Impact of Serum Phosphorus Levels on Outcomes After Implantation of Drug-Eluting Stents in Patients on Hemodialysis.

BACKGROUND: Elevated serum phosphorus level is an important risk factor for cardiovascular death in general patients on hemodialysis (HD). However, the effect of serum phosphorus levels on outcomes after drug-eluting stent (DES) implantation in HD patients is unknown.Methods and Results:This was a post-hoc study of the OUCH study series, a series of prospective multicenter registries of HD patients who underwent DES implantation comprising 359 patients from 31 centers in Japan. Patients were categorized into 3 groups according to their preprocedural serum phosphorus levels. The 1-year clinical outcomes of the 336 patients treated for de novo lesions were evaluated. Compared with patients with high (>5.5 mg/dL; n=65) or normal (3.5-5.5 mg/dL; n=219) serum phosphorus levels, those with low serum phosphorus levels (<3.5 mg/dL; n=52) had significantly fewer target lesion revascularization events (13.9% vs. 16.9% vs. 1.9%; P=0.0090) and major adverse cardiac and cerebrovascular events (29.2% vs. 31.1% vs. 13.5%; P=0.032). Multivariate logistic regression analysis revealed that low serum phosphorus level was an independent negative predictor for major adverse cardiac and cerebrovascular events (adjusted odds ratio, 0.31; 95% confidence interval, 0.12-0.70; P=0.0036). CONCLUSIONS: Lowering of serum phosphorus levels beyond the current recommended range may be considered in HD patients who undergo DES implantation.

Application of composite water quality identification index on the water quality evaluation in spatial and temporal variations: a case study in Honghu Lake, China.

Composite Water Quality Identification Index (CWQII) and multivariate statistical techniques were used to investigate the temporal and spatial variations of water quality in Honghu Lake. The aims are to explore the characteristics of water quality trends in annual, monthly, and site spatial distribution and to identify the main pollution factors. The results showed that the values of CWQII increased from 2.0 to 4.0 from the years 2001 to 2005, then decreased from 2006 and kept a balance between 2.0 and 3.0 from 2006 to 2011, indicating that the water quality of Honghu Lake deteriorated from 2001 to 2005 and has gradually improved since 2006, which were likely achieved after water protection measurements taken since 2004. The monthly change rules of water quality were influenced by a superposition of natural processes and human activities. In samples numbered 1-9 from upstream to downstream, the maximum values of CWQII often occurred in sample site 9 while the minimum ones often occurred in sample site 2, indicating that the water quality near the upstream tributary was the poorest and that in the core zone was the best. Incoming water from the trunk canal of the Sihu area upstream was the largest pollution source. The sensitive pollution nutrients were mainly caused by the total nitrogen, followed by the total phosphorus.

Seasonal baseline of nutrients and stable isotopes in a saline lake of Argentina: biogeochemical processes and river runoff effects.

The seasonal variability of inorganic and organic nutrients and stable isotopes and their relations with plankton and environmental conditions were monitored in Lake Chasicó. Principal component analysis evidenced the strong influence of the river runoff on several biogeochemical variables. Silicate concentrations were controlled by diatom biomass and river discharge. Higher values of nitrate and soluble reactive phosphorus (SRP) indicated agricultural uses in the river basin. Elevated pH values (∼ 9) inhibiting nitrification in the lake explained partially the dominance of ammonium: ∼ 83 % of dissolved inorganic nitrogen (DIN). The low DIN/SRP ratio inferred nitrogen limitation, although the hypotheses of iron and CO2 limitation are relevant in alkaline lakes. Particulate organic matter (POM) and dissolved organic matter (DOM) were mainly of autochthonous origin. The main allochthonous input was imported by the river as POM owning to the arid conditions. Dissolved organic carbon was likely top-down regulated by the bacterioplankton grazer Brachionus plicatilis. The δ(13)C signature was a good indicator of primary production and its values were influenced probably by CO2 limitation. The δ(15)N did not evidence nitrogen fixation and suggested the effects of anthropogenic activities. The preservation of a good water quality in the lake is crucial for resource management.

Estimating reference nutrient criteria for Maryland ecoregions.

Management of stream nutrients is becoming increasingly important in order to protect both water quality and aquatic resources throughout the USA. Using an extensive water quality database from the long-term Maryland Biological Stream Survey (MBSS), we describe nutrient relationships to landscape characteristics as total nitrogen (TN) and total phosphorus (TP) of small-order, non-tidal streams in USEPA L2 and L3 ecoregions in Maryland and by MBSS stream order at the L2 and L3 ecoregion levels. To protect stream ecosystem integrity, preliminary reference nutrient estimates (TN and TP) as percentiles (25th of all stream reaches and 75th of stream reference reaches) for the six Maryland L3 ecoregions are: Blue Ridge TN 0.29 and 0.64 mg/L, TP 0.0065 and 0.0090 mg/L; Central Appalachians TN 0.40 and 1.0 mg/L, TP 0.0060 and 0.015 mg/L; Middle Atlantic Coastal Plains TN 0.93 and 2.5 mg/L, TP 0.094 and 0.065 mg/L; Northern Piedmont TN 1.6 and 1.8 mg/L, TP 0.010 and 0.015 mg/L; Ridge and Valley TN 0.40 and 0.98 mg/L, TP 0.0063 and 0.012 mg/L; and Southeastern Plains TN 0.33 and 0.82 mg/L, TP 0.016 and 0.042 mg/L. High levels of both TN and TP are present in many streams found in non-tidal watersheds associated with all Maryland ecoregions, but are especially elevated in the Northern Piedmont and Middle Atlantic Coastal Plain ecoregions, with the latter second-order streams (average TN > 2.9 mg/L) significantly higher than all other ecoregion-order combinations. Across all six ecoregions, mean nutrient loading for both TN and TP was generally equivalent in first-order streams to nutrient concentrations seen in both second- and third-order streams, indicating a definite need to increase efforts in preventing nutrients from entering first-order streams. Small-order stream nutrient levels are the drivers for subsequent TN and TP inputs into the upper freshwater tidal reaches of the Chesapeake Bay, resulting in a potential risk for altered estuarine ecosystems.

[Dietary reference intakes of phosphorus].

Phosphorus (P) exists at the all organs and plays important physiological roles in the body. A wide range of food contains P, which is absorbed at a higher level (60-70%) and its insufficiency and deficiency are rarely found. P is used as food additives in many processed food, where risk of overconsumption could be an issue. P has less evidence in terms of nutrition. P has the adequate intake and the tolerable upper intake level, for risk reduction of health disorders associated with excess intake, at the Dietary Reference Intakes for Japanese (2010 edition).

Rationale for control of anthropogenic nitrogen and phosphorus to reduce eutrophication of inland waters.

Concentrations of phosphorus and nitrogen in surface waters are being regulated in the United States and European Union. Human activity has raised the concentrations of these nutrients, leading to eutrophication of inland waters, which causes nuisance growth of algae and other aquatic plants. Control of phosphorus often has had the highest priority because of its presumed leading role in limiting development of aquatic plant biomass. Experimental evidence shows, however, that nitrogen is equally likely to limit growth of algae and aquatic plants in inland waters, and that additions of both nutrients cause substantially more algal growth than either added alone. A dual control strategy for N and P will reduce transport of anthropogenic nitrogen through drainage networks to aquatic ecosystems that may be nitrogen limited. Control of total phosphorus in effluents is feasible and is increasingly being required by regulations. The control strategy for nitrogen in effluents is more difficult, but could be made more feasible by recognition that a substantial portion of dissolved organic nitrogen is not bioavailable; regulation should focus on bioavailable N (nitrate, ammonium, and some dissolved organic nitrogen) rather than total N. Regulation of both N and P also is essential for nonpoint sources.

Reliability analysis of wastewater treatment plants.

This article presents a reliability analysis of 166 full-scale wastewater treatment plants operating in Brazil. Six different processes have been investigated, comprising septic tank+anaerobic filter, facultative pond, anaerobic pond+facultative pond, activated sludge, upflow anaerobic sludge blanket (UASB) reactors alone and UASB reactors followed by post-treatment. A methodology developed by Niku et al. [1979. Performance of activated sludge process and reliability-based design. J. Water Pollut. Control Assoc., 51(12), 2841-2857] is used for determining the coefficients of reliability (COR), in terms of the compliance of effluent biochemical oxygen demand (BOD), chemical oxygen demand (COD), total suspended solids (TSS), total nitrogen (TN), total phosphorus (TP) and fecal or thermotolerant coliforms (FC) with discharge standards. The design concentrations necessary to meet the prevailing discharge standards and the expected compliance percentages have been calculated from the COR obtained. The results showed that few plants, under the observed operating conditions, would be able to present reliable performances considering the compliance with the analyzed standards. The article also discusses the importance of understanding the lognormal behavior of the data in setting up discharge standards, in interpreting monitoring results and compliance with the legislation.

The role of alkalinity in setting water quality metrics: phosphorus standards in United Kingdom rivers.

UK implementation of the European Union Water Framework Directive (for the 2015-2021 cycle) Ecological Status (ES) classification for river phosphorus is based on the calculation of reference conditions for reactive phosphorus (RP) using river alkalinity measurements. Underpinning this approach is that the alkalinity is primarily from rock weathering and is free of anthropogenic influences. However, the potential contribution of anthropogenic alkalinity needs to be considered and, if possible, quantified. In the rural South West River Basin District of England, 38 river sites were examined with respect to river alkalinity loads in order to test this consideration. At river base flow when RP can cause enhanced algal growth, 9 sites (24%) had effluent alkalinity contributions amounting to 25-49% of the total riverine alkalinity load, while 11 (29%) of the sites received ≥50% of their alkalinity load from effluent. When flows increased above base flow to Q95 flow at these 11 sites, catchment diffuse run-off became the largest load of alkalinity at 9 of the sites, and that at the Q95 flows, combined effluent and diffuse alkalinity loads contributed 68-100% of the total alkalinity load. Anthropogenic alkalinity is likely to be present in diffuse run-off, but it is difficult to apportion alkalinity loads between natural and contaminant sources. It is likely that diffuse loads of alkalinity will dominate on the annual timescales used to assess WFD compliance, even at sites where ground water alkalinity dominates at base river flows. In principle, inclusion of anthropogenic alkalinity in the calculation of ES boundary concentrations for RP may lead to a relaxation of the standards. In practice this may not follow. It is likely that at the river sites used initially to develop the algorithms now used for P standard setting, anthropogenic alkalinity was present, to varying and unknown degrees, and that this alkalinity would have influenced the measured and reference RP and biological metrics on which the P standards are based. Apart from RP, alkalinity is also used to underpin water quality metrics for additional chemical and biological parameters, and for this reason, understanding the complex factors determining river alkalinity loads should be an important task for water quality regulators.

Developing High Performance GaP/Si Heterojunction Solar Cells.

To improve the efficiency of Si-based solar cells beyond their Shockley-Queisser limit, the optimal path is to integrate them with III-V-based solar cells. In this work, we present high performance GaP/Si heterojunction solar cells with a high Si minority-carrier lifetime and high crystal quality of epitaxial GaP layers. It is shown that by applying phosphorus (P)-diffusion layers into the Si substrate and a SiNx layer, the Si minority-carrier lifetime can be well-maintained during the GaP growth in the molecular beam epitaxy (MBE). By controlling the growth conditions, the high crystal quality of GaP was grown on the P-rich Si surface. The film quality is characterized by atomic force microscopy and high-resolution x-ray diffraction. In addition, MoOx was implemented as a hole-selective contact that led to a significant increase in the short-circuit current density. The achieved high device performance of the GaP/Si heterojunction solar cells establishes a path for further enhancement of the performance of Si-based photovoltaic devices.

Response of regional agricultural soil phosphorus status to net anthropogenic phosphorus input (NAPI) determined by soil pH value and organic matter content in subtropical China.

Exploring the relationship between net anthropogenic phosphorus input (NAPI) and soil available P (SAP) content could inform applied issues related to environmental quality and agronomic productivity and increase our knowledge of element biogeochemical cycles. Here, the NAPI was estimated and the SAP content determined in eight counties in subtropical China from 1980 to 2010. It is suggested that the NAPI ranging 318-924 km-2 yr-1 in 1980 had increased substantially to 865-3601 km-2 yr-1 in 2010 across the eight counties, in which the P fertilizer application was estimated to represent the largest individual source of NAPI, accounting for an average of 36.1-74.6% of the NAPI. The NAPI in agricultural land (NAPIa) was the largest component of the NAPI, and 60.7-77.1% of the NAPIa accumulated in the upper 20 cm layer of agricultural soils, which significantly increased soil total-P (TP) and SAP contents. The increases in SAP, resulting from 10,000 kg P km-2 of the NAPIa (IOPNAPI), were estimated to be 1.61-4.36 mg P kg-1 in the counties. Both the correlation and variation partitioning analyses (VPAs) suggested that the soil pH and organic matter content (SOM) were the most important factors influencing the variations of IOPNAPI (determination coefficient: 72.5%). Therefore, the contribution of soil pH and SOM should be considered in enriching soil SAP levels and implementing optimal P management strategies to improving the agronomic effectiveness of P fertilization and further reduce the environmental risk of P loss in subtropical region.

Nonphytate phosphorus requirement of laying hens with and without phytase on a phase feeding program.

An experiment was conducted to reevaluate the nonphytate P (NPP) requirement of laying hens with and without phytase. The experiment involved 12 treatments in a 6 x 2 factorial design. The hens of the control group (T1) were fed a sequence of 0.40-0.35-0.30% NPP during 30 to 42, 42 to 54, and 54 to 66 wk, respectively. The NPP was reduced in increments of 0.05% in T2 to T6. The hens of T7 to T12 were fed NPP regimens similar to T1 to T6 but with 300 units phytase/kg diet. Two digestion trials were conducted during 42 and 66 wk, and nitrogen, phytate, and total P retention were determined. In the absence of phytase, production traits were not different for hens fed a NPP regimen of 0.25-0.20-0.15% than for the unsupplemented phytase control group for the entire experiment (P > 0.05). However, production traits were inferior for hens fed the lower NPP regimens (P < 0.05). In the presence of phytase, production traits were not different for hens fed the lowest NPP regimen (0.15-0.10-0.10%) than for the unsupplemented phytase control for the entire experiment (P > 0.05). The overall effect of NPP regimens and phytase on specific gravity for the entire experiment was significant. Specific gravity was greater for hens fed the regimens with less NPP than for hens fed regimens with greater NPP, and phytase had an adverse effect on specific gravity. However, specific gravity of hens fed the lowest NPP regimen with phytase was not significantly different from the unsupplemented phytase control group. The overall effect of phytase on phytate P retention was significant during digestion trials; phytase increased phytate P retention by about 15%. Daily total P excretion was 34 to 47% less for hens fed the lowest NPP regimen with phytase than for the unsupplemented phytase control group. Significant interactions existed for a number of traits and are discussed in the text.

[Nutritive value of daily food rations prepared in different regions of the country. III. The levels of calcium, phosphorus, magnesium, iron and potassium]. / Wartosc odzywcza calodziennych racji pokarmowych odtwarzanych w kilku regionach kraju. Cz. III. Zawartosc wapnia, fosforu, magnezu, zelaza i potasu.

Studies on the content of macrominerals in daily diets reconstructed in 1988 on the basis of the analysis of family budgets in 1986 carried out by the Central Statistical Bureau were carried on. Two social groups i.e. manual and mental workers with medium income were considered. The diets were prepared for 5 regions (Warszawa, Lublin, Olsztyn, Poznan, Wroclaw). According to the studies the requirements for calcium and magnesium were met in about 70% and those for iron in about 84%. The content of potassium in the diets was in the range of recommended allowances while the phosphorus exceeded the allowances by about 20-30%. The comparison of the presently studied diets with the ones from 1973, 1980, 1981 showed a lower degree of realization of the recommended intake of calcium and magnesium in 1986. The content of studied minerals in the diets was usually similar in all five regions.

Development of freshwater sediment management standards for organic matters, nutrients, and metals in Korea.

Korean water quality managers are required to promptly develop national assessment standards for freshwater sediment quality due to the Four Major River Restoration Project in Korea in 2009. We conducted this study to develop sediment management standards (SMSs), determining obviously and severely polluted sediment, which could have adverse impacts on water quality and aquatic ecosystem. The SMSs values were derived from the 95th percentile of concentration distribution for organic matter and nutrients in sediment quality database. For the SMSs of metals, foreign sediment quality guidelines (SQGs) were adopted. As a result, 13% for loss on ignition (LOI), 1,600 mg/kg for total phosphorus (TP), and 5,600 mg/kg for total nitrogen (TN) were set as the SMSs for freshwater sediment in Korea. These values were higher than the range of heavily polluted sediment from USEPA Region 5 guideline derived by the similar approaches for the Great Lakes harbor sediments, and similar or lower than the severe effect level (SEL) from provincial sediment quality guideline (PSQG) of Ontario, Canada by screening level concentration (SLC) approach. However, SMSs in the present study are appropriate considering the concentration ranges and the Korean SMSs' definition for freshwater sediments in Korea. The Puget Sound marine sediment cleanup screening level (CSL) in Washington State, USA were adopted as the Korean SMSs for As (93 mg/kg), Cd (6.7 mg/kg), Cr (270 mg/kg), Cu (390 mg/kg), Pb (530 mg/kg), and Zn (960 mg/kg) in freshwater sediments. Hg concentration (0.59 mg/kg) of CSL was too low to determine the polluted freshwater sediments in Korea, and the SEL of Ontario, Canada for mercury concentration (2 mg/kg) was selected as the SMS for Hg. These values were found reasonable through the assessment of applicability with the datasets from locations directly affected by obvious point sources. These results indicate that SMSs for organic matter, nutrient, and metals derived within the present study can successfully determine obviously and severely polluted sediment in Korea. However, the SMSs have limits to specifically determine the effects of polluted sediment on water quality and aquatic ecosystem in Korea. Thus, we will revise and specify SMSs considering those effects and further sediment quality assessment framework in the near future.

Net anthropogenic phosphorus inputs (NAPI) index application in Mainland China.

This study provides a new understanding on sources of P, which may serve as a foundation for further exploration of anthropogenic effects on P input. Estimation of net anthropogenic phosphorus input (NAPI) was based on an inventory of phosphorus (P) fertilizer use, consumption of human food and animal feed, seeding phosphorus and non-food phosphorus net flux. Across Mainland China, NAPI had an upward trend from 1981 to 2009, which reflects development trend of the population and economic. NAPI for years 1981, 1990, 2000 and 2009 are 190 kg P km(-2)yr(-1) (1.8 kg P per person yr(-1)), 295 kg P km(-2) yr(-1) (2.5 kg P per person yr(-1)), 415 kg P km(-2) yr(-1) (3.1 kg P per person yr(-1)) and 465 kg P km(-2) yr(-1) (3.4 kg P per person yr(-1)), respectively. On a geographical basis, NAPI per unit area is lower in northwest Mainland China than in southeast Mainland China with the largest NAPI of 3101 kg P km(-2) yr(-1) in Shanghai, while NAPI per person is in reverse with the largest NAPI 7.7 kg P per person yr(-1) in Tibet. P input of fertilizer is the largest source of NAPI, accounting for 57.35-83.73% (109-390 kg P km(-2) yr(-1)) of the total NAPI, followed by non-food P and P in human food and animal feed. Year 2000 was a critical point where P changed almost from net input to output. Grain production rate per unit mass of fertilizer showed an obvious downward trend. The primary factor in relation to the change in NAPI is total population.

Multivariate optimization of an analytical method for the analysis of dog and cat foods by ICP OES.

Experimental design methodology was used to optimize an analytical method for determination of the mineral element composition (Al, Ca, Cd, Cr, Cu, Ba, Fe, K, Mg, Mn, P, S, Sr and Zn) of dog and cat foods. Two-level full factorial design was applied to define the optimal proportions of the reagents used for microwave-assisted sample digestion (2.0 mol L(-1) HNO3 and 6% m/v H2O2). A three-level factorial design for two variables was used to optimize the operational conditions of the inductively coupled plasma optical emission spectrometer, employed for analysis of the extracts. A radiofrequency power of 1.2 kW and a nebulizer argon flow of 1.0 L min(-1) were selected. The limits of quantification (LOQ) were between 0.03 µg g(-1) (Cr, 267.716 nm) and 87 µg g(-1) (Ca, 373.690 nm). The trueness of the optimized method was evaluated by analysis of five certified reference materials (CRMs): wheat flour (NIST 1567a), bovine liver (NIST 1577), peach leaves (NIST 1547), oyster tissue (NIST 1566b), and fish protein (DORM-3). The recovery values obtained for the CRMs were between 80 ± 4% (Cr) and 117 ± 5% (Cd), with relative standard deviations (RSDs) better than 5%, demonstrating that the proposed method offered good trueness and precision. Ten samples of pet food (five each of cat and dog food) were acquired at supermarkets in Aracaju city (Sergipe State, Brazil). Concentrations in the dog food ranged between 7.1 mg kg(-1) (Ba) and 2.7 g kg(-1) (Ca), while for cat food the values were between 3.7 mg kg(-1) (Ba) and 3.0 g kg(-1) (Ca). The concentrations of Ca, K, Mg, P, Cu, Fe, Mn, and Zn in the food were compared with the guidelines of the United States' Association of American Feed Control Officials (AAFCO) and the Brazilian Ministry of Agriculture, Livestock, and Food Supply (Ministério da Agricultura, Pecuária e Abastecimento-MAPA).

An integrated risk management model for source water protection areas.

Watersheds are recognized as the most effective management unit for the protection of water resources. For surface water supplies that use water from upstream watersheds, evaluating threats to water quality and implementing a watershed management plan are crucial for the maintenance of drinking water safe for humans. The aim of this article is to establish a risk assessment model that provides basic information for identifying critical pollutants and areas at high risk for degraded water quality. In this study, a quantitative risk model that uses hazard quotients for each water quality parameter was combined with a qualitative risk model that uses the relative risk level of potential pollution events in order to characterize the current condition and potential risk of watersheds providing drinking water. In a case study of Taipei Source Water Area in northern Taiwan, total coliforms and total phosphorus were the top two pollutants of concern. Intensive tea-growing and recreational activities around the riparian zone may contribute the greatest pollution to the watershed. Our risk assessment tool may be enhanced by developing, recording, and updating information on pollution sources in the water supply watersheds. Moreover, management authorities could use the resultant information to create watershed risk management plans.

Distribution of rare earth elements in marine sediments from the Strait of Sicily (western Mediterranean Sea): evidence of phosphogypsum waste contamination.

Concentrations of rare earth elements (REE), Y, Th and Sc were recently determined in marine sediments collected using a box corer along two onshore-offshore transects located in the Strait of Sicily (Mediterranean Sea). The REE+Y were enriched in offshore fine-grained sediments where clay minerals are abundant, whereas the REE+Y contents were lower in onshore coarse-grained sediments with high carbonate fractions. Considering this distribution trend, the onshore sediments in front of the southwestern Sicilian coast represent an anomaly with high REE+Y concentrations (mean value 163.4 µg g(-1)) associated to high Th concentrations (mean value 7.9 µg g(-1)). Plot of shale-normalized REE+Y data of these coastal sediments showed Middle REE enrichments relative to Light REE and Heavy REE, manifested by a convexity around Sm-Gd-Eu elements. These anomalies in the fractionation patterns of the coastal sediments were attributed to phosphogypsum-contaminated effluents from an industrial plant, located in the southern Sicilian coast.