Productive water uses at household level in rural Kenya: case study of the Ukambani district

As a result of the growing world population and enhanced by the rising of living standards, competition for water is growing and this causes increased pressure on water resources worldwide. This tendency gave rise to the development of the integrated water resources management approach (IWRM), acknowledging the need to manage water resources in a holistic and integrated way. The IWRM objective to optimize economic, social and environmental outcomes of water management, can however only be reached if impact of water uses is correctly assessed. Nevertheless, often multiple uses of water within sectors are insufficiently recognized in planning and management. One of these neglected uses is the productive water use by households. Nonetheless, this use is extremely important to the livelihood of the poor, especially in the vast semi-arid rural areas of the developing world. An adequate evaluation of this use will not only help to improve outcome of water management, but will also add to the goal of poverty reduction. In this study, the role of productive water use for the rural community of the Ukambani district in Kenya was monitored, thereby focusing on income contributions and improvements in nutritional status

Low Doses of Cadmium Chloride and Methallothionein-1-Bound Cadmium Display Different Accumulation Kinetics and Induce Different Genes in Cells of the Human Nephron

Background/Aims: The present study was conducted to investigate the renal tubular handling of inorganic cadmium (Cd2+) by exposing primary human tubular cell cultures to physiologically relevant doses of cadmium chloride (CdCl2). Furthermore, the cellular accumulation of Cd2+ was compared to that of metallothionein-1-bound Cd (Cd7MT-1). Finally, this study aimed to investigate the effect of the accumulation of Cd (both Cd2+ and Cd7MT-1) in renal cells on the expression of genes relevant to nephrotoxic processes. Methods: Cd concentration was measured using atomic absorption spectrometry. mRNA expression was evaluated by quantitative real-time RT-PCR. Results: Cd2+ accumulated into human tubular cells in a concentration- and time-dependent way. Furthermore, cellular accumulation of Cd2+ was different from the cellular accumulation of Cd7MT-1, indicative for different uptake routes. Finally, mRNA expression of the genes encoding the anti-oxidative proteins metallothionein-1 (MT-1) and heme-oxygenase-1 (HO-1) as well as the pro-apoptotic Bcl-2-associated X protein (Bax) were upregulated by CdCl2 and not by Cd7MT1. Conclusion: In the presence of physiologically relevant Cd concentrations, tubular accumulation of the element in its inorganic form is different from that of Cd7MT-1. Furthermore, the tubular accumulation of inorganic Cd induces mRNA expression of genes of which the protein products may play a role in Cd-associated renal toxicity

Epoetin Delta Reduces Oxidative Stress in Primary Human Renal Tubular Cells

Erythropoietin (EPO) exerts (renal) tissue protective effects. Since it is unclear whether this is a direct effect of EPO on the kidney or not, we investigated whether EPO is able to protect human renal tubular epithelial cells (hTECs) from oxidative stress and if so which pathways are involved. EPO (epoetin delta) could protect hTECs against oxidative stress by a dose-dependent inhibition of reactive oxygen species formation. This protective effect is possibly related to the membranous expression of the EPO receptor (EPOR) since our data point to the membranous EPOR expression as a prerequisite for this protective effect. Oxidative stress reduction went along with the upregulation of renoprotective genes. Whilst three of these, heme oxygenase-1 (HO-1), aquaporin-1 (AQP-1), and B-cell CLL/lymphoma 2 (Bcl-2) have already been associated with EPO-induced renoprotection, this study for the first time suggests carboxypeptidase M (CPM), dipeptidyl peptidase IV (DPPIV), and cytoglobin (Cygb) to play a role in this process

Increased serum strontium levels in dialysis patients: An epidemiological survey

Increased serum strontium levels in dialysis patients: An epidemiological survey.BackgroundWe previously reported on increased bone strontium levels in dialysis patients with osteomalacia versus those presenting other types of renal osteodystrophy. A causal role of strontium in the development of osteomalacia was established in a chronic renal failure rat model.MethodsTo further elucidate the latter issue and to find out whether dialysis patients from particular centers/countries are at an increased risk for strontium accumulation, a worldwide multicenter study was established. In total, 834 patients from 34 dialysis centers in 23 countries were included. In each of the patients, a serum sample was taken for strontium determination, and water and dialysate samples were taken at the various steps of the water purification process. For each patient clinical data and for each center dialysis modalities were recorded.ResultsStrontium levels in serum of dialysis patients showed major differences between the various centers, ranging from mean values of 25 ± 8 μg/liter in the center with the lowest level up to 466 ± 90 μg/liter in the center with the highest concentration. It is of interest that these high levels were mainly found in developing countries. Furthermore, our data point toward a role of the final dialysate in the accumulation of the element, as indicated by the strong correlation (r = 0.74, P < 0.001) between mean serum and dialysate strontium levels. As the high tap water concentration of strontium was adequately reduced during the water purification process, contamination of the final dialysis fluid occurred by the addition of concentrates contaminated with strontium. Besides the dialysate, other factors, such as duration of dialysis, vitamin D supplements, or types of phosphate binders, played a less important role in the accumulation of the element.ConclusionsData of this multicenter study indicate patients of particular dialysis centers to be at an increased risk for strontium accumulation, the clinical consequence of which is under current investigation

A comparison between chemical cleaning efficiency in lab-scale and full-scale reverse osmosis membranes : role of extracellular polymeric substances (EPS)

Chemical cleaning is vital for the optimal operation of membrane systems. Membrane chemical cleaning protocols are often developed in the laboratory flow cells (e.g., Membrane Fouling Simulator (MFS)) using synthetic feed water (nutrient excess) and short experimental time of typically days. However, full-scale Reverse Osmosis (RO) membranes are usually fed with nutrient limited feed water (due to extensive pre-treatment) and operated for a long-time of typically years. These operational differences lead to significant differences in the efficiency of chemical Cleaning-In-Place (CIP) carried out on laboratory-scale and on full-scale RO systems. Therefore, we investigated the suitability of lab-scale CIP results for full-scale applications. A lab-scale flow cell (i.e., MFSs) and two full-scale RO modules were analysed to compare CIP efficiency in terms of water flux recovery and biofouling properties (biomass content, Extracellular Polymeric Substances (EPS) composition and EPS adherence) under typical lab-scale and full-scale conditions. We observed a significant difference between the CIP efficiency in lab-scale (~50%) and full-scale (9–20%) RO membranes. Typical biomass analysis such as Total Organic Carbon (TOC) and Adenosine triphosphate (ATP) measurements did not indicate any correlation to the observed trend in the CIP efficiency in the lab-scale and full-scale RO membranes. However, the biofilms formed in the lab-scale contains different EPS than the biofilms in the full-scale RO modules. The biofilms in the lab-scale MFS have polysaccharide-rich EPS (Protein/Polysaccharide ratio = 0.5) as opposed to biofilm developed in full-scale modules which contain protein-rich EPS (Protein/Polysaccharide ratio = 2.2). Moreover, EPS analysis indicates the EPS extracted from full-scale biofilms have a higher affinity and rigidity to the membrane surface compared to EPS from lab-scale biofilm. Thus, we propose that CIP protocols should be optimized in long-term experiments using the realistic feed water

Prognostic and predictive value of circulating tumor cells and CXCR4 expression as biomarkers for a CXCR4 peptide antagonist in combination with carboplatin-etoposide in small cell lung cancer: exploratory analysis of a phase II study.

Background Circulating tumor cells (CTCs) and chemokine (C-X-C motif) receptor 4 (CXCR4) expression in CTCs and tumor tissue were evaluated as prognostic or predictive markers of CXCR4 peptide antagonist LY2510924 plus carboplatin-etoposide (CE) versus CE in extensive-stage disease small cell lung cancer (ED-SCLC). Methods This exploratory analysis of a phase II study evaluated CXCR4 expression in baseline tumor tissue and peripheral blood CTCs and in post-treatment CTCs. Optimum cutoff values were determined for CTC counts and CXCR4 expression in tumors and CTCs as predictors of survival outcome. Kaplan-Meier estimates and hazard ratios were used to determine biomarker prognostic and predictive values. Results There was weak positive correlation at baseline between CXCR4 expression in tumor tissue and CTCs. Optimum cutoff values were H-score ≥ 210 for CXCR4+ tumor, ≥7% CTCs with CXCR4 expression (CXCR4+ CTCs), and ≥6 CTCs/7.5 mL blood. Baseline H-score for CXCR4+ tumor was not prognostic of progression-free survival (PFS) or overall survival (OS). Baseline CXCR4+ CTCs ≥7% was prognostic of shorter PFS. CTCs ≥6 at baseline and cycle 2, day 1 were prognostic of shorter PFS and OS. None of the biomarkers at their respective optimum cutoffs was predictive of treatment response of LY2510924 plus CE versus CE. Conclusions In patients with ED-SCLC, baseline CXCR4 expression in tumor tissue was not prognostic of survival or predictive of LY2510924 treatment response. Baseline CXCR4+ CTCs ≥7% was prognostic of shorter PFS. CTC count ≥6 at baseline and after 1 cycle of treatment were prognostic of shorter PFS and OS