Ethics roundtable: Using new, expensive drugs

Costly genetically engineered therapies, which threaten to cripple the health care industry economy and undermine the common good if applied indiscriminately, loom on the horizon. The spectrum of applicable candidates include moribund nursing home patients at the end of life. They will be fair game for therapy that will ultimately send them back to nursing homes to return later with the same condition. 'Quality of life' assessments that limit patient autonomy may be forced as a result. Discussants from South Africa, New Zealand, and the USA suggest methods to deal with this issue in a just and ethical framework

'Round-table' ethical debate: is a suicide note an authoritative 'living will'?

Living wills are often considered by physicians who are faced with a dying patient. Although popular with the general public, they remain problems of authenticity and authority. It is difficult for the examining physician to know whether the patient understood the terms of the advance directive when they signed it, and whether they still consider it authoritative at the time that it is produced. Also, there is little consensus on what spectrum of instruments constitutes a binding advance directive in real life. Does a 'suicide note' constitute an authentic and authoritative 'living will'? Our panel of authorities considers this problem in a round-table discussion

Alternative low-cost adsorbent for water and wastewater decontamination derived from eggshellwaste: an overview

As the current global trend towards more stringent environmental standards, technical applicability and cost-effectiveness became key factors in the selection of adsorbents for water and wastewater treatment. Recently, various low-cost adsorbents derived from agricultural waste, industrial by-products or natural materials, have been intensively investigated. In this respect, the eggshells from egg-breaking operations constitute significant waste disposal problems for the food industry, so the development of value-added by-products from this waste is to be welcomed. The egg processing industry is very competitive, with low profit margins due to global competition and cheap imports. Additionally, the costs associated with the egg shell disposal (mainly on landfill sites) are significant, and expected to continue increasing as landfill taxes increase. The aim of the present review is to provide an overview on the development of low-cost adsorbents derived from eggshell by-products

A longitudinal study of systemic inflammation and recovery of lean body mass among malnourished HIV-infected adults starting antiretroviral therapy in Tanzania and Zambia

BACKGROUND/OBJECTIVES: The effects of inflammation on nutritional rehabilitation after starting antiretroviral therapy (ART) are not well understood. We assessed the relationship between inflammation and body composition among patients enrolled in the Nutritional Support for African Adults Starting Antiretroviral therapy (NUSTART) trial in Tanzania and Zambia from 2011 to 2013. SUBJECTS/METHODS: HIV-infected, ART-eligible adults with body mass index (BMI) of <18.5 kg/m(2) enrolled in the NUSTART trial were eligible for this study. Anthropometric and body composition data were collected at recruitment and 6 and 12 weeks post ART and C-reactive protein (CRP) was measured at recruitment and 6 weeks. The relationships between CRP and body composition were assessed using multiple regression. RESULTS: Of the 1815 trial participants, 838 (46%) had baseline and 6-week CRP measurements. Median age was 36 years, 55% were females and median CD4 count was 135 cells/μl. A one-log reduction in CRP at 6 weeks was associated with increased mid-upper arm circumference (0.45 cm; 95% CI: 0.30, 0.61), calf circumference (0.38 cm; 0.23, 0.54), waist circumference (0.98 cm; 0.59, 1.37), BMI (0.37 kg/m(2); 0.24, 0.50) and fat-free mass (0.58 kg; 0.26, 0.91), but not with fat mass (0.09 kg; -0.17, 0.34). Fat-free mass gains persisted at 12 weeks and were more closely associated with 6-week CRP values than with baseline values. CONCLUSIONS: Reduction in CRP shortly after ART initiation was associated with higher fat-free mass gains. Further studies are warranted to determine whether interventions to reduce systemic inflammation will enhance gains in fat-free mass

The comparative biology of New Zealand oystercatchers

Oystercatchers comprise a distinctive group of mollusc-eating shorebirds. They form an extremely uniform monogeneric family which has not undergone any major adaptive radiations into a diversity of ecological niches, but rather has dispersed from original centres of distribution to occupy identical niches in new geographical localities. The uniformity of structure and habit displayed within the group has been attributed by Larson (1957) to a high ecobiotic specialisation with centripetal selection involved. Throughout their range, oystercatchers exploit identical ecological niches which require specialised habits for successful utilisation. The specialised feeding habits of oystercatchers are well documented (Murphy, 1925; Dewar, 1940; Larson, 1957; Tinbergen and Norton-Griffiths, 1964; Dare, 1966), and a natural consequence of this specialisation is that it is restrictive to adaptive radiation

Removal of chromate by solvent impregnated resins (SIRs) stabilized by coating and chemical crosslinking. I. Batch-mode sorption studies

WOS: 000221113100002Solvent impregnated resins (SIRs) that are stabilized by coating with vinyl sulphone crosslinked poly(vinyl alcohol) have been employed for the removal of chromate ions from an aqueous solution at pH 4.0. Batch sorption studies have shown that both uncoated and coated SIRs containing Aliquat 336 are effective for the removal of chromate ions from aqueous solution when an optimum concentration of SIRs is used in the solution. A series of batch-mode sorption-elution studies was performed to compare uncoated and coated-crosslinked SIRs in cyclic operation. Elution of chromate from SIRs was quantitatively achieved with a mixed 1 M NaOH-1 M NaCl solution. The sorption performance of coated SIRs remained almost constant after seven sorption-washing-elution-washing cycles whilst a decrease in sorption performance of uncoated SIRs was observed. However, the kinetic performance of uncoated SIRs was more favourable for chromate removal. However, it was possible to attain rapid kinetics by decreasing the degree of crosslinking of the resin coating. In addition, pre-conditioning of coated resins using a mixed I M NaOH-NaCl solution prior to sorption considerably enhanced the kinetic performance of coated SIRs. (C) 2004 Elsevier B.V. All rights reserved