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Introduction: Among patients with chronic disease, non-attendance at scheduled healthcare visits is associated with poor outcomes. The impact of non-attendance among patients with bleeding disorders is unknown., Methods: Scheduling and medical record data over a 5-year period for all individuals with at least one scheduled appointment during 2010-2014 at a US Hemophilia Treatment Center (HTC) were analysed. Non-attendance rates were calculated as the number of non-attended visits divided by the number of years as a patient during the time period. Consistent non-attenders were patients who did not attend more than one scheduled appointment per person-year on average. Logistic regression determined characteristics associated with consistent non-attendance and Poisson regression estimated adjusted incidence rate ratios (aIRRs) describing associations between non-attendance and emergency department (ED) visits and hospitalizations., Results: There were 8028 appointments scheduled for 950 individuals; 12% were not attended. Consistent non-attenders (n = 62; 7% of the HTC patient population) accounted for over one-third of non-attended appointments and over one-quarter of hospitalizations. Characteristics associated with consistent non-attendance included public health insurance and black race. Higher non-attendance rates were associated with more ED visits (aIRR 1.78; 95% CI: 1.37-2.30) and hospitalizations (aIRR 2.73; 95% CI: 2.18-3.42). Consistent non-attenders had more ED visits (aIRR 2.49; 95% CI: 1.56-3.96) and hospitalizations (aIRR 4.73; 95% CI: 2.96-7.57) compared with patients who never missed appointments., Conclusions: Frequent non-attendance identified a small but at-risk population. Interventions to improve disease management that target them may have an impact on health outcomes and healthcare utilization., (© 2018 John Wiley & Sons Ltd.)

Background: Early detection examinations take place from birth to the age of 6 years. The youth screening is a continuation of the screening of the "U-series" and should be carried out between the age of 12-15 and 16-17, respectively. Afterwards adolescent girls have good contact with a gynecologist, but adolescent boys usually do not have a medical contact person who they can trust in., Materials and Methods: To evaluate the state of knowledge on boys' health, a 15-item comprehensive knowledge survey was conducted among ninth grade students at 7 secondary schools (Gymnasien) in North Rhine-Westphalia. The knowledge survey took place at three specified times (before, immediately after and approximately 3 months after adolescent sexual education classes). Only completed questionnaires were analyzed and evaluated in a gender-specific manner., Results: Overall, 459 students participated from March-September 2017. Before sexual education instruction, about half of all questions were answered correctly by the students. Immediately after class, the proportion increased by a factor of 1.5 to a total of 79.24%. Then 2-3 months after the class, the percentage was 69.67%. Considering gender separately, this resulted in an increase of 15.32% for the female students and 16.99% for the male students., Conclusion: The knowledge survey reveals a need to catch up on facts on the subject of boys' health. Despite evidence of an increase in knowledge of both sexes after sexual education instruction, there is a gender gap. Hence, a preventive check-up especially for boys should be established and offered. Issues such as the prevention of sexually transmitted diseases, options for vaccination against human papillomavirus, etc. should be actively addressed.

Background: Because sick and injured children from war and crisis areas can often only be helped to a limited extent in their countries of origin, those children with the most complex diseases often receive medical treatment in Europe., Materials and Methods: To evaluate the postoperative outcome of reconstructive interventions in children from war and crisis areas, an evaluation of the clinic's internal database between 1997 and 2017 was carried out. The operative indication, the surgical procedure, any revisions or conversions and the overall mortality were analyzed., Results: During the above-mentioned period a total of 44 (male: 32, female: 12) children aged 3-14 years from Afghanistan, Angola, Central Asia and the Caucasus were treated. Indications for the reconstructive procedures were bladder exstrophy (n = 23), neurogenic bladder dysfunction (n = 9), penile partial amputation (n = 1) and traumatic bladder dysfunction (n = 11). In 26 children, a conduit was created, 11 children received a sigma rectum pouch and 1 child an ileocecal pouch, while 5 other children received bladder augmentation and 1 child an oral mucosal urethroplasty. In total, 7 revisions or conversions due to ureteral implantation stenoses and recurrent acidosis had to be performed. Five children died in their home country due to acidosis, sepsis, end stage renal failure, accident and social exclusion., Conclusion: In the long term 39 of the 44 (88.6%) children live socially integrated in their home country and are regularly monitored by local aid organizations. When choosing the reconstructive intervention, the local conditions must be considered.

Worldwide environmental pollution is increasing at the same rate as social and economic development. This growth, however, is disorganized and leads to increased degradation of water resources. Water, which was once considered inexhaustible, has become the focus of environmental concerns because it is essential for life and for many production processes. This article describes monitoring of the water quality at three points along the Sinos River (RS, Brazil), one in each of the upper, middle and lower stretches. The points were sampled in 2013 and again in 2014. The water samples were analyzed to determine the following physical and chemical parameters plus genotoxicity to fish: metals (Cr, Fe, Al), chemical oxygen demand, biochemical oxygen demand, chlorides, conductivity, total suspended solids, total phosphorous, total and fecal coliforms, pH, dissolved oxygen, turbidity, total Kjeldahl nitrogen nitrate and ammoniacal nitrogen. Genotoxicity was tested by exposing individuals of the species Astyanax jacuhiensis to water samples and then comparing them with a control group exposed to water from the public water supply. The results confirmed the presence of substances with genotoxic potential at the sample points located in the middle and lower stretches of the river. The results for samples from the upper stretch, at P1, did not exhibit differences in relation to the control group. The physical and chemical analyses did not detect reductions in water quality in the lower stretch, as had been expected in view of the large volumes of domestic and industrial effluents discharged into this part of the river.

This paper describes a silicon cantilever sensor coated with a conducting polymer layer. The mechanical response (deflection) of the bimaterial (the coated microcantilever) was investigated under the influence of several volatile compounds-methanol, ethanol, acetone, propanol, dichloroethane, toluene and benzene. The variations in the deflection of the coated and uncoated microcantilevers when exposed to volatile organic compounds were evaluated, and the results indicated that the highest sensitivity was obtained with the coated microcantilever and methanol. The uncoated microcantilever was not sensitive to the volatile organic compounds. An increase in the concentration of the volatile organic compound resulted in higher deflections of the microcantilever sensor. The sensor responses were reversible, sensible, rapid and proportional to the volatile concentration.

In the present work, PANI (polyaniline) emeraldine salt (doped) and base (dedoped) were used as the sensitive layer of a silicon microcantilever, and the mechanical response (deflection) of the bimaterial (coated microcantilever) was investigated under the influence of humidity. PANI in the emeraldine base oxidation state was obtained by interfacial synthesis and was deposited on the microcantilever surface by spin-coating (dedoped). Next, the conducting polymer was doped with 1 M HCl (hydrochloric acid). A four-quadrant AFM head with an integrated laser and a position-sensitive detector (AFM Veeco Dimension V) was used to measure the optical deflection of the coated microcantilever. The deflection of the coated (doped and undoped PANI) and uncoated microcantilever was measured under different humidities (in triplicate) at room pressure and temperature in a closed chamber to evaluate the sensor's sensitivity. The relative humidity (RH) in the chamber was varied from 20% to 70% using dry nitrogen as a carrier gas, which was passed through a bubbler containing water to generate humidity. The results showed that microcantilevers coated with sensitive layers of doped and undoped PANI films were sensitive (12,717 ± 6% and 6,939 ± 8%, respectively) and provided good repeatability (98.6 ± 0.015% and 99 ± 0.01%, respectively) after several cycles of exposure to RH. The microcantilever sensor without a PANI coating (uncoated) was not sensitive to humidity. The strong effect of doping on the sensitivity of the sensor was attributed to an increased adsorption of water molecules dissociated at imine nitrogen centers, which improves the performance of the coated microcantilever sensor. Moreover, microcantilever sensors coated with a sensitive layer provided good results in several cycles of exposure to RH (%)., (© 2013 Wiley Periodicals, Inc.)

Twiddler's syndrome describes a rare complication following implantation of a pacemaker/defibrillator and is characterized by spontaneous, repeated rotation of the generator in the subpectoral pocket. We describe the case of a 78-year-old man who presented with an exit block 7 months after defibrillator implantation. As cause, a 15-fold rotation of the defibrillator's generator around its own axis could be verified, which entailed dislocation of the defibrillator's electrode. Safe fixation of the electrode and generator in the subpectoral pocket is of paramount importance, particularly in patients with loose subcutaneous fatty tissue, to prevent this rare complication.

To gain an insight into vertebrate genome evolution, we have analysed the organization of an approximately 40-kb genomic clone of an amphioxus (Branchiostoma floridae) cosmid library. Amphioxus is considered as being the last non-vertebrate relative to vertebrates. Sequencing and analysis of the above clone using three different exon prediction programs (Grail, GenScan, Mzef) have led to the identification of a gene of the aldo-keto reductase family as well as further exons that gave a significant database match to known genes.

Interactions of natural killer cell receptors with their cognate ligands play a major role in regulating NK cell function. The NKG2 gene family encodes several highly similar proteins, which are known to form heterodimers with the CD94 receptor. These dimers play a role in the inhibition as well as the activation of NK cells. We have analyzed the gene structures of the NKG2C, D, E, and F genes, and determined their genomic organization. Restriction mapping and sequencing revealed the four genes to be closely linked to one another, and of the same transcriptional orientation. An exon duplication within the NKG2C and E genes was identified, although the duplicated version of this exon has not yet been found in mRNA sequences. The NKG2C, E, and F genes, despite being highly similar, are variable at their 3' ends. We show that NKG2C consists of six exons, whereas NKG2E has seven, and the splice acceptor site for the seventh exon occurs in an Alu repeat. NKG2F consists of only four exons and part of exon IV is in some cases spliced to the 5' end of the NKG2D transcript. NKG2D has only a low similarity to the other NKG2 genes.

Human marrow was obtained as material discarded during total hip replacement and was established in culture with phenol red-free alpha-MEM with 10% fetal bovine serum (FBS) and antibiotics. Insulin-like growth factor I (IGF-I) and its binding proteins were secreted by human marrow cells, in amounts that increased with time in culture. Western ligand blotting showed that insulin-like growth factor binding protein-3 (IGFBP-3) accounted for the majority (approximately 75%) of the secreted binding proteins. Evidence for marrow secretion of BP-3 protease was found by electrophoretic analysis of mixtures of radiolabeled IGFBP-3 and marrow-conditioned media. The amount of constitutive secretion of IGFBP-3 increased with age of the subject (r = 0.97, p = 0.0058). A notable exception was marrow from a postmenopausal women on estrogen replacement therapy (ERT) at the time of surgery; her marrow secreted 89.3 ng/mL after 14 d in vitro, only 38% of the IGFBP-3 that was secreted by cultures from two age-matched peers (208.8 and 285.2 ng/mL). This in vivo effect of estrogen was matched by an in vitro experiment in which 10(-8) M 17-beta estradiol suppressed IGFBP-3 to 60% of the constitutive level. In all cultures of marrow from postmenopausal women, IL-1 beta suppressed IGFBP-3 secretion to either undetectable levels or levels between 11% and 35% of control. Thus, human bone marrow cultures demonstrate components of the skeletal IGF regulatory system: IGF-I, IGF-binding proteins, and evidence of IGFBP-3 proteolysis. These results provide evidence of regulation by both systemic (age, estrogen status) and cytokine (IL-1 beta) factors.

The nucleotide sequences of the genes for two ribosomal proteins, HS15 and HSH, from the archaeon Haloarcula marismortui, have been determined. The genes were found in a cluster together with another open reading frame with a probable regulatory function. HS15 and HSH have counterparts in eucarya. HS15 is significantly homologous to S19 from frog (Xenopus laevis). HSH is related to S37 from yeast (Saccharomyces cerevisiae) and S27 from fly (Drosophila melanogaster), as well as to other members of the S27 family. Eubacterial counterparts were not found, suggesting that these proteins are 'extra proteins' that are absent in eubacterial ribosomes.

In 84 patients after nephrectomy due to renal cell carcinoma a computerized tomography was performed to evaluate local tumor recurrence. The findings are classified stage-dependent. Other metastatic lesions were found by conventional radiologic methods. Based on stage-dependent different occurrence of metastases or local recurrences recommendations are made to the use of computerized tomography in the follow-up of patients suffering from renal cell carcinoma after nephrectomy.