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Recycling urine can reduce the flux of reactive nitrogen in the environment. This paper presents a novel approach to recover all N (Ntot) from urine, including ammonia (TAN; about 5% of Ntot), which is usually volatilised when alkalised urine is dehydrated. As analytical methods for measuring N have a standard deviation of at least 5%, real fresh urine was fortified with ammonia (urineN) or ammonia and phosphate (urineNP) so that TAN comprised 10% of Ntot. The urine was then added to different magnesium-based alkaline substrates (MgO, Mg(OH)2, MgCl2 + Mg(OH)2) and dried at 38 ˚C. Chemical speciation modelling suggested that, irrespective of the substrate, >98% of Ntot in urineNP was recovered and 86% of TAN was precipitated as struvite. Experimental results showed that 10 throughout the treatment, urease enzyme-catalysed degradation of urea to ammonia is prevented, resulting in complete recovery of all nutrients. The end-product is a solid fertiliser containing 10–11% nitrogen, 1–2% phosphorus and 2–3% potassium.

Background:The activity-stat theory infers that total physical activity (PA) in children is constant, independent of environmental interventions.Methods:We conducted a 3-year prospective population-based controlled PA intervention study including, at baseline, 7- to 9-year-old children (66 boys, 40 girls in the intervention and 50 boys, 38 girls in the control group). PA was increased in the intervention group from 60 to 200 minutes/week, while the controls maintained 60 minutes/week. We registered weekly duration of total PA and leisure-time PA and daily duration of sedentary activities, through questionnaires at baseline and 2 and 3 years after baseline.Results:Between intervention and control groups PA was similar before intervention start. After intervention start, total PA in both genders was increased during the entire period (P-values adjusted for age and Tanner stage at follow-up between 0.001 and 0.002). Duration of sedentary activities was unchanged with no group differences. Children in the intervention group changed their behavior so that they also achieved more leisure-time PA.Conclusions:A 3-year school-based PA intervention program in prepubertal children increases the duration of total PA without increasing the duration of sedentary activities, and the program seems to initiate more PA during leisure-time. Our results refute the activity-stat theory.

Background Physical activity (PA) in childhood is associated with musculoskeletal benefits while the effect on fracture risk is yet to be determined. The aim of this study was to evaluate whether extension of a PA intervention leads to improvement in musculoskeletal traits with an accompanied reduced fracture risk. We hypothesized that the PA program would have beneficial effects in both sexes, but more so in girls since they tend to be less physically active than boys during this time frame. Methods In one elementary school we increased physical education (PE) from 60 to 200 min per school week and followed 65 girls and 93 boys from a mean age of 7 years until a mean age of 15 years. Thirty-nine girls and 37 boys in three other schools continued with 60 min of PE per week during the same years and served as controls. We measured bone mineral content (BMC), areal bone mineral density (aBMD), and bone area annually with dual energy X-ray absorptiometry, and leg muscle strength with a computerized dynamometer. In 3534 children within the same PE program (1339 in the intervention and 2195 in the control group) we registered incident fractures during the 8-year study period and estimated annual sex-specific fracture incidence rate ratios (IRRs). Results Girls in the intervention group annually gained more total body less head aBMD, spine aBMD (p < 0.01), femoral neck BMC (p < 0.05), lumbar vertebrae size (p < 0.05), and knee flexion strength (p < 0.05) than girls in the control cohort. In boys we found no group differences. There was an inverse correlation between number of years with extra PE and the annual IRR of sustaining fractures in both girls (r = − 0.90 (95% CI − 0.98 to − 0.51); p < 0.001) and boys (r = − 0.74 (95% CI − 0.94 to − 0.02); p < 0.05). Conclusion In this 8-year pediatric school-based moderate exercise intervention program there is an inverse correlation in both sexes between annual IRR and each additional year of extra PA. A sub-cohort of girls in the intervention group had greater gains in bone mass, bone size, and muscle strength, which could possibly explain the inverse correlation between years within the PA program and fracture risk, while in boys the reason for the inverse correlation remains unknown. It should be noted that differences in unreported factors such as skeletal maturity status, diet, and spare time PA could confound our inferences. That is, true causality cannot be stated.

Transport infrastructure is closely linked to several sustainability issues of main policy relevance, and significant impacts on biodiversity as well as resource use and construction costs relate t ...

Although knee osteoarthritis (OA) is common, its etiology is poorly understood. Specifically, it is not known whether knee OA is associated with abnormal anthropometric and musculoskeletal characteristics known to be associated with OA in general. We recently studied this topic for patients with hip arthritis; however, it is important to evaluate it for knee OA separately, because there are reports indicating that patients with primary OA in different joints may have a different phenotype.Do patients with primary knee OA have a phenotype with higher bone mineral density (BMD), higher body mass index (BMI), larger skeletal size, lower lean body mass, and higher fat content?We included 38 women and 74 men (mean age, 61 years; range, 34-85 years) with primary knee OA and 122 women and 121 men as control subjects. We used dual-energy x-ray absorptiometry to measure total body BMD (g/cm2), femoral neck width (cm), fat and lean mass (%), and BMI (kg/m2). Z scores were calculated for each individual. Data are presented as means with 95% confidence intervals.Women with knee OA had the following Z scores: total body BMD 0.8 (0.5-1.0); BMI 1.6 (1.1-2.0); femoral neck width 0.1 (-0.3 to 0.4); proportion of lean mass -1.0 (-1.5 to -0.6); and proportion of fat mass 1.0 (0.6-1.4). Men with knee OA had the following Z scores: total body BMD 0.5 (0.3-0.7); BMI 0.9 (0.6-1.1); femoral neck width 0.3 (0.1-0.7); proportion of lean mass -0.9 (-1.1 to -0.8); and proportion of fat mass 0.7 (0.5-0.9).Women and men with idiopathic knee OA have a phenotype with higher BMD, higher BMI, proportionally higher fat mass, and proportionally lower lean body mass. Men also have a larger skeletal size.A higher BMD may lead to stiffer bone, a higher BMI to a greater joint load, and a proportionally lower lean body (muscle) mass to lower joint-protective ability, and all trait deviations probably predispose for knee OA.

Although hip osteoarthritis (OA) is common, its etiology is poorly understood. Specifically, it is not known whether hip OA is associated with abnormal relationships among the anthropometric and musculoskeletal characteristics that are associated with OA in general.We asked whether patients with primary hip OA have a phenotype with higher bone mineral density (BMD), higher BMI, larger skeletal size, lower lean body mass, and higher fat content.We included 30 women and 32 men (mean age, 66 years; range, 42-84 years) with primary hip OA and 96 women and 91 men as control subjects. Dual energy x-ray absorptiometry was used to measure total body BMD (g/cm(2)), femoral neck width (cm), fat and lean mass (%), and BMI (kg/m(2)). Z scores were calculated for each individual. Data are presented as means with 95% CI.Women with hip OA had the following Z scores: total body BMD 0.6 (0.3, 1.0); BMI 0.6 (0.2, 1.0); femoral neck width 0.2 (-0.6, 1.0); percent total body lean mass -0.9 (-1.2, -0.5); and percent total body fat mass 0.6 (0.2, 0.9). Men with hip OA had the following mean Z scores: total body BMD 0.5 (0.0, 1.0); BMI 0.8 (0.3, 1.3); femoral neck width 0.4 (0.01, 0.9); percent total body lean mass -0.8 (-1.1, -0.5); and percent total body fat mass 0.5 (0.2, 0.8).Women and men with idiopathic hip OA have a phenotype with higher BMD, higher BMI, proportionally higher fat mass, and proportionally lower lean body mass. Men also have a larger skeletal size.A higher BMD may lead to a stiffer bone and a proportionally lower lean body mass to lower joint-protective ability, both traits probably predisposing for hip OA.

SummaryPhysical training, if including specific different training modalities, reduces the fall risk in healthy community-dwelling older people, as does a home hazards modification programme. Vitamin D supplementation in older individuals with low levels of vitamin D, adjustment of psychotropic medication, and structured modification of multi-pharmacy are all drug-focused programmes that reduce the number of falls. Anti-slip shoe devices during icy conditions for older people who walk outdoors and multifaceted podiatry in patients with specific foot disability reduce the fall risk. First eye cataract surgery and pacemakers in patients with cardio-inhibitory carotid sinus hypersensitivity are surgical interventions that reduce the fall risk. Multi-factorial preventive programmes that include training, both individually designed and generally prescribed, also reduce the fall frequency. With this in mind, we ought to initiate fall preventive programmes in older people, especially in high- risk groups, to reduce the number of falls and fallers in society.

Aims: Falls often result in soft tissue injuries, dislocations, fractures, longstanding pain and reduced quality of life. Therefore, fall preventive programmes have been developed. Methods: In this review, we evaluate programmes that in randomized controlled trials (RCT) have been shown with fall reducing effect. Results: Physical exercise that includes several training modalities, especially balance and strength training, is the only intervention programme that reduces both the number of fallers and the number of falls in community dwellers. Home hazards modification reduces the fall risk in community-living elderly but has the best effects in high risk groups when the programme is led by occupational therapists. Vitamin D supplement in those with low levels of vitamin D, adjustment of psychotropic medication and modification of multi-pharmacy are drug-related programmes that reduce the fall risk. Anti-slip shoe devices in elderly who walk outdoors during icy conditions and multifaceted podiatry to patients with specific foot disability are interventions targeted at the lower extremities with a fall-reducing effect. First eye cataract surgery and pacemakers in patients with cardio-inhibitory carotid sinus hypersensitivity are surgical procedures with fall-reducing effect. Multifactorial standardized preventive programmes that include an exercise component and individually-designed subject-specific programmes also reduce the number of falls. Conclusions: Fall preventive interventions should be provided to elderly by a structured approach, especially to high risk groups, as to reduce the number of falls and fallers.

The aim of this study was to investigate the gut microbiota in preschool children with and without overweight and obesity. Twenty overweight or obese children and twenty children with BMI within the normal range (age: 4-5 years) were recruited from the south of Sweden. The gut microbiota was accessed by quantitative PCR (qPCR) and terminal restriction fragment length polymorphism and calprotectin was measured in feces. Liver enzymes were quantified in obese/overweight children. The concentration of the gram-negative family Enterobacteriaceae was significantly higher in the obese/overweight children (P = 0.036), whereas levels of Desulfovibrio and Akkermansia muciniphila-like bacteria were significantly lower in the obese/overweight children (P = 0.027 and P = 0.030, respectively). No significant differences were found in content of Lactobacillus, Bifidobacterium or the Bacteroides fragilis group. The diversity of the dominating bacterial community tended to be less diverse in the obese/overweight group, but the difference was not statistically significant. Concentration of Bifidobacterium was inversely correlated to alanine aminotransferase (ALT) in obese/overweight children. The fecal levels of calprotectin did not differ between the study groups. These findings indicate that the gut microbiota differed among preschool children with obesity/overweight compared with children with BMI within the normal range.

Aims: Animal studies indicate a role for 11 beta-hydroxysteroid dehydrogenase type 1 (HSD11B1) in the development of obesity. The association to glucose homeostasis is less clear. We investigated the relationship between HSD11B1 mRNA levels in adipose tissue and in skeletal muscle and anthropometric and metabolic measurements in humans with and without impaired glucose homeostasis. Methods: Twelve obese subjects with impaired glucose homeostasis (MetS+) and 12 obese controls (MetS-) received a Very Low Calorie Diet for 16 weeks and adipose tissue biopsies, blood samples and measurements were obtained. In a second cohort, skeletal muscle biopsies, blood samples and measurements were obtained from 18 subjects with type 2 diabetes (T2DM) and 17 subjects with normal glucose tolerance (NGT). Gene expression was measured by DNA microarray in both studies. Results: HSD11B1 mRNA levels were reduced during diet, and anthropometric measurements and metabolic parameters were associated with HSD11B1 mRNA levels in the MetS-group. However, in the MetS+ group these associations were lost or in opposite direction. This difference was also observed in skeletal muscle between T2DM and NGT. Conclusions: HSD11B1 mRNA levels are associated with metabolic parameters and anthropometric measurements in subjects with normal glucose homeostasis but not in subjects with impaired glucose homeostasis. (C) 2010 Elsevier Ireland Ltd. All rights reserved. (Less)

The influence of pregnancy on bone mineral density (BMD) was evaluated by dual-energy X-ray absorptiometry (DXA) in 73 women (mean age 29 years, range 20-44 years) postpartum. Fifty-five age-matched women served as controls. The influence of lactation was evaluated in 65 of the delivered women who were followed with repeated measurements, a mean of 4.5 +/- 0.1 and 11.5 +/- 0.1 months after the delivery. The influence of multiple pregnancies was evaluated in 39 premenopausal women (mean age 38 years, range 31-54 years) with a minimum of four pregnancies (range 4-7). Fifty-eight age-matched healthy premenopausal women with a maximum of two pregnancies (range 0-2) served as controls. Data are presented as mean +/- SEM. BMD data are adjusted for differences in total fat mass and total lean mass. Lumbar spine BMD was 7.6 +/- 0.1% and total body BMD 3.9 +/- 0.1% lower in women postpartum compared with controls (both p

During pregnancy and lactation, changes occur in a variety of factors which have great potential to influence bone mineral density (BMD). Smoking habits, the level of alcohol consumption, the level of physical activity, body weight, soft tissue composition and hormone levels are all factors that change during the course of these conditions. Some of these factors are capable of increasing BMD, and some can reduce it. Due to these various changes, it is virtually impossible to predict the development in BMD that will occur during a pregnancy and lactation. However, longitudinal studies have suggested that both pregnancy and lactation are associated with a BMD loss of up to 5%, albeit that the BMD recovers after weaning. Cross-sectional studies have indicated that women with many children and a long total period of lactation have similar or higher BMD and similar or lower fracture risk than their peers who have not given birth. As the studies showing this trend have been observational and cross sectional case-control studies, the conclusions can only be regarded as being suggestive, and no causality can be proven.

If exercise is to be recommended during growth, benefits in bone mineral density (BMD) must be maintained in old age and shown to prevent fractures. Our cross-sectional study of soccer players suggests that a high BMD is no longer recorded after retirement and fracture frequency is no less than predicted in old age.

Ulcerative colitis (UC) is characterized by chronic inflammation of the colonic mucosa. Administration of dextran sulfate sodium (DSS) to animals is a frequently used model to mimic human colitis. Deregulation of the immune response to the enteric microflora or pathogens as well as increased intestinal permeability have been proposed as disease-driving mechanisms. To enlarge the understanding of the pathogenesis, we have studied the effect of DSS on the immune system and gut microbiota in mice. Intestinal inflammation was verified through histological evaluation and myeloperoxidase activity. Immunological changes were assessed by flow cytometry in spleen, Peyer′s patches and mesenteric lymph nodes and through multiplex cytokine profiling. In addition, quantification of the total amount of bacteria on colonic mucosa as well as the total amount of lactobacilli, Akkermansia, Desulfovibrio and Enterobacteriaceae was performed by the use of quantitative PCR. Diversity and community structure were analysed by terminal restriction fragment length polymorphism (T-RFLP) patterns, and principal component analysis was utilized on immunological and T-RFLP patterns. DSS-induced colitis show clinical and histological similarities to UC. The composition of the colonic microflora was profoundly changed and correlated with several alterations of the immune system. The results demonstrate a relationship between multiple immunological changes and alterations of the gut microbiota after DSS administration. These data highlight and improve the definition of the immunological basis of the disease and suggest a role for dysregulation of the gut microbiota in the pathogenesis of colitis.