Production Levels Research Articles

Have a Little Heart (or Not): Highly Minimized Skeletal Muscle Regulatory Cassettes with Low or No Activity in the Heart.

Adeno-associated virus-mediated gene therapies for certain muscle disorders require regulatory cassettes that provide high-level, striated muscle-specific activity. However, cardiotoxicity has emerged as a serious concern in clinical trials for Duchenne muscular dystrophy and X-linked myotubular myopathy. While this may be caused by systemic inflammatory effects of the treatment, high transgene expression in the heart may also play a role. Thus, certain muscle disorders may require a modulated level of therapeutic expression in the heart, while others may not require any cardiac expression at all. Additionally, the size of some cargos requires regulatory cassettes to be small enough that large cDNAs and other therapeutic payloads can be accommodated. Thus, we have performed enhancer/promoter optimization to develop highly minimized regulatory cassettes that are active in skeletal muscles, with either low or no detectable activity in cardiac muscle. Our No-heart (NH) cassette is active in most skeletal muscles, but exhibits only very low activity in extensor digitorum longus (EDL), soleus, and diaphragm, and no activity in the heart. By contrast, our Have a Little Heart (HLH) cassette displays high activity in most skeletal muscles, comparable to the ∼800-bp CK8 cassette, with increased activity in EDL, soleus, and diaphragm, and low activity in the heart. Due to their small size, these cassettes can be used in therapeutic strategies with both flexible (e.g., antisense) and stringent (e.g., CRISPR/Cas or bicistronic) size limitations. Thus, our new cassettes may be useful for gene therapies of muscle disorders in which the need for low or almost no expression in cardiac muscle would outweigh the need for high levels of therapeutic product in certain skeletal muscles.

Exploring the complex interplay of green finance, business cycles, and energy development

Green finance has emerged as a contemporary mechanism to support investments in renewable energy, energy efficiency, and sustainable infrastructure projects. This study aims to provide empirical insights into the asymmetric influence of green finance and business cycle fluctuations on energy development in 60 developing countries from 2000 to 2021. Four aspects of energy development, including energy access, stability, efficiency, and production gap, are examined using panel quantile regression with additive fixed effects. The research findings demonstrate that green finance plays a significant role in fostering energy development, with varying effects across different quantiles of the distribution. Specifically, the results indicate that green finance supports energy access and stability, particularly during economic recession, low-income levels, and limited technological advancement. However, the impact of green finance on energy efficiency exhibits notable heterogeneity, contingent upon technological and periods of economic expansion. Achieving tangible improvements in energy efficiency necessitates a certain level of technological and economic development. Moreover, green finance shows a capacity to maintain an optimal level of energy production, particularly evident during economic expansion and for highly technologically developed countries. The impact of business cycle fluctuations varies across different quantile distributions of energy development indicators, predominantly exerting an inhibitory effect of economic recession. In light of these results, it is recommended that policies in developing countries be revised to enhance energy access, optimize energy production levels, and promote the cost-effectiveness of renewable energy in conjunction with green finance initiatives.

TWIST1+FAP+ fibroblasts in the pathogenesis of intestinal fibrosis in Crohn's disease.

Intestinal fibrosis, a severe complication of Crohn's disease (CD), is characterized by excessive extracellular matrix (ECM) deposition and induces intestinal strictures, but there are no effective anti-fibrosis drugs available for clinical application. We performed single-cell RNA sequencing (scRNA-seq) of fibrotic and non-fibrotic ileal tissues from CD patients with intestinal obstruction. Analysis revealed mesenchymal stromal cells (MSCs) as the major producers of ECM and the increased infiltration of its subset FAP+ fibroblasts in fibrotic sites, which was confirmed by immunofluorescence and flow cytometry. Single cell transcriptomic profiling of chronic Dextran Sulfate Sodium Salt (DSS) murine colitis model revealed Cd81+Pi16- fibroblasts exhibited transcriptomic and functional similarities to human FAP+ fibroblasts. Consistently, FAP+ fibroblasts were identified as the key subtype with the highest level of ECM production in fibrotic intestines. Furthermore, specific knockout or pharmacological inhibition of TWIST1, which was highly expressed by FAP+ fibroblasts, could significantly ameliorate fibrosis in mice. In addition, TWIST1 expression was induced by CXCL9+ macrophages enriched in fibrotic tissues via IL-1β and TGF-β signal. These findings suggest the inhibition of TWIST1 as a promising strategy for CD fibrosis treatment.

Research on the marketing strategy of agricultural product community e-commerce

With the continuous progress and development of the “global e-commerce era”, China's community e-commerce of marketing environment of agricultural products is growing rapidly. At present, the level of e-commerce development in various regions of China is not balanced, resulting in farmers in many regions still lacking marketing awareness of community e-commerce. Through the analysis of the current status of China's e-commerce development of agricultural products, this study found that there are existing problems such as: the imbalance of agricultural products e-commerce development scale in various regions, the difficulty of agricultural products logistics and distribution, the uneven quality level of agricultural products, the lack of community marketing awareness among merchants, and the gap in e-commerce talents. Based on the content marketing theory, this paper draws research conclusions and puts forward suggestions for optimizing community e-commerce marketing.

Inter-departmental dyadic coordination in organizations with reference to human resource and operations management

PurposeWith today’s increasing globalization and associated growing demand for talented operations managers, human resources management (HRM) in operations management (OM) has emerged as a top priority for firms. However, a thorough analysis of HRM issues in operations domain has not been made so far. The study presents current status of interaction, collaboration and coordination between operations and HRM and importance of coordination that helps in improvising the outcomes of the organization.Design/methodology/approachOperations management consists of employees responsible for creating highest level of efficiency and productivity within the organization. The initial studies on HRM and OM put forward strong arguments that the coordination between the departments happens to be at a low level, whereas, strong effective interaction, collaboration and coordination is required between both the departments to positively bring forth the organizational outcomes. A study on sample of 257 with descriptive research design was conducted. Out of 257, the valid 228 responses were used for testing of model and analysis.FindingsThe findings of the study conclude that the operations department employees should be in constant touch with their human resource partner. The overall organizational performance and productivity improve and strengthen when there is good interdepartmental coordination between operations and HRM. Employee job satisfaction and work life balance remains appropriate when there is proper synchronization between the departments. The study recommends organizations should work upon better integrating the team such that there is strong synchronization, mutual understanding, harmony, proper communication and information flow between the HRM and OM.Originality/valueCoordinated efforts and working of both the teams helps in bringing out more productive results, thereby contributing positively to the overall success of the organization, employee satisfaction and better productivity.

Analisis Wacana Kritis Norman Fairclough Pada Film Barbie 2023 Sebagai Representasi Budaya Patriarki

Film is part of audio-visual mass media communication and aims to convey social messages to the audience in accordance with the reality that is growing and developing in society. One of the films that has this purpose is the film Barbie Live Action 2023. The purpose of this research is to dissect the discourse in three dimensions, namely textual, discourse practice, and sociocultural practice. In this research, the type of research used is qualitative-descriptive research. The paradigm used in this research is the critical paradigm. The appropriate research method used for this research is Norman Fairclough's Critical Discourse Analysis method. In the textual dimension, the linguistic tools of Diction, Cohesion, Modality and figure of speech metaphor are obtained. In the discourse practice dimension, at the production level the Barbie film is produced with two backgrounds, namely Barbieland and the real world, namely the city of Los Angles, United States with English language dialogue. At a text consumption level, the film is the highest-grossing box office film of all time with earnings of $1.45 billion. Sociocultural practices have 3 levels, namely situational, institutional and social levels. Situational Barbie script was written during the pandemic. For example, the film Barbie was a box office success in almost the entire world and became the hope of the global community regarding the end of the pandemic. Furthermore, at the institutional level, which includes the media, is Greta Gerwig herself as a film filmmaker. Warner Bros. is the production house for the 2023 Barbie Live Action film. Then there is Mattel as the company behind the production of Barbie dolls. Finally, at the social level, this film shows how patriarchy persists in reality, the social and cultural system of American society still adheres to patriarchal culture and neglects women's rights and protection.

Variations in the Forest Productivity of Pinus patula Plantations in Tanzania: The Need for an Improved Site Classification System

The productivity of forests in sub-Saharan Africa is often summarized into large compartments or site classes. However, the classification of forest productivity levels based on the original site index model in Tanzania and the techniques applied to generate the model did not include the micro-toposequence variations within compartments. This may create false expectations of wood supply and hinder the estimation of sustainable harvesting processes. This study analyzed variations in forest productivity and the site index in P. patula stands in two forest plantations of Tanzania to assess the applicability and generality of the present site classification system. We used dominant height as a proxy for forest productivity in 48 plots at the Sao Hill forest plantation (SHFP) and 24 plots at the Shume forest plantation (SFP). We stratified the sampling plots in each site class along the soil catena and recorded the elevation, slope, and slope positions (summit, mid, and lower). Our results showed that the site classes did not generally match the previously assigned site classes and the productivity of a given site class varied between the two plantations. We found a consistently higher productivity than that implied by the original site index in SFP, while in SHFP, the productivity was both higher and lower than estimated in different compartments. Both elevations and slope significantly contributed to predicting the productivity variations within site classes. Overall, the results indicate that physiographic factors affect variations in forest productivity within the assigned site classes. We recommend a more comprehensive site productivity assessment that takes into account physiographic variations and hence provides more accurate information for sustainable forest plantation management in Tanzania and in the region at large.

Edaphic Factors Modulating Phosphorus Availability in Lowland Rice Systems, Nigeria

ABSTRACT The low rice production level in Africa is attributed to poor soil fertility despite the potential for rice cultivation in the inland valleys. This study was conducted to evaluate soil characteristics in some lowlands that have been continuously and intensively used for rice production for over two decades in southwestern Nigeria. Soil physical, chemical, and mineralogical properties, as well as phosphorus sorption characteristics, were assessed in soil samples collected from diagnostic horizons of profiles in six benchmark soils. The results show kaolinite, quartz, potassium(K)-feldspars, and mixed-layered smectite as the predominant minerals. The iron oxide fractions indicate that the soils are at varying degrees of development where the soils at the advanced stage of development are predominantly rich in kaolinite and quartz with a high concentration of total pedogenic iron oxide and generally low in soil fertility. Soil phosphorus buffering capacity is low and varies inversely with pH, confirming the deficiency of phosphorus at low pH. Short-range-order (SRO) iron (Fe) oxides show a strong affinity for phosphorus and this is stronger at lower soil horizons and mediated by some redoxomorphic reactions. The SRO iron oxide concentration has more influence on phosphorus retention in soils rather than the absolute concentration of iron oxides. The study concludes that SRO Fe oxides and soil pH are the major edaphic factors playing a prominent role in phosphorus retention and availability in the wetland soils rather than the clay minerals.

Digital transformation of enterprises empowers the development of new productive forces of enterprises

Based on the data of financial statements of A-share listed companies from 2015 to 2022 and ESG index data of Huazheng Company, this paper empirically analyzes the effect and mechanism of digital transformation on the new quality productive forces of enterprises. The results show that digital transformation can significantly promote the improvement of the new quality productive forces of enterprises, and the results are still valid after dealing with endogenous problems, eliminating special years and changing cluster test. Heterogeneity analysis shows that from the perspective of enterprise nature, the digital transformation of state-owned enterprises and high-tech enterprises has a more significant role in promoting the new quality productive forces of enterprises. The mechanism research shows that digital transformation can promote ESG practice of enterprises, and then promote the improvement of new quality productive forces level of enterprises. Therefore, it is proposed to accelerate the green transformation of enterprise development mode, promote the digital transformation of enterprises and corporate social responsibility governance by institutional supply, and strengthen the empowerment effect of internal governance of digital technology, hoping to provide useful reference for the development of new quality productive forces of enterprises.

What Drives Carbon Emissions in German Manufacturing: Scale, Technique or Composition?

AbstractEmissions of local pollutants from industry have declined across many developed countries over the last decades. For carbon emissions such reductions have yet to materialize. Using German administrative micro-data at the product level, we apply the workhorse model for decomposing emission changes into scale, composition (changes in the mix of goods produced) and technology (emission factors of production) effects. We find that the production composition in German manufacturing shifted towards less CO2 intensive goods, while emission intensities of production increased. We show that data aggregation matters. Both effects are substantially underestimated when using data at the sector level as compared to the product level. A complementary plant level decomposition reveals that emission intensities of production increased both within plant, and due to a reallocation of production to more emission intensive plants.

Berberine hydrochloride alleviates chronic prostatitis/chronic pelvic pain syndrome by modifying gut microbiome signaling.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is highly prevalent worldwide and poses a significant threat to men's health, particularly affecting young men. However, the exact causes and mechanisms behind CP/CPPS remain unclear, leading to challenges in its treatment. In this research, a CP/CPPS rat model was established with complete Freund's adjuvant (CFA), and berberine hydrochloride was administered through daily gavage to assess its therapeutic effects. The alterations in the gut microbiome induced by CP/CPPS and berberine hydrochloride were investigated through 16S ribosomal RNA sequencing of cecum content and colonic epithelial cells. To investigate the impact of the gut microbiome on CP/CPPS, a pseudo germ-free rat model was established, and fecal microbiome transplantation (FMT) was performed on these rats. In all, berberine hydrochloride demonstrated effective reduction of inflammation and oxidative stress in the prostate, offering significant therapeutic advantages for CP/CPPS. Through analysis of the gut microbiome using 16S ribosome RNA sequencing, distinct differences were observed between CP/CPPS rats and control rats, and Clostridium butyricum was identified as a key bacteria. Pseudo germ-free rats that underwent FMT from CP/CPPS rats or rats treated with berberine hydrochloride displayed varying levels of inflammatory cytokine production, oxidative stress, and activity of associated signaling pathways. In conclusion, the therapeutic potential of berberine hydrochloride in addressing CP/CPPS is highly significant. The gut microbiome has emerged as a critical factor in the development of CP/CPPS and plays a pivotal role in mediating the therapeutic effects of berberine hydrochloride.

Wheat redistribution in Huang-Huai-Hai, China, could reduce groundwater depletion and environmental footprints without compromising production

The Huang-Huai-Hai region accounts for 80% of China’s wheat production, leading to severe groundwater depletion and substantial environmental impacts. Here we present an optimization framework for wheat redistribution to reduce both water requirements and environmental impacts without compromising production. Our results show that environmental footprints can be reduced—blue water by 16%, grey water by 21%, and greenhouse gas emissions by 18%—while enhancing resource use efficiency, with irrigation water productivity improving by 21% and nitrogen use efficiency by 11%. Maintaining current production levels is achievable with these adjustments. Furthermore, allowing a 17–18% decrease in wheat production could result in a groundwater depth increase of 9.03–9.38 m by 2030, ensuring sustainable groundwater use. In regions experiencing groundwater depletion, blue water, grey water and greenhouse gas emissions could decrease by over one third. Our findings offer an alternative strategy for promoting sustainable agriculture in regions facing groundwater depletion worldwide.

Design Method of Museum Cultural and Creative Products Based on Multi sensory Experience

To explore the design method of museum cultural and creative products based on multi sensory experience, improve product level and user experience, and provide new directions for the development of museum cultural and creative design. The method first introduces the cognitive principles and sensory expression methods of sensory experience, and then focuses on the study of three common multi sensory phenomena: multi sensory integration, synesthesia, and sensory compensation. It analyzes their application in the design of cultural and creative products, summarizes the transformation process of user generated multi sensory experience, and establishes a multi sensory experience cultural and creative product design process based on this. Conclusion: Product design with multi sensory experience can bring users a more comprehensive and profound experience, help promote the inheritance and development of museum culture, and improve the serious problem of homogenization in the cultural and creative industry.

Dietary fiber monosaccharide content alters gut microbiome composition and fermentation.

The survival of a microbial species in the gut depends on the availability of the nutrients necessary for that species to survive. Carbohydrates in the form of non-host digestible fiber are of particular importance, and the set of genes possessed by each species for carbohydrate consumption can vary considerably. Here, differences in the monosaccharides that are the building blocks of fiber are considered for their impact on both the survival of different species of microbes and on the levels of microbial fermentation products produced. This work demonstrates that foods with similar monosaccharide content will have consistent effects on the survival of microbial species and on the production of microbial fermentation products.

RAGE signalling contributes to oxidative stress and inflammation in knee osteoarthritis patients with metabolic syndrome.

Metabolic factors play significant role in the natural history of knee osteoarthritis (KO). There is a limited understanding of molecular and cellular events that give rise to the disease in patients. This study explored the possible cellular mechanisms by which metabolic syndrome leads to KO. This cross-sectional study enrolled 80 subjects with KO who fulfilled the ACR diagnostic criteria and were undergoing total knee replacement surgery. The patients were divided into two groups: KO patients without metabolic syndrome and KO patients with metabolic syndrome. We hypothesised that metabolic syndrome may accelerate pathogenesis of OA by enhanced RAGE axis in articular cartilage and Infrapatellar fat pad of the knee joint. We have found enhanced protein expression of receptor for advanced glycation end products (RAGE) and its ligands AGEs and HMGB-1 in knee joint tissue of KO patients with metabolic syndrome as compared to KO patients without metabolic syndrome. Further downstream, the gene expression of oxidative stress regulators such as NADPH and inflammation, NFĸB were upregulated in KO patients with MetS as compared to KO patients alone. Higher levels of advanced oxidation products and inflammatory marker IL-17 were exhibited in synovial fluid of KO patients with metabolic syndrome. The enhanced levels of these oxidative stress and inflammatory markers were reflected in the serum of KO patients with metabolic syndrome as well. We conclude that enhanced function of RAGE axis could be one of the mechanisms by which metabolic syndrome leads to KO.

Addressing Circularity Strategies by Reconfiguring Smart Products during Their Lifecycle

Considering circularity aspects during the engineering of smart products implies a significantly increased complexity of engineering processes. Especially technical reconfiguration of smart products, offered as services in availability-oriented business models, enables the integration of circular economy aspects in sustainable products and lifecycles, through realizing several aspects of the 9R strategies. This paper introduces an analysis of interdependencies between 9R strategies potential reconfiguration options, technical characteristics of smart products, different maturity levels of smart product and abilities for circularity. Partial engineering models managed in different product lifecycle management systems provide a technical basis for systematization and evaluation of circular abilities of reconfigurable smart products in different lifecycle phases. The approach aims to improve circularity-related decision making in systems engineering processes in the early development phases and during the reconfiguration of smart products during utilization phase. An industrial use case considering a microelectronic-centered smart product used in e-mobility solutions validates the approach.

The Role of Differentiated Learning at English Language Classes to Develop Key Competencies of Students

Discusses the role of differentiated learning in English lessons for the development of key competencies of students, namely informative, social-communicative, as well as self-awareness and problem solving. The author defines the need for diagnostics at the beginning of the lesson in order to determine the level of basic knowledge and adjust the further learning process. Differentiation is gives opportunity to each child, motivates students to learn the language, allows them to achieve the goal of the lesson and make the learning process more effective. Differentiation can be achieved through the content of learning, the process and demonstration of results. Differentiated learning can contribute to the organization of learning at the reproductive, productive and creative levels, taking into account the individual characteristics to develop key competencies of students.

Mapping Corporate Sustainability and Firm Performance Research: A Scientometric and Bibliometric Examination

Corporate sustainability has garnered increasing attention within the business community as corporations communicate to influence their stakeholders to build sustainable relationships. There has been a surge in research exploring its connection to firm performance, but existing studies lack a cohesive and concentrated approach. The aim of this study is to explore the trends of growth of publications; gauge the annual growth rate, annual ratio of growth, relative growth rate, doubling time, and scientific production index; predict future production levels; and look at the relationship between corporate sustainability and firm performance by analysing the literature as well as identifying clusters and links with the Sustainable Development Goals (SDGs). The top countries contributing to the research were China, India, and the United States, accounting for over 45% of the global publications. The study analysed a focused corpus of 65 documents from the Scopus database on specific subfields of corporate sustainability and firm performance, identifying five main thematic clusters related to environmental performance, financial performance, corporate sustainability reporting, corporate social performance, and green supply chain management, with significant citations related to 17 SDGs. The annual growth rate (AGR) of publications was found to be −2.88%, with an average of 4.06 publications per year. The relative growth rate (RGR) decreased from 0.69 in 2010 to 0.36 in 2023, and the doubling time (Dt.) increased from 1.00 in 2010 to 1.93 in 2023. Employing structured methods and the PRISMA protocol, this scientifically rigorous study points towards identification of research themes linking sustainability practices to firm performance. Exponential smoothing (Holt’s linear trend model) is employed to project future research output within the field. The significant trends include an increase in publication frequency since 2017, indicating a growth phase in the research field. The findings highlight the need for greater investigation from developing countries and the importance of integrating sustainability considerations into business strategies.

Productivity Of Various Cocoa Clones (Theobroma Cacao L.) At Different Rainfall Levels In Tettikenrarae Village, Soppeng Regency

Changes in rainfall are one of the causes of declining production in cocoa plants and cause land degradation, thus reducing national cocoa productivity. This study aims to analyze the productivity of various clones of cocoa plants at different rainfall levels so that the relationship between production levels and cocoa productivity at different rainfall levels is known. This study used the observation method. Data collection was done by random sampling in farmers' farms by determining the appropriate sample plants. The sample plants used came from three different clones, namely MCC Clone 01 (M01), MCC Clone 02 (45), and Sulawesi Clone 1 (S1) which were 13 years after planting and still productive. Rainfall data was obtained from available data at the BMKG of South Sulawesi Province. Data analysis was conducted to determine the productivity comparison of three cocoa clones at different rainfall levels. The results showed that: 1) Different rainfall levels affect the productivity of various cocoa clones in Tettikenrarae Village, Soppeng Regency. This can be seen in the parameters of number of seeds and weight of seeds, with productivity respectively for clone MCC 02 amounting to 4350.66 kg, clone S1 4326.78 kg, and clone MCC 01 with a production of 3863.29 kg. 2) Productivity of cocoa clones in Tettikenrarae Village, Soppeng Regency is best in moderate rainfall conditions, where clone MCC 02 has the highest productivity of 1820.47 kg which occurs in rainfall of 100 - 300 mm.

Effects of active vitamin D analogs and calcimimetic agents on PTH and bone mineral biomarkers in hemodialysis patients with SHPT: a network meta-analysis.

Active vitamin D analogs and calcimimetic agents are primary drugs for patients with secondary hyperparathyroidism. Due to the different pharmacological mechanisms, they have different effects on the level of parathyroid hormone, serum calcium, phosphorus, and bone turnover biomarkers. This study aimed to evaluate the active vitamin D analogs and calcimimetic agents in hemodialysis patients with secondary hyperparathyroidism. We included randomized clinical trials of hemodialysis patients with secondary hyperparathyroidism, comparing active vitamin D analogs to calcimimetic agents or placebo/control. The primary outcome was the change of PTH level from baseline to end-up. The secondary outcome was the change in serum calcium, phosphorus, calcium-phosphorus product, and bone turnover biomarkers. A network meta-analysis method was applied to complete this study. The forest plots reflected statistical differences in the outcomes between active vitamin D analogs and calcimimetic agents. The SUCRA result presented the ranking of impact on the outcomes. Twenty-one randomized clinical trials with 4653 patients were included in this network meta-analysis. Global and splitting-node inconsistencies provided no evidence of inconsistency in this study. There was no statistical difference between two active vitamin D analogs and three calcimimetic agents in the PTH, and phosphorus levels changed. Considering serum calcium level, compared with placebo, calcitriol (9.73, 3.09 to 16.38) and paricalcitol (9.74, 3.87 to 15.60) increase serum calcium. However, cinacalcet (- 1.94, - 3.72 to - 0.15) and etelcalcetide (- 7.80, - 11.80 to - 3.80) reduced the serum calcium, even a joint use of cinacalcet with active vitamin D analogs (- 5.83, - 9.73 to - 1.93). Three calcimimetic agents decreased calcium levels much more than calcitriol and paricalcitol. The same type of drugs was not distinct, with each one affecting the change in calcium level. Cinacalcet reduced calcium-phosphorus product much more than paricalcitol (- 3.66, - 6.72 to - 0.60). Evocalcet decreased calcium-phosphorus product more than cinacalcet (- 5.64, - 8.91 to - 2.37), calcitriol (- 9.36, - 14.81 to - 3.92), and paricalcitol (- 9.30, - 13.78 to - 4.82). Compared with paricalcitol, cinacalcet significantly increases the level of ALP (24.50, 23.05 to 25.95) and bALP (0.67, 0.03 to 1.31). The incidence of gastrointestinal disorders in cinacacet (29.35, 1.71 to 504.98) and etelcalcetide (20.92, 1.20 to 365.68) was notably higher than in paricalcitol. Etelcalcetide (0.71, 0.53 to 0.96) and evocalcet (0.46, 0.33 to 0.64) presented a lower rate of gastrointestinal disorders than cinacalcet. Cinacalcet ranked first in adverse gastrointestinal, nervous, and respiratory reactions. The same kinds of agents perform similar efficacy on the level of PTH, serum calcium, phosphorus, and calcium-phosphorus product. Paricalcitol did not lead to more hypercalcemia than calcitriol. The calcium decrease induced by cinacalcet was not settled even by associating it with active vitamin D analogs. Cinacalcet and evocalcet were superior to calcitriol and paricacitol in reducing calcium-phosphorus product. Calcimimetics induced more gastrointestinal disorders than active vitamin D analogs, especially cinacalcet.