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Enterolobium cyclocarpum and Piscidia piscipula are two important tree Fabaceae species distributed from the Yucatan Peninsula, Mexico. Our aims were focused on the E. cyclocarpum and P. piscipula seeds for: (1) to examine the seed permeability and imbibition rate, (2) to evaluate the effect of seed pre-germinative treatments, and (3) to characterize the structures involved on the presence of physical dormancy (PY). We used fresh seeds to determine seed permeability and imbibition rate, seed viability by means of tetrazolium test, furthermore, we applied mechanical scarification and boiler shocks for 5 s, 10 s and 15 s treatments. Morphological characterization of the seed coat was by Scanning Electron Microscope (SEM). Seed viability in E. cyclocarpum and P. piscipula were 100% and 96%, respectively. Seed permeability and imbibition rate in E. cyclocarpum were low. The highest germination in E. cyclocarpum was in the mechanical scarification (92%), while in P. piscipula, this parameter was in the 10 s boiling water treatment (76.0%). The presence of PY was confirmed in both species because they showed low seed permeability, and imbibition rate; furthermore, exhibited macrosclereids cells. The present research seeks to promote the sustainable use of E. cyclocarpum and P. piscipula. [ABSTRACT FROM AUTHOR]

Every year, new organisms that survive and colonize adverse environments are discovered and isolated. Those organisms, called extremophiles, are distributed throughout the world, both in aquatic and terrestrial environments, such as sulfurous marsh waters, hydrothermal springs, deep waters, volcanos, terrestrial hot springs, marine saltern, salt lakes, among others. According to the ecosystem inhabiting, extremophiles are categorized as thermophiles, psychrophiles, halophiles, acidophiles, alkalophilic, piezophiles, saccharophiles, metallophiles and polyextremophiles. They have developed chemical adaptation strategies that allow them to maintain their cellular integrity, altering physiology or improving repair capabilities; one of them is the biosynthesis of extracellular polysaccharides (EPS), which constitute a slime and hydrated matrix that keep the cells embedded, protecting from environmental stress (desiccation, salinity, temperature, radiation). EPS have gained interest; they are explored by their unique properties such as structural complexity, biodegradability, biological activities, and biocompatibility. Here, we present a review concerning the biosynthesis, characterization, and potential EPS applications produced by extremophile microorganisms, namely, thermophiles, halophiles, and psychrophiles. A bibliometric analysis was conducted, considering research articles published within the last two decades. Besides, an overview of the culture conditions used for extremophiles, the main properties and multiple potential applications of their EPS is also presented. • Extremophiles have developed adaptation strategies to maintain their cellular integrity. • Biosynthesis of extracellular polysaccharides (EPS) is one of their strategies. • EPS' structural diversity makes them competitive with current commercial polysaccharides. • EPS from extremophiles can be considered as new promising "green gold" in biotechnology. [ABSTRACT FROM AUTHOR]

We present evidence of volcano‐tectonic interactions at Sabancaya volcano that we relate to episodic magma injection and high regional fluid pore pressures. We present a surface deformation time series at Sabancaya including observations from ERS‐1/2, Envisat, Sentinel‐1, COSMO‐SkyMed, and TerraSAR‐X that spans June 1992 to February 2019. These data show deep‐seated inflation northwest of Sabancaya from 1992–1997 and 2013–2019, as well as creep and rupture on multiple faults. Afterslip on the Mojopampa fault following a 2013 MW 5.9 earthquake is anomalously long lived, continuing for at least 6 years. The best fit fault plane for the afterslip is right‐lateral motion on an EW striking fault at 1 km depth. We also model surface deformation from two 2017 earthquakes (MW 4.4 and MW 5.2) on unnamed faults, for which the best fit models are NW striking normal faults at 1–2 km depth. Our best fit model for a magmatic inflation source (13 km depth, volume change of 0.04 to 0.05 km3 yr−1) induces positive Coulomb static stress changes on these modeled fault planes. Comparing these deformation results with evidence from satellite thermal and degassing data, field observations, and seismic records, we interpret strong pre‐eruptive seismicity at Sabancaya as a consequence of magmatic intrusions destabilizing tectonic faults critically stressed by regionally high fluid pressures. High fluid pressure likely also promotes fault creep driven by static stress transfer from the inflation source. We speculate that combining high pore fluid pressures with sufficiently large, offset magmatic inflation can promote strong earthquakes during volcanic unrest. Key Points: InSAR analysis provides evidence for laterally and vertically complex volcanic plumbing system at SabancayaHigh fluid pressure at Sabancaya promotes strong seismicity during 2012–2019 eruptive periodHigh fluid pressure and static stress transfer from deep inflation promote long‐lived fault creep [ABSTRACT FROM AUTHOR]

• First report on the production and characterization of exopolysaccharide produced by Haloferax mucosum. • Haloferax mucosum showed high exopolysaccharide (EPS) production of 7.15 g/L. • EPS had a high molecular mass of 152. • EPS exhibited high emulsion stability to extreme conditions and with different nonpolar solvents. The physicochemical characterization and emulsifying functional properties of a novel exopolysaccharide (EPS) produced by haloarchaea Haloferax mucosum (DSM 27191) were investigated. This biopolymer has a high molecular weight of 152 kDa and important protein content of 10%. Different culture media compositions were investigated taking the ATCC 2185 medium as a base and supplementing with varying concentrations of yeast extract and glucose or sucrose as carbon sources to produce the EPS in a liquid medium. The highest EPS production (7.15 ± 0.44 g/L) was obtained at 96 h. EPS aqueous dispersions showed a non-Newtonian rheological behavior which was well fitted to the Cross equation. The EPS (at 0.32% w/w) was capable of stabilizing water-in-oil emulsions with different nonpolar solvents, including n -hexane, kerosene, chloroform, castor oil and mineral oil. EPS retained its emulsifying activity after to be incubated for one hour in a wide range of temperatures (25, 40, 70 and 100 °C), pH (4, 6.5, 7 and 12) and NaCl concentrations (0, 2.0 and 4.0 M). The viscoelastic behavior and stability of hexane-in-water emulsion were examined through oscillatory shear measurements. [ABSTRACT FROM AUTHOR]

Surface‐Active Biomolecules (SAB) obtained from microbial sources are safe alternatives to chemically synthesized counterparts for many environmental and industrial applications. These applications frequently involve the exposure of the SAB to extreme factors making necessary to seek for molecules that are able to function under such conditions. In this work, the polyextremophilic bacterium Salibacterium sp. 4CTb is reported as a SAB producer. Its emulsifier activity increased almost twofold when the C/N ratio and culture conditions were modified. The partially purified molecule was able to form stable emulsions under extreme conditions (70 °C, pH 12, and 4 M NaCl) better than other commercial molecules, and reduced the surface tension of the water to 49.78 mN m−1 with critical micelle concentration (CMC) of 15.1 mg L−1. Carbohydrate, lipid, and protein assays, accompanied by the Fourier Transform Infra‐Red (FTIR) and electrospray ionization mass spectroscopy (ESI‐MS) results, indicate the lipopeptide nature of the compound with masses around 645 and 746 Da. The SAB obtained from Salibacterium sp. 4CTb may be suitable for electrical, food, pharmaceutical and cosmetic industries, agriculture, and environmental applications, among others. [ABSTRACT FROM AUTHOR]

Background: Increasing dialysate flow rates (Qd) from 500 to 800 ml/min has been recommended to increase dialysis efficiency. A few publications show that increasing Qd no longer led to an increase in mass transfer area coefficient (KoA) or Kt/V measurement. Our objectives were: 1) Studying the effect in Kt of using a Qd of 400, 500, 700 ml/min and autoflow (AF) with different modern dialysers. 2) Comparing the effect on Kt of water consumption vs. dialysis time to obtain an individual objective of Kt (Ktobj) adjusted to body surface. Methods: This is a prospective single-centre study with crossover design. Thirty-one patients were studied and six sessions with each Qd were performed. HD parameters were acquired directly from the monitor display: effective blood flow rate (Qbe), Qd, effective dialysis time (Te) and measured by conductivity monitoring, final Kt. Results: We studied a total of 637 sessions: 178 with 500 ml/min, 173 with 700 ml/min, 160 with AF and 126 with 400 ml/min. Kt rose a 4% comparing 400 with 500 ml/min, and 3% comparing 500 with 700 ml/min. Ktobj was reached in 82.4, 88.2, 88.2 and 94.1% of patients with 400, AF, 500 and 700 ml/min, respectively. We did not find statistical differences between dialysers. The difference between programmed time and Te was 8′ when Qd was 400 and 500 ml/min and 8.8′ with Qd = 700 ml/min. Calculating an average time loss of eight minutes/session, we can say that a patient loses 24′ weekly, 312′ monthly and 62.4 hours yearly. Identical Kt could be obtained with Qd of 400 and 500 ml/min, increasing dialysis time 9.1′ and saving 20% of dialysate. Conclusions: Our data suggest that increasing Qd over 400 ml/min for these dialysers offers a limited benefit. Increasing time is a better alternative with demonstrated benefits to the patient and also less water consumption. [ABSTRACT FROM AUTHOR]

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Strandings provide valuable information about rare marine organisms and their relationship with their environment. In the southern Gulf of México, specifically on the central coast of Campeche, Mexico, strandings of oceanic cetaceans have rarely been recorded, therefore, biological information has also been scarce. One of such rare stranding cases occurred on September 7, 2022, on the coast of Seybaplaya, Campeche. The specimen was identified as a female of Tursiops truncatus with the morphology features of the oceanic ecotype. The carcass was examined shortly after death, and samples for different analyses were obtained fresh. Tissue samples were collected, and some particular observations were made to define the individual's general health status. Results of the analyses revealed damage in the liver, lungs, and kidneys, probably related to 1) the advanced age of the organism (>35 years), and 2) the presence of persistent organic pollutants. Most importantly, this study contributed two new findings, the first record of the parasite Anisakis and the presence of renal calculi in the oceanic ecotype of T. truncatus in the southern Gulf of Mexico. [ABSTRACT FROM AUTHOR]

Mitochondria play an important role as an intracellular energy plant and signaling organelle. However, mitochondria also exist outside cells where they could mediate cell-to-cell communication, repair and serve as an activator of the immune response. Their effects depend on the mitochondrial state or the form in which it is present, either as a whole functional structure as fragments or only as mitochondrial DNA. Herein, we provide evidence of why extracellular mitochondria and their varying forms are considered regenerative factors or pro-inflammatory activators. Understanding these aspects will provide the base of their use in therapy or as a biomarker of disease severity and prognosis. • Extracellular mitochondria regulate cell-to-cell communication, regeneration, danger sensing and immune response. • Extracellular forms of mitochondria are freeMitos, those inside a membrane as in platelets or vesicles, and ccf-mtDNA. • Extracellular mitochondria show potential to be used as a biomarker, target for therapies, and as a therapeutic agent. [ABSTRACT FROM AUTHOR]

• Oocyte's can carry mitochondrial DNA with mutations affecting embryo health. • Mitochondrial replacement therapies (MRT) may reestablish embryo health. • MRT are invasive and could affect oocyte and embryo viability. • MitoCeption could be a non-invasive option to transfer mitochondria to oocytes. • Mitocepted mitochondria were observed in oocytes and zygotes by qPCR and fluorescence. Oocytes may carry mutations in their mitochondrial DNA (mtDNA) which affect fertility and embryo development leading to hereditary diseases or rejection. Mitochondrial replacement therapies (MRTs) such as polar body transfer, spindle transfer and pronuclear transfer, aim to change dysfunctional to normal mitochondria inside oocytes and zygotes resulting in healthier offspring. Even with promising results, MRTs techniques are invasive to oocytes and may negatively affect their viability and the success of the procedure. This article shows early evidence of the use of MitoCeption, a mitochondria transfer/transplant (AMT/T) technique to possibly induce the internalization of exogenous mitochondria in a dose-dependent manner to recipient oocytes in comparison to coincubation. By using human isolated mitochondria in a mix obtained from different donors we were able to identify their mtDNA in murine oocytes by qPCR. Fluorescence microscopy showed that exogenous and transferred mitochondria (MitoTracker ® Red) by MitoCeption were internalized in oocytes and zygotes (CellTracker® Green). After maintaining mitocepted zygotes to two-cell embryos, we transferred them to subrogate female mice and obtained healthy mice pups; however, without clear evidence of the maintenance of human mtDNA in the tissues of mice pups. These early results are puzzling, and they open the path to generate more research regarding the use of MitoCeption in comparison to coincubation in order to transfer mitochondria to oocytes using less invasive procedures. [ABSTRACT FROM AUTHOR]

A burial and a rich offering were found under Room 2 in the Murals Building, Bonampak, a Mayan archaeological site situated in Chiapas, Mexico. This burial may be related with the creation of the famous mural paintings. A rich set of jewelry made of green stones was among the different objects found. Green stones have great importance in Mesoamerican cultures, those composed of jadeite being the most appreciated. To characterize the green stones, different spectroscopic techniques were used in a complementary way: Raman and infrared spectroscopies (FT-IR) were used for global mineralogical analysis, while X-ray diffraction (XRD) and X-ray fluorescence (XRF) were applied simultaneously in situ on the artifacts that were not successfully identified by these molecular techniques. In addition, XRF was used to contrasts the elemental information from pieces composed of pyroxenes that may be related to the raw sources of jade in Guatemala. The main minerals identified within the beads and earrings were jadeite with omphacite and jadeite with albite; to a minor extent, quartz, and serpentine. In this paper, the main features of the molecular and X-ray techniques are compared in order to determine the advantages and limitations of these spectroscopies for mineral identification. With this combination of techniques, it was possible to undertake a suitable characterization of the analyzed objects. This paper focuses on the XRD–XRF combined analysis for in situ noninvasive characterization. [ABSTRACT FROM AUTHOR]

Dialysis patients are a risk group for SARS-CoV-2 infection and possibly further complications, but we have little information. The aim of this paper is to describe the experience of the first month of the SARS-CoV-2 pandemic in a hospital haemodialysis (HD) unit serving the district of Madrid with the second highest incidence of COVID-19 (almost 1,000 patients in 100,000h). In the form of a diary, we present the actions undertaken, the incidence of COVID-19 in patients and health staff, some clinical characteristics and the results of screening all the patients in the unit. We started with 90 patients on HD: 37 (41.1%) had COVID-19, of whom 17 (45.9%) were diagnosed through symptoms detected in triage or during the session, and 15 (40.5%) through subsequent screening of those who, until that time, had not undergone SARS-CoV-2 PCR testing. Fever was the most frequent symptom, 50% had lymphopenia and 18.4% <95% O 2 saturation. Sixteen (43.2%) patients required hospital admission and 6 (16.2%) died. We found a cluster of infection per shift and also among those using public transport. In terms of staff, of the 44 people involved, 15 (34%) had compatible symptoms, 4 (9%) were confirmed as SARS-CoV-2 PCR cases by occupational health, 9 (20%) required some period of sick leave, temporary disability to work (ILT), and 5 were considered likely cases. CONCLUSIONS: We detected a high prevalence of COVID-19 with a high percentage detected by screening; hence the need for proactive diagnosis to stop the pandemic. Most cases are managed as outpatients, however severe symptoms are also appearing and mortality to date is 16.2%. In terms of staff, 20% have required sick leave in relation to COVID-19., (Copyright © 2020 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

The fresh or cryopreserved human umbilical cord (HUC) and its byproducts, such as cells and extracts, have different uses in tissue regeneration. Defining what HUC byproduct is more effective in a particular application is a challenge. Furthermore, the methods of isolation, culture and preservation, may affect cell viability and regenerative properties. In this article, we review the HUC and its byproducts' applications in research and clinical practice. We present our results of successful use of HUC as a patch to treat gastroschisis and its potential to be applied in other conditions. Our in vitro results show an increase in proliferation and migration of human fibroblasts by using an acellular HUC extract. Our goal is to promote standardization of procedures and point out that applications of HUC and its byproducts, as well as the resulting advances in regenerative medicine, will depend on rigorous quality control and on more research in this area., (Copyright © 2020 Velarde, Castañeda, Morales, Ortega, Ocaña, Álvarez-Barreto, Grunauer, Eguiguren and Caicedo.)

Increased acetataemia during haemodialysis sessions has been associated with a number of abnormalities, including increased oxidative stress, pro-inflammatory cytokines and nitric oxide synthesis. However, citric acid may play an alternative role to acetate as a dialysate stabiliser given that the effect of citrate on complement and leukocyte activation is different to that of acetate. The purpose of this study was to compare the inflammatory effect in immunocompetent blood cells of acetate dialysate and citrate dialysate., Material and Methods: The effect of acetate and/or citrate was investigated in the whole blood of uraemic patients and in healthy in vitro samples. Four types of dialysate were tested: dialysate 1, acetate-free with 1mmol/L of citrate; dialysate 2, with 0.8mmol/L of citrate and 0.3mmol/L of acetate; dialysate 3, citrate-free with 3mmol/L of acetate; and dialysate 4, citrate-free with 4mmol/L of acetate. The cell types used were: human monocyte culture (THP-1); and peripheral blood mononuclear cells (PBMCs) from healthy subjects and uraemic patients on haemodialysis. ICAM-1 was determined and levels of reactive oxygen species and total microvesicles were quantified., Results: Unlike the citrate dialysates, the dialysates with acetate (dialysate 3 and dialysate 4) induced increased ICAM-1 expression density in THP-1 cells; an increase in ICAM-1 expression was observed in the immunocompetent cells of healthy subjects with acetate dialysate (dialysate 3 and dialysate 4) but not with citrate dialysate (dialysate 1 and dialysate 2). No significant ICAM-1 differences were found between the different dialysates in the cells of haemodialysed patients. Reactive oxygen species expression and the number of microvesicles increased significantly with acetate dialysate but not with citrate dialysate in the cells of both healthy subjects and haemodialysed patients., Conclusions: At the concentrations in which it is generally used in clinical practice, acetate-based dialysate increases oxidative stress and the total number of microvesicles and may induce other pro-inflammatory stimuli typical of uraemic patients on haemodialysis. Citrate dialysates do not induce this activation, which could make them a suitable alternative in clinical practice., (Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

The addition of phosphorus (P) to the dialysate (LD) in the form of enema Casen® is common practice in patients with hypophosphatemia. The estimation of the amount to be used and the identification of the problems that may can occur are not well defined. As a result of our work we propose a practical approach of how to proceed to increase phosphate concentration in the hemodialysate. We present a reasoned formula to calculate how much enema has to be added and the problems that may arise., (Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

Jadeite was greatly appreciated by pre-Hispanic cultures in Mesoamerica. Despite its importance, knowledge of its mining sources was lost after the Spanish conquest. In the 1950s the only confirmed jadeite deposits in Mesoamerica were found in the Motagua River Fault (MRF), Guatemala. The aim of this study is to present a methodology that is appropriate for the study of archeological jadeite objects using non-destructive spectroscopic and micro-ion beam analysis techniques. This methodology has been applied to perform mineral, elemental, and luminescence characterization of five jadeite samples from the MRF, with white, lilac, and green colors. Fourier-transformed infrared spectroscopy and X-ray diffraction analysis confirmed the presence of jadeite, albite, and omphacite as the main mineral phases in the samples. Elemental maps using particle-induced X-ray emission (PIXE) with a nuclear microprobe and elemental concentration analysis from individual mineral grains using micro-PIXE coupled with micro-ionoluminescence (IL) allowed the detection of minor feldspar, titanite, and grossular mineral contents. Distinctive features from the mineral, elemental, and luminescence characterization have been found that allow the identification of these five jadeite samples.

Background: The daily pill burden in hemodialysis patients is one of the highest reported to date in any chronic disease. The adherence to prescribed treatment has implications on the quality of life, the survival of patients, and the economic cost of their treatment, this being a priority public health issue., Objective: To evaluate the adherence to pharmacological treatment examining, among the possible causes of non-adherence, psychosocial factors such as depression, anxiety, cognitive impairment and social support., Method: Transversal-observational study of thirty five patients that suffer from chronic renal disease and who are on manteinance hemodialysis, evaluated by self-reported measures., Results: Non-adherent patients have significant higher depression index than adherent patients. Anxiety, cognitive impairment and social support do not show a significant relation with the degree of adherence or compliance with farmacological treatment., Conclusions: These results suggest that psychological intervention in chronic haemodialysis patients with a severe depression index could increase the degree of fulfillment and general well-being of renal patients.

Introduction: Haemodiafiltration (HDF) with high reinfusion volumes is the most effective technique for clearing uraemic toxins. There are various modalities depending on the location where the replacement volume is administered in the extracorporeal circuit: pre-dilution, mixed or mid-dilution and post-dilution, in which the infusion is carried out pre-dilution, pre- and post-dilution simultaneously and post-dilution, respectively., Objective: Compare the clearance of small, medium-sized and protein-bound molecules and the convective volume administered in online HDF (OL-HDF) in post-dilution and mixed (pre-post-dilution) infusion., Material and Method: A prospective, randomised, crossover study comparing post-dilution and mixed OL-HDF. Patients (n=8) were randomly assigned to receive 6 sessions in each technique. We conducted 89 sessions, of which 68 were at a scheduled time (ST) and 21 at an effective time (ET). We determined the reduction rate (RR) percentages for various substances and the infusion volumes. The RR study was performed using ET., Results: The KT value obtained was greater with post-dilution OL-HDF [68 (8.1) compared to 64.9 (8.8) litres] (P=.009) when patients were dialysed at ST. This difference disappeared when dialysis was performed at ET. The difference between ST and ET was greater in mixed HDF than in post-dilution HDF [10.3 (7.4) compared to 6.5 (3.1) minutes, P=.02]. We found no differences in the RR of the substances analysed., Conclusion: Mixed OL-HDF is not inferior to post-dilution OL-HDF either in the clearance of small and medium-sized molecules or in the clearance of protein-bound molecules at the same ET.

Introduction: 25-hydroxy vitamin D (25-OH-vit D) levels in the blood are associated with multiple pathologies. "Normal" values have been defined based on cardiovascular risk, and under this framework, patients with chronic kidney disease often have a deficit. 25-OH-vit D replacement in patients on haemodialysis (HD), in which dosage has not yet been clearly established, is becoming a constant in our daily practice., Objective: To assess whether dialysis technique influences the baseline concentration of 25-OH-vitamin D and the response to supplements., Method: Prospective observational study of two cohorts of patients, those patients treated with calcifediol and those untreated (controls). Blood levels of Ca, P, PTH, and 25-OH-vit D were measured in 59 prevalent patients on HD (35 male; mean age: 65.2 (15.7) years) in November 2010. Thirty-six patients with 25-OH-vit D<10 ng/ml were treated with weekly calcifediol (Hidroferol®, 1 ampoule: 266 μg) since January 2011, which was administered after HD by a nurse. They received 6 doses, and blood levels were measured again in March 2011. We compared the response based on the technique of HD (online haemodiafiltration [OL-HDF] vs HD)., Results: Mean baseline values (n=59): 25-OH-vit D: 9.8 (7.0)ng/ml, Ca: 9.3 (0.5)mg/dl, P: 4.5 (1.4)mg/dl, and iPTH: 299 (224)pg/ml. There were no differences by age, sex, or dialysis technique (HD vs OL-HDF). Treated patients (n=36): 25-OH-vit D levels rose from 6.2 (3.4)ng/ml to 51 (22.9)ng/ml (P<.0001), without significant changes in Ca. Serum phosphate increased an average of 0.6 (1.4)mg/dl, from 4.4 mg/dl to 5mg/dl, (P=.015). PTH decreased an average of 85 (208)pg/ml (P=.023). In these patients, the indication for phosphate binders increased by an average dose equivalent of 0.47 (0.82)mg/dl (P<.001). The 13 patients under treatment with OL-HDF reached 25-OH-vit D levels significantly higher than the 23 treated on HD: 63 (21)ng/ml vs 43 (21)ng/ml (P=.011). Dual treatment with native and active Vit D was associated with significantly increased levels of P (P=.043). Untreated patients (n=23): 25-OH-vit D levels decreased from 15.3 (7.5)ng/ml in November to 11.1 (6.8)ng/ml in March (P<.01), without significant changes in P or PTH and without differences according to age. 25-OH-vit D levels declined in patients on HD (15) but not in patients on OL-HDF., Conclusion: The patients on haemodialysis have low or very low baseline values for 25-OH-vit D. The response to treatment with calcifediol is good, with the most marked improvement occurring in patients on OL-HDF. Furthermore, 25-OH-vit D levels decreased in untreated patients, which was probably correlated with the lower sun exposure in winter. Some patients experienced an increase in phosphataemia despite increasing the dosage of phosphate binders, mainly in those receiving treatment with active vitamin D.