Phosphorus Supplementation Research Articles

The Benefits of Midmorning Snack to Combat Stunting: A Longitudinal Panel Study in the Riau Province of Indonesia

Aim:The aim of this research was to help stunted adolescents improve their nutritional status.Background:Stunting is a leading global nutritional problem, especially in developing countries such as Indonesia. This was a longitudinal panel study in the SMP Negeri 3 Pekanbaru Riau Province Junior High School in Indonesia.Objective:The objective of this study was to determine the impact of calcium and phosphorus supplementation via additional midmorning snacks for adolescents with stunting conditions.Methods:We included 36 participants, aged 12–15 years with a height-for-age Z-score of <-2 standard deviation. They underwent a one-month nutritional intervention during which selected snacks and high-calcium milk were given for midmorning snacks. The midmorning snack menu varied daily and included gado-gado (rice, boiled egg, potato, tempeh, tofu, long beans, cabbage & peanut sauce), fried vermicelli (vermicelli, omelet, cucumber & prawn crackers), batagor (tofu, cassava flour crackers, boiled egg & peanut sauce), lontong medan (rice, boiled egg, vermicelli, french fries, fried anchovy, green bean & carrots curry), sandwich (plain toast, omelet, cucumber, lettuce, tomato & chili sauce), chicken porridge (rice porridge, fried bread, shredded chicken & chicken broth), and fried rice teri (rice, anchovy, prawn crackers, cucumber, chili sauce & soy sauce). The total amount of energy from the meals and milk was 541.8 kcal (30 % of RDARecommended Dietary Allowance), 25 g of protein (50 % of RDA), 90 g of carbohydrate (30 % of RDA), and 600 mg of calcium (35 % of RDA). Meal and milk administration lasted 34 days in total. Data analysis and food intake consumption were conducted using the Pearson Product moments test.Results:The participants’ mean height-for-age Z-score before and after the nutritional intervention was -2.5 ± 0.4 (-3.2 — -2.0) and -2.3 ± 0.4 (-3.2 — -1.2), respectively. After the intervention, the rate of stunting was reduced up to 19.4%; the rate of calcium intake before the nutritional intervention was 50% below the recommended dietary allowance—27.3 ± 27.8 (3.3:100.0) %; the rate of phosphorus intake among the participants was sufficient. The rate of calcium intake after the nutritional intervention was 59.1 ± 19.0 (15.5 — 100.0) % due to which the nutritional quality of food before the intervention was still lacking, namely 52.7 ± 15.5 (28.4 — 86.3) after the nutrition intervention increased to 84.8 ± 20.3 (30.9 — 100.0); (r-value = 0.43; p-value = 0.01).Conclusion:The nutritional intervention increased calcium intake. The outcome of the nutritional intervention led to the improvement of nutritional status from stunting to the normal category.Other:The midmorning snack given to teenagers is a snack meal available in the school canteen that they can buy with pocket money. It is necessary to create awareness about the importance of consuming high calcium midmorning snacks for teenagers. The activity of consuming high-calcium midmorning snacks by adolescents can be continued independently. So far, teenagers do not use pocket money to buy midmorning snacks that are high in calcium, but they buy other types of snacks that are low in calcium, consisting of pastel, noodles, tofu, fritters, pao, tempeh, rice cake, and eclairs. So far, no nutritional intervention has significantly increased the nutritional status of stunted children to normal levels; however, this type of intervention may become a viable option in the future.

Treatment of X-Linked Hypophosphatemia in Children

The conventional treatment for X-linked hypophosphatemia (XLH), consisting of phosphorus supplementation and a biologically active form of vitamin D (alfacalcidol or calcitriol), is used to treat rickets and leg deformities and promote growth. However, patients’ adult height often remains less than −2 SD. Moreover, adverse events, such as renal calcification and hyperparathyroidism, may occur. The main pathology in XLH is caused by excessive production of fibroblast growth factor 23 (FGF23). Several studies have demonstrated that treatment with burosumab, a blocking neutralizing antibody against FGF23, is better than conventional therapy for severe XLH and has no serious, short-term side effects. Thus, treatment with burosumab may be an option for severe XLH. The present article reviews the conventional and burosumab therapies. In addition to the fact that the long-term efficacy of antibody-based treatment has not been demonstrated, there are other, unresolved issues concerning the burosumab treatment of XLH.

Early calcium and phosphorus supplementation in VLBW infants to reduce metabolic bone disease of prematurity: a quality improvement initiative

ObjectiveTo reduce the incidence of metabolic bone disease (MBD) among very low birthweight (VLBW) infants admitted to neonatal intensive care unit from baseline of 35% by 50% over 2 years...

Enteral Calcium or Phosphorus Supplementation in Preterm or Low Birth Weight Infants: a Systematic Review and Meta-analysis.

To assess effects of calcium or phosphorous supplementation compared with no supplementation in human milk-fed preterm or low birth weight infants. Data sources include Cochrane Central Register of Controlled Trials, Medline and Embase. We included Randomized controlled trials (RCTs) and non-randomized trials (quasi-randomized). Three studies (4 reports; 162 infants) were included. At latest follow-up (38 weeks), there was reduction in osteopenia (3 studies, 159 participants, relative risk 0.68, 95% confidence interval [CI] 0.46-0.99). At latest follow-up (6 weeks), there was no effect on weight (1 study, 40 participants, mean difference [MD] 138.50 g, 95% CI -82.16 to 359.16); length (1 study, 40 participants, MD 0.77 cm, 95% CI -0.93 to 2.47); and head circumference (1 study, 40 participants, MD 0.33 cm, 95% CI -0.30 to 0.96). At latest follow-up, there was no effect on alkaline phosphatase (55 weeks) (2 studies, 122 participants, MD -126.11 IU/L, 95% CI -298.5 to 46.27, I2 = 73.4%); serum calcium (6 weeks) (1 study, 40 participants, MD 0.54 mg/dL, 95% CI -0.19 to 1.27); and serum phosphorus (6 weeks) (1 study, 40 participants, MD 0.07 mg/dL, 95% CI -0.22 to 0.36). The certainty of evidence ranged from very low to low. No studies reported on mortality and neurodevelopment outcomes. The evidence is insufficient to determine whether enteral supplementation with calcium or phosphorus for preterm or low birth weight infants who are fed mother's own milk or donor human milk is associated with benefit or harm.

Inappropriate secretion of fibroblast growth factor 23 despite hypophosphataemia with changes in bone turnover markers in a girl with systemic lupus erythematosus: Case report and review of the literature.

We report an 11-year-old girl with systemic lupus erythematosus (SLE) who showed hypophosphataemia (1.7 mg/dl, normal range: 3.9-5.8 mg/dl), a decrease in the tubular maximum reabsorption of phosphate/glomerular filtration rate (TmP/GFR) (0.77 mg/dl, normal range: 3.4-5.6 mg/dl), and an elevated serum fibroblast growth factor 23 (FGF23) (circulating phosphate-regulatory hormone) concentration (FGF23: 282 pg/ml, normal range: <52 pg/ml) at the onset. The patient was treated with intravenous pulse methylprednisolone, oral prednisolone, mycophenolate mofetil, hydroxychloroquine, and phosphorus supplement. Serum FGF23 concentrations decreased to near the reference value at 5 months after the onset of SLE, and the TmP/GFR (4.61 mg/dl) simultaneously improved. The urinary deoxypyridinoline (bone resorption marker) concentration on admission (18.9 nmol/mmol creatinine, normal range: 75.4 ± 6.8 nmol/mmol creatinine) was greatly reduced, and the bone-type alkaline phosphatase (bone formation marker) concentration (30.6 µg/l, normal range: 58.6 ± 15.3 µg/l) was also reduced during the increase in FGF23 concentrations before steroid therapy was initiated. The reason for the inappropriate secretion of FGF23, despite hypophosphataemia, remains unknown. The findings in our case suggest that changes in bone turnover markers can occur in patients with SLE and excess inappropriate secretion of FGF23, despite severe and persistent hypophosphataemia.

Phosphorus Nutrition in Songpu Mirror Carp (Cyprinus carpio Songpu) During Chronic Carbonate Alkalinity Stress: Effects on Growth, Intestinal Immunity, Physical Barrier Function, and Intestinal Microflora.

Carbonate alkalinity is a major environmental stress factor affecting aquatic feed configuration, which easily causes oxidative stress and hypoimmunity for fish. Hence, the purpose of the study is to assess the potential effect of phosphorus on growth, intestinal oxidation resistance, physical barrier function, and microflora for Songpu mirror carp (Cyprinus carpio Songpu) (initial average weight of 2.95 ± 0.21 g) reared at the high-concentration carbonate alkalinity environment. A two-factor, three-level (2 × 3) design was applied, in which diets with three different phosphorus levels (3.6, 7.0, and 10.5 g/kg dry matter) were randomly assigned to 0 and 15 mmol/L carbonate alkalinity groups with three replicate aquariums. After the 8-week trial, we found that weight gain rate (WGR), specific growth rate (SGR), protein efficiency ratio (PER), and lipase and amylase activities in the intestine significantly (p < 0.05) declined with increasing carbonate alkalinity. Carbonate alkalinity of 15 mmol/L significantly reduced glutathione peroxidase (GSHPx) activities in the intestine (p < 0.05). The relative expressions of nuclear factor (erythroid-derived 2)-like 2 (Nrf2), glutathione peroxidase 1a (GPX1a), Clautin3, Clautin11, and tumor necrosis factor β (TNF-β) in the intestine were markedly downregulated by increasing carbonate alkalinity levels (p < 0.05), whilst the relative expressions of interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) in the intestine were markedly upregulated (p < 0.05). At the 15 mmol/L carbonate alkalinity treatment, Songpu mirror carp suffer from hypoimmunity status with failed digestion, antioxidant, inflammation, and immune response, thereby inducing impaired growth. Additionally, significant increments in the abundance of Proteobacteria and a significant decrease in the abundance of Fusobacteria and the Firmicutes/Bacteroidetes ratio were caused due to excessively high carbonate alkalinity (15 mmol/L) and excessively low dietary phosphorus supply (3.6 g/kg). Collectively, 7.0 g/kg dietary phosphorus supplementation was effective in promoting intestinal antioxidant enzyme activities and the corresponding gene expression via the Keap1-Nrf2 signaling pathway and in enhancing intestinal immunity by upregulating anti-inflammatory and downregulating pro-inflammatory genes. Appropriate dietary phosphorus supply could promote the formation of beneficial microflora in freshwater, and it has the potential ability to transfer the adverse effect of carbonate alkalinity stress to the structural composition of intestinal microflora. Hence, consideration should be given to suitable phosphorus supply for fish under the chronic carbonate alkalinity stress.

Influence of Calcium and Nonphytate Phosphorus (NPP) on Meat-Type Quail’s Growth, Carcass Features, and Tibia Indices

This study aimed to evaluate the role of increasing dietary calcium (Ca) and non-phytate phosphorus (NPP) supplementation on the growth, carcass, edible portions, and tibia indicators of growing quail. The current study was conducted in a 3×3 factorial design, for this, 360 1-wk-old quails were haphazardly assigned to nine groups, each group is with three gradual levels of Ca (0.60, 0.90, and 1.20 %) and NPP (0.20, 0.40 and 0.60 %). Each group was divided into five replicates with eight-quail each. Results of the study suggested that except at 2 and 6 weeks of age, dietary Ca level did not exhibit any significant (P &gt; 0.05) impact on body weight. Similarly, in the case of NPP, apart from the live weight at 2 and 3 weeks of age, NPP did not have a significant impact on live body weight. Further, in comparison to the low Ca level, the moderate or high Ca levels have higher values of body weight gain. During all the experiments, dietary Ca, NPP, or their mixtures had no significant (P &gt; 0.05) impact on feed consumption. Similarly, feed conversion rate and carcass metrics were also not affected by the individual or combined application of Ca or NPP supplementation Similarly, dietary intakes of Ca or P did not have any significant effect on the various tibia indicators (P &gt; 0.05). Results of the study can be concluded that the effect of the Ca and NPP levels in Japanese quail diets is lowered and it does not much affect the growth rate, feed utilization, carcass yields, edible components, or tibia indices.

Hypocalcemia After the Administration of Denosumab in a Patient With Osteoporotic Fracture and Vitamin D Deficiency

Denosumab is a potent antiresorptive agent used for the treatment of osteoporosis and the prevention of skeletal-related events in patients with multiple myeloma or bone metastasis from solid tumors. Although denosumab generally seems to be safe and well tolerated, denosumab-associated hypocalcemia may occur, and the majority of cases are asymptomatic or mild. Underlying malignancy, renal failure, calcium or vitamin D deficiency, and high bone turnover have been reported as risk factors for hypocalcemia. Here, the author reports a case of hypocalcemia and hypophosphatemia following the administration of denosumab for the treatment of osteoporotic fracture in a patient with underlying but unrecognized severe vitamin D deficiency. Following the supplementation of calcium, vitamin D, and phosphorus, serum calcium and phosphorus levels returned to normal levels after about 2 weeks. To avoid denosumab-associated hypocalcemia, calcium and vitamin D status, as well as renal function should be assessed and corrected if appropriate. J Endocrinol Metab. 2022;12(3):111-115 doi: https://doi.org/10.14740/jem810

P42. Estimating the digestibility of phosphorus sources of mineral and animal origin for phosphorus supplementation of growing pigs

P42. Estimating the digestibility of phosphorus sources of mineral and animal origin for phosphorus supplementation of growing pigs

Effect of strategic mineral supplementation on the occurrence of hemoglobinuria in pregnant buffaloes

The supplementation study was carried out in 20 advanced pregnant buffaloes selected from the area of study. Availability of major elements (Ca, P and Mg), trace elements (Fe, Cu, Mn, Zn,) for animals were calculated on the basis of mineral composition of feedstuffs and feed intake. The mineral availability of individual animal was compared with the nutrient requirements calculated with the help of feeding standards. Results indicated that there was shortage of phosphorus 40.34%, zinc 86.34% and copper 46.26%. But calcium, magnesium, iron, and manganese was shown to be supplied in excess 394.87%, 177.22%, 309.09% and 16.22% respectively on daily basis.The amount of strategic mineral supplement containing deficient minerals was added in the normal routine diet of advanced pregnant buffaloes. Supplementation of phosphorus, zinc and copper during gestation period of buffalo was found beneficial and has successfully prevented the occurrence of hemoglobinuria in advanced pregnant buffaloes.

A Retrospective Chart Review to Determine Hypophosphatemia Incidence and Phosphorus Supplementation Requirements in Patients With Severe Thermal Cutaneous Injuries Receiving High-Volume Hemofiltration.

Patients with severe thermal injuries have increased metabolic demands necessitating frequent phosphate supplementation. Patients with acute renal failure may have less requirements, due to reduced elimination. However, patients being supported with renal replacement therapy have varying degree of requirements. Little published evidence depicts the incidence of hypophosphatemia and repletion requirements in patients with severe thermal injuries treated with high-volume hemofiltration (HVHF) and a high-flux membrane. The objective of this retrospective chart review was to determine the incidence of hypophosphatemia and characterize repletion requirements and response in this population. Enrolled patients had at least 20% TBSA thermal injuries and required continuous hemofiltration with prefilter replacement fluid doses ≥35 mL/kg IBW/hr. A randomly selected cohort without acute kidney injury (AKI) and matched based on age and extent of TBSA was used to compare phosphorus requirements over an initial 14-day period. Demographics, diet, and variables affecting phosphorus concentrations were collected. Sixteen patients were included in the retrospective HVHF group and 16 patients in a case-control cohort to better depict the impact of HVHF. The average age was 60.2 ± 15.1 years and median TBSA was 30% (23.4, 56.3) in the HVHF group, compared to 53.3 ± 16.4 years (P = .22) and TBSA 29% (26.4, 33.9; P = .73). All patients in the HVHF group were started on HVHF with a 1.6 m2 polyethersulfone membrane for AKI. As expected, the HVHF group exhibited statistically higher than normal baseline potassium and phosphorous laboratory values. The HVHF group experienced more days with hypophosphatemia (49.6 ± 12.4% vs 29.3 ± 16.3%, P = .012), despite 0.75 mmol/kg/day phosphorous supplementation (compared to 0.66 mmol/kg/day for the control group, P = .45). Patients with longer durations of HVHF therapy experienced increasing risk of hypophosphatemia, reaching 100% by the end of the study period. This study demonstrates severe thermally injured patients receiving HVHF for AKI are at increased risk for hypophosphatemia, and require high phosphate supplementation.

Hypophosphatemic rickets. Clinical cases

Hypophosphatemic rickets (HR) is a genetically heterogeneous disease that is accompanied by hypophosphatemia, skeletal (rickets-like) disorders, growth retardation in children and adults and by damage of other organs and systems. Its incidence is 3.9 cases per 100.000 live births, and the prevalence ranges from 1.7 per 100,000 children to 4.8 per 100,000 people (children and adults).&#x0D; The study was aimed on the investigation of diagnostic features and treatment strategy of different HR subtypes and evaluation of the effectiveness of therapy. Three cases of patients with HR from two families have been described. Laboratory and instrumental investigations were used to confirm the HR. Genetic diagnosis was done using next-generation target sequencing (tNGS) (skeletal dysplasia panel).&#x0D; General clinical features of skeletal disorders (e.g. severe deformity of the lower extremities from early childhood) and growth retardation were observed in patients with HR. All patients had hypophosphatemia with normal/slightly elevated or decreased PTH levels. All patients underwent repeated surgical treatment (without appropriate laboratory and genetic testing and correction of phosphorus-calcium metabolism), which turned out to be ineffective and led to disability. In two patients from one family, genetic testing confirmed the presence of heterozygous pathogenic PHEX variant, and in one — a homozygous SLC34A3 variant. Normophosphatemia was achieved in a girl with SLC34A3 after starting therapy with the phosphorus supplements. In patients with PHEX variant, treatment with calcitriol, cholecalciferol and phosphorus supplements had little effect (P levels increased but normalization was not achieved), thus only burosumab proved to be rational therapy for such patients. Prior to any corrective surgery, a thorough laboratory and genetic examination should be performed to compensate the phosphorus-calcium metabolism. Timely initiation of pathogenetic conservative treatment can improve bone structure and final growth, as well as reduce the need for corrective surgery.

Metabolic Bone Disease of Prematurity: Discerning Calcium Versus Phosphorus Deficiency and Role of Calcitriol in Its Management

Introduction: Metabolic bone disease of prematurity (MBDP) is prevalent among preterm infants despite major advances in neonatal care. Initial and ongoing assessment of complete bone metabolic markers help direct correct therapeutic mineral replacement. Case Presentation: A preterm infant of 30 weeks gestation and birth weight 1 kg sustained multiple spontaneous metaphyseal fractures at 5 months of age. The infant had multiple comorbidities including perforated necrotizing enterocolitis, chronic lung disease, short gut syndrome, and total parenteral nutrition-related cholestasis. Initial metabolic bone profile showed a rising trend of alkaline phosphatase (ALP) with normal calcium and declining phosphorus levels despite ongoing phosphorus supplements. Further workup showed elevated parathyroid hormone (PTH), low tubular reabsorption of phosphate (TRP), and low 25-hydroxyvitamin D (25(OH)D) levels, suggesting calcium/vitamin D deficiency with secondary hyperparathyroidism rather than inadequate phosphorus intake. Calcium and vitamin D supplementation were commenced and optimized, resulting in a decline in PTH, but ALP remained elevated. Treatment with calcitriol at dose range of 0.07 mcg/kg/day to 0.12 mcg/kg/day for 4.5 months duration led to a fall in ALP and PTH to near normal levels. Conclusion: Early nutrition with focus on calcium, phosphorus, and vitamin D is crucial to prevent MBDP. MBDP assessment should include serum PTH, TRP, and 25(OH)D levels to determine the specific mineral deficiency so that calcium, phosphorus, or vitamin D can be supplemented appropriately. Calcitriol is an effective treatment modality for calcipenic rickets where targeted mineral supplementation has been optimized.

Hiperfosfatemia durante la renutrición en pacientes con anorexia nerviosa grave

IntroductionAnorexia nervosa (AN) is a disorder associated with many medical complications. Regarding phosphorus metabolism, the only recognized alteration is hypophosphatemia associated with refeeding syndrome. However, in our clinical practice, we have observed a high frequency of hyperphosphatemia in late phases of nutrition therapy in severely malnourished AN patients, which has barely been described. Materials and methodsWe carried out a retrospective study of patients with AN hospitalized for severe decompensation of the disease. ResultsEleven patients were included, all women, with a median age of 23 years (20-46) and a body mass index at admission of 12.2kg/m2 (11.7-13.1). Hyperphosphatemia was noted in 9 of the 11 cases (81.8%) with a median time to onset of 53 days (30-75). The median peak serum phosphorus (P) level was 5.1mg/dl (4.9-5.4). An inverse relationship was found between the increase in P levels and phosphorus supplementation at the onset of admission. The magnitude of the P increase was associated with the body weight gain achieved during nutrition therapy. ConclusionLate hyperphosphatemia during nutrition therapy in severely malnourished AN patients affects more than 80% of cases. Body weight gain throughout nutrition therapy is a predictor of increased P levels.

Progress of vanadium phosphorous oxide catalyst for n-butane selective oxidation

The utilization of lighter alkanes into useful chemical products is essential for modern chemistry and reducing the CO2 emission. Particularly, n-butane has gained special attention across the globe due to the abundant production of maleic anhydride (MA). Vanadium phosphorous oxide (VPO) is the most effective catalyst for selective oxidation of n-butane to MA so far. Interestingly, the VPO complex exists in more or less fifteen different structures, each one having distinct phase composition and exclusive surface morphology and physiochemical properties such as valence state, lattice oxygen, acidity etc., which relies on precursor preparation method and the activation conditions of catalysts. The catalytic performance of VPO catalyst is improved by adding different promoters or co-catalyst such as various metals dopants, or either introducing template or structural-directing agents. Meanwhile, new preparation strategies such as electrospinning, ball milling, hydrothermal, barothermal, ultrasound, microwave irradiation, calcination, sol–gel method and solvothermal synthesis are also employed for introducing improvement in catalytic performance. Research in above-mentioned different aspects will be ascribed in current review in addition to summarizing overall catalysis activity and final yield. To analyze the performance of the catalytic precursor, the reaction mechanism and reaction kinetics both are discussed in this review to help clarify the key issues such as strong exothermic reaction, phosphorus supplement, water supplement, deactivation, and air/n-butane pretreatment etc. related to the various industrial applications of VPO.

Secondary Metabolism and Plant Growth of Piper divaricatum (Piperaceae) Inoculated with Arbuscular Mycorrhizal Fungi and Phosphorus Supplementation

Arbuscular mycorrhizal fungi (AMF) species and/or phosphorus addition in the soil can affect secondary metabolism production and growth in plants. This study evaluated these effects on Piper divaricatum culture, which presents an essential oil rich in phenylpropanoids. Growth parameters, leaf volatile composition, total phenolic content, and the enzymatic activity of lipoxygenase (LOX) and phenylalanine ammonia-lyase (PAL) were monitored. At 90 days post inoculation (dpi), the treatments with AMF and AMF + P were more effective in terms of the number and biomass of leaves. In addition, the AMF group had increased plant height and root length. Phenylpropanoid and methyl eugenol contents were higher at 30 dpi in the P and AMF + P association treatments. However, at 90 dpi, the plants with P addition at 20 mg·dm−3 and AMF + 200 mg of P·dm−3 showed higher phenolic contents and PAL activity, respectively. All treatments increased LOX activity, especially with P addition at 200 mg·dm−3. These results demonstrate that P and AMF can be applied to optimize leaf biomass and volatile compound production in P. divaricatum.

Altering calcium and phosphorus supplementation in pregnancy and lactation affects offspring craniofacial morphology in a sex-specific pattern

The effects on offspring craniofacial bone morphology and accretion because of altered maternal exposure to dietary components such as calcium (Ca) and phosphorus (P) are unclear. The objective of this study was to investigate the changes in offspring skull morphology and tissue mineral density (TMD), including sex-specific changes, with exposure to a maternal diet high in Ca-to-P levels during gestation and lactation in mice. Time-mated FVB wild-type mice were fed a normal or experimental diet during gestation until weaning. The experimental diet contained a 3-fold increase in Ca and a 3-fold decrease in P (Ca:P molar ratio, 10.5) compared with normal mouse chow (Ca:P molar ratio, 1.5). The heads of 6-week-old control andexperimental offspring mice were collected and scanned using microcomputed tomography. Three-dimensional geometric morphometric analysis was performed to analyze changes in craniofacial morphology. TMD measurements were also analyzed. We observed subtle changes and no significant differences between offspring control and experimental skulls when we compared all samples. However, when we separated skulls by sex, we discovered significant differences in craniofacial morphology and TMD. Experimental female offspring possessed skulls that were smaller, narrower transversely, taller vertically, and decreased in TMD. Experimental male offspring possessed skulls that were larger, wider transversely, shorter vertically, and increased in TMD. Maternal exposure to diet and increased Ca:P molar ratio during gestation and lactation led to significant, sex-specific morphologic and TMD changes in 6-week-old mouse skulls.

POS-090 CYSTINOSIS: A RARE BUT TREATABLE CAUSE OF PROXIMAL RENAL TUBULAR ACIDOSIS

Cystinosis is a rare lysosomal storage disorder which is characterized by defective cystine transporter and accumulation of cystine in lysosomes of cells of various body organs. Most common and severe presentation is in infancy as Fanconi syndrome (infantile nephropathic cystinosis). Incidence of cystinosis is 1 in 1 to 2 lakh newborns; with high incidence in Europe and UK. In India total 19 cases are registered with Cystinosis Society of India. The most common reported Indian mutation is p. Ser141Phe in contrast to 57Kb deletion affecting first 10 exons of CTNS which is commonly reported in Europe. We report a 23 months old male child of Indian origin, born out of non-consanguineous marriage, who presented with acute gastroenteritis and seizure. On examination, child had severe dehydration, pallor, signs of rickets, failure to thrive and polyuria even in the state of dehydration. Initial evaluation revealed a S. creatinine 2.62mg/dl. After fluid resuscitation renal functions improved (nadir S. creatinine 0.82mg/dl). As per mother the child had increased frequency of urination since age of 7 months with history of hospitalization twice for dehydration and dyselectrolytemia at the age of 8 months and 10 months. During follow up period, child had persistent hyperchloremic metabolic acidosis and low serum phosphate.Urine analysis revealed- proteinuria (2+, 100mg/dl), glycosuria (sugar 1+ , 100mg/dl) and phosphaturia. Urinary anion gap was positive; Urine chromatography was suggestive of generalized aminoaciduria. Ultrasound abdomen was normal. On the basis of above findings, the diagnosis of proximal renal tubular acidosis was made. Eye evaluation was suggestive of fine crystals deposition in cornea. In view of possibility of cystinosis, Genetic analysis by next generation sequencing was done which confirmed novel mutation in cystinosine gene (NM_001031681.2: c.771_793delGGGACCACGTGGCTGCAGT;p.Gly258SerfsTer30). Child was started treatment with cysteamine capsules and eyedrops along with bicarbonate, vitamin D, calcium and phosphorus supplements. On treatment child started gaining height and weight, urine output decreased and S. creatinine continued to be at nadir value of 0.8 mg/dl. Renal tubular acidosis may be just a clinical presentation of an underlying systemic disorder, therefore relevant clinical examination with need based molecular testing should be done. As early diagnosis forms the key to specific therapy for long term favorable outcome.

Development of a Culture Medium for Microalgae Production Based on Minimal Processing of Oil Palm Biomass Ash

With the increasing participation of biomass in the world energy matrix, large amounts of ash are produced through combustion, resulting in the need to dispose of this waste to minimize the environmental impact. An alternative is to use ashes as phosphorus supplements in microalgae cultures. The present work describes the development and use of a balanced culture medium based on the minimal processing of oil palm biomass ash to cultivate Arthrospira platensis Paracas, Neochloris oleoabundans UTEX 1185, and Dunaliella salina SAG 184. The acid extraction process of phosphorus (P) was defined by evaluating the following parameters: temperature (20 to 70 °C), acid load (0.01 to 0.03 mols/g of ash) of HNO3, and liquid/solid ratio (50 to 150 mLg−1). The best efficiency of the extraction process was 97%. The use of HNO3 allowed for the production of an extract containing balanced amounts of N and P sources, the BAX medium (Biomass Ash Extract). This medium was efficient for cultivating the three microorganisms studied, reaching biomass concentrations of 2.03, 0.902, and 0.69 g/L or 84%, 82%, and 99% of the control concentrations for A. platensis, N. Oleoabundans, and D. salina, respectively. In a final scaling-up test, A. platensis showed productivity of 0.047 g L−1d−1 in a 120 L tank in a greenhouse. BAX can be an alternative nutrient medium for microalgae cultivation, especially in integration with biomass-fueled biorefineries.

Matrix enrichment by black phosphorus improves ionization and reproducibility of mass spectrometry of intact cells, peptides, and amino acids

Intact (whole) cell matrix-assisted laser desorption/ionization mass spectrometry (MALDI-TOF MS) is an established method for biotyping in clinical microbiology as well as for revealing phenotypic shifts in cultured eukaryotic cells. Intact cell MALDI-TOF MS has recently been introduced as a quality control tool for long-term cultures of pluripotent stem cells. Despite the potential this method holds for revealing minute changes in cells, there is still a need for improving the ionization efficiency or peak reproducibility. Here we report for the first time that supplementation by fine particles of black phosphorus to the standard MALDI matrices, such as sinapinic and α-cyano-4-hydroxycinnamic acids enhance intensities of mass spectra of particular amino acids and peptides, presumably by interactions with aromatic groups within the molecules. In addition, the particles of black phosphorus induce the formation of small and regularly dispersed crystals of sinapinic acid and α-cyano-4-hydroxycinnamic acid with the analyte on a steel MALDI target plate. Patterns of mass spectra recorded from intact cells using black phosphorus-enriched matrix were more reproducible and contained peaks of higher intensities when compared to matrix without black phosphorus supplementation. In summary, enrichment of common organic matrices by black phosphorus can improve discrimination data analysis by enhancing peak intensity and reproducibility of mass spectra acquired from intact cells.