OBJECTIVE: Evaluate utility of postoperative phosphate and calcium/phosphate ratio (Ca/P) as surrogates for parathyroid hormone (PTH) following total thyroidectomy.
METHODS: Retrospective cohort study.
METHODS: Tertiary care hospital.
METHODS: We retrospectively reviewed patients 18 years or older who underwent total thyroidectomy in a tertiary care hospital by a single surgeon from 2015 through 2021. Patients with incomplete data, pre-existing hypoparathyroidism, vitamin D deficiency, or renal failure were excluded. All patients had PTH drawn within 4 hours of surgery and serum calcium, albumin, and phosphate levels on postoperative Day 1. Corrected calcium was used to calculate a Ca/P. Receiver operating characteristic (ROC) curves were generated to compare phosphate level or Ca/P with PTH. Each possible surrogate was assessed relative to PTH cutoffs of less than 5, 10, 15, and 20 pg/mL. A good screening test was defined as having an area under the curve (AUC) greater than 0.8.
RESULTS: A total of 185 patients underwent total thyroidectomy with 1 fellowship-trained otolaryngologist. Most patients were female (62%), median age 48 years. Most surgeries were performed for cancer (68%). Six (3.2%) patients required IV calcium supplementation and 2 (1.1%) required readmission for symptomatic hypocalcemia. ROC curves comparing phosphate and Ca/P to PTH at the listed cutoffs demonstrated AUC ranging from 0.55 to 0.66 and 0.61 to 0.79, respectively. None met the threshold for a good screening test.
CONCLUSIONS: Postoperative phosphate and Ca/P ratio are not surrogates for PTH levels following total thyroidectomy. More research is needed to identify cost-effective strategies for postoperative calcium monitoring in patients undergoing total thyroidectomy.
METHODS: Retrospective cohort study.

This study aimed to assess the ability of modern resin-based \"bioactive\" materials (RBMs) to induce dentine remineralisation via mineral deposition and compare the results to those obtained with calcium silicate cements (CSMs). The following materials were employed for restoration of dentine cavities: CSMs: ProRoot MTA (Dentsply Sirona), MTA Angelus (Angelus), Biodentine (Septodont), and TheraCal LC (Bisco); RBMs: ACTIVA BioACTIVE Base/Liner (Pulpdent), ACTIVA Presto (Pulpdent), and Predicta Bioactive Bulk (Parkell). The evaluation of the mineral deposition was performed through scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) on the material and dentine surfaces, as well as at the dentine-material interface after immersion in simulated body fluid. Additionally, the Ca/P ratios were also calculated in all the tested groups. The specimens were analysed after setting (baseline) and at 24 h, 7, 14, and 28 days. ProRoot MTA, MTA Angelus, Biodentine, and TheraCal LC showed significant surface precipitation, which filled the gap between the material and the dentine. Conversely, the three RBMs showed only a slight ability to induce mineral precipitation, although none of them was able to remineralise the dentine-material interface. In conclusion, in terms of mineral precipitation, modern \"bioactive\" RBMs are not as effective as CSMs in inducing dentine remineralisation; these latter represent the only option to induce a possible reparative process at the dentin-material interface.

In animal husbandry, diets should help in maintaining a healthy body condition, support reproduction, and promote species-specific longevity. It is recommended to feed folivorous primates kept in zoos a high-fiber diet, i.e., leaves, although satisfying such a requirement is challenging in temperate regions because it is difficult to obtain fresh leaves, especially in autumn and winter. As equally important for their appropriate treatment, it is valuable to provide details of clinical reports of medical problems and pathological findings, although such clinical reports are rather limited. Therefore, in foregut-fermenting proboscis monkeys (Nasalis larvatus), we (1) described the individual clinical reports of renal disease and weight loss at the Yokohama Zoological Gardens in Japan, (2) determined the nutritional profile of the diets supplied to these animals because other potential triggers for their renal disease and weight loss could be excluded, (3) modified the diet regimen to minimize weight loss and the development of hypercalcemia and hypophosphatemia, and (4) assessed the effects of such dietary modification by comparing the body weight and the Ca and P concentrations and the Ca/P ratios in the blood before and after diet modification with a comparison of these measurements between zoo and free-ranging individuals. Based on the nutritional profile of the diets, we concluded that the reported cases of renal failure might be caused by consumption of leaves with a Ca/P ratio far above the appropriate level in autumn and winter. Additionally, the dietary modification of minerals and metabolizable energy achieved certain beneficial effects on zoo-kept proboscis monkeys.

Literature reports indicate that during bracket removal there can be enamel damage. We compare the shear bond strength (SBS) and tooth enamel loss of four adhesive systems and identify the Ca/P ratio. Then a total of 20 premolars were divided into four groups of five each. After prophylaxis, photographs were taken at 35× with a scanning electron microscope (SEM) and analyzed with X-ray spectroscopy (EDS) at 250×. Brackets were bonded with Transbond™ MIP(G1), Transbond™ PLUS SEP(G2), Enlight(G3) and Stylus®(G4) adhesives, 24 h after were debonded with a Instron universal testing machine at 1 mm/min. All the brackets were photographed with the SEM. The amount of lost enamel was measured with AutoCad. All the results were measured with a significance level p < .05. The SBS general average at debonding was 7.94 ± 2.26 MPa, meanwhile the SBS for G1, G2, G3 and G4 was 9.38 ± 1.46, 6.28 ± 0.69, 9.08 ± 2.45 and 7.04 ± 2.64 MPa respectively. 90% of the samples had no enamel loss, 10% had enamel loss. Only two samples in G1 presented an enamel loss area of 0.34mm2 and 0.80mm2 respectively. From EDS analysis, the Ca/P ratio was 1.6 ± 0.05, 1.61 ± 0.03, 1.64 ± 0.83 and 1.59 ± 0.07 for G1, G2, G3 and G4 respectively; no statistically significant differences were found. We conclude that no association was found between the Ca/P ratio and enamel damage when brackets are removed. HIGHLIGHTS: Where enamel is lost, we observe fractures, steps, horizontal and vertical enamel loss. There is a loss of tooth enamel from 0.34 to 0.80 mm2 with Transbond PLUS SEP. Structural loss of enamel is almost inevitable during the separation of the bracket.

Phycocyanin (PC) is a blue-colored, pigment-protein complex with unique fluorescence characteristics. However, heat leads to PC fading and fluorescence decay, hampering its widespread application. To improve the thermal stability of PC, we induced the in situ mineralization of calcium phosphate (CaP) on the PC surface to prepare PC@Mg-CaP. The nanoparticles were characterized using transmission electron microscopy, energy dispersive spectrometry, fourier transform infrared spectroscopy, and X-ray diffraction. The results showed that PC@Mg-CaP was spherical, and the nanoparticle size was less than 200 nm. The shell of PC@Mg-CaP was composed of amorphous calcium phosphate (ACP). The study suggested that CaP mineralization significantly improved the thermal stability of PC. After heating at 70 °C for 30 min, the relative concentration of PC@Mg-CaP with a Ca/P ratio = 2 was 5.31 times higher than that of PC. Furthermore, the Ca/P ratio was a critical factor for the thermal stability of PC@Mg-CaP. With decreasing Ca/P, the particle size and thermal stability of PC@Mg-CaP significantly increased. This work could provide a feasible approach for the application of PC and other thermal-sensitive biomolecules in functional foods requiring heat treatment.

Pathophysiological conditions can modify the skeletal chemical concentration. This study analyzes the elemental composition in two anatomical regions from dry femoral bone using a portable X-Ray Fluorescence (pXRF) and evaluates its impact in the bone mineral density (BMD). The left femora of 97 female skeletons (21-95 years old individuals) from the Coimbra Identified Skeletal Collection were studied. Diagenetic biases were discarded at the outset and BMD was determined with Dual-energy X-ray absorptiometry. Chemical measurements were performed at the midpoint of the femoral neck and at the midshaft using a pXRF device, and comparisons were made considering the age and the BMD values. Only elements with a Technical Measurement Error ≤ 5% were selected: P, S, Ca, Fe, Zn, As, Sr, Pb and the Ca/P ratio. Statistically significant differences were found between regions, with higher concentrations of P, Ca, Zn and S at the midshaft, and the Ca/P ratio at the femoral neck. The concentration of P is higher in individuals < 50 years, while S and Ca/P ratio increase in individuals ≥ 50 years. The decrease of P with age can be simultaneously related to the decline of its concentration in osteoporosis. Decreased BMD is also associated with higher levels of S and Pb. Osteoporosis enhances the absorption of osteolytic elements in specific locations. This fast and non-destructive technique has proved effective for the comprehension of chemical changes related to bone mass loss. This study highlights the potential of identified skeletal collections to improve the knowledge about bone fragility.

The hypothesis was tested that an increased digestion of coarse compared with fine limestone can alleviate the negative effects of a low dietary Ca/P ratio on the growth performance and characteristics of tibia strength (CTS) in broilers. A total of 1,152 Ross 308 broiler chickens received a standard commercial starter feed from day 0 to 13. From day 14 onward, birds received 1 of 12 diets containing 1 of 6 Ca/P ratios (0.50, 0.75, 1.00, 1.25, 1.50, and 1.75) and 1 of 2 limestone particle sizes (<500 [fine] and 500 to 2,000 [coarse] μm) in a study with a 6 × 2 factorial arrangement of treatments. Total P content was fixed at 5.5 g/kg for all treatment diets. Each treatment was replicated 6 times with 16 birds per replicate pen. On day 20 and 21, twelve birds per pen were randomly selected from 4 of the 6 replicate pens for tibia analysis and digesta collection from different gut segments. The apparent Ca digestibility was higher for fine than coarse limestone in the jejunum (P = 0.043). However, this difference in Ca digestibility disappeared for the low, whereas it remained for the high Ca/P ratios in the proximal (Pinteraction = 0.067) and distal (Pinteraction = 0.052) ileum. In addition, coarse limestone improved apparent P digestibility in the proximal and distal ileum (P < 0.001) but not in the jejunum (P = 0.305). Regardless of limestone particle size, reducing dietary Ca/P ratio linearly improved apparent Ca and P digestibility in the proximal and distal ileum (P < 0.001). Moreover, decreasing dietary Ca/P ratio linearly (P < 0.001) and quadratically (P < 0.046) reduced the CTS. Reducing dietary Ca/P ratio linearly (P < 0.003) and quadratically (P ≤ 0.006) decreased body weight gain and increased feed conversion ratio. For both fine and coarse limestone, the optimal Ca/P ratio was 1.00 to 1.25 to optimize apparent Ca and P digestibility while maintaining growth performance and CTS. Reducing Ca/P ratio from 1.75 to 1.00 improved distal ileal Ca and P apparent digestibility from 36.6 to 53.7% and 48.0 to 58.3%, respectively. In conclusion, coarse limestone is equally digestible with fine limestone at a low Ca/P ratio but is less digestible at a high Ca/P ratio, and the optimal Ca/P ratio in the diet is 1.00 to 1.25 for both fine and coarse limestone.

This study aimed to investigate the mineralization and chemical composition of the bone-implant interface and peri-implant tissues on human histological samples using an environmental scanning electron microscope as well as energy-dispersive x-ray spectroscopy (ESEM-EDX) as an innovative method. Eight unloaded implants with marginal bone tissue were retrieved after four months from eight patients and were histologically processed and analyzed. Histological samples were observed under optical microscopy (OM) to identify the microarchitecture of the sample and bone morphology. Then, all samples were observed under ESEM-EDX from the coronal to the most apical portion of the implant at 500x magnification. A region of interest with bone tissue of size 750 × 500 microns was selected to correspond to the first coronal and the last apical thread (ROI). EDX microanalysis was used to assess the elemental composition of the bone tissue along the thread interface and the ROI. Atomic percentages of Ca, P, N, and Ti, and the Ca/N, P/N and Ca/P ratios were measured in the ROI. Four major bone mineralization areas were identified based on the different chemical composition and ratios of the ROI. Area 1: A well-defined area with low Ca/N, P/N, and Ca/P was identified as low-density bone. Area 2: A defined area with higher Ca/N, P/N, and Ca/P, identified as new bone tissue, or bone remodeling areas. Area 3: A well-defined area with high Ca/N, /P/N, and Ca/P ratios, identified as bone tissue or bone chips. Area 4: An area with high Ca/N, P/N, and Ca/P ratios, which was identified as mature old cortical bone. Bone Area 2 was the most represented area along the bone-implant interface, while Bone Area 4 was identified only at sites approximately 1.5 mm from the interface. All areas were identified around implant biopsies, creating a mosaic-shaped distribution with well-defined borders. ESEM-EDX in combination with OM allowed to perform a microchemical analysis and offered new important information on the organic and inorganic content of the bone tissue around implants.

The aim of the work was an assessment of the morphological structure and chemical composition of dental hard tissues in persons suffering from chronic kidney disease and the effectiveness of remineralizing therapy in them. The study of the morphological structure and chemical composition of dental hard tissues in individuals suffering from chronic kidney disease and the effectiveness of 6 weeks of remineralizing therapy in the course of individual oral hygiene in combination with the intake of vitamin-mineral complex was conducted by means of ABT-55 electron microscope (Japan) combined with a LinkAN-10 000/S85 microprobe (United Kingdom) in comparison with persons without somatic pathology. It has been established that in people suffering from chronic kidney disease dental hard tissues morphological features were determined by their pathological changes due to carious process or non-carious lesions. In chronic kidney disease a significant decrease in the level of mineralization in both enamel and dentin was found, which was most pronounced in patients with chronic renal failure and did not depend on whether they received hemodialysis. The use of remineralizing therapy in people with chronic kidney disease within the framework of individual oral hygiene combined with a vitamin-mineral complex intake for 6 weeks significantly contributed to an increase in the Ca/P ratio in tooth enamel and may be seen as a useful tool for prevention of dental hard tissues pathology in the patient\'s group.
Цель работы - оценка морфологического строения и химического состава твердых тканей зубов у лиц, страдающих хронической болезнью почек, и эффективности проведения у них реминерализующей терапии. С использованием электронного микроскопа ABT-55 (Япония), совмещенного с микрозондом LinkAN-10 000/S85 (Великобритания), изучены морфологическое строение и химический состав твердых тканей зубов у лиц, страдающих хронической болезнью почек, и эффективность проведения у них в течение 6 нед реминерализующей терапии в ходе индивидуальной гигиены полости рта в сочетании с приемом витаминно-минерального комплекса, в сравнении с лицами, не имеющими соматической патологии. Установлено, что у людей, страдающих хронической болезнью почек, особенности морфологического строения твердых тканей зубов определялись их патологическими изменениями за счет кариозного процесса или некариозных поражений. При хронической болезни почек выявлено достоверное понижение уровня минерализации как эмали, так и дентина, что было наиболее выражено у лиц с хронической почечной недостаточностью и не зависело от их нахождения на гемодиализе. Использование реминерализующей терапии у лиц с хронической болезнью почек в рамках индивидуальной гигиены полости рта в сочетании с применением в течение 6 нед витаминно-минерального комплекса способствовало значимому повышению Ca/P-коэффициента в эмали зубов, что позволяет рекомендовать данный подход к применению в клинической практике.

Based on the requirements for advanced treatment and resource recovery of nitrogen and phosphorus pollutants in wastewater, the coupled anammox and hydroxyapatite crystallization (anammox-HAP) process was studied with an aim of achieving high efficiency and low energy consumption during simultaneous nitrogen and phosphorus removal. In the long-term experiments and batch tests, the effects of substrate conditions (nitrogen and phosphorus load, calcium concentration, etc.) on the nitrogen removal and phosphorus recovery efficiencies were investigated. The granular structure and crystal properties were analyzed together with microscopic characterization methods, and the formation mechanism of coupled anammox-HAP granules was verified. Based on these experiments, a theoretical model and technical method for realizing the coupled process were established, and a reference for practical engineering application was provided.