Titanate nanotubes for reinforcement of a poly(ethylene oxide)/chitosan polymer matrix.

Soft polyethylene oxide (PEO)/chitosan mixtures, reinforced with hard titanate nanotubes (TiNTs) by co-precipitation from aqueous solution, have been used to produce compact coatings by the 'drop-cast' method, using water soluble PEO polymer and stable, aqueous colloidal solutions of TiNTs. The effects of the nanotube concentration and their length on the hardness and modulus of the prepared composite have been studied using nanoindentation and nanoscratch techniques. The uniformity of TiNT dispersion within the polymer matrix has been studied using transmission electron microscopy (TEM). A remarkable increase in hardness and reduced Young's modulus of the composites, compared to pure polymer blends, has been observed at a TiNT concentration of 25 wt %. The short (up to 30 min) ultrasound treatment of aqueous solutions containing polymers and a colloidal TiNT mixture prior to drop casting has resulted in some improvements in both hardness and reduced Young's modulus of dry composite films, probably due to a better dispersion of ceramic nanotubes within the matrix. However, further (more than 1 h) treatment of the mixture with ultrasound resulted in a deterioration of the mechanical properties of the composite accompanied by a shortening of the nanotubes, as observed by the TEM.

Rectal atresia and anal stenosis: the difference in the operative technique for these two distinct congenital anorectal malformations.

Rectal atresia and anal stenosis are rare forms of anorectal malformations. The aim of the definitive surgical repair in such cases is to preserve the anal canal, the dentate line, and the sphincter complex. We present a case of rectal atresia and anal stenosis to demonstrate the differences in the operative repair. The techniques described leave the anterior wall of the very distal anal canal untouched in both rectal stenosis and anal atresia; however, the dissection of the rectum differs. The atretic rectum in rectal atresia is mobilized and sutured to the anal canal circumferentially. In anal stenosis, the posterior rectum is mobilized in the form of rectal advancement, and the posterior 180° is anastomosed directly to the skin (as in a standard PSARP) with preservation of the anal canal as the anterior 180° of the final anoplasty. These patients have an excellent prognosis for bowel control and fecal continence, and therefore, complete mobilization and resection of the anal canal must be avoided.

No change in calcium absorption in adult Pakistani population before and after vitamin D administration using strontium as surrogate.

UNLABELLED: Vitamin D, parathyroid hormone levels and calcium absorption was assessed before and after cholecalciferol using Strontium as a surrogate. Increase in 25OHD, lowering of iPTH with no effect on Sr absorption was seen, suggesting the possibility that maximal Ca absorption had already been achieved in these volunteers. INTRODUCTION: This paper discusses the determination of calcium (Ca) absorption, using strontium (Sr) as a surrogate, before and after a single IM injection of vitamin D(3) (600,000 IU). METHODS: Baseline serum 25-hydroxyvitamin D (25OHD), Sr, Ca, P, and intact parathyroid hormone (iPTH) were determined in 53 fasting volunteers, followed by administrating (PO) 0.03 mM (4.8 mg/kg) SrCl(2) and collecting blood at 0.5, 1 and 4 h to determine the absorption (AUC(0 → t )) of Sr. Following the initial absorption test, volunteers received a single IM injection of 600,000 IU vitamin D(3). Two months later, the fasting serum and the Sr absorption test were repeated, as described above. RESULTS: The IM injection of vitamin D(3) caused a significant increase in fasting 25OHD (from 43.5 ± 19 to 66.1 ± 19.1 nmol/L (p < 0.001)) and a trend toward lower serum iPTH (from 59.8 ± 27.8 to 53 ± 31 ng/L). Fasting serum Ca and P remained unchanged. A higher 25OHD level failed (p = 0.32) to translate into a higher rate of Sr absorption. AUC(0 → 4 h) were almost identical before and after the IM injection of vitamin D(3). CONCLUSION: A single vitamin D(3) injection of 600,000 IU significantly increase mean 25OHD concentration and tended to lower iPTH concentrations in volunteers with initially low 25OHD status, suggesting to utilize this simple form of treatment to improve vitamin D status and to have a possible biological effect on Ca homeostasis. However, we found no obvious effect on Sr absorption, suggesting the possibility that maximal vitamin D-dependent Ca absorption had already been achieved in these volunteers at a lower vitamin D status.

Programmable matter by folding.

Programmable matter is a material whose properties can be programmed to achieve specific shapes or stiffnesses upon command. This concept requires constituent elements to interact and rearrange intelligently in order to meet the goal. This paper considers achieving programmable sheets that can form themselves in different shapes autonomously by folding. Past approaches to creating transforming machines have been limited by the small feature sizes, the large number of components, and the associated complexity of communication among the units. We seek to mitigate these difficulties through the unique concept of self-folding origami with universal crease patterns. This approach exploits a single sheet composed of interconnected triangular sections. The sheet is able to fold into a set of predetermined shapes using embedded actuation. To implement this self-folding origami concept, we have developed a scalable end-to-end planning and fabrication process. Given a set of desired objects, the system computes an optimized design for a single sheet and multiple controllers to achieve each of the desired objects. The material, called programmable matter by folding, is an example of a system capable of achieving multiple shapes for multiple functions.

Spring and latch dynamics can act as control pathways in ultrafast systems.

Ultrafast movements propelled by springs and released by latches are thought limited to energetic adjustments prior to movement, and seemingly cannot adjust once movement begins. Even so, across the tree of life, ultrafast organisms navigate dynamic environments and generate a range of movements, suggesting unrecognized capabilities for control. We develop a framework of control pathways leveraging the non-linear dynamics of spring-propelled, latch-released systems. We analytically model spring dynamics and develop reduced-parameter models of latch dynamics to quantify how they can be tuned internally or through changing external environments. Using Lagrangian mechanics, we test feedforward and feedback control implementation via spring and latch dynamics. We establish through empirically-informed modeling that ultrafast movement can be controllably varied during latch release and spring propulsion. A deeper understanding of the interconnection between multiple control pathways, and the tunability of each control pathway, in ultrafast biomechanical systems presented here has the potential to expand the capabilities of synthetic ultra-fast systems and provides a new framework to understand the behaviors of fast organisms subject to perturbations and environmental non-idealities.

Anaesthesia for 1131 patients undergoing proximal femoral fracture repair: a retrospective, observational study of effects on blood pressure, fluid administration and perioperative anaemia.

Intra-operative hypotension is a frequent occurrence during anaesthesia for hip fracture surgery in older patients with co-morbidities. We analysed retrospective data from the Brighton Hip Fracture Database to determine the intra-operative fall in systolic blood pressure, and the incidence of absolute (lowest systolic blood pressure < 90 mmHg) and relative (> 20% fall in systolic blood pressure from baseline) hypotension during general or spinal anaesthesia among 1131 non-consecutive patients with hip fracture. General anaesthesia for 489 patients (43.2%) produced a greater mean (SD) fall in systolic blood pressure than spinal anaesthesia for 578 patients (51.1%): 34.2% (13.0%) vs 29.7% (10.8%), respectively (p < 0.0001), mean difference 4.5% (95% CI 3.1-5.9%), and was associated with greater mean (SD) intra-operative fluid administration (1555 (801) ml vs 1375 (621) ml, respectively, p < 0.0001). We observed a correlation between the volume of subarachnoid hyperbaric bupivacaine 0.5% and fall in systolic blood pressure (p = 0.004): compared with patients receiving > 1.5 ml (n = 463), fewer patients receiving ≤ 1.5 ml bupivacaine 0.5% (n = 97) experienced episodes of absolute (31.1% vs 11.3%, p < 0.0001) or relative (83.9% vs 26.8%, p < 0.0001) hypotension. Both mean (SD) intravenous fluid administration (1097 ml (439) vs 1431 ml (638), p < 0.0001) and mean peri-operative fall in haemoglobin concentration (2.1 (1.8) g.dl(-1) vs 2.6 (1.7) g.dl(-1), p = 0.009) were lower in the low-dose spinal group. If these data are confirmed by other researchers, intra-operative hypotension (and consequent haemodilution secondary to reactive fluid administration) in this patient group may be reduced by the simple expedient of administering more cautious general anaesthesia, or reduced volumes of subarachnoid local anaesthetic.

The tribological behaviour of different clearance MOM hip joints with lubricants of physiological viscosities.

Clearance is one of the most influential parameters on the tribological performance of metal-on-metal (MOM) hip joints and its selection is a subject of considerable debate. The objective of this paper is to study the lubrication behaviour of different clearances for MOM hip joints within the range of human physiological and pathological fluid viscosities. The frictional torques developed by MOM hip joints with a 50 mm diameter were measured for both virgin surfaces and during a wear simulator test. Joints were manufactured with three different diametral clearances: 20, 100, and 200 microm. The fluid used for the friction measurements which contained different ratios of 25 percent newborn calf serum and carboxymethyl cellulose (CMC) with the obtained viscosities values ranging from 0.001 to 0.71 Pa s. The obtained results indicate that the frictional torque for the 20 microm clearance joint remains high over the whole range of the viscosity values. The frictional torque of the 100 microm clearance joint was low for the very low viscosity (0.001 Pa s) lubricant, but increased with increasing viscosity value. The frictional torque of the 200 microm clearance joint was high at very low viscosity levels, however, it reduced with increasing viscosity. It is concluded that a smaller clearance level can enhance the formation of an elastohydrodynamic lubrication (EHL) film, but this is at the cost of preventing fluid recovery between the bearing surfaces during the unloaded phase of walking. Larger clearance bearings allow a better recovery of lubricant during the unloaded phase, which is necessary for higher viscosity lubricants. The selection of the clearance value should therefore consider both the formation of the EHL film and the fluid recovery as a function of the physiological viscosity in order to get an optimal tribological performance for MOM hip joints. The application of either 25 per cent bovine serum or water in existing in vitro tribological study should also be revised to consider the relevance of clinic synovial fluid viscosities and to avoid possible misleading results.

Consensus exercise identifying priorities for research in the field of general surgery of childhood in the UK.

BACKGROUND: The evidence base underlying clinical practice in children's general surgery is poor and high-quality collaborative clinical research is required to address current treatment uncertainties. The aim of this study was, through a consensus process, to identify research priorities for clinical research in this field amongst surgeons who treat children. METHODS: Questions were invited in a scoping survey amongst general surgeons and specialist paediatric surgeons. These were refined by the study team and subsequently prioritized in a two-stage modified Delphi process. RESULTS: In the scoping survey, a total of 226 questions covering a broad scope of children's elective and emergency general surgery were submitted by 76 different clinicians. These were refined to 71 research questions for prioritization. A total of 168 clinicians took part in stage one of the prioritization process, and 157 in stage two. A 'top 10' list of priority research questions was generated for both elective and emergency general surgery of childhood. These cover a range of conditions and concepts, including inguinal hernia, undescended testis, appendicitis, abdominal trauma and enhanced recovery pathways. CONCLUSION: Through consensus amongst surgeons who treat children, 10 priority research questions for each of the elective and emergency fields have been identified. These should provide a basis for the development of high-quality multicentre research projects to address these questions, and ultimately improve outcomes for children requiring surgical care.

Insect population control using a dominant, repressible, lethal genetic system.

A major modification to the sterile insect technique is described, in which transgenic insects homozygous for a dominant, repressible, female-specific lethal gene system are used. We demonstrate two methods that give the required genetic characteristics in an otherwise wild-type genetic background. The first system uses a sex-specific promoter or enhancer to drive the expression of a repressible transcription factor, which in turn controls the expression of a toxic gene product. The second system uses non-sex-specific expression of the repressible transcription factor to regulate a selectively lethal gene product. Both methods work efficiently in Drosophila melanogaster, and we expect these principles to be widely applicable to more economically important organisms.

Thermal Desorption Analysis of Hydrogen in Non-hydrogen-Charged Rolling Contact Fatigue-Tested 100Cr6 Steel.

Hydrogen diffusion during rolling contact fatigue (RCF) is considered a potential root cause or accelerator of white etching cracks (WECs) in wind turbine gearbox bearing steels. Hydrogen entry into the bearing steel during operation is thought to occur either through the contact surface itself or through cracks that breach the contact surface, in both cases by the decomposition of lubricant through catalytic reactions and/or tribochemical reactions of water. Thermal desorption analysis (TDA) using two experimental set-ups has been used to measure the hydrogen concentration in non-hydrogen-charged bearings over increasing RCF test durations for the first time. TDA on both instruments revealed that hydrogen diffused into the rolling elements, increasing concentrations being measured for longer test durations, with numerous WECs having formed. On the other hand, across all test durations, negligible concentrations of hydrogen were measured in the raceways, and correspondingly no WECs formed. Evidence for a relationship between hydrogen concentration and either the formation or the acceleration of WECs is shown in the rollers, as WECs increased in number and severity with increasing test duration. It is assumed that hydrogen diffusion occurred at wear-induced nascent surfaces or areas of heterogeneous/patchy tribofilm, since most WECs did not breach the contact surface, and those that did only had very small crack volumes for entry of lubricant to have occurred.

The Evolution of White Etching Cracks (WECs) in Rolling Contact Fatigue-Tested 100Cr6 Steel.

The formation of white etching cracks (WECs) in steel rolling element bearings can lead to the premature rolling contact fatigue (RCF) failure mode called white structure flaking. Driving mechanisms are still debated but are proposed to be combinations of mechanical, tribochemical and electrical effects. A number of studies have been conducted to record and map WECs in RCF-tested samples and bearings failed from the field. For the first time, this study uses serial sectioning metallography techniques on non-hydrogen charged test samples over a range of test durations to capture the evolution of WEC formation from their initiation to final flaking. Clear evidence for subsurface initiation at non-metallic inclusions was observed at the early stages of WEC formation, and with increasing test duration the propagation of these cracks from the subsurface region to the contact surface eventually causing flaking. In addition, an increase in the amount of associated microstructural changes adjacent to the cracks is observed, this being indicative of the crack being a prerequisite of the microstructural alteration.

Segmental colonic dilation is associated with premature termination of high-amplitude propagating contractions in children with intractable functional constipation.

BACKGROUND: Colonic dilation is common in children with intractable functional constipation (FC). Our aim was to describe the association between segmental colonic dilation and colonic dysmotility in children with FC. METHODS: We performed a retrospective study on 30 children with intractable FC (according to the Rome III criteria) who had undergone colonic manometry and contrast enema within a 12-month time period. Colonic diameter was measured at 5 cm intervals from the anal verge up to the splenic flexure. Moreover, the distance between the lateral margins of the pedicles of vertebra L2 was measured to provide a ratio (colonic diameter or length/distance between the lateral margins; "standardized colon size" [SCS]). All manometry recordings were visually inspected for the presence of high-amplitude propagating contractions (HAPCs); a parameter for colonic motility integrity. The intracolonic location of the manometry catheter sensors was assessed using an abdominal X-ray. KEY RESULTS: Colonic segments with HAPCs had a significantly smaller median diameter than colonic segments without HAPCs (4.08 cm vs 5.48 cm, P<.001; SCS 1.14 vs 1.66, P=.001). Children with prematurely terminating HAPCs had significantly larger SCS ratios for colonic diameter than children with fully propagating HAPCs (P=.008). SCS ratios for the length of the rectosigmoid and the descending colon and the SCS ratio for sigmoid colon diameter were significantly larger in children with FC compared to a previously described normative population (P<.0001, P<.0001 and P=.0007 respectively). CONCLUSIONS & INFERENCES: Segmental colonic dilation was associated with prematurely terminating HAPCs and may be a useful indicator of colonic dysmotility.

Perching and takeoff of a robotic insect on overhangs using switchable electrostatic adhesion.

For aerial robots, maintaining a high vantage point for an extended time is crucial in many applications. However, available on-board power and mechanical fatigue constrain their flight time, especially for smaller, battery-powered aircraft. Perching on elevated structures is a biologically inspired approach to overcome these limitations. Previous perching robots have required specific material properties for the landing sites, such as surface asperities for spines, or ferromagnetism. We describe a switchable electroadhesive that enables controlled perching and detachment on nearly any material while requiring approximately three orders of magnitude less power than required to sustain flight. These electroadhesives are designed, characterized, and used to demonstrate a flying robotic insect able to robustly perch on a wide range of materials, including glass, wood, and a natural leaf.

Increased vitamin D receptor level enhances 1,25-dihydroxyvitamin D3-mediated gene expression and calcium transport in Caco-2 cells.

Altered vitamin D receptor (VDR) level has been proposed to explain differences in intestinal responsiveness to 1,25-dihydroxyvitamin D3 [1,25(OH)2D3]. We tested whether the enterocyte VDR level influences 1,25(OH)2D3-mediated gene expression and transepithelial calcium (Ca) transport in the human intestinal cell line Caco-2. Cells were stably transfected with a human metallothionein (hMT) IIA promoter-human VDR (hVDR) complementary DNA (cDNA) transgene that overexpressed hVDR in response to heavy metals. In MTVDR clones, induction of 25-hyroxyvitamin D3-24-hydroxylase (24-OHase) messenger RNA (mRNA) expression by 1,25(OH)2D3 (10(-9) M, 4 h) was correlated to metal-induced changes in nuclear VDR level (r2 = 0.99). In MTVDR clones, basal VDR level was 2-fold greater and 1,25(OH)2D3-mediated Ca transport (10(-7) M, 24 h) was 43% higher than in parental Caco-2 cells. Treatment of MTVDR clones with Cd (1 microM, 28 h) increased VDR level by 68%, significantly enhanced 1,25(OH)2D3-mediated Ca transport by 24%, and increased accumulation of calbindin D9K mRNA by 76% relative to 1,25(OH)2D3 alone. These observations support the hypothesis that the enterocyte VDR level is an important modulator of intestinal responsiveness to 1,25(OH)2D3.

The BsmI vitamin D receptor restriction fragment length polymorphism (BB) predicts low bone density in premenopausal black and white women.

We conducted a study to determine whether a recently described restriction fragment length polymorphism in the vitamin D receptor gene (VDR-RFLP) predicts bone mineral density (BMD) in unrelated, premenopausal women as well as to determine the racial contribution to any genotypic influences on BMD. White (n = 83) and black (n = 72) women between 20 and 40 years of age were genotyped based on the presence (b) or absence (B) of a BsmI restriction enzyme site in the VDR gene, and BMD in the lumbar spine and femur neck was determined for each subject. There were 16 BB, 73 Bb, and 66 bb women. No significant difference was observed in genotypic distribution between the racial groups. The interaction of race by genotype on age- and body mass index (BMI)-adjusted BMD was not significant at either site. Age- and BMI-adjusted BMD was higher in black women at the spine (by 7.2%, p = 0.046) and femur neck (7.3% higher, p = 0.004). In the group as a whole, mean BMD in the femur neck was lower in the BB women that the bb (by 8.1%, p = 0.034) or Bb women (by 9.3%, p = 0.015) after controlling for age, BMI, race, and the race by genotype interaction. Adjusted lumbar spine BMD was lower in the BB women than the Bb women (6.4% lower, p = 0.036) in the group as a whole. No difference were detected between Bb and bb women at either site. A similar pattern of low BMD at the femur neck and the lumbar spine was seen in BB women of both races.(ABSTRACT TRUNCATED AT 250 WORDS)

Intestinal calcium absorption in the aged rat: evidence of intestinal resistance to 1,25(OH)2 vitamin D.

We investigated the role of circulating 1,25-dihydroxycholecalciferol (1,25(OH)2D) and intestinal resistance to 1,25(OH)2D in the diminished intestinal calcium absorption capacity of the senescent rat. We measured plasma 1,25(OH)2D, total and unoccupied duodenal vitamin D receptor, duodenal calbindin D9k protein (calbindin D), and net dietary calcium absorption in rats at several ages. As expected, circulating 1,25(OH)2D, calbindin D, and net calcium absorption decreased with age. However, no age-related changes were evident in intestinal vitamin D receptor levels. We then measured duodenal calcium absorption from in situ intestinal loops after continuous s.c. infusion of 1,25(OH)2D for up to 6 days and found that despite a marked elevation of plasma 1,25(OH)2D duodenal calcium absorption was significantly lower in old compared with young rats. To assess calcium absorption over a wide physiological range of plasma 1,25(OH)2D, in a dose-response study we altered plasma 1,25(OH)2D by continuous infusion of 1,25(OH)2D (at 0, 4, or 14 ng/100 g BW/day) for 9 days. We found that the slope of the linear regression between plasma 1,25(OH)2D and duodenal Ca transport in old rats was only 46% of that observed in young rats, suggesting an age-related resistance of the duodenal calcium transport process to the hormonal action of 1,25(OH)2D. Collectively, our observations suggest a dual defect in vitamin D metabolism in old animals: one defect related to the low circulating levels of 1,25(OH)2D and a second defect related to a relative intestinal resistance to the action of 1,25(OH)2D, which is apparently not due to a reduction in intestinal vitamin D receptor levels.

Growth hormone and parathyroid hormone stimulate intestinal calcium absorption in aged female rats.

Aged (16-month-old) female rats (n = 8/treatment) were injected for 12 days with GH (100 micrograms/100 g x day), PTH (8 micrograms/100 g x day), GH plus PTH, or vehicle (V) in an experiment designed to determine the effects of these hormones on intestinal mineral absorption in senescent rats. PTH and GH increased fractional net calcium absorption to a similar extent (PTH, 1.6-fold; GH, 1.4-fold) even though PTH increased serum 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] 3.7-fold, and GH had no significant effect. GH plus PTH caused no further increase in serum 1,25-(OH)2D3 above that caused by PTH alone, but resulted in an additive effect on net calcium absorption (2.3-fold increase). PTH and GH also had statistically independent effects on phosphate absorption; magnesium absorption was elevated only by PTH. Duodenal calbindin-D9k levels were increased by GH (from 3.79 +/- 0.72 to 6.98 +/- 0.73 micrograms/mg protein) and PTH (from 3.23 +/- 0.46 to 7.55 +/- 0.75 micrograms/mg protein); PTH plus GH treatment resulted in an additive effect on calbindin-D9k levels. Additional in vitro transport studies in the human intestinal cell line Caco-2 showed that 72 h of pretreatment with the local mediator of GH action, insulin-like growth factor-I (at 10 and 100 ng/ml), stimulated transcellular calcium transport (22% and 44%, respectively) regardless of concomitant 1 nM 1,25-(OH)2D3 pretreatment (80% increase). Our findings suggest a 1,25-(OH)2D3-mediated mechanism for PTH-induced changes in calcium and phosphorus absorption. In contrast, the effects of GH in the senescent rat are independent of changes in circulating 1,25-(OH)2D3 and our data suggest that these effects may be mediated by insulin-like growth factor-I.

Lower serum ionized calcium and abnormal calciotropic hormone levels in preeclampsia.

Relative hypocalciuria has been reported in women with preeclampsia. However, there has been no systematic explanation for this finding. We measured serum and urinary calcium and serum calciotropic hormones in third trimester women with preeclampsia (n = 12, gestational hypertension and proteinuria) and with normotensive pregnancies (n = 24) to try to explain these changes. We confirmed that the women with preeclampsia have a relative hypocalciuria (2.9 +/- 0.7 vs. 6.5 +/- 0.2 mmol/day, P less than 0.01). Preeclamptic women also had lower serum ionized calcium than normotensive third trimester pregnant women (1.20 +/- 0.01 vs. 1.26 +/- 0.01 mmol/L, P less than 0.02). Intact PTH levels were significantly higher in preeclamptic women (29.9 +/- 4.3 vs. 15.4 +/- 1.3 ng/L, P less than 0.01) and a significant inverse relationship was observed between PTH and both urine calcium (r = -0.60, P less than 0.0001) and serum ionized calcium (r = -0.36, P less than 0.05). We measured vitamin D metabolites in a subgroup of both normotensive and preeclamptics. Preeclamptic and normotensive pregnant women had equivalent levels of 25-hydroxyvitamin D [25(OH)D]; however, preeclamptics had significantly lower 1,25-dihydroxyvitamin D [1,25-(OH)2D] levels (172.1 +/- 18.5 vs. 219.6 +/- 12.7 pmol/L, P less than 0.05). Lower 1,25-(OH)2D may contribute to suboptimal intestinal absorption of calcium during a time of increased calcium demand resulting in lower ionized calcium, increased PTH, and hypocalciuria in preeclampsia. Abnormalities in calcium homeostasis may contribute to the increased vascular sensitivity documented in preeclampsia.

High dietary calcium intakes reduce zinc absorption and balance in humans.

Optimal calcium intakes of 37.5 mmol(1500 mg)/d have been proposed for elderly people. We investigated the effects of calcium supplementation on zinc absorption and balance in 18 relatively healthy, postmenopausal women aged 59-86 y. All subjects received a standardized basal diet of typical foods supplying 269 mumol (17.6 mg) Zn/d and 22.2 mmol (890 mg) Ca/d during the 36-d study. In two of three experimental periods, an additional 11.7 mmol (468 mg) Ca/d as either milk or an inorganic calcium phosphate supplement was provided. Net zinc absorption and zinc balance were significantly reduced by approximately 2 mg/d during both high-calcium treatments. In a second study, conducted in a separate group of men and women aged 21-69 y, a whole-gut lavage, zinc-absorption test was used to investigate the acute effect of a 15-mmol CaCO3 (600 mg Ca) supplement, with and without extra zinc, on zinc absorption from a single test meal supplying 111.7 mumol (7.3 mg) Zn. Zinc absorption was reduced significantly by 50% when the calcium supplement was given with the meal. Inclusion of an extra 119.3 mumol (7.8 mg) Zn as part of a calcium supplement offset the detrimental effect of calcium on zinc absorption. Our findings suggest that high-calcium diets can reduce net zinc absorption and balance and may increase the zinc requirement in adult humans.