Symptoms of voiding dysfunction and other coexisting pelvic floor dysfunctions: the impact of transvaginal, mesh-augmented sacrospinous ligament fixation.

INTRODUCTION AND HYPOTHESIS: The objective was to investigate the prevalence for voiding dysfunction and if symptom improvement can be achieved by adequate pelvic floor surgery. METHODS: We evaluated the Propel Study data from 281 women with pelvic organ prolapse (POP) stage 2-4. Bother caused by obstructive micturition, voiding dysfunction, and coexisting pelvic floor symptoms were assessed using the Pelvic Floor Distress Inventory (PFDI) preoperatively and 6, 12, and 24 months after vaginal prolapse repair. Successful reconstruction (Pelvic Organ Prolapse Quantification [POP-Q] stage 0-I throughout the 2-year follow-up at all compartments, "responders"), was compared with all others ("non-responders"). RESULTS: Prevalence of voiding dysfunction was significantly reduced after surgery for all patients with "moderate" to "quite a bit" of bother ("R2") regarding all examined PFDI questions. Defects of the posterior/apical compartment and lower stage defects were found to cause obstructive micturition, which improved significantly after POP surgery. Six months after surgery, the prevalence of R2 for voiding dysfunction symptoms was reduced significantly for responders compared with non-responders. Significant reduction of R2 in patients with rectoceles could be shown for some PFDI questions, whereas the rate was lower in patients with cystoceles. Other pelvic floor symptoms often coexisted in patients with voiding dysfunction symptoms and improved significantly after surgery as well. CONCLUSIONS: Symptoms of voiding dysfunction are frequent in female patients with POP and can significantly improve after vaginal mesh-augmented prolapse repair even for posterior and minor defects. Before counseling patients to undergo POP surgery because of their obstructive symptoms, other causes of voiding dysfunction must first have been ruled out.

Perspectives and limitations of symmetric X-ray Bragg reflections for inspecting polytypism in nanowires.

X-ray diffraction, possibly time-resolved during growth or annealing, is an important technique for the investigation of polytypism in free-standing nanowires. A major advantage of the X-ray diffraction approach for adequately chosen beam conditions is its high statistical significance in comparison with transmission electron microscopy. In this manuscript the interpretation of such X-ray intensity distribution is discussed, and is shown to be non-trivial and non-unique given measurements of the [111]c or [333]c reflection of polytypic nanowires grown in the (111)c direction. In particular, the diffracted intensity distributions for several statistical distributions of the polytypes inside the nanowires are simulated and compared. As an example, polytypic GaAs nanowires are employed, grown on a Si-(111) substrate with an interplanar spacing of the Ga (or As) planes in the wurtzite arrangement that is 0.7% larger than in the zinc blende arrangement along the (111)c direction. Most importantly, ambiguities of high experimental relevance in the case of strongly fluctuating length of the defect-free polytype segments in the nanowires are demonstrated. As a consequence of these ambiguities, a large set of deviations from the widely used Markov model for the stacking sequences of the nanowires cannot be detected in the X-ray diffraction data. Thus, the results here are of high relevance for the proper interpretation of such data.

Polytypism in GaAs nanowires: determination of the interplanar spacing of wurtzite GaAs by X-ray diffraction.

In GaAs nanowires grown along the cubic [111]c direction, zinc blende and wurtzite arrangements have been observed in their stacking sequence, since the energetic barriers for nucleation are typically of similar order of magnitude. It is known that the interplanar spacing of the (111)c Ga (or As) planes in the zinc blende polytype varies slightly from the wurtzite polytype. However, different values have been reported in the literature. Here, the ratio of the interplanar spacing of these polytypes is extracted based on X-ray diffraction measurements for thin GaAs nanowires with a mean diameter of 18-25 nm. The measurements are performed with a nano-focused beam which facilitates the separation of the scattering of nanowires and of parasitic growth. The interplanar spacing of the (111)c Ga (or As) planes in the wurtzite arrangement in GaAs nanowires is observed to be 0.66% ± 0.02% larger than in the zinc blende arrangement.

Monitoring the thin film formation during sputter deposition of vanadium carbide.

The thin film formation of magnetron sputtered polycrystalline coatings was monitored by in situ X-ray reflectivity measurements. The measured intensity was analyzed using the Parratt algorithm for time-dependent thin film systems. Guidelines for the on-line interpretation of the data were developed. For thick coatings, the experimental resolution needs to be included in the data evaluation in order to avoid misinterpretations. Based on a simple layer model, the time-dependent mean electron density, roughness and growth velocity were extracted from the data. As an example, the method was applied to the hard coating material vanadium carbide. Both instantaneous and slowly varying changes of the coating could be detected. It was shown that the growth velocity is proportional to the DC power. Significant changes of the microstructure induced by the working gas pressure are mainly driven by the chemical composition.

Evolution of polytypism in GaAs nanowires during growth revealed by time-resolved in situ x-ray diffraction.

In III-V nanowires the energetic barriers for nucleation in the zinc blende or wurtzite arrangement are typically of a similar order of magnitude. As a result, both arrangements can occur in a single wire. Here, we investigate the evolution of this polytypism in self-catalyzed GaAs nanowires on Si(111) grown by molecular beam epitaxy with time-resolved in situ x-ray diffraction. We interpret our data in the framework of a height dependent Markov model for the stacking in the nanowires. In this way, we extract the mean sizes of faultless wurtzite and zinc blende segments-a key parameter of polytypic nanowires-and their temporal evolution during growth. Thereby, we infer quantitative information on the differences of the nucleation barriers including their evolution without requiring a model of the nucleus.

Retrieving the displacement of strained nanoobjects: the impact of bounds for the scattering magnitude in direct space.

Coherent X-ray diffraction imaging (CXDI) of the displacement field and strain distribution of nanostructures in kinematic far-field conditions requires solving a set of non-linear and non-local equations. One approach to solving these equations, which utilizes only the object's geometry and the intensity distribution in the vicinity of a Bragg peak as a priori knowledge, is the HIO+ER-algorithm. Despite its success for a number of applications, reconstruction in the case of highly strained nanostructures is likely to fail. To overcome the algorithm's current limitations, we propose the HIO(O(R))(M)+ER(M)-algorithm which allows taking advantage of additional a priori knowledge of the local scattering magnitude and remedies HIO+ER's stagnation by incorporation of randomized overrelaxation at the same time. This approach achieves significant improvements in CXDI data analysis at high strains and greatly reduces sensitivity to the reconstruction's initial guess. These benefits are demonstrated in a systematic numerical study for a periodic array of strained silicon nanowires. Finally, appropriate treatment of reciprocal space points below noise level is investigated.

Cluster coherent potential approximation for disordered photonic crystals using photonic Wannier functions.

We present an investigation of disordered photonic crystals (PhCs) based on the combination of photonic Wannier functions with the concept of the coherent potential approximation (CPA). In particular, we provide the theoretical foundation of a real-space cluster CPA that is causal, enforces the proper symmetries of the effective medium, and includes effects of multiple scattering of the same and nearby defects, which is essential for strong defects. Based on this, we present results for the density of states of disordered PhCs for different types of disorder. Our results are thus relevant to such diverse areas as random lasing and the analysis of fabricational imperfections in PhCs.

A Pilot Study of Non-invasive Sacral Nerve Stimulation in Treatment of Constipation in Childhood and Adolescence.

Background/Aims: Constipation shows both, a high prevalence and a significant impact. However, it is often perceived as minor and treatment choices are limited. The neuromodulation approach is a valuable option to be considered. This study assesses the use of non-invasive sacral nerve stimulation to reduce constipation in children. Methods: Between February 2013 and May 2015, pediatric patients with chronic constipation were treated with this non-invasive neuromodulation procedure, adapted from classical sacral nerve stimulation. A stimulation device attached to adhesive electrodes on the lower abdomen and back generated an electrical field with a stable frequency of 15 Hz via variable stimulation intensity (1-10 V). The effect of therapy was evaluated in routine check-ups and by specialized questionnaires. Results: The study assessed non-invasive sacral nerve stimulation in 17 patients (9 boys, 8 girls, mean age 6.5 years). They underwent stimulation with 6-9 V for a mean of 11 h per day (range 0.5-24 h) over a mean of 12.7 weeks. Improvement of constipation was achieved in more than half of the patients (12/17) and sustained in almost half of these patients (5/12). Complications were minor (skin irritation, electrode dislocation). Conclusions: Non-invasive sacral nerve stimulation appears to be effective in achieving improvement in pediatric patients with chronic constipation. As an additional external neuromodulation concept, this stimulation may represent a relevant addition to currently available therapeutic options. Further studies are needed to confirm these results.