Impact of nutritional vitamin D supplementation on parathyroid hormone and 25-hydroxyvitamin D levels in non-dialysis chronic kidney disease : a meta-analysis

Background. Secondary hyperparathyroidism (SHPT) is a common and major complication in chronic kidney disease (CKD), reflecting the increase of parathyroid hormone (PTH) in response to reduced vitamin D signalling and hypocalcaemia. This meta-analysis evaluated the impact of nutritional vitamin D (NVD) (cholecalciferol or ergocalciferol) on SHPT-related biomarkers. Methods. A systematic literature search was performed in PubMed to identify relevant randomized control trials to be included in the meta-analysis. Fixed- and random-effects models were used to pool study-level results. Effects were studied within NVD study arms and relative to control groups (placebo/no treatment); the former in order to identify the effect of actively altering biomarkers levels. Results. Reductions in PTH from supplementation with NVD were small when observed within the NVD study arms (pooled reduction: 10.5 pg/mL) and larger when compared with placebo/no treatment (pooled reduction: 49.7 pg/mL). NVD supplementation increased levels of 25-hydroxyvitamin D [25(OH)D] in both analyses (increase within NVD study arm: 20.6 ng/mL, increase versus placebo/no treatment: 26.9 ng/mL). While small and statistically non-significant changes in phosphate and fibroblast growth factor 23 were observed, NVD supplementation caused calcium levels to increase when compared with placebo/no treatment (increase: 0.23 mg/dL). Conclusions. Our results suggest that supplementation with NVD can be used to increase 25(OH)D to a certain extent, while the potential of NVD to actively reduce PTH in non-dialysis-CKD patients with SHPT is limited

Implications of population changes among the Arvicolinae (Rodentia, Mammalia) in El Mirón Cave (Cantabria, Spain) for the climate of the last c. 50,000 years

The El Mirón Cave site in Spain has one of the most complete archaeological and palaeontological records of the Late Pleistocene in the Iberian Peninsula, encompassing most of the last c. 50,000 years. Among other studies, the fossiliferous record has allowed the development of various interpretations of faunal and climatic changes during this period of time in the northern Atlantic region of the Iberian Peninsula. The addition of more radiocarbon dates from El Mirón Cave make it possible to revise some of the interpretations of the micromammal sequence carried out earlier for this major site. The record of small mammals is one of the most used tools to study the climate of the past, and among them the several Arvicolinae species are of great importance for the study of Quaternary climatic variations, due to their adaptations to a great diversity of habitats. New methodologies such as ancient DNA and geometric morphometric analyses now permit us to conduct a review of the Arvicolinae species previously described at this site and better to differentiate between species with similar morphologies, like Microtus arvalis and M. agrestis. We also identified the presence of a species not recorded before in El Mirón, Terricola pyrenaicus. With the study of the Arvicolinae species associations, we reaffirm the climate variations originally described in this deposit, indicating in detail how the successive changes in temperature and environment took place throughout the course of the late Last Glacial and early Postglacial periods (Marine Isotope Stages 3–1)

Physicochemical characterisation of restructured Fenalår and safety implications of salt and nitrite reduction

There is a new trend to produce dry-cured ham from lamb in shorter times by boning the ham before salting to later obtain restructured hams that are easier to dry and slice. However, little information about the physicochemical characteristics of Norwegian Fenalårs during the process or the safety implications of their elaboration procedures is reported in the literature. The aim of this study was to characterize the colour, texture and physicochemical properties of restructured Fenalårs when using Standard Salting (SS), Salt Reduced (SR) and a Non-Nitrite Salt Reduced (NNSR) treatments. Microbiological safety implications of the elaboration process when using the different salting treatments were also assessed using predictive microbiology. To do so, sixty Fenalårs were elaborated using a Standard Salting (SS), a Salt reduced (SR) and a Non-Nitrite Salt Reduced (NNSR) treatments. Physicochemical characterization (instrumental colour and texture and Zinc Protoporphyrin content) was performed at the end of the process using thirty Fenalårs. The rest of the Fenalårs were used to characterize the product through the elaboration process (pH and aw) for the evaluation of microbiological hazards when using the different salting treatments using predictive microbiology. Results showed a significant increase in softness when reducing salt content and a decrease of redness when no nitrite was used, attributed to the formation of ZnPP content instead of nitrosylmyoglobin. In terms of risk assessment, the decrease of aw through the elaboration process reduced the growth capacity of all the microorganisms evaluated. However, microbiological safety implications in salt reduced Fenalårs are important, especially when no nitrite was added, because the considerable increase of growth potential of L. monocytogenes. The increase of growth potential of proteolytic C. botulinum is very little and no relevant effect of nitrite on growth potential of S. aureus was observed. Predictive microbiology and optimization of the process to enhance ZnPP formation can help to ensure safety and quality of salt reduced restructured Fenalårs without additives.info:eu-repo/semantics/acceptedVersio

Preliminary results on climate change evidence from coprolites of Myotragus balearicus Bate 1909 (Artiodactyla, Caprinae)

Plants may vary their stomata density as a function of environmental factors, such as [CO2], drought and temperature. Under the present atmospheric conditions, it is expected that leaves have different stomata density than they had hundreds or thousands of years ago, due to the rise of CO2 in the atmosphere. Microhistological analyses of coprolites of the extinct Myotragus balearicus from Cova Estreta (Pollença, Mallorca), with a radiocarbon age of 4950 ± 38 BP (3775-3640 2σ cal BC; Wk-33010), have shown a diet including an important amount of Buxus balearica epidermal fragments. Three of these coprolites were used to estimate the stomata density on Buxus balearica epidermal fragments from this period. Additionally, three samples of the endangered Buxus balearica, the sole species of Buxus currently present on Mallorca, were collected in three different localities and leaves were examined under microscopy to determine the stomata density. A significant difference between epidermal fragments from coprolites and epidermal fragments of living plants (c² = 34.46, P<0.0001, L-R c² test), with a density average of 27.21 and 19.05 stomata/mm2 res pectively, has been recorded. The current lower density of stomata could be a plant response to climatic change in the Mediterranean islands

Parathyroid hormone-related protein as a renal regulating factor: From Vessels to Glomeruli and Tubular Epithelium

Parathyroid hormone (PTH) and PTH-related protein (PTHrP) produce similar biological effects through the PTH/PTHrP receptor. Less is known about the physiological role of PTHrP, which was first identified as the agent of the humoral hypercalcemia of malignancy. Despite the widespread production of PTHrP in healthy individuals, the concentration of the protein is below the detectable limit of current assays, suggesting that PTHrP normally functions locally in an autocrine or paracrine manner. Thus, some differences in their biological activities have been described and they may be related to the presence of different receptors. In this regard, a second receptor that binds selectively to PTH has also been found. Recent studies have demonstrated the expression of both PTH/PTHrP receptor and protein in the renal glomeruli. Moreover, there are convincing data that support a direct role of PTH and PTHrP in modulating renal blood flow and glomerular filtration rate. This multifunctional protein, PSHrP, also has a proliferative effect on both glomerular mesangial cells and tubular epithelial cells. Increases in the expression of PTHrP have been observed in several experimental models of nephropathies, suggesting that PTHrP upregulation is a common event associated with the mechanism of renal injury and repair

Circulating markers of bone turnover

Renal osteodystrophy is a feature of chronic kidney disease (CKD), with increasing prevalence as CKD progresses. This bone disease is responsible for major morbidity, including fractures, and a deterioration in the quality of life and its sequelae. Circulating biomarkers of renal osteodystrophy typically indicate bone turnover, but not other features of bone, like bone volume, mineralization, quality or strength. Bone turnover can be considered to be primarily a reflection of bone cell activity, in particular that of osteoblasts and osteoclasts. Since current treatments for bone disease usually target cellular activity, biomarkers are considered to be able to contribute to the decision-making for treatment and its follow-up. In CKD, one has to consider the impact of a diminished clearance of biomarkers or their altered metabolism, both potentially limiting its clinical use. Here, several aspects of the most frequently used biomarkers of bone turnover are reviewed, with an emphasis on the specific situation represented by CKD. This review is based on the overview lecture at the symposium held in Amsterdam, September 23, 2016: "The Bone In CKD", organized by the CKD-MBD working group of ERA-EDTA

Body Shape and Life Style of the Extinct Balearic Dormouse Hypnomys (Rodentia, Gliridae): New Evidence from the Study of Associated Skeletons

Hypnomys is a genus of Gliridae (Rodentia) that occurred in the Balearic Islands until Late Holocene. Recent finding of a complete skeleton of the chronospecies H. morpheus (Late Pleistocene-Early Holocene) and two articulated skeletons of H. cf. onicensis (Late Pliocene) allowed the inference of body size and the calculation of several postcranial indexes. We also performed a Factorial Discriminant Analysis (FDA) in order to evaluate locomotory behaviour and body shape of the taxa. Using allometric models based on skull and tooth measurements, we calculated a body weight between 173 and 284 g for H. morpheus, and direct measurements of articulated skeletons yielded a Head and Body Length (HBL) of 179 mm and a Total Body Length of 295 mm for this species. In addition to the generally higher robustness of postcranial bones already recorded by previous authors, H. morpheus, similar to Canariomys tamarani, another extinct island species, displayed elongated zygopodium bones of the limbs and a wider distal humerus and femur than in an extant related taxon, Eliomys quercinus. Indexes indicated that Hypnomys was more terrestrial and had greater fossorial abilities than E. quercinus. This was also corroborated by a Discriminant Analysis, although no clear additional inference of locomotory abilities could be calculated

Evidence in chronic kidney disease&#8211;mineral and bone disorder guidelines: is it time to treat or time to wait?

Chronic kidney disease\u2013mineral and bone disorder (CKD\u2013MBD) is one of the many important complications associated with CKD and may at least partially explain the extremely high morbidity and mortality among CKD patients. The 2009 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline document was based on the best information available at that time and was designed not only to provide information but also to assist in decision-making. In addition to the international KDIGO Work Group, which included worldwide experts, an independent Evidence Review Team was assembled to ensure rigorous review and grading of the existing evidence. Based on the evidence from new clinical trials, an updated Clinical Practice Guideline was published in 2017. In this review, we focus on the conceptual and practical evolution of clinical guidelines (from eMinence-based medicine to eVidence-based medicine and \u2018living\u2019 guidelines), highlight some of the current important CKD\u2013MBD-related changes, and underline the poor or extremely poor level of evidence present in those guidelines (as well as in other areas of nephrology). Finally, we emphasize the importance of individualization of treatments and shared decision-making (based on important ethical considerations and the \u2018best available evidence\u2019), which may prove useful in the face of the uncertainty over the decision whether \u2018to treat\u2019 or \u2018to wait\u2019

Prevalence of vertebral fractures and their prognostic significance in the survival in patients with chronic kidney disease stages 3-5 not on dialysis

The prevalence of vertebral fractures (VF) and their association with clinical risk factors and outcomes are poorly documented in chronic kidney disease (CKD) cohorts. The aim of the study was to evaluate the prevalence of VF in patients with non-dialysis dependent CKD (NDD-CKD), their value in predicting mortality and its correlation with parameters of bone mineral metabolism and vascular calcification. 612 NDD 3-5 stage CKD patients participating in the OSERCE-2 study, a prospective, multicenter, cohort study, were prospectively evaluated and categorized into two groups according to presence or absence of VF at enrollment. VF were assessed with lateral radiographs and Genant semi-quantitative method was applied. Three radiologists specialized in musculoskeletal radiology performed consensual reading of individual images obtained using a Raim DICOM Viewer and a Canon EOS 350 camera to measure with Java Image software in those who had traditional acetate X-ray. Factors related to VF were assessed by logistic regression analysis. Association between VF and death over a 3-year follow-up was assessed by Kaplan-Meier survival curves and Cox-proportional hazard models. VF were detected in 110patients(18%). Serumphosphatelevels(OR0.719,95%CI0.532to0.972,p = 0.032),ankle-brachial index 3 and serum phosphate, the presence of VF (HR 1.983, 95% CI 1.009-3.898, p = 0.047) were an independent predictor of all-cause mortality. In our study 18% of patients with NDD-CKD have VF. Factors associated with VF were age, low serum phosphate levels and peripheral vascular disease. The presence of VF was an independent risk factor for mortality in stages 3-5 NDD-CKD patients. Clinical trials are needed to confirm whether this relationship is causal and reversible with treatment for osteoporosis

Evaluation of Alternative Methods of Tunnel Composting (submitted by the European Composting Network)

Two alternative methods for the production of compost from certain category 3 animal by-products (catering waste and processed foodstuffs of animal origin) were assessed. The first proposed a minimum temperature of 55°C for 72&nbsp;h; the second 60°C for 48&nbsp;h, each with a maximum particle size of 200&nbsp;mm. The proposed composting processes were assessed by the BIOHAZ Panel&nbsp;for their efficacy to achieve a reduction of 5 log10 of Enterococcus faecalis or Salmonella Senftenberg (775W, H2S negative) and a 3 log10 reduction of the infectivity titre of thermoresistant viruses, such as parvovirus, in the composted material, as set out in Annex V, Chapter 3, Section&nbsp;2 of Commission Regulation (EU) No 142/2011. The assessment of the BIOHAZ Panel&nbsp;exclusively focused on the ABP raw materials (catering waste and processed foodstuffs) intended for human consumption. The applicant did not provide any validation experiments with direct measurement of the reduction of viability of endogenous indicators or spiked surrogate bacteria. However, from thermal inactivation parameters reported in the literature, it can be concluded that the proposed composting standards can achieve at least a 5 log10 reduction of Enterococcus faecalis or Salmonella Senftenberg 775W. The applicant did not consider thermoresistant viruses as a relevant hazard and therefore did not provide any data from direct measurements of the reduction of infectivity of spiked thermoresistant viruses, nor provide data from validation studies undertaken at national level or data from literature supporting the efficacy of the proposed composting standards on thermoresistant viruses. However, thermoresistant viruses should be considered to be a relevant hazard in this context and validation data should have been provided accordingly. The BIOHAZ Panel&nbsp;considers that the evidence provided by the applicant does not demonstrate that the requirements of Annex V, Chapter 3, Section&nbsp;2 of Commission Regulation (EU) No 142/2011 are achieved