Rural Medicare patients less likely to undergo penile prosthesis implantation following radical cystectomy.

INTRODUCTION Erectile dysfunction is common after radical cystectomy; however, research on sexual dysfunction after this procedure is relatively scarce. Our goal was to evaluate the incidence of penile prosthesis implantation after radical cystectomy, with a focus on rural/urban disparity. MATERIALS AND METHODS: We used the SEER-Medicare database to identify patients with bladder cancer diagnosed between 1991-2009 who had a radical cystectomy (ICD-9 codes 57.7, 57.71, 57.79). The outcome was placement of a penile implant (ICD-9 codes 64.95 and 64.97). Covariates extracted included rural county status, age, race, ethnicity, marital status, geographic region, socioeconomic status, Charlson comorbidity, pathologic cancer stage, and type of urinary diversion. RESULTS: A total of 95 penile implants were performed in the 11,477 cystectomy patients (0.83%). Patients who had a penile implant were mostly from urban counties (85.1%) and in the Western region of the United States (83.9%). After controlling for covariates, rural patients who underwent an ileal conduit for urinary diversion were less likely to have a penile prosthesis procedure after radical cystectomy. CONCLUSIONS: Penile prosthetic procedures are uncommon in bladder cancer patients who have undergone radical cystectomy; therefore, sexual health should be considered and discussed with patients after radical cystectomy.

Dynamic modulation of the Fermi energy in suspended graphene backgated devices.

Freestanding (suspended) graphene films, with high electron mobility (up to ~200,000 cm2V-1s-1), good mechanical and electronic properties, could resolve many of the current issues that are hampering the upscaling of graphene technology. Thus far, attempts at reliably fabricating suspended graphene devices comprising metal contacts, have often been hampered by difficulties in exceeding sizes of 1 µm in diameter, if using UV lithography. In this work, area of suspended graphene large enough to be utilized in microelectronic devices, have been obtained by suspending a CVD graphene film over cavities, with top contacts defined through UV lithography with both wet and dry etching. An area of up to 160 µm2 can be fabricated as backgated devices. The suspended areas exhibit rippling of the surfaces which simultaneously introduces both tensile and compressive strain on the graphene film. Finally, the variations of the Fermi level in the suspended graphene areas can be modulated by applying a potential difference between the top contacts and the backgate. Having achieved large area suspended graphene, in a manner compatible with CMOS fabrication processes, together with enabling the modulation of the Fermi level, are substantial steps forward in demonstrating the potential of suspended graphene-based electronic devices and sensors.