B\,^1\Sigma^{+}_{u} and EF\,^{1}\Sigma^{+}_{g} level energies of D2_{2}

Accurate absolute level energies of the B\,^1\Sigma^{+}_{u}, $v=0-8, N$ and EF\,^{1}\Sigma^{+}_{g}, $v=0-21, N$ rovibrational quantum states of molecular deuterium are derived by combining results from a Doppler-free two-photon laser excitation study on several lines in the $EF\,{}^{1}\Sigma_{g}^{+}-X\,{}^{1}\Sigma_{g}^{+}$ (0,0) band, with results from a Fourier-transform spectroscopic emission study on a low-pressure hydrogen discharge. Level energy uncertainties as low as 0.0005 cm$^{-1}$ are obtained for some low-lying E\,^{1}\Sigma^{+}_{g} inner-well rovibrational levels, while uncertainties for higher-lying rovibrational levels and those of the F\,^{1}\Sigma^{+}_{g} outer-well states are nominally 0.005 cm$^{-1}$. Level energies of B\,^1\Sigma^{+}_{u} rovibrational levels, for $v \leq 8$ and $N \leq 10$ are determined at an accuracy of 0.001 cm$^{-1}$. Computed wavelengths of D$_2$ Lyman transitions in the B\,^1\Sigma^{+}_{u}-X\,^{1}\Sigma^{+}_{g} ($v,0$) bands are also tabulated for future applications.Comment: appears in Journal of Molecular Spectroscopy (2014

The Bone-Vasculature Axis:Calcium Supplementation and the Role of Vitamin K

Calcium supplements are broadly prescribed to treat osteoporosis either as monotherapy or together with vitamin D to enhance calcium absorption. It is still unclear whether calcium supplementation significantly contributes to the reduction of bone fragility and fracture risk. Data suggest that supplementing post-menopausal women with high doses of calcium has a detrimental impact on cardiovascular morbidity and mortality. Chronic kidney disease (CKD) patients are prone to vascular calcification in part due to impaired phosphate excretion. Calcium-based phosphate binders further increase risk of vascular calcification progression. In both bone and vascular tissue, vitamin K-dependent processes play an important role in calcium homeostasis and it is tempting to speculate that vitamin K supplementation might protect from the potentially untoward effects of calcium supplementation. This review provides an update on current literature on calcium supplementation among post-menopausal women and CKD patients and discusses underlying molecular mechanisms of vascular calcification. We propose therapeutic strategies with vitamin K2 treatment to prevent or hold progression of vascular calcification as a consequence of excessive calcium intake

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

Irradiance footprint of phototherapy devices:a comparative study

Background Phototherapy (PT) is the standard treatment of neonatal unconjugated hyperbilirubinemia. The irradiance footprint, i.e., the illuminated area by the PT device with sufficient spectral irradiance, is essential for PT to be effective. Irradiance footprint measurements are not performed in current clinical practice. We describe a user-friendly method to systematically evaluate the high spectral irradiance (HSI) footprint (illuminated area with spectral irradiance of >= 30 mu W cm(-2) nm(-1)) of PT devices in clinical practice. Materials and methods Six commercially available LED-based overhead PT devices were evaluated in overhead configuration with an incubator. Spectral irradiance (mu W cm(-2) nm(-1)) and HSI footprint were measured with a radiospectrometer (BiliBlanket Meter II). Results The average measured spectral irradiance ranged between 27 and 52 mu W cm(-2) nm(-1) and HSI footprint ranged between 67 and 1465 cm(2), respectively. Three, two, and one PT devices out of six covered the average BSA of an infant born at 22, 26-32, and 40 weeks of gestation, respectively. Conclusion Spectral irradiance of LED-based overhead PT devices is often lower than manufacturer's specifications, and HSI footprints not always cover the average BSA of a newborn infant. The proposed measurement method will contribute to awareness of the importance of irradiance level as well as footprint measurements in the management of neonatal jaundice. Impact While a sufficient spectral irradiance footprint is essential for PT to be effective, some PT devices have spectral irradiance footprints that are too small to cover the entire body surface area (BSA) of a newborn infant. This study introduces a user-friendly, accessible method to systematically evaluate the spectral irradiance level and footprint of PT devices. This study supports awareness on the role of the spectral irradiance footprint in the efficacy of PT devices. Irradiance footprint can be easily measured during phototherapy with the proposed method

Lack of evidence does not justify neglect. how can we address unmet medical needs in calciphylaxis

Calcific uraemic arteriolopathy (CUA), or calciphylaxis, is a rare disease predominantly occurring in comorbidity with dialysis. Due to the very low frequency of CUA, prospective studies on its management are lacking and even anecdotal reports on treatment remain scarce. Therefore, calciphylaxis is still a challenging disease with dismal prognosis urgently requiring adequate strategies for diagnosis and treatment.In an attempt to fill some of the current gaps in evidence on various, highly debated and controversial aspects of dialysis-associated calciphylaxis, 13 international experts joined the 1st Consensus Conference on CUA, held in Leuven, Belgium on 21 September 2015. The conference was supported by the European Calciphylaxis Network (EuCalNet), which is a task force of the ERA-EDTA scientific working group on Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD). After an intense discussion, a 9-point Likert scale questionnaire regarding 20 items on calciphylaxis was anonymously answered by each participant. These 20 items addressed unsolved issues in terms of diagnosis and management of calciphylaxis. On the one hand, the analysis of the expert opinions identified areas of general consensus, which might be a valuable aid for physicians treating such a disease with less experience in the field. On the other hand, some topics such as the pertinence of skin biopsy and administration of certain treatments revealed divergent opinions. The aim of the present summary report is to provide some guidance for clinicians who face patients with calciphylaxis in the current setting of absence of evidence-based medicin

A multidisciplinary review of the science of vitamin D receptor activation

Our understanding of the vitamin D receptor (VDR) and the effects of VDR activation has changed dramatically in recent years, with the publication of several new studies looking at selective VDR activation and effects on the cardio-renal syndrome (CRS).1 These advances have the potential to change the perspective of VDR activation beyond its role in mineral metabolism. Pleiotropic vitamin D effects have come into the focus of interest