Women's health and kidney protective medications.

PURPOSE OF REVIEW: We discuss the sex-based differences in the pharmacokinetics and pharmacodynamics of kidney protective medications and their implications on women's health. RECENT FINDINGS: A critical examination of adverse drug reactions highlights the underrepresentation of women in clinical trials for kidney and cardiovascular protective drugs, such as SGLT2 inhibitors, ACE inhibitors, and endothelin receptor antagonists. This underscores the need for sex-specific analyses in clinical studies to accurately assess medication efficacy and safety. SUMMARY: The research demonstrates that women are more likely to experience adverse events and less likely to benefit from certain treatments, emphasizing the urgent need for healthcare providers to adopt a sex-informed approach in prescribing practices. Future research should prioritize sex differences from the outset to enhance understanding and improve clinical outcomes for women with chronic kidney disease and cardiovascular conditions.

From digital voices to vaccine choices: increasing female vaccine acceptance in Sudan through social listening.

The early COVID-19 vaccine rollout in Sudan experienced a gender disparity in vaccine uptake, with women accounting for less than 40% of vaccinations after four months of vaccine access. Initial analysis revealed that demand generation approaches were not sufficiently tailored to address the challenges and concerns of women. Using real-time social media monitoring, also known as social listening, to understand this inequity, we used an analytical tool called "Talkwalker" to track public sentiment and engagement regarding vaccination on social media platforms. The data captured subsequently informed a gender-responsive messaging campaign on social media that directly addressed specific concerns of Sudanese women. Within one week of the campaign's onset in September 2021, we observed a 144% increase in women's COVID-19 related social media engagement. Subsequent campaigns further enhanced women's engagement from 31% to between 35%-47%. Two subsequent campaigns in January and February/March 2022 were complemented with in-person activities, such as group meetings with community members and home visits by health promoters. Women's vaccination rates increased by 9% while the first two campaigns were live. System constraints hindered data linkages for the third campaign. These findings demonstrate the value of integrating real-time feedback with large-scale social media campaigns and the potential of linking online and offline strategies to further refine interventions, particularly in a conflict-prone and low-income country context. Our experience reinforces the notion that "one size does not fit all" when it comes to health-related communication. Responses should be tailored, contextualized, and person-centered, particularly in addressing concerns unique to women.

Simultaneous immobilization of lead and arsenic and improved phosphorus availability in contaminated soil using biochar composite modified with hydroxyapatite and oxidation: Findings from a pot experiment.

Multi-metals/metalloids contaminated soil has received extensive attention because of their adverse health effects on the safety of the food chain and environmental health. In order to provide additional insight and aid in mitigating environmental risks, a pot experiment was directed to assess the impacts of biochars derived from rice straw (BC), and modified biochars i-e., hydroxyapatite modified (HAP-BC) and oxidized biochars (Ox-BC) on the redistribution, phytoavailability and bioavailability of phosphorus (P), lead (Pb), and Arsenic (As), as well as their effects on the growth of maize (Zea mays L.) in a Lead (Pb)/Arsenic (As) contaminated soil. The results showed that HAP-BC increased the soil total and available P, compared with raw biochar and control treatment. HAP-BC improved soil properties by elevating soil pH and electric conductivity (EC). The Hedley fractionation scheme revealed that HAP-BC enhanced the labile and moderately labile P species in soil. Both HAP-BC and Ox-BC assisted in the P build-up in plant roots and shoots. The BCR (European Community Bureau of Reference) sequential extraction data for Pb and As in soil showed the pronounced effects of HAP-BC towards the transformation of labile Pb and As forms into more stable species. Compared with control, HAP-BC significantly (P ≤ 0.05) decreased the DTPA-extractable Pb and As by 55% and 28%, respectively, subsequently, resulting in reduced Pb and As plant uptakes. HAP-BC application increased the plant fresh and dry root/shoot biomass by 239%, 72%, 222% and 190%, respectively. The Pb/As immobilization by HAP-BC was mainly driven by precipitation, ion exchange and surface complexation mechanisms in soil. In general, HAP-BC application indicated a great capability to be employed as an effective alternative soil amendment for improving P acquisition in soil, simultaneously immobilizing Pb and As in the soil-plant systems.

An Explorative Study into the Aetiology of Developmental Dysplasia of the Hip Using Targeted Urine Metabolomics.

Developmental dysplasia of the hip (DDH) is the most prevalent congenital musculoskeletal disorder, yet its cause remains unknown. Adequate nutrient provision and coordinated electron exchange (redox) processes are critical for foetal growth and tissue development. This novel study sought to explore specific biochemical pathways in skeletal development for potential involvement in the aetiology of DDH. Spot urine samples were collected from infants, aged 13-61 days, with and without DDH. Ion chromatography-mass spectrometry was used to quantify thiosulphate, sulphate, nitrate, and phosphate, whilst nitrite was quantified using high-performance liquid chromato-graphy. Thiobarbituric acid reactive substances (TBARS) were measured as markers of lipid peroxidation. Creatinine and osmolality were determined by a 96-well plate assay and micro-osmometer to potentially normalise values for renal function, lean body mass, and hydration status. Urine samples were analysed from 99 babies: 30 with DDH and 69 age-matched non-DDH controls. Thiosulphate, TBARS, and creatinine concentrations differed between the DDH group and the controls (p = 0.025, 0.015, and 0.004 respectively). Urine osmolality was significantly lower in DDH compared to the controls (p = 0.036), indicative of the production of a more diluted urine in DDH infants. Following adjustment for osmolality, significant differences became apparent in urinary sulphate levels in DDH (p = 0.035) whereas all other parameters were similar between the groups. This is the first study to assess the potential role of these inorganic anions in DDH. The higher levels of sulphate found in infants with DDH suggests either enhanced intake from milk, increased endogenous formation, or impaired renal reabsorption. This investigation demonstrates the power of urine metabolomics and highlights the importance of normalisation for hydration status to disentangle developmental disorders. Our results strongly suggest that DDH is a systemic disease associated with altered uptake, formation, or handling of sulphate. There is potential for new opportunities in the prevention or treatment of DDH via nutritional intervention.

Adsorption of Pb(II) from wastewater using a red mud modified rice-straw biochar: Influencing factors and reusability.

Efficient environmental remediation of toxic chemicals using effective sorbents has received considerable attention recently. For the present study, the synthesis of a red mud/biochar (RM/BC) composite was performed from rice straw with the aim of achieving Pb(II) removal from wastewater. Characterization was performed by using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), energy dispersive spectroscopy (EDS), Zeta potential analysis, elemental mapping, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Results showed that RM/BC had higher specific surface area (SBET = 75.37 m2 g-1) than raw biochar (SBET = 35.38 m2 g-1). The Pb(II) removal capacity (qe) of RM/BC was 426.84 mg g-1 at pH 5.0, and the adsorption data well fitted pseudo second order kinetics (R2 = 0.93 and R2 = 0.98), as well as the Langmuir isotherm model (R2 = 0.97 and R2 = 0.98) for both BC and RM/BC. Pb(II) removal was slightly hindered with the increasing strength of co-existing cations (Na+, Cu2+, Fe3+, Ni2+, Cd2+). The increase in temperatures (298 K, 308 K, 318 K) favored Pb(II) removal by RM/BC. Thermodynamic study indicated that Pb(II) adsorption onto BC and RM/BC was spontaneous and primarily governed by chemisorption and surface complexation. A regeneration study revealed the high reusability (>90%) and acceptable stability of RM/BC even after five successive cycles. These findings indicate that RM/BC evidenced special combined characteristics of red mud and biochar, hence its use for Pb removal from wastewater offers a green and environmentally sustainable approach fitting the "waste treating waste" concept.

Potential Mechanisms Involved in Chronic Kidney Disease of Unclear Etiology.

BACKGROUND AND OBJECTIVES: The etiology of chronic kidney disease of unclear etiology, also known as Mesoamerican nephropathy, remains unclear. We investigated potential etiologies for Mesoamerican nephropathy in an immigrant dialysis population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Migrants with Mesoamerican nephropathy kidney failure (n=52) were identified by exclusion of known causes of kidney disease and compared using a cross-sectional survey with demographically similar patients with kidney failure from other causes (n=63) and age/sex/place of origin-matched healthy participants (n=16). Survey results were extended to the bench; C57BL/6 mice (n=73) received 10-15 weekly intraperitoneal injections of paraquat (a reactive oxygen species-generating herbicide) or vehicle. Kidney function, histology, and expression of organic cation transporter-2 (proximal tubule entry for paraquat) and multidrug and toxin extrusion 1 (extrusion pathway) were examined. Kidney biopsies from Nicaraguan patients with acute Mesoamerican nephropathy were stained for the above transporters and compared with patients with tubulointerstitial nephritis and without Mesoamerican nephropathy. RESULTS: Patients with Mesoamerican nephropathy and kidney failure were young agricultural workers, almost exclusively men; the majority were from Mexico and El Salvador; and they had prior exposures to agrochemicals, including paraquat (27%). After adjustment for age/sex, exposure to any agrochemical or paraquat was associated with Mesoamerican nephropathy kidney failure (odds ratio, 4.86; 95% confidence interval, 1.82 to 12.96; P=0.002 and odds ratio, 12.25; 95% confidence interval, 1.51 to 99.36; P=0.02, respectively). Adjusted for age/sex and other covariates, 1 year of agrochemical exposure was associated with Mesoamerican nephropathy kidney failure (odds ratio, 1.23; 95% confidence interval, 1.04 to 1.44; P=0.02). Compared with 16 matched healthy controls, Mesoamerican nephropathy kidney failure was significantly associated with exposure to paraquat and agrochemicals. Paraquat-treated male mice developed kidney failure and tubulointerstitial nephritis consistent with Mesoamerican nephropathy. Organic cation transporter-2 expression was higher in male kidneys versus female kidneys. Paraquat treatment increased organic cation transporter-2 expression and decreased multidrug and toxin extrusion 1 expression in male kidneys; similar results were observed in the kidneys of Nicaraguan patients with Mesoamerican nephropathy. CONCLUSIONS: Exposure to agrochemicals is associated with Mesoamerican nephropathy, and chronic exposure of mice to paraquat, a prototypical oxidant, induced kidney failure similar to Mesoamerican nephropathy.

Nano-hydroxyapatite modified biochar: Insights into the dynamic adsorption and performance of lead (II) removal from aqueous solution.

Adsorption of lead as Pb(II) using biochar is an environmentally sustainable approach to remediate this kind of pollution affecting wastewater. In this study, rice straw biochar (BC) was modified by combination with nano-hydroxy-apatite (HAP), resulting in a material designated as BC@nHAP, with enhanced adsorption performance. Based on Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) analyses, it was evidenced that, after modification, HAP greatly enhanced surface functional groups (i.e., -COOH and/or -OH) of raw biochar's surface. Batch tests showed that the maximum sorption capacity of BC (63.03 mg g-1) was improved due to the modification, reaching 335.88 mg g-1 in BC@nHAP. Pseudo-second order (PSO) kinetics fitted well the adsorption data (R2 = 0.99), as well as the Langmuir isotherm model (showing an adsorption value of 335.88 mg g-1 for qe). The results of thermodynamic calculations showed that the adsorption was primarily governed by chemisorption process. FTIR spectroscopy and XPS spectrum after adsorption further confirmed that the adsorption mechanisms were ion exchange with Pb2+ and surface complexation by -OH and -COOH. In addition, BC@nHAP revealed a brilliant regeneration capability. The maximum adsorption capacity by BC@nHAP was higher than that of raw biochar or other previously reported adsorbents. Therefore, BC@nHAP could be seen as a new sorbent material with high potential for real-scale heavy metal removal from wastewater, and specifically as a capable candidate new sorbent for Pb(II) removal from wastewater, which has clear implications as regard preservation of environmental quality and public health.

Revisiting diuretic choice in chronic kidney disease.

PURPOSE OF REVIEW: Existing guidelines offer little direction about the use of thiazide and loop diuretics in patients with chronic kidney disease (CKD). This review summarizes recent studies impacting indications and safety considerations for these agents in patients with CKD. RECENT FINDINGS: Chlorthalidone reduces blood pressure compared to placebo in patients with advanced CKD, challenging the belief that thiazide diuretics lose efficacy at lower glomerular filtration rates (GFR). Existing studies show no clear impact of thiazide or loop diuretic use on kidney or cardiovascular outcomes in patients with CKD. Sodium-glucose co-transporter type 2 (SGLT2) inhibitors have diuretic effects, but concomitant use of a diuretic does not diminish the preventive benefits of these agents against acute kidney injury (AKI). Despite theoretical concerns, thiazide diuretics likely do not worsen circulating vasopressin levels or cyst progression in polycystic kidney disease and may be useful for alleviating polyuria from tolvaptan. Diuretics cause multiple adverse effects, including electrolyte abnormalities, hemodynamic-mediated decrease in estimated GFR, and AKI. SUMMARY: Recent evidence supports expanded indications for diuretics in patients with kidney disease, including chlorthalidone for hypertension in advanced CKD. Monitoring electrolytes and estimated GFR is critical to ensure patient safety when prescribing these agents for patients with CKD.

The impact of pristine and modified rice straw biochar on the emission of greenhouse gases from a red acidic soil.

With the growing awareness of environmental impacts of land degradation, pressure is mounting to improve the health and productivity of degrading soils, which could be achieved through the use of raw and modified biochar materials. The primary objective of the current study was to investigate the efficiency of pristine and Mg-modified rice-straw biochar (RBC and MRBC) for the reduction of greenhouse gases (GHG) emissions and improvement of soil properties. A 90 days' incubation experiment was conducted using treatments which included control (CK), two RBC dosages (1% and 2.5%), and two MRBC doses (1% and 2.5%). Soil physico-chemical and biological properties were monitored to assess the effects due to the treatments. Results showed that both biochars improved soil physicochemical properties as the rate of biochar increased. The higher rates of biochar (RBC2.5 and MRBC2.5) particularly increased enzymatic activities (Catalase, Invertase and Urease) in comparison to the control. Data obtained for phospholipid fatty acid (PLFA) concentration indicated an increase in the Gram-negative bacteria (G-), actinomycetes and total PLFA with the increased biochar rate, while Gram-positive bacteria (G+) showed no changes to either level of biochar. As regards fungi concentration, it decreased with the biochar addition, whereas arbuscular mycorrhizal fungi (AMF) showed non-significant changes. The release of CO2, CH4 and N2O showed a decreasing trend over the time. CO2 cumulative emission decreased for MRBC1 (5%) and MRBC2.5 (9%) over the pristine biochar treatments. The cumulative N2O emission decreased by 15-32% for RBC1 and RBC2.5 and by 22-33% for MRBC1 and MRBC2.5 as compared to the control, whereas CH4 emission showed non-significant changes. Overall, the present study provides for the first-time data that could facilitate the correct use of Mg-modified rice biochar as a soil additive for the mitigation of greenhouse gas emission and improvement of soil properties.

Highly efficient uranium (VI) capture from aqueous solution by means of a hydroxyapatite-biochar nanocomposite: Adsorption behavior and mechanism.

The exploration and rational design of easily separable and highly efficient sorbents with the sufficient capability of retaining radioactive and toxic uranium U(VI) is paramount. In this study, a hydroxyapatite (HAP) biochar nanocomposite (BR/HAP) was successfully fabricated from rice straw biochar (BR), to be used as a new and efficient adsorbent for removing U(VI) from aqueous solution. Both BR and the BR/HAP composite were characterized via Brunauer-Emmett-Teller (BET), scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), transmission electron microscopy (TEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and X-ray photo electron spectroscopy (XPS) techniques. Batch test results showed that BR/HAP exhibited remarkably higher adsorption capacity than the raw BR. A pseudo-second order kinetic model thoroughly explained the adsorption kinetics, providing the maximum U(VI) adsorption capacities (qe) of 110.56 mg g-1 (R2 = 0.98) and 428.25 mg g-1 (R2 = 0.99), for BR and BR/HAP, respectively, which was indicative of the rate-limited sorption via diffusion or surface complexation after rapid initial adsorption steps. The Langmuir isotherm model fitted the experimental data to accurately simulate the adsorption of U(VI) onto BR and BR/HAP (R2 = 0.97 and R2 = 0.99). The thermodynamic results showed negative values for ΔG°, clearly indicating that the reaction was spontaneous, as well as positive values for ΔH° (11.04 kJ mol-1 and 28.86 kJ mol-1, respectively) and ΔS° (88.97 kJ mol-1 K-1, and 183.42 kJ mol-1 K-1), making clear the endothermic nature of U(VI) adsorption onto both sorbents, with an increase in randomness at a molecular level. FTIR spectroscopy and XPS spectrum further confirmed that the primary mechanisms were ion exchange with UO22+ and surface complexion by -OH and -COOH. In addition, BR/HAP showed an excellent reusability, making it a promising candidate as a new sorbent for U(VI) removal from wastewater. In view of that, it would be interesting to perform future research to explore practical implications of this sorbent material regarding protection from environmental and public health issues related to that pollutant.

Adsorption of arsenic (III) from aqueous solution by a novel phosphorus-modified biochar obtained from Taraxacum mongolicum Hand-Mazz: Adsorption behavior and mechanistic analysis.

A novel phosphorus (P) modified biochar (PLBC) was produced by pyrolyzing biomass of the dietic herb Taraxacum mongolicum Hand-Mazz (TMHM) and treating it with monopotassium phosphate (KH2PO4). This phosphorous loaded biochar was then assessed as adsorbent for As(III) removal from contaminated water. In the current research, the adsorbent was characterized before and after P loading by means of SEM-EDX, TEM, FTIR and XRD techniques. It was evidenced that the presence of P on the surface of the biochar (BC) could improve its efficiency to remove As(III) from contaminated environments. Adsorption kinetics were evaluated by performing batch-type experiments at varied times and pH values (5, 7 and 9). The kinetic study revealed that a contact time of 24 h was required to attain equilibrium and the experimental data were best fitted to the pseudo-second-order kinetic model (qe = 17.1 mg g-1). In addition, several batch experiments were conducted with varied arsenic concentrations. During the adsorption tests, the maximum adsorption of As(III) was found at pH 5. The adsorption study further showed that compared to BC, PLBC depicted increased removal of As(III) from contaminated solutions. The adsorption experimental data showed the best fit to the Langmuir isotherm model (with R2 = 0.84), with maximum As(III) adsorption capacity reaching 30.76 mg g-1 for PLBC.

Fabrication, characterization and U(VI) sorption properties of a novel biochar derived from Tribulus terrestris via two different approaches.

Water contamination due to radionuclides is considered a crucial environmental issue. In this study, Tribulus terrestris plant biomass was used as a precursor for obtaining biochar (BC), that was further modified by two different methods using FeCl3 to obtain two different magnetic biochars. Both (one-step biochar, called 1S-BC, and two-steps biochar, called 2S-BC) were studied to investigate their capability for adsorbing/removing uranium (VI) from aqueous solutions. The U(VI) removal efficacy of both biochars was tested for different values of pH, ionic strength, initial concentration of U(VI) and temperature. Experimental adsorption data fitted well to the Freundlich model (achieving as highest value for adsorption capacity KF = 49.56 mg g-1 (mg L-1)-1/n, R2 = 0.99). Thermodynamic studies revealed that adsorption was endothermic, characterized by inner-sphere complexation, and entropy-driven with a relatively increased randomness in the solid-solution interface. X-ray photoelectron spectroscopy (XPS) revealed that U(VI) sorption took place by surface complexation between U(VI) and oxygen containing functional groups on both biochars. Five consecutive regeneration cycles verified an excellent reusability for 1S-BC. The overall results allow to conclude that the FeCl3 modification of the biochar obtained from Tribulus terrestris plant biomass could give an efficient alternative adsorbent for U(VI) removal in a variety of environmental conditions, promoting protection of the environment and human health, as well as facilitating resource utilization and sustainable management of the materials studied.

Enhanced adsorption of aqueous Pb(II) by modified biochar produced through pyrolysis of watermelon seeds.

A biochar (BC) was obtained by the pyrolysis of watermelon seeds (WM) in nitrogen environment. In addition, a modified biochar (HP-BC) was obtained by means of H2O2 treatment of BC. Later on, both kinds of biochar (BC and HP-BC) were characterized and compared as regards their potential for Pb(II) adsorption from wastewater. Characterization was performed by using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), energy dispersive spectroscopy (EDS), Zeta potential analysis, elemental mapping, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Pb(II) adsorption characteristics for HP-BC and BC as were evaluated as a function of solution pH, contact time and Pb(II) equilibrium concentration, using kinetic and thermodynamic studies, as well as adsorption isotherms. Regarding kinetics, the pseudo-second order model showed good fitting to experimental data. Based on the Langmuir model, the maximum Pb(II) adsorption capacities were calculated as 44.32 mg g-1 and 60.87 mg g-1 for BC and HP-BC, respectively. Thermodynamic study indicated that Pb(II) adsorption onto BC and HP-BC was spontaneous and primarily governed by chemisorption and surface complexation. In view of the results, the H2O2 modification of the watermelon seeds biochar can be considered as a promising and cost effective approach as regards Pb(II) removal from water/wastewater, which would not cause adverse impacts on the surrounding environments. Overall, it can be seen as a procedure promoting the effective recycling of a waste/by-product, in line of the precepts of the circular economy, aiding to protect human and environmental health.

Utilization of Citrullus lanatus L. seeds to synthesize a novel MnFe2O4-biochar adsorbent for the removal of U(VI) from wastewater: Insights and comparison between modified and raw biochar.

Uranium (U) is a radioactive and highly toxic metal. Its excessive concentrations in the aqueous environments may result in severe and irreversible damage. To fight this hazard, a raw biochar was prepared from Citrullus lanatus L. seeds, then characterized and compared with a MnFe2O4 modified biochar, both tested for U(VI) adsorption from wastewater, which was assayed for the first time in this study. The characterization of the adsorbent materials was performed by means of scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) with elemental mapping, transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD) techniques. The effects of solution pH, concentration of sorbate and sorbents, temperature, time and ionic strength were assessed as regards their influence on U(VI) adsorption. The experimental adsorption data showed good fit to a pseudo-second-order kinetic model (reaching a value of qe = 15.12 mg g-1, R2 = 0.96 at equilibrium), and to the Langmuir isotherm (achieving a maximum score of qmax = 27.61 mg g-1, R2 = 0.96). The maximum adsorption capacity was found at 318 K. The results of the study indicate that the binding of negatively charged functional groups (carbonyls, hydroxyls, and some carboxylic groups) with MnFe2O4 significantly enhanced U(VI) adsorption. In view of the overall results, it can be concluded that the MnFe2O4 modification of the Citrullus lanatus L. seeds biochar could give an efficient alternative adsorbent for U(VI) removal in a variety of environmental conditions, simultaneously promoting resource utilization and good sustainable management of the materials studied, aiding to protect the environment and human health.

Impacts of long-term inorganic and organic fertilization on phosphorus adsorption and desorption characteristics in red paddies in southern China.

Soil phosphorus (P) adsorption and desorption occur in an important endogenous cycle linked with soil fertility problems and relevant to the environmental risk assessment of P. In our study, the effect of long-term inorganic and organic fertilization on P adsorption and desorption characteristics in relation to changes in soil properties was evaluated by selecting three long-term experimental sites in southern China. The selected treatments at each site were CK (unfertilized), NPK (synthetic nitrogen, phosphorus and potassium) and NPKM (synthetic NPK plus manure). The adsorption and desorption characteristics of P were evaluated using Langmuir and Freundlich isotherms. The results showed that long-term application of NPK plus manure significantly increased soil organic carbon (SOC), total P and available P at all three sites compared with the NPK and CK treatments. All three treatments fit these equations well. The maximum adsorption capacity (Qm) of P increased with NPKM treatment, and the binding energy of P (K) and the maximum buffering capacity (MBC) showed increasing trends. NPKM showed the highest Qm (2346.13 mg kg-1) at the Jinxian site, followed by Nanchang (221.16 mg kg-1) and Ningxiang (2219.36 mg kg-1). Compared to CK and NPK, the NPKM treatment showed a higher MBC as 66.64, 46.93 and 44.39 L kg-1 at all three sites. The maximum desorption capacity (Dm) of P in soil was highest with the NPKM treatment (157.58, 166.76, 143.13 mg kg-1), showing a better ability to release P in soil. The correlation matrix showed a significant positive correlation of SOC, total and available P with Qm, Dm and MBC. In conclusion, it is suggested that manure addition is crucial to improve P utilization in red paddy soils within the recommended range to avoid the risk of environmental pollution.

Sexual Dysfunction in Women With Kidney Disease.

Sexual health is inversely associated with estimated glomerular filtration rate and is associated with adverse cardiovascular outcomes, depression, poor self-image, and impaired quality of life. Many women with chronic kidney disease (CKD) and ESKD experience symptoms of sexual dysfunction which is underrecognized secondary to a variety of factors including physicians' discomfort in discussing sexual health, patients' reluctance to bring up sexual health, difficulty in the assessment of sexual health in comparison to men, and the overall lack of well-conducted clinical studies in women. The pathophysiology is not fully understood but likely involves changes in sex hormones throughout the hypothalamic-pituitary-ovarian axis. Proper evaluation of this axis is necessary as treatment is tailored to these findings and can improve outcomes. A comprehensive assessment of sexual dysfunction inclusive of women with varying gender identification and sexual orientation, partnered with recognition and treatment of contributing factors as well as identifying the underlying cause, is paramount. With the lack of studies, particularly in women with CKD, treatment options, in some cases, can be considered unchartered territory. In this article, we will review available evidence on the pathophysiology, clinical manifestations, and treatment for sexual dysfunction in women with CKD and ESKD.

Primary and Secondary Prevention of Cardiovascular Disease in Patients with Chronic Kidney Disease.

PURPOSE OF REVIEW: Non-dialysis-dependent chronic kidney disease (NDD-CKD) patients are at an increased risk of cardiovascular disease (CVD)-related deaths in comparison with the general population. This review summarizes recent guideline recommendations and studies on primary and secondary prevention of traditional cardiovascular (CV) risk factors in those with NDD-CKD. RECENT FINDINGS: The use of antiplatelet agents for primary prevention in CKD is not supported by clinical trial evidence; however, they offer potential benefits when used for secondary prevention of CVD in the absence of an elevated bleeding risk. Lipid-lowering therapy reduces CV risk and is recommended for all NDD-CKD patients. In light of recent clinical trial findings, current clinical practice guidelines recommend a blood pressure (BP) goal < 130/80 mmHg and support the use of renin-angiotensin-aldosterone system inhibitors. Evidence supporting intensive glycemic control is limited in those with diabetes and CKD. Newer oral glycemic agents such as sodium-glucose co-transporter type 2 (SGLT2) inhibitors and glucagon-like-peptide-1 (GLP-1) receptor agonists reduce urinary albumin excretion, slow kidney disease progression, and reduce CV events. Despite the absence of dedicated clinical trials in the CKD population, lifestyle modifications including smoking cessation, intentional weight loss, and regular physical activity should be recommended to those with CKD. Patients with NDD-CKD should be treated with statins and a BP target of 130/80 mmHg should be aimed for. Limited data exists for interventions targeting other CV risk factors in CKD patients. Future studies examining the impact of various interventions targeting different primary and secondary CV prevention strategies are needed to fill knowledge gaps and improve CV outcomes.

Changes in phosphorus fractions associated with soil chemical properties under long-term organic and inorganic fertilization in paddy soils of southern China.

The identification of phosphorus (P) fractions is essential for understanding the transformation and availability of P in paddy soils. To investigate the soil P fractions associated with soil properties under long-term fertilization, we selected three fertilization treatments, including no fertilization (CK), chemical fertilizers (NPK) and chemical fertilizers combined with manure (NPKM), from three long-term experiments located in Nanchang (NC), Jinxian (JX) and Ningxiang (NX). The results showed that chemical fertilizers combined with manure (NPKM) significantly (P ≤ 0.05) increased the soil total phosphorus, Olsen P and soil organic matter (SOM) by 2, 3 and 1 times, respectively, compared with the NPK treatment, and by 4, 17 and 2 times, respectively, compared with the CK treatment. NPKM significantly increased the grain yield compared with CK and NPK at all sites. The apparent P balance with NPK was higher in NC and NX but lower in JX compared with NPKM. Hedley fractionation revealed the predominance of most of the organic and inorganic phosphorus (Po and Pi) fractions with long-term fertilization, especially with the NPKM treatment, at all sites. The nonlabile P pool decreased by 14% and 18% whereas the moderately labile P pool proportions increased by 3 and 6 times with the NPK and NPKM treatments, respectively, compared to the CK treatment. The labile P pool showed a significant positive relationship with the SOM, total P and Olsen P contents. The moderately labile P was positively correlated with the total P and Olsen P. A significant positive correlation was observed between soil pH and the nonlabile P pool. Redundancy analysis revealed that the moderately labile P fraction (HCl dil. Pi fraction) was remarkably increased by the NPKM treatment and significantly correlated with the soil pH and total P concentration. The labile P fraction (NaHCO3-Pi) showed a strong relationship with the Olsen P and total P. However, the residual P fraction was negatively correlated with the HCl. dil. Pi fraction. We concluded that NPKM application improved P availability by many folds compared to NPK, which could lead to environmental pollution; therefore, the rate of combined application of manure and chemical fertilizer should be reduced compared to chemical fertilizer inputs to minimize the wastage of resources and environmental P losses.

Effect of task specific circuit training on Gait parameters and mobility in stroke survivors.

Objective of the study was to investigate effects of task specific circuit gait training to improve gait parameters and mobility among sub-acute and chronic stroke patients. A randomized control trial was conducted on stroke survivors of either gender being capable of standing 10 seconds and having 2-4 score on Rankin Modified Scale. Sample comprised of 30 participants randomly assigned into two groups. Training was given for a session of 40-50 minutes for 3-4 days/week for six weeks. Timed get up and go test (TUG), Cadence, Step Length and Step Width assessed measures of concern. The sample included 16 males and 14 females with mean age of 54.10 ± 10.10 years. After six weeks, significant improvement was recorded in TUG (p=0.014). Cadence (p=0.001), step length (p<0.001) and step width (p=0.009) were also significantly improved. Circuit gait training improves mobility and gait in stroke patients.