcomes in a large cohort of patients who underwent inpatient rehabilitation (IR) in a highly specialized, high-volume German urologic rehabilitation center after radical cystectomy (RC) and creation of an ileal neobladder (INB). METHODS: Data for 842 patients, who underwent three weeks of IR after RC and urinary diversion between April 2018 and December 2019 were prospectively collected. INB patients were surveyed on continence and sexual function. Data were collected at 4 weeks (T1), 6 months (T2), and 12 months (T3) after RC. Multivariate logistic regressions were performed to identify predictors of better functional outcomes. RESULTS: INB was chosen as urinary diversion in 395 patients (357 male, 38 female). Social continence (maximum of one safety pad/24 h) was reported by 78.3% of men and 64.0% of women at T3. Severe incontinence was reported by 27.3% of men and 44.0% of women. Male sex was identified as an independent predictor for the use of no pads at T3 (OR 4.110; 95% CI 1.153-14.655; p = 0.029). Nerve-sparing surgery was identified as an independent predictor both for the use of only a safety pad (OR 1.918; 95% CI 1.031-3.569; p = 0.040) and good erectile function at T3 (OR 4.377; 95% CI 1.582-12.110; p = 0.004). CONCLUSION: Urologists should aspire for nerve-sparing surgery. When advising patients before RC, functional outcomes (continence, sexual function) should be given special attention. Women should be counseled on potentially prolonged urinary incontinence.
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Neoplasias da Bexiga Urinária , Derivação Urinária , Incontinência Urinária , Coletores de Urina , Humanos , Feminino , Masculino , Cistectomia/efeitos adversos , Neoplasias da Bexiga Urinária/cirurgia , Neoplasias da Bexiga Urinária/etiologia , Resultado do Tratamento , Bexiga Urinária/cirurgia , Incontinência Urinária/etiologia , Derivação Urinária/efeitos adversosRESUMO
In this Letter, we report the site-controlled growth of InP nanolasers on a silicon substrate with patterned SiO2 nanomasks by low-temperature metal-organic chemical vapor deposition, compatible with silicon complementary metal-oxide-semiconductor (CMOS) post-processing. A two-step growth procedure is presented to achieve smooth wurtzite faceting of vertical nanopillars. By incorporating InGaAs multiquantum wells, the nanopillar emission can be tuned over a wide spectral range. Enhanced quality factors of the intrinsic InP nanopillar cavities promote lasing at 0.87 and 1.21 µm, located within two important optical telecommunication bands. This is the first demonstration of a site-controlled III-V nanolaser monolithically integrated on silicon with a silicon-transparent emission wavelength, paving the way for energy-efficient on-chip optical links at typical telecommunication wavelengths.
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In this work the position-controlled growth of GaN nanowires (NWs) on diamond by means of molecular beam epitaxy is investigated. In terms of growth, diamond can be seen as a model substrate, providing information of systematic relevance also for other substrates. Thin Ti masks are structured by electron beam lithography which allows the fabrication of perfectly homogeneous GaN NW arrays with different diameters and distances. While the wurtzite NWs are found to be Ga-polar, N-polar nucleation leads to the formation of tripod structures with a zinc-blende core which can be efficiently suppressed above a substrate temperature of 870 °C. A variation of the III/V flux ratio reveals that both axial and radial growth rates are N-limited despite the globally N-rich growth conditions, which is explained by the different diffusion behavior of Ga and N atoms. Furthermore, it is shown that the hole arrangement has no effect on the selectivity but can be used to force a transition from nanowire to nanotube growth by employing a highly competitive growth regime.
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We demonstrate the nucleation of self-assembled, epitaxial GaN nanowires (NWs) on (111) single-crystalline diamond without using a catalyst or buffer layer. The NWs show an excellent crystalline quality of the wurtzite crystal structure with m-plane faceting, a low defect density, and axial growth along the c-axis with N-face polarity, as shown by aberration corrected annular bright-field scanning transmission electron microscopy. X-ray diffraction confirms single domain growth with an in-plane epitaxial relationship of (10 Ì 10)(GaN) [parallel] (01 Ì 1)(Diamond) as well as some biaxial tensile strain induced by thermal expansion mismatch. In photoluminescence, a strong and sharp excitonic emission reveals excellent optical properties superior to state-of-the-art GaN NWs on silicon substrates. In combination with the high-quality diamond/NW interface, confirmed by high-resolution transmission electron microscopy measurements, these results underline the potential of p-type diamond/n-type nitride heterojunctions for efficient UV optoelectronic devices.
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INTRODUCTION: Diagnostic diversity has been in the focus of several studies of health services research. As the fraction of people with statutory health insurance changes with age and gender it is assumed that diagnostic diversity may be influenced by these parameters. METHODS: We analyze fractions of patients in Schleswig-Holstein with respect to the chapters of the ICD-10 code in outpatient treatment for quarter 2/2016 with respect to age and gender/sex of the patient. In a first approach we analyzed which diagnose chapters are most relevant in dependence of age and gender. To detect diagnostic diversity, we finally applied Shannon's entropy measure. Due to multimorbidity we used different standardizations. RESULTS: Shannon entropy strongly increases for women after the age of 15, reaching a limit level at the age of 50 years. Between 15 and 70 years we get higher values for women, after 75 years for men. DISCUSSION: This article describes a straight forward pragmatic approach to diagnostic diversity using Shannon's Entropy. From a methodological point of view, the use of Shannon's entropy as a measure for diversity should gain more attraction to researchers of health services research.
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Classificação Internacional de Doenças , Pacientes Ambulatoriais , Fatores Etários , Entropia , Humanos , Fatores SexuaisRESUMO
In this work, simulations of the electronic band structure of a p-GaN/n-ZnO heterointerface are presented. In contrast to homojunctions, an additional energy barrier due to the type-II band alignment hinders the flow of majority charge carriers in this heterojunction. Spontaneous polarization and piezoelectricity are shown to additionally affect the band structure and the location of the recombination region. Proposed as potential UV-LEDs and laser diodes, p-GaN/n-ZnO heterojunction nanowires were fabricated by plasma-assisted molecular beam epitaxy (PAMBE). Atomic resolution annular bright field scanning transmission electron microscopy (STEM) studies reveal an abrupt and defect-free heterointerface with a polarity inversion from N-polar GaN to Zn-polar ZnO. Photoluminescence measurements show strong excitonic UV emission originating from the ZnO-side of the interface as well as stimulated emission in the case of optical pumping above a threshold of 55 kW/cm(2).