Influence of dietary constituents on intestinal absorption of aluminum

Orally-ingested aluminum compounds have been implicated in the development of dialysis encephalopathy, osteomalacic dialysis osteodystrophy and other disorders in both hemodialyzed and nonhemodialyzed patients suffering from chronic renal failure [1–10]. Both dialysate aluminum content [7, 11, 12] and aluminum-containing phosphate binding agents [12–15] have been identified as contributing to hyperaluminemia in uremic patients. The health threat from dialysate fluids has been reduced by the recommendation that the dialysate contains less than 10 µg/liter of aluminum [16]. Alternative phosphate-binding agents which do not contain aluminum are available but these agents are not free of problems [17], and uremic patients continue to ingest significant doses of aluminum-containing phosphate binding agents.Aluminum is the most common metal in the biosphere of humans but, aside from uremic patients, causes no widespread toxicity. This may be as a result of the extremely limited solubility of aluminum at the pH range of the small intestine and blood [18]. Advances in analytical chemistry have made it possible to measure picogram quantities of aluminum in body fluids, thus enabling accurate determination of plasma aluminum levels in the part per billion (µg/liter) range. These analytical techniques have shown that orally ingested aluminum-containing antacids elevate plasma aluminum levels in man [13]. Balance studies monitoring aluminum absorption and elimination revealed an average positive balance from 23 to 313mg of aluminum per day when diets were supplemented with 1 to 3g of aluminum per day [15]. These studies show that a small fraction of the ingested aluminum is absorbed. This absorption presents potential toxic effects to uremic patients whose ability to eliminate aluminum is impaired.In addition, Slanina et al [19] have shown that addition of citric acid to aluminum-supplemented dietary regimens results in blood aluminum levels that are significantly higher than those found in subjects treated with aluminum-supplemented dietary regimens alone. This result suggests that dietary factors may contribute to aluminum absorption.This study was undertaken to determine if the form of aluminum present in the intestinal lumen significantly affects the absorption of aluminum following oral ingestion

Covalent bonding and the nature of band gaps in some half-Heusler compounds

Half-Heusler compounds \textit{XYZ}, also called semi-Heusler compounds, crystallize in the MgAgAs structure, in the space group $F\bar43m$. We report a systematic examination of band gaps and the nature (covalent or ionic) of bonding in semiconducting 8- and 18- electron half-Heusler compounds through first-principles density functional calculations. We find the most appropriate description of these compounds from the viewpoint of electronic structures is one of a \textit{YZ} zinc blende lattice stuffed by the \textit{X} ion. Simple valence rules are obeyed for bonding in the 8-electron compound. For example, LiMgN can be written Li$^+$ + (MgN)$^-$, and (MgN)$^-$, which is isoelectronic with (SiSi), forms a zinc blende lattice. The 18-electron compounds can similarly be considered as obeying valence rules. A semiconductor such as TiCoSb can be written Ti$^{4+}$ + (CoSb)$^{4-}$; the latter unit is isoelectronic and isostructural with zinc-blende GaSb. For both the 8- and 18-electron compounds, when \textit{X} is fixed as some electropositive cation, the computed band gap varies approximately as the difference in Pauling electronegativities of \textit{Y} and \textit{Z}. What is particularly exciting is that this simple idea of a covalently bonded \textit{YZ} lattice can also be extended to the very important \textit{magnetic} half-Heusler phases; we describe these as valence compounds \textit{ie.} possessing a band gap at the Fermi energy albeit only in one spin direction. The \textit{local} moment in these magnetic compounds resides on the \textit{X} site.Comment: 18 pages and 14 figures (many in color

Mature Care and Nursing in Psychiatry: Notions Regarding Reciprocity in Asymmetric Professional Relationships

The idea behind this article is to discuss the importance and to develop the concept of reciprocity in asymmetric professional relationships. As an empirical starting point for an examination of the possible forms of reciprocity between patients and nurses in psychiatry, we chose two qualitative in-depth interviews with two different patients. The manners in which these two patients relate to medical personnel—one is dependent, the other is independent—show that this presents challenges to nurses. The theoretical context is provided by the notion of mature care as it has been developed by feminist-oriented ethics of care, in contrast to the notion of altruistic care. In relation to the concept of mature care, we discuss how nursing can be perceived in demanding relationships with patients in psychiatry. Reciprocity implies that, in principle, the interests of the nurses also matter in a nurse-patient relationship. We show that reciprocity—in practice—is complicated and challenging in a number of different ways. Mature care—with its systematic inclusion of relationships and reciprocity—provides an alternative understanding of what takes place between patients and nurses compared with an altruistic notion of care. As such, mature care can be regarded as an useful paradigm for nurse-patient relationships in psychiatry

Utslepp av kommunalt slam til Korsfjorden frå Andershola slamtømmestasjon i Sund kommune

Sund kommune har i fleire år tømt utvatna kommunalt slam i Korsfjorden gjennom eit røyr som går frå Andershola tømmestasjon og ut til 57 m djup i fjorden. Kommunen har ønskt å få utgreidd miljøkonsekvensane av å halde fram med denne måten å bli kvitt komunalt slam. NIVA har gjennomgått opplysningar om resipienten og har i tillegg foretatt strømmåling ved utsleppsstaden. Det er rekna på og vurdert kva effektar som kan oppstå. Det er konkludert med at effektar vil vere avgrensa til botnen ved utsleppet og til eit vassjikt i 30-40 m djup i sjøen i nærområdet sørvest for utsleppet. For Korsfjorden totalt utgjer utsleppet kun eit lite bidrag til næringssalt og oksygenforbruk. I rapporten er det referert til ein del litteratur som omhandlar effektar av kloakkutslepp. Det er referert til gjeldane regelverk på området utan å vurdere lovlegheita av slamtømminga. Nokre tekniske tiltak som kan redusere effektar, er også nemnt.Sund kommun

Sotatercept safety and effects on hemoglobin, bone, and vascular calcification

Introduction: Patients with end-stage kidney disease (ESKD) exhibit anemia, chronic kidney disease‒mineral bone disorder (CKD-MBD), and cardiovascular disease. The REN-001 and REN-002 phase II, multicenter, randomized studies examined safety, tolerability, and effects of sotatercept, an ActRIIA-IgG1 fusion protein trap, on hemoglobin concentration; REN-001 also explored effects on bone mineral density (BMD) and abdominal aortic vascular calcification. Methods: Forty-three patients were treated in REN-001 (dose range: sotatercept 0.3‒0.7 mg/kg or placebo subcutaneously [s.c.] for 200 days) and 50 in REN-002 (dose range: 0.1‒0.4 mg/kg i.v. and 0.13‒0.5 mg/kg s.c. for 99 days). Results: In REN-001, frequency of achieving target hemoglobin response (\u3e10 g/dl [6.21 mmol/l]) with sotatercept was dose-related and greater than placebo (0.3 mg/kg: 33.3%; 0.5 mg/kg: 62.5%; 0.7 mg/kg: 77.8%; 0.7 mg/kg [doses 1 and 2]/0.4 mg/kg [doses 3‒15]: 33.3%; placebo: 27.3%). REN-002 hemoglobin findings were similar (i.v.: 16.7%-57.1%; s.c.: 11.1%‒42.9%). Dose-related achievement of ≥2% increase in femoral neck cortical BMD was seen among only REN-001 patients receiving sotatercept (0.3‒0.7 mg/kg: 20.0%‒57.1%; placebo: 0.0%). Abdominal aortic vascular calcification was slowed in a dose-related manner, with a ≤15% increase in Agatston score achieved by more REN-001 sotatercept versus placebo patients (60%‒100% vs. 16.7%). The most common adverse events during treatment were hypertension, muscle spasm, headache, arteriovenous fistula site complication, and influenza observed in both treatment and placebo groups. Conclusion: In patients with ESKD, sotatercept exhibited a favorable safety profile and was associated with trends in dose-related slowing of vascular calcification. Less-consistent trends in improved hemoglobin concentration and BMD were observed

Formulation of a killed whole cell pneumococcus vaccine - effect of aluminum adjuvants on the antibody and IL-17 response

Background Streptococcus pneumoniae causes widespread morbidity and mortality. Current vaccines contain free polysaccharides or protein-polysaccharide conjugates, and do not induce protection against serotypes that are not included in the vaccines. An affordable and broadly protective vaccine is very desirable. The goal of this study was to determine the optimal formulation of a killed whole cell pneumococcal vaccine with aluminum-containing adjuvants for intramuscular injection. Methods Four aluminium-containing adjuvants were prepared with different levels of surface phosphate groups resulting in different adsorptive capacities and affinities for the vaccine antigens. Mice were immunized three times and the antigen-specific antibody titers and IL-17 responses in blood were analyzed. Results Although all adjuvants induced significantly higher antibody titers than antigen without adjuvant, the vaccine containing aluminum phosphate adjuvant (AP) produced the highest antibody response when low doses of antigen were used. Aluminum hydroxide adjuvant (AH) induced an equal or better antibody response at high doses compared with AP. Vaccines formulated with AH, but not with AP, induced an IL-17 response. The vaccine formulated with AH was stable and retained full immunogenicity when stored at 4°C for 4 months. Conclusions Antibodies are important for protection against systemic streptococcal disease and IL-17 is critical in the prevention of nasopharyngeal colonization by S. pneumoniae in the mouse model. The formulation of the whole killed bacterial cells with AH resulted in a stable vaccine that induced both antibodies and an IL-17 response. These experiments underscore the importance of formulation studies with aluminium containing adjuvants for the development of stable and effective vaccines

Urban water system metabolism assessment using WaterMet2 model

12th International Conference on Computing and Control for the Water Industry, CCWI2013, 2013-09-06, 2013-09-09, Perugia, ItalyThis paper presents a new "WaterMet2" model for integrated modelling of an urban water system (UWS). The model is able to quantify the principal water flows and other main fluxes in the UWS. The UWS in WaterMet2 is characterised using four different spatial scales (indoor area, local area, subcatchment and system area) and a daily temporal resolution. The main subsystems in WaterMet2 include water supply, water demand, wastewater and cyclic water recovery. The WaterMet2 is demonstrated here through modelling of the urban water system of Oslo city in Norway. Given a fast population growth, WaterMet2 analyses a range of alternative intervention strategies including 'business as usual', addition of new water resources, increased rehabilitation rates and water demand schemes to improve the performance of the Oslo UWS. The resulting five intervention strategies were compared with respect to some major UWS performance profiles quantified by the WaterMet2 model and expert's opinions. The results demonstrate how an integrated modelling approach can assist planners in defining a better intervention strategy in the future.This work was carried out as part of the ‘TRansition to Urban water Services of Tomorrow’ (TRUST) project. The authors wish to acknowledge the European Commission for funding TRUST project in the 7th Framework Programme under Grant Agreement No. 265122

Geometric, electronic, and magnetic structure of Co2_2FeSi: Curie temperature and magnetic moment measurements and calculations

In this work a simple concept was used for a systematic search for new materials with high spin polarization. It is based on two semi-empirical models. Firstly, the Slater-Pauling rule was used for estimation of the magnetic moment. This model is well supported by electronic structure calculations. The second model was found particularly for Co$_2$ based Heusler compounds when comparing their magnetic properties. It turned out that these compounds exhibit seemingly a linear dependence of the Curie temperature as function of the magnetic moment. Stimulated by these models, Co$_2$FeSi was revisited. The compound was investigated in detail concerning its geometrical and magnetic structure by means of X-ray diffraction, X-ray absorption and M\"o\ss bauer spectroscopies as well as high and low temperature magnetometry. The measurements revealed that it is, currently, the material with the highest magnetic moment ($6\mu_B$) and Curie-temperature (1100K) in the classes of Heusler compounds as well as half-metallic ferromagnets. The experimental findings are supported by detailed electronic structure calculations

Access to health care for persons with disabilities in rural South Africa

BACKGROUND: Global research suggests that persons with disabilities face barriers when accessing health care services. Yet, information regarding the nature of these barriers, especially in low-income and middle-income countries is sparse. Rural contexts in these countries may present greater barriers than urban contexts, but little is known about access issues in such contexts. There is a paucity of research in South Africa looking at "triple vulnerability" - poverty, disability and rurality. This study explored issues of access to health care for persons with disabilities in an impoverished rural area in South Africa. METHODS: The study includes a quantitative survey with interviews with 773 participants in 527 households. Comparisons in terms of access to health care between persons with disabilities and persons with no disabilities were explored. The approach to data analysis included quantitative data analysis using descriptive and inferential statistics. Frequency and cross tabulation, comparing and contrasting the frequency of different phenomena between persons with disabilities and persons with no disabilities, were used. Chi-square tests and Analysis of Variance tests were then incorporated into the analysis. RESULTS: Persons with disabilities have a higher rate of unmet health needs as compared to non-disabled. In rural Madwaleni in South Africa, persons with disabilities faced significantly more barriers to accessing health care compared to persons without disabilities. Barriers increased with disability severity and was reduced with increasing level of education, living in a household without disabled members and with age. CONCLUSIONS: This study has shown that access to health care in a rural area in South Africa for persons with disabilities is more of an issue than for persons without disabilities in that they face more barriers. Implications are that we need to look beyond the medical issues of disability and address social and inclusion issues as well