Anemia Status Research Articles

75 AI-Enhanced Hematocrit Analysis: Revolutionizing rapid anemia detection in small ruminants

Abstract In recent times, there has been a growing focus on the well-being and healthcare of small ruminants, particularly in relation to the issue of anemia due to infection with blood-feeding gastrointestinal nematodes, such as Haemonchus contortus. The objective of this study was to assess the hematocrit levels in blood samples obtained from small ruminants, specifically goats. Additionally, the study is an attempt to design and create a quick sensor for identifying anemia, which could be conveniently used on farms. A total of 75 mature, intact male Spanish goats were subjected to hematocrit analysis to ascertain their spectrum of hematocrit values and association with anemic conditions. Simultaneously, a unique sensor with user-friendly features was developed to promptly provide farmers with feedback on the anemic status of animals using AI-based machine learning algorithms, enabling timely intervention. The sensor utilized a semi-invasive approach with minimal blood sample requirement. 30 µL of blood was dropped on glycerol soaked Whatman filter paper No. 1, and images were taken at 90 sec, 150 sec, and 270 sec to capture the blood pattern on filter paper soaked in glycerol using a cell phone. These images were correlated with actual hematocrit value obtained from conventional hematocrit analysis. A RMSprop with adjusted learning rate convolution neural network (RMSprop-CNN) based images classification model was developed for the classification of different patterns at different levels of hematocrit. The model was trained on a total of 1,000 images with a training and testing split of 80:20 ratio. For the optimization process, the Adam optimizer with a learning rate of 0.001 is employed. The model is compiled with a categorical cross-entropy loss function, aiming to improve its accuracy metric over training iterations. The initial studies demonstrated a detection accuracy level of 70.31 % at 10 epochs in identifying different hematocrit levels (Level 1; healthy, to Level 5; severely anemic) but improved significantly up to 94.89 % by 100 epochs, resulting in a notable reduction in the time and level of knowledge previously necessary for conducting such evaluations. The present study not only provides valuable insights into the hematological characteristics of small ruminants, but also establishes a foundation for the development of a straightforward and efficient method for detecting anemia. Consequently, this advancement has the potential to enhance the overall care and well-being of animals within agricultural environments.

The effectiveness of albendazole against hookworm infections and the impact of bi-annual treatment on anaemia and body mass index of school children in the Kpandai district of northern Ghana.

The impact of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) (initiated in 2000 in Ghana and ran for 12 years) in mitigating soil-transmitted helminth (STH) infections in LF-endemic areas is unknown. During a 1-year hiatus which ensued between 2011 and 2012, a longitudinal study was conducted to determine GPELF effect on hookworm infections in selected communities involved in the programme since its inception, while measuring the effectiveness of biannual ALB treatments on schoolchildren living in such communities. A total of 399 school children aged 3 to 18 years were randomly selected from four communities in the Kpandai district of northern Ghana. Each presented a single stool sample at baseline, 21 days post-treatment, at the 3rd and 6th months, 21 days post-second intervention (i.e. following sample collection and treatment with ALB in the 6th month), and in the ninth month of the study period. Haemoglobin (hb) levels were also measured at all time points using finger prick blood samples and a URIT digital test kit. Each participant submitting a sample, was treated with a single-dose ALB (400mg) at baseline and in the sixth month. Stool samples were processed by preparing duplicate Kato-Katz slides per sample, and examined by microscopy. The Body Mass Index-for-age z-scores (BAZ) of participants were assessed following the determination of BMIs at each time point by measuring their height and weight with a stadiometer and weighing scale. Overall hookworm prevalences were 25.68% (95% CI = 20.51-31.75) at baseline, 11.18% (95% CI = 7.87-15.41) 21 days post-treatment, 11.78% (95% CI = 8.38-16.11) and 6.95% (95% CI = 4.41-10.43) in the 3rd and 6th months, 0.91% (95% CI = 0.19-2.65) 21 days post-second intervention, and 8.46% (95% CI = 5.62-12.23) in the ninth month. Observed overall faecal egg count reduction rates (ERRs) were 94.21% (95% CI = 81.50%- 100.00%) 21 days after baseline treatment, 97.70% (95% CI = 85.08-100.00) and 96.95% (95% CI = 84.18%- 100.00%) in the 3rd and 6th months, 99.98% (95% CI = 86.42%- 100.00%) 21 days post-second intervention, and 17.18% (95% CI = 14.07%- 20.67%) in the 9th month. Respective cure rates (CRs) were 62.35% (95% CI = 46.71-81.56%), 85.88% (95% CI = 67.32-100.00%), 87.06% (95% CI = 68.36%- 100.00%), 98.82% (95% CI = 78.83%- 100.00%), and 36.36% (95% CI = 9.91%- 93.11%). Additionally, increases in the percent frequency of 'normal hb' (p < 0.01) were observed across the study time points, whilst 'normal BAZ' cases remained high (from 94.87% to 98.87%) throughout the study period. These findings primarily indicate satisfactory effectiveness of ALB which may be maintainable in mass drug administration programmes by the modification of treatment strategies from annual to bi-annual regimes. This could minimize the likelihood of emerging poorly-responding hookworm phenotypes in Ghana. Additionally, a positive impact of bi-annual treatment on participant anaemia status is herein indicated with particular regard to the school children in our cohort.

Impact Assessment of Iron and Folic Acid Supplementation with and Without Intensive Health Education in Pregnant Women of Rural Area of District Etawah: An Interventional Study

Background: Low birth weight , post-partum haemorrhage still births and maternal deaths are associated with anaemia in pregnancy. If prevalence of anemia will be reduced then there will be improvement in maternal and child health and its outcome. Aim &amp; Objectives: To evaluate the changes in the hematological profile of the study subjects and to determine the impact of intensive health education intervention on anemia status of pregnant women. Methodology: A Community based interventional study was conducted among 200 Pregnant women of selected villages in rural area of Etawah district (100 women in each interventional and non-interventional group) using a self-developed, pre designed, pretested, structured and validated questionnaire. statistical package for social sciences (SPSS) software was used to analyse the data. Result: After health education intervention there is significant increase in the haematological profile of study participants of interventional group (p&lt;0.05) as before intervention values of mean Hb was 10.58±1.79 gm/dl which became 11.72±1.48 gm/dl There were 34 (73.9%) participants in the interventional group that were originally anaemic before the study, but after the intervention, they became non-anaemic. Conclusion: Health education sessions helped the pregnant women to improve their knowledge regarding anemia in pregnancy, as well as improve their ability to select iron rich foods, increase compliance with iron supplementation, and raise their haemoglobin levels.

Is child anemia associated with early childhood development? A cross-sectional analysis of nine Demographic and Health Surveys.

Anemia is a significant public health problem in many low- and middle-income countries (LMICs), with young children being especially vulnerable. Iron deficiency is a leading cause of anemia and prior studies have shown associations between low iron status/iron deficiency anemia and poor child development outcomes. In LMICs, 43% of children under the age of five years are at risk of not meeting their developmental potential. However, few studies have examined associations between anemia status and early childhood development (ECD) in large population-based surveys. We examined the associations between severe or moderate anemia and ECD domains (literacy-numeracy, physical, social-emotional, and learning) and an overall ECD index among children age 36-59 months. Nine Demographic and Health Surveys (DHS) from phase VII of The DHS Program (DHS-7) that included the ECD module and hemoglobin testing in children under age five years were used. Bivariate and multivariate logistic regressions were run for each of the five outcomes. Multivariate models controlled for early learning/interaction variables, child, maternal, and paternal characteristics, and socio-economic and household characteristics. Results showed almost no significant associations between anemia and ECD domains or the overall ECD index except for social-emotional development in Benin (AOR = 1.00 p < 0.05) and physical development in Maldives (AORs = 0.97 p < 0.05). Attendance at an early childhood education program was also significantly associated with the outcomes in many of the countries. Our findings reinforce the importance of the Nurturing Care Framework which describes a multi-sectoral approach to promote ECD in LMICs.

Early Childhood Caries Prevalence &amp; Associated Factors In A Low Income Urban Community Of Karachi

Objectives: The primary and secondary objective of the study was to determine the prevalence of Early Childhood Caries among 2-6 year old children living in a low income, urban community of Karachi and to describe oral health and hygiene in the study population showing association be- tween Early Childhood Caries and anemia in 2-6 year old children, which was also the aim of our study. Methods: A cross-sectional, community-based survey was conducted on a total of 409 children in Sultanabad between 2 and 6 years of age, Karachi. A preformed, structured questionnaire collected information on child related, parental, and household characteristics. Included participants were one child, either male or female, aged between 2 years and 6 years at the time of the survey and the fam- ily was a permanent resident of Sultanabad, who had been living in the same vicinity for at least the last 6 months. Exclusion criteria were children with dento-facial or skeletal deformities such as cleft lip/palate or any congenital dysplasia. Statistical procedures and analyses including descriptive analy- sis, uni-variate and multivariable modeling were all performed on STATA version 12. Results: A total of 409 households from 6 blocks were surveyed from the community. The overall prevalence of Early Childhood Caries was 52.5% (95% CI: 47.7%-57.3%), which included 29.3% (25.0%-33.6%) mild/moderate Early Childhood Caries and 23.2% (19.2%-27.2%) severe Early Child- hood Caries. Frequency was higher in older age groups and in male children. The zero-inflated nega- tive binomial regression model identified the child’s anaemic status to be associated with DMFT scores; we found significant association between mean DMFT scores and the presence of severe anaemia in children. Conclusion: The study concluded that high burden of Early Childhood Caries in the community, most of which comprises decayed, untreated teeth. The findings add to the current evidence showing asso- ciation between Early Childhood Caries and anaemia in 2-6 year old children.

The relationship of daily income, marital status, nutritional status and anemia with work-related fatigue among wanita tukang suun in the heritage area of Badung Market post the COVID-19 pandemic

Purpose: The COVID-19 pandemic has affected all aspects of life. The socio-economic aspect is one of the affected aspects. This study aimed to determine the relationship between income, marital status, nutritional status, and anemia status with work fatigue among wanita tukang suun at the Badung Market Heritage area after the COVID-19 pandemic. &#x0D; Methods: The type of research used in this research is observational analytic with a cross-sectional research design. This research was conducted in the Badung Market Heritage area. The sample of this study was taken by total sampling and obtained 107 respondents. The exclusion criteria in this study were wanita tukang suun who were under 18 years of age and had jobs other than as wanita tukang suun. The data in this study were collected using several instruments. &#x0D; Results: Wanita tukang suun mostly earns more than IDR 50.000 per day with a total of 75 respondents (70,1%), is married with a total of 96 respondents (89,7%), has a normal BMI with a total of 56 respondents (52.3%), have mild anemia with a total of 92 respondents (86.0%), experience light fatigue with a total of 92 respondents (86.0%).&#x0D; Conclusion: The results of this study indicate that there is a relationship between anemia status and nutritional status with work fatigue. Variables of daily income and marital status are not related to the incidence of work burnout among wanita tukang suun.

Correlation between Body Mass Index with Anaemia Status of Pregnant women after Intervention Infused Okra Water and Ferrous Sulfate

Background: Lack of intake of macronutrients such as energy, protein and micronutrients such as iron, vitamins in the daily diet of pregnant women is a problem that has an impact on iron deficiency and chronic energy deficiency. To increase the bioavailability and absorption of iron sulfate supplements and improve the nutritional status of pregnant women, researchers provide interventions by consuming infused okra water. Okra contains macronutrients and micronutrients that can provide nutrition during pregnancy and increase iron absorption. This study aims to analyse the nutritional status of pregnant women by measuring BMI and its relation to their anaemia status. Methods: This research is a experimental study with a one group pretest-posttest design. The population in this study was all pregnant women with gestational ages of 16–32 weeks and Hb levels less than 11 gr/dl. Purposive sampling was used to collect 50 samples from 50 people. The intervention provided was 100 grams of fresh okra fruit, which had been made into infused okra water, which was then drunk by the respondents after consuming ferrous sulphate tablets 60 mg per day. To analyse the relationship between BMI and anaemia status, the researchers used the chi-square test. Results: There was no relationship between increases in BMI and Hb levels in pregnant women in this study. Conclusions: An increase in body mass index (BMI) in pregnant women who were given infused okra water and ferrous sulphate tablets did not have a positive effect on haemoglobin levels. Based on BMI, it appears that pregnant women are not malnourished.

Prevalence of Anemia Among Adolescent Girls in a Rural Area of Jharkhand, India

Background: Anemia accounts for a majority of the nutritional problem across the globe. The prevalence of anemia is inordinately higher among developing nations, because of low socioeconomic status and indigent access to the healthcare services. Adolescent period is signalized by marked physical activity and rapid growth spurt; therefore they need additional nutritional supplements and are at utmost risk of developing nutritional anemia. This study was carried out to find out the prevalence of anemia among adolescent girls. Materials and Methods: This study was a cross-sectional study conducted among 255 adolescent girls. After getting informed consent from the subjects, the information regarding age, socio demographic status, menstrual history, and short clinical details were recorded. Blood samples were collected and analyzed using automated hematology analyzer. Results and Discussion: Overall prevalence of anemia was found to be 48.63% (n = 124). The majority of the anemic girls (55.64%, n = 69) were having mild degree of anemia. Among 255 girls, 188 (73.73%) were from the early adolescent age group (10–14 years). Prevalence of anemia (52.24%) was high among the late adolescents and those belonging to low socioeconomic class. Conclusion: There is a significant relationship between anemia and socioeconomic status, dietary modification, nutritional supplementation, and helminthes control; in addition, compliance with consumption of iron and folic acid tablets will prevent anemia to a great extent among adolescent girls.

The medium-term impact of a micronutrient powder intervention on anemia among young children in Rural China

BackgroundPoor development of young children is a common issue in developing countries and it is well established that iron deficiency anemia is one of the risk factors. Research has shown that iron deficiency is a common micronutrient deficiency among children in rural China and can result in anemia. A previous paper using data from the same trial as those used in the current study, but conducted when sample children were younger, found that after 6 months of providing caregivers of children 6–11 months of age free access to iron-rich micronutrient powder (MNP) increased the hemoglobin concentrations (Hb) of their children. However, no effects were found 12 and 18 months after the intervention. The current study followed up the children four years after the start of the original intervention (when the children were 4–5 years old) and aims to assess the medium-term impacts of the MNP program on the nutritional status of the sample pre-school-aged children, including their levels of Hb, the prevalence of anemia, and the dietary diversity of the diets of the children.MethodsAt baseline, this study sampled 1,802 children aged 6–11 months in rural Western China. The intervention lasted 18 months. In this medium-term follow-up study that successfully followed 81% (n = 1,464) of children (aged 49–65 months) from the original study population 4 years after the start of the intervention, we used both intention-to-treat (ITT) effect and average treatment on the treated effect (ATT) analyses to assess the medium-term impacts of the MNP distribution program on the nutritional status of sample children.ResultsThe ITT analysis shows that the MNP intervention decreased the prevalence of anemia of young children in the medium run by 8% (4 percentage points, p < 0.1). The ATT analysis shows that consuming 100 (out of 540) MNP sachets during the initial intervention led to a decrease in anemia of 4% (2 percentage points, p < 0.1). Among children with moderate anemia at baseline (Hb < 100 g/L), the intervention reduced the probability of anemia by 45% (9 percentage points, p < 0.1), and, for those families that complied by consuming 100 (out of 540) sachets, a 25% (5 percentage points, p < 0.05) reduction in the anemia rate was found. The MNP intervention also led to a persistent increase in dietary diversity among children that were moderately anemic at baseline. The results from the quantile treatment effect analysis demonstrated that children with lower Hb levels at baseline benefited relatively more from the MNP intervention.ConclusionsThe findings of the current study reveal that the MNP intervention has medium-term effects on the nutritional status of children in rural China. The impacts of the MNP program were relatively higher for children that initially had more severe anemia levels. Hence, the implications of this study are that programs that aim to increase caregiver knowledge of nutrition and improve their feeding practices should be encouraged across rural China. Families, policymakers, and China’s society overall need to continue to pay more attention to problems of childhood anemia in rural areas. This is particularly crucial for families with moderately anemic children at an early age as it can significantly contribute to improving the anemia status of children across rural areas of China.Trial registrationISRCTN44149146 (15/04/2013).

Multiple Micronutrient Deficiency Among Adolescent Girls with Normal Nutritional Status - Need for Fortified Nutritional Support in Rural Settings of South Tamil Nadu, India

Introduction: Adolescents contribute to one fifth of the world's population and is a high priority lifecycle stage for nutrition needs and intervention. Nutritional deficiency, including micronutrients, hinders their normal growth and development. Improving adolescent girls’ nutrition has reproduction-related benefits and serves as a unique opportunity to break the vicious cycle of intergenerational structural problems. The objective is to estimate the prevalence of anaemia, micronutrient deficiency and nutritional status among adolescent girls in rural India. Methods: A community-based cross-sectional study was conducted among 241 adolescent girls in rural Tirunelveli, India with 220 blood samples. Results: The mean age of 241 adolescent girls was 13.8±1.4 years and nutritional status was normal, overweight, obese, thin and stunted in 81.7%, 14.5%, 3.3%,0.4% and 4.6% respectively. The prevalence of anaemia, iron deficiency and iron-deficiency anaemia were 37.2%, 34.5% and 12.3%. Except for selenium, the estimated micronutrient deficiency levels were Vitamin B12 - 40.9%, Copper-30.9%, Zinc-13.6% and Iodine- 11%. Only 19.1% girls had adequate levels of all micronutrients. Vitamin B12 deficiency was more in girls who were overweight (p&lt;0.05). Conclusion: Multiple micronutrient deficiency with normal nutritional status is high among adolescent girls with Vitamin B12 deficiency higher than Iron. Multipronged strategies, including introducing micronutrient fortified healthy snacks in schools, might bring greater acceptance and improvement in nutritional health among these girls.

Detection of anemic condition in patients from clinical markers and explainable artificial intelligence.

Anaemia is a commonly known blood illness worldwide. Red blood cell (RBC) count or oxygen carrying capability being insufficient are two ways to describe anaemia. This disorder has an impact on the quality of life. If anaemia is detected in the initial stage, appropriate care can be taken to prevent further harm. This study proposes a machine learning approach to identify anaemia from clinical markers, which will help further in clinical practice. The models are designed with a dataset of 364 samples and 12 blood test attributes. The developed algorithm is expected to provide decision support to the clinicians based on blood markers. Each model is trained and validated on several performance metrics. The accuracy obtained by the random forest, K nearest neighbour, support vector machine, Naive Bayes, xgboost, and catboost are 97%, 98%, 95%, 95%, 98% and 97% respectively. Four explainers such as Shapley Additive Values (SHAP), QLattice, Eli5 and local interpretable model-agnostic explanations (LIME) are explored for interpreting the model predictions. The study provides insights into the potential of machine learning algorithms for classification and may help in the development of automated and accurate diagnostic tools for anaemia.

Growth performance, hematological and oxidative stress responses in Nile tilapia (Oreochromis niloticus) exposed to polypropylene microplastics

AbstractThe present study investigated the effect of polypropylene (PP) microplastics on the growth performance, hematological profile and oxidative stress responses in the liver and brain tissues of Oreochromis niloticus juvenile. The microplastic exposure was done by offering microplastic‐incorporated feed to the fish. The feed was prepared by mixing microplastics and the feed in three different ratios; Low (1.5 g/kg), Medium (3.0 g/kg), High (4.5 g/kg), and a control with no plastics in it. The trial was done for 7 weeks. A significant impact on the growth performance of the fish was observed in terms of body weight gain, specific growth rate, metabolic growth rate, protein efficiency ratio and energy retention. All the treatments had a significant difference in growth parameters compared to the control. The results of the hematological profile confirmed erythropoietic impairment in the fishes due to high microplastic exposure which led to an anemic condition in the fishes and mortality in the early juvenile stage. The antioxidant enzyme analysis also shows significant oxidative stress induced in liver and brain tissues in a dose‐dependent manner. Exposure to PP microplastics significantly affected the growth, health and metabolism of O. niloticus. Further studies on genetic and cellular levels should be done to elucidate the wide‐ranging effects of MPs on fish species.

Relationship between Anemia and Readmission among Older Patients in Rural Community Hospitals: A Retrospective Cohort Study.

Readmission rates among older adults are a growing concern, and the association of readmission with anemia and the potential benefits of a systematic assessment and intervention remain unclear. This study investigated the association between anemia and readmission within 28 and 90 days in an older population. Data from 1280 patients admitted to the Department of General Medicine of Unnan City Hospital between April 2020 and December 2021 were retrospectively analyzed. Variables such as anemia status, Charlson comorbidity index (CCI) score, Functional Independence Measure (FIM) score, and dependent status were evaluated. Multivariate logistic regression was used to determine the associations between 28-day and 90-day readmissions. The average age was 84.9 years, and the prevalence of anemia was 36.4%. The readmission rates within 28 and 90 days were 10.4% and 19.1%, respectively. Anemia was significantly associated with readmission in both periods (28-day adjusted odds ratio, 2.28; 90-day adjusted odds ratio, 1.65). CCI score, FIM score, and dependent status were also identified as significant factors. Anemia is significantly associated with short- and medium-term readmissions in older patients. Addressing anemia, along with other identified factors, may help reduce readmission rates.

Interaction between anemia and renal dysfunction in relation to long-term survival following acute myocardial infarction.

Anemia and chronic kidney disease (CKD) adversely affect prognosis following acute myocardial infarction (AMI). We aimed to assess their interaction regarding long-term survival post-AMI. This is a single-center, retrospective analysis of consecutive AMI survivors. Stratified by admission-time anemia status and CKD grade, as determined by hemoglobin and creatinine levels, the cohort was evaluated for all-cause mortality at 10 years after hospital discharge. A total of 11,395 patients (69.1% males, mean age 65.8 ± 13.9 years, 49.6% with ST elevation MI) were included, of whom 29.9% had anemia and 15.9% -grade 3b or higher CKD. CKD was more advanced among anemic patients and the prevalence of anemia rose as CKD grade increased (p for trend < 0.001). At 10 years, 47.8% of patients died. Notwithstanding differences in baseline characteristics, presentation, and treatment between those with various anemia status and CKD grades, anemia presence (HR 1.40, 95% CI 1.32-1.49, p < 0.001) and increasing CKD grade (HR 1.10, 95% CI 1.02-1.20, p for trend < 0.001) were independently associated with a higher mortality risk. The incremental hazard imposed by either anemia or more advanced CKD was limited to patients with normal renal function and up to grade 3a (in the total cohort and the conservative treatment subgroup) or 4 (in the invasive revascularization subgroup) CKD. The added risk associated with increasing CKD grade also affected non-anemic individuals irrespective of the specific CKD grade. Anemia and more advanced CKD are associated with reduced long-term survival post-AMI, inflicting higher risk when conjoined in lower-grade CKD.

Comparative analysis of RADAR vs. conventional techniques for AVF maturation in patients with blood viscosity and vessel elasticity-related diseases through fluid-structure interaction modeling: Anemia, hypertension, and diabetes.

This study aims to compare two surgical techniques, the standard Vein-to-Artery and the newer Artery-to-Vein (Radial Artery Deviation And Reimplantation; RADAR), for enhancing the success of Arterio-Venous Fistula maturation in end-stage renal disease patients. The impact of diseases like anemia, diabetes, hypertension, and chronic kidney disease were considered. The goals are to advance Arterio-Venous Fistula (AVF) surgery, improve patient outcomes, and contribute to evidence-based surgical guidelines. Fluid-structure interaction modeling was employed to investigate how hemodynamic and mechanical stresses impact arteriovenous fistula maturation, with a particular focus on the role of wall shear stress in determining maturation outcomes. The critical threshold for vessel injury was identified as wall shear stress values exceeding 35 N/m2, while stenosis formation was projected to occur at levels below 1 N/m2. This work introduced a novel approach by considering disease-related factors, including blood viscosity (anemia), and vessel elasticity (diabetes, hypertension, and chronic kidney diseases), which directly influence hemodynamics and the generation of wall shear stress. Furthermore, the model was designed to incorporate varying thicknesses and elasticities for both the vein and artery, accurately representing authentic vascular anatomy. The RADAR technique has demonstrated superior performance compared to the standard technique by providing appropriate wall shear stress in critical regions and minimizing the risk of wall damage. Its use of a thicker vessel also reduces the risk of vessel injury, making it particularly effective for patients with Chronic Kidney Disease (CKD), hypertension, anemia, and diabetes, ensuring optimal blood flow and fewer complications. However, there are minor concerns about stenosis formation in hypertension and anemia cases, which could be mitigated by adjusting the anastomosis angle to be lower than 30°. Diabetes and hypertension have significant physiological effects that increase the risks associated with arteriovenous fistula maturation. The anemic condition resulting from CKD may help reduce vessel injury but raises concerns about potential stenosis formation. Despite these co-morbidities, the RADAR technique has demonstrated its ability to induce more favorable hemodynamic changes, promoting arteriovenous fistula maturation.

Associations of fish and meat intake with iron and anaemia in Malawian children.

Animal flesh foods are rich in bioavailable iron but infrequently consumed by young children. We aimed to determine whether flesh food intake was associated with iron and anaemia status among 585 Malawian infants enroled in a 6-month egg-feeding trial. The percentage of days of small fish, large fish and meat consumption were assessed through weekly 7-day animal-source food screeners. Grams of intake were assessed through 24-h recalls conducted at 6-9, 9-12 and 12-15 months of age. Plasma ferritin, soluble transferrin receptor (sTfR) and haemoglobin concentrations were measured at 6-9 and 12-15 months of age. Iron biomarkers were adjusted for inflammation during analysis. At enrolment, each flesh food category was consumed by <5% of children in the past 24 h. Over the next 6 months, small fish, large fish and meat were consumed on 25%, 8% and 6% of days, respectively, with mean usual intakes of <5 g/day. More frequent small fish consumption was associated with lower sTfR (geometric mean ratio [95% CI]: 0.98 mg/L [0.96, 1.00] per 10 percentage point difference) but not ferritin (1.03 µg/L [0.98, 1.07]) or haemoglobin (1.01 g/dL [1.00, 1.01]). Large fish consumption was associated with higher anaemia (prevalence ratio [95% CI]: 1.09 [1.01, 1.19]) and lower iron deficiency (0.96 [0.93, 1.00]) prevalence. Gram intakes of flesh food categories were not associated with any iron or anaemia indicators. Small fish were a primary contributor to flesh food intake in this cohort of Malawian children, although usual portions were small. Fish was associated with modest improvements to iron status, but meat was too infrequent to be associated with anaemia and iron deficiency.

Association between low selenoprotein P concentrations and anaemia in hospitalized heart failure patients.

Heart failure (HF) patients with anaemia tend to have a worse outcome, with increased hospitalization rates, decreased exercise tolerance, and higher mortality compared to those without anaemia. Limited research exists on the association between selenium deficiency and anaemia specifically in HF patients, despite previous findings of a correlation in different populations. The BIOSTAT-CHF study demonstrated that higher selenium levels in HF patients were associated to a lower risk of anaemia and iron deficiency. This study investigates the relationship between selenoprotein P (SELENOP) concentrations, a major contributor and functional biomarker of selenium transport, and anaemia, Hb levels, and iron status in hospitalized HF patients. SELENOP was analysed in 320 hospitalized HF subjects, with complete data available for 310 subjects. The relationships between continuous SELENOP concentrations and 1) Hb concentrations, 2) anaemia (Hb<115g/L (women), <130g/L (men)), and 3) iron status (as measured by transferrin receptor 1 (TfR1) which increases in iron deficiency) were evaluated using multivariable logistic and linear regression models. Additionally, SELENOP concentrations in the lowest quartile were related to anaemia, haemoglobin, and iron state in multivariable logistic and linear models. The mean age of the study population was 75.0±11.6years, and 30% were women. Anaemia was present in 133 subjects (42.9%). SELENOP concentrations were positively correlated with haemoglobin concentrations (0.238; P<0.001) and negatively with TfR1 concentrations (-0.238, P<0.001). In multivariable regression models, higher SELENOP concentrations were associated with higher Hb concentrations (B=3.23; P=0.002) and lower TfR1 concentrations (B=-0.20; P<0.001). Furthermore, SELENOP deficiency was associated with lower Hb concentrations (B=-7.64: P=0.001), higher TfR1 concentrations (B=0.31; P=0.003), and higher odds of anaemia in HF patients (odds ratio 2.17; 95% confidence interval 1.23-3.82; P=0.008). In hospitalized heart failure patients, lower concentrations of SELENOP were associated with higher prevalence of anaemia.

Impact of Anemia on Cardiovascular Events and All-Cause Death Among Participants Who Received Intense Blood Pressure Treatment: A Secondary Analysis of SPRINT.

To investigate whether anemia is associated with incident cardiovascular events and all-cause death among participants who received intensive blood pressure (BP) treatment in the Systolic Blood Pressure Intervention Trial (SPRINT). A total of 4394 participants who received intensive BP control (systolic BP 120 mmHg) in SPRINT were included. Anemia status was self-reported. Our primary outcome was a composite of cardiovascular events, and the secondary outcome was all-cause death. Cox regression was used to compare the incidence of outcomes between participants with anemia and non-anemia. In order to balance the baseline characteristics between the 2 groups, inverse probability of treatment weighting (IPTW) was applied. Hazard ratios (HRs), along with 95% confidence intervals (CIs), were then calculated. There were 4394 participants who received intensive BP control (537 participants with anemia). Participants with anemia were older (mean age 68.86 versus 67.75, p = 0.01) and more likely to be female (64.8% versus 31.8%, p 0.001). The presence of anemia was strongly associated with composite cardiovascular events after adjusting for potential confounders (HR 1.66, 95% CI 1.18-2.34, p = 0.004). The association remained statistically significant even in the population after IPTW (HR 1.55, 95% CI 1.06-2.27, p = 0.024). The secondary outcome revealed that participants with anemia had a higher rate of all-cause death compared to those without anemia. The HR of all-cause death for participants with anemia was 1.61 (95% CI 1.00-2.57, p = 0.049) in the population after IPTW. Anemia appears to be an independent risk factor for composite cardiovascular events and all-cause death among participants who received intensive BP control in SPRINT. URL: https://www.clinicaltrials.gov; Unique identifier: NCT01206062. All SPRINT anonymized data can be found at the National Heart, Lung and Blood Institute (NHLBI) Biologic Specimen and Data Repository (https://biolincc.nhlbi.nih.gov/home/).

Risk factors and current state of therapy for anemia after kidney transplantation.

Post-transplant anemia is one of the most common complications in kidney transplant recipients, severely affecting patient prognosis and quality of life, and is an independent predictor of graft kidney loss and patient mortality. However, our clinical understanding and the attention given to post-transplant anemia are currently insufficient. This paper reviews the current status, risk factors, and therapeutic progress in anemia after transplantation in kidney transplant recipients. We recommend that clinical staff pay attention to anemia and its complications in kidney transplant recipients and intervene early for anemia.

Application of the (fr)AGILE scale in the evaluation of multidimensional frailty in elderly inpatients from internal medicine wards: a cross-sectional observational study.

With the rapid growth of an aging global population and proportion, the prevalence of frailty is constantly increasing. Therefore, finding a frailty assessment tool suitable for clinical application by physicians has become the primary link in the comprehensive management of frailty in elderly patients. This study used the (fr)AGILE scale to investigate the frailty status of elderly patients from internal medicine wards and identified relevant factors that affect the severity of frailty. In this study, 408 elderly inpatients in internal medicine departments of Qilu Hospital of Shandong University from May 2021 to August 2022 were enrolled as research subjects, and a cross-sectional observational study was conducted. Researchers evaluated the frailty based on the (fr)AGILE scale score. The general condition, past medical history, physical examination, laboratory examination, nutrition control score, intervention and treatment measures and other elderly patient information was collected. Logistic regression analysis was used to analyze the relevant factors that affect the severity of frailty and hospitalization costs. According to the (fr)AGILE scale score, the elderly patients were divided into groups to determine whether they were frail and the severity of the frailty. Among them, 164 patients were in the prefrailty stage, which accounted for 40.2%. There were 188 cases of mild frailty that accounted for 46.1%, and 56 cases of moderate to severe frailty that accounted for 13.7%. Decreased grip strength, elevated white blood cell levels, and low sodium and potassium are independent risk factors affecting the severity of frailty. As the severity of frailty increases, the proportion of sodium, potassium, albumin supplementation as well as anti-infection gradually increases. Frailty is a common elderly syndrome with a high incidence among elderly patients in internal medicine departments. The main manifestations of frailty vary with different severity levels. Inflammation, anemia, and poor nutritional status can lead to an increase in the severity of frailty as well as blood hypercoagulability, myocardial damage, and additional supportive interventions. This ultimately leads to prolonged hospitalization and increased hospitalization costs.