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Access to essential medications and health products is critical to effective management of kidney disease. Using data from the ISN Global Kidney Health Atlas multinational cross-sectional survey, global access of patients with kidney disease to essential medications and health products was examined. Overall, 125 countries participated, with 118 countries, composing 91.5% of the world’s population, providing data on this domain. Most countries were unable to access eGFR and albuminuria in their primary care settings. Only one-third of low-income countries (LICs) were able to measure serum creatinine and none were able to access eGFR or quantify proteinuria. The ability to monitor diabetes mellitus through serum glucose and glycated hemoglobin measurements was suboptimal. Pathology services were rarely available in tertiary care in LICs (12%) and lower middle-income countries (45%). While acute and chronic hemodialysis services were available in almost all countries, acute and chronic peritoneal dialysis services were rarely available in LICs (18% and 29%, respectively). Kidney transplantation was available in 79% of countries overall and in 12% of LICs. While over one-half of all countries publicly funded RRT and kidney medications with or without copayment, this was less common in LICs and lower middle-income countries. In conclusion, this study demonstrated significant gaps in services for kidney care and funding that were most apparent in LICs and lower middle-income countries.

An international survey led by the International Society of Nephrology in 2016 assessed the current capacity of kidney care worldwide. To better understand how governance and leadership guide kidney care, items pertinent to government priority, advocacy, and guidelines, among others, were examined. Of the 116 responding countries, 36% (n = 42) reported CKD as a government health care priority, which was associated with having an advocacy group (χ2 = 11.57; P = 0.001). Nearly one-half (42%; 49 of 116) of countries reported an advocacy group for CKD, compared with only 19% (21 of 112) for AKI. Over one-half (59%; 68 of 116) of countries had a noncommunicable disease strategy. Similarly, 44% (48 of 109), 55% (57 of 104), and 47% (47 of 101) of countries had a strategy for nondialysis CKD, chronic dialysis, and kidney transplantation, respectively. Nearly one-half (49%; 57 of 116) reported a strategy for AKI. Most countries (79%; 92 of 116) had access to CKD guidelines and just over one-half (53%; 61 of 116) reported guidelines for AKI. Awareness and adoption of guidelines were low among nonnephrologist physicians. Identified barriers to kidney care were factors related to patients, such as knowledge and attitude (91%; 100 of 110), physicians (84%; 92 of 110), and geography (74%; 81 of 110). Specific to renal replacement therapy, patients and geography were similarly identified as a barrier in 78% (90 of 116) and 71% (82 of 116) of countries, respectively, with the addition of nephrologists (72%; 83 of 116) and the health care system (73%; 85 of 116). These findings inform how kidney care is currently governed globally. Ensuring that guidelines are feasible and distributed appropriately is important to enhancing their adoption, particularly in primary care. Furthermore, increasing advocacy and government priority, especially for AKI, may increase awareness and strategies to better guide kidney care.

In this essay, I present eating as a vital theological concern and an integral part of the church’s ministries and mission in the world. I argue that food is not reducible to the status of a commodity but is instead God’s love made delectable. The production and the sharing of good food is a witness to God’s presence among us.

There appears to be a law that when creatures have reached the level of consciousness, as men have, they must become conscious of the creation; they must learn how they fit into it and what its needs are and what it requires of them, or else pay a terrible penalty: the spirit of the creation will go out of them, and they will become destructive; the very earth will depart from them and go where they cannot follow.1Human beings have lost their creaturely nature; this has been corrupted by their being sicut deus [like god]. The whole created world is now covered in a veil; it is silent and lacking explanation, opaque and enigmatic.2

This essay argues that a good and faithful agriculture, and the healthy eating practices made possible by it, should play a vital role in the healing of creation. The interconnectedness of ecological problems means that if we get our eating right, much other environmental good will follow. What good eating and good agriculture look like are developed in terms of God's own example as the One who plants and gardens the world. Today's industrial agriculture and our culture's obsession with cheap and convenient food are shown to lie behind much of the world's degradation and economic injustice. I suggest that Christians can play an important role in the healing and celebration of creation by participating in God's caring, gardening ways with the world, and that we can do this most effectively in the eating we choose to do. Churches should take a leading role in the promotion of a God-honoring agriculture and in the advocacy of economic and political priorities that serve the well being of all creation's eaters.

QCD superconductors in the color–flavor-locked (CFL) phase support excitations (generalized mesons) that can be described as pairs of particles or holes (rather than particle–hole) around a gapped Fermi surface. In weak coupling and to leading logarithm accuracy the scalar and pseudoscalar excitations are massless and the vector and axial-vector excitations are massive and degenerate. The massless scalar excitations are combined with the longitudinal gluons leading to the Meissner effect in the CFL phase. The mass of the composite vector excitations is close to twice the gap in weak coupling, but goes asymptotically to zero with increasing coupling thereby realizing Georgi's vector limit in cold and dense matter. We discuss the possible mixing of the composite scalar and vector excitations with the gluons, their possible coupling to the modified photons and their decay into light pseudoscalars in the CFL phase. The issue of hidden gauge-symmetry in the QCD superconductor is critically examined. The physical implications of our results on soft dilepton and neutrino emission in cold and dense matter are briefly discussed.

We show that color can leak from a QCD bag if we allow for pseudoscalar isoscalar singlet (η′) coupling at the surface. To enforce total confinement of color an additional boundary term is suggested. New relations between the η′ mass and decay constant and the QCD gluon condensates are derived and compared with the empirical parameters.

Most discussions of chaotic scattering systems are devoted to two-dimensional systems. It is of considerable interest to extend these studies to the, in general, more realistic case of three dimensions. In this context, it is conceptually important to investigate the quality of semiclassical methods as a function of the dimensionality. As a model system, we choose various three-dimensional generalizations of the famous three-disk problem which played a central role in the study of chaotic scattering in two dimensions. We present a quantum-mechanical treatment of the hyperbolic scattering of a point particle off a finite number of nonoverlapping and nontouching hard spheres in three dimensions. We derive expressions for the scattering matrixSand its determinant. The determinant ofSdecomposes into two parts, the first one contains the product of the determinants of the individual one-sphereS-matrices and the second one is given by a ratio involving the determinants of a characteristic KKR-type matrix and its conjugate. We justify our approach by showing that all formal manipulations in these derivations are correct and that all the determinants involved which are of infinite dimension exist. Moreover, for all complex wave numbers, we conjecture a direct link between the quantum-mechanical and semiclassical descriptions: The semiclassical limit of the cumulant expansion of the KKR-type matrix is given by the Gutzwiller–Voros zeta function plus diffractional corrections in the curvature expansion. This connection is direct since it is not based on any kind of subtraction scheme involving bounded reference systems. We present numerically computed resonances and compare them with the corresponding data for the similar two-dimensionalN-disk systems and with semiclassical calculations.

The12C(p, ?)13N reaction has been used as a method to determine the absolute proton beam energy in the region ofEp=150–350 keV with a precision of the order of 0.4 keV. The method makes use of the resulting capture?-ray transition, whose intensity varies smoothly with beam energy and whose varying energy can be determined to high accuracy by comparison with precisely known energies of?-rays from radioactive sources.

The reaction12C+12C has been studied in the energy rangeEcm=2.45–6.15 MeV by?-ray spectroscopy. Gamma-ray transitions from a large number of excited states in20Ne,23Na and23Mg were observed, which show strong and rapid yield variations. When the influence of the Coulomb barrier is removed, these structures appear superimposed on a flat reaction yield, which does not show a strong increase at low energies, in contrast to previous work. These results obviate the need for the hypothesis of absorption under the barrier at least down toEcm=2.45 MeV. The nuclear and astrophysical aspects of the data are discussed.

The15N(?, a0)12C reaction has been investigated in the energy range ofEp(lab)=78-810keV. The measurement of the excitation functions and a-particle angular distributions involved solid targets as well as a quasi-point supersonic jet gas target. The determination of absolute cross sections has been carried out with the gas target. The observed energy dependence of the total cross sections can be described in terms of two-level Breit-Wigner shapes including the resonances atEp(Jp)=335(1-) and 1,028(1-)keV. The data lead to a zero-energy intercept of the astrophysicalS(E) factor ofS(0)= 65±4MeV-b. The angular distributions are asymmetric around 90° and require an additional amplitude in the reaction mechanism, which interferes predominantly with the 335 keV resonance. The origin of this background amplitude is discussed.

The diffraction trace formula derived previously and the spectral determinant are tested on the open three-disk scattering system. The system contains a generic and exponentially growing number of diffraction periodic orbits. In spite of this it is shown that even the scattering resonances with large imaginary part can be reproduced semiclassically. The nontrivial interplay of the diffraction periodic orbits with the usual geometrical orbits produces the fine structure of the complicated spectrum of scattering resonances, which are beyond the resolution of the conventional periodic orbit theory.

In this essay an agrarian approach to ecotheology is briefly described.

Several letters to the editor are presented in response to articles in previous issues including "Same Language, Different Country," by Julian Worker in the November 2012 issue and "Words We Don't Like," by Jenny Baranick and "Not My Size," by John Cadley, both in the December 2012 issue.