Changes In Hemoglobin Concentration Research Articles

Streamlined Preoperative Iron Deficiency Screening and IV Treatment for Colorectal Cancer Patients beyond Clinical Trials

Background/objectives: Iron deficiency anemia is common in patients with colorectal cancer and affects postoperative outcomes. Preoperative intravenous iron supplementation corrects anemia effectively; however, the effect on the postoperative clinical course is unclear. The aim of this study was to investigate the effects of implementing a screening program for iron deficiency anemia and correction in patients with colorectal cancer. Methods: This was a retrospective single-institutional quality-assurance study that included patients undergoing elective surgery for colorectal cancer between January 2019 and December 2021. On 1 March 2020, screening for iron deficiency was implemented. Anemia was corrected by intravenous ferricarboyxmaltose. Patients with hemoglobin <7mmol/L and ferritin <30 µg/L or ferritin 30–100 µg/L and TSAT < 0.2 were divided into iron- and non-iron groups. The primary outcome was a change in hemoglobin concentration, and secondary outcomes included blood transfusion, complications, length of stay, mortality, and implementation efficacy. Data from the patients were extracted from digital patient charts and entered into a database. Results: A total of 532 patients were included, of which 177 patients (33.3%) were anemic, 63 were in the iron group, and 114 were in the non-iron group. Adherence to the screening program was 86.3%. Hemoglobin (iron group) increased from a mean of 5.7 mmol/L (SD 0.8) to 6.9 (0.8) mmol/L, p < 0.001. Iron treatment decreased transfusion rates from 27.7% to 9.1%, p = 0.007, and increased the rate of patients without complications from 53.2% to 79.6%, p < 0.001, which held true after controlling for confounding. In addition, 90-day mortality was lower in the iron group; however, this was not significant. Conclusions: Administration of intravenous iron increased hemoglobin, leading to reduced use of blood transfusion and fewer complications.

Efficacy and Safety of Roxadustat for Anemia in Patients Receiving Chemotherapy for Nonmyeloid Malignancies: A Randomized, Open-Label, Active-Controlled Phase III Study.

We evaluated the efficacy and safety of roxadustat, a first-in-class hypoxia-inducible factor prolyl hydroxylase inhibitor, for chemotherapy-induced anemia (CIA) in patients with nonmyeloid malignancies receiving multicycle treatments of chemotherapy. In this open-label, noninferiority phase III study conducted at 44 sites in China, 159 participants age ≥18 years with CIA nonmyeloid malignancy and CIA were randomly assigned (1:1) to oral roxadustat or subcutaneous recombinant human erythropoietin-α (rHuEPO-α) three times a week for 12 weeks. Roxadustat starting dosages were 100, 120, and 150 mg three times a week for participants weighing 40-<50, 50-60, and >60 kg, respectively. rHuEPO-α starting dosage for all participants was 150 IU/kg three times a week. Both roxadustat and rHuEPO-α dosages could be modified. The primary end point was least-squares mean (LSM) change in hemoglobin (Hb) concentration from baseline to the concentration averaged over weeks 9-13. Of the 159 participants randomly assigned, 140 were included in the per-protocol set (roxadustat, n = 78; rHuEPO-α, n = 62). The LSM (95% two-sided CI) change from baseline to weeks 9-13 in Hb concentration was 17.1 (13.58 to 20.71) g/L with roxadustat and 15.4 (11.34 to 19.50) g/L with rHuEPO-α (mean difference [95% CI], 1.7 [-3.39 to 6.84]). The lower bound of the one-sided 97.5% CI for the treatment difference (‒3.4 g/L) was greater than the predefined noninferiority margin of ‒6.6 g/L, establishing noninferiority. Noninferiority was supported by five of six key secondary end points. Rates of adverse events were generally comparable between treatments and consistent with previous findings. Roxadustat was noninferior to rHuEPO-α in treating CIA in participants with nonmyeloid malignancies receiving multicycle treatments of myelosuppressive chemotherapy. The oral formulation of roxadustat may potentially increase compliance.

Exploring the impact and influence of melanin on frequency-domain near-infrared spectroscopy measurements.

Near-infrared spectroscopy (NIRS) is a non-invasive optical method that measures changes in hemoglobin concentration and oxygenation. The measured light intensity is susceptible to reduced signal quality due to the presence of melanin. We quantify the influence of melanin concentration on NIRS measurements taken with a frequency-domain near-infrared spectroscopy system using 690 and 830nm. Using a forehead NIRS probe, we measured 35 healthy participants and investigated the correlation between melanin concentration indices, which were determined using a colorimeter, and several key metrics from the NIRS signal. These metrics include signal-to-noise ratio (SNR), two measurements of oxygen saturation (arterial oxygen saturation, , and tissue oxygen saturation, ), and optical properties represented by the absorption coefficient ( ) and the reduced scattering coefficient ( ). We found a significant negative correlation between the melanin index and the SNR estimated in oxy-hemoglobin signals ( , ) and levels ( , ). However, no significant changes were observed in the optical properties and ( , ). We found that estimated SNR and values show a significant decline and dependence on the melanin index, whereas and optical properties do not show any correlation with the melanin index.

Whole-head high-density diffuse optical tomography to map infant audio-visual responses to social and non-social stimuli

Abstract Infancy is a time of rapid brain development. High-density diffuse optical tomography (HD-DOT) is an optical neuroimaging method that maps changes in cortical haemoglobin concentration, a marker of functional brain activation. Recent years have seen a huge advance in wearable hardware for HD-DOT, however previous headgear has only been capable of sampling specific areas of the cortex. In this work, we aimed to develop headgear capable of sampling across the whole infant scalp surface and to conduct a proof-of-concept demonstration of whole-head HD-DOT in infants aged 5 to 7 months. We developed a whole-head infant implementation of the high-density LUMO design developed by Gowerlabs Ltd. (UK). HD-DOT data were collected from a cohort of infants (N = 16) during the presentation of a screen-based paradigm assessing social processing. Using whole-head HD-DOT, we mapped activity across the entirety of the optically-accessible cortex which far exceeds coverage achieved by previous infant optical neuroimaging methods. We found activity in temporal regions which corroborates previous research. Further, we mapped activity in regions outside those typically sampled in infant research using social processing paradigms, finding activation in regions across the occipital, parietal, and frontal cortices as well as an apparent inverted response in sensorimotor regions. Following this proof-of-concept, we envisage that whole-head HD-DOT will be applied to map the interaction between different regions of the brain, opening new avenues to map activity in the awake infant brain to better understand the trajectory of typical and atypical neurodevelopment.

Cerebral Synchronization Between Mothers and Their Newborns During Breastfeeding.

Introduction: Breastfeeding is a fundamental biological function in mammals, allowing the progeny to develop in a physiological way. A physical and emotional dialog between mothers and offspring during breastfeeding has been described as part of the attachment relationship, and a synchronicity between maternal and neonatal brains can be hypothesized. This study aimed to assess if neonatal and maternal cortical areas activated during breastfeeding are functionally synchronized since the second day of life. Materials and Methods: Twenty mothers and their term newborns were enrolled. Cortical activation during breastfeeding was identified by multichannel near-infrared spectroscopy, which detects changes in haemoglobin concentration from multiple cortical regions. Functional activity was simultaneously detected (hyperscanning) in mothers and newborns' frontal and motor/primary somatosensory cortical areas during the first 5 minutes of breastfeeding. Cluster analysis and Student's t test were used to detect oxygenated haemoglobin increase, as cortical activation estimate. Wavelet transform coherence (WTC) analysis was used to identify a possible synchronization between maternal and neonatal activated cortical regions. Results: Mothers showed an activation of the central motor/primary somatosensory cortex, above the sagittal fissure. In newborns, the bilateral frontal cortex was activated. WTC analysis revealed two different cyclical synchronizations between mothers and infants' activated cortical regions. Conclusions: Such evidence may reflect a very early common sharing of experiences, possibly associated with reciprocal dynamic motor adjustments, hormonal coregulation, and somatic stimulations and sensations. The observed cyclical neural synchronization, between the mother and her newborn's cortex during breastfeeding, may play an important role in promoting their bonding.

Prediction of the response to antiangiogenic sunitinib therapy by non-invasive hybrid diffuse optics in renal cell carcinoma.

In this work, broadband diffuse reflectance spectroscopy (DRS) and diffuse correlation spectroscopy (DCS) were used to quantify deep tissue hemodynamics in a patient-derived orthotopic xenograft mouse model of clear cell renal cancer undergoing antiangiogenic treatment. A cohort of twenty-two mice were treated with sunitinib and compared to thirteen control untreated mice, and monitored by DRS/DCS. A reduction in total hemoglobin concentration (THC, p = 0.03), oxygen saturation (SO2, p = 0.03) and blood flow index (BFI, p = 0.02) was observed over the treatment course. Early changes in tumor microvascular blood flow and total hemoglobin concentration were correlated with the final microvessel density (p = 0.014) and tumor weight (p = 0.024), respectively. Higher pre-treatment tumor microvascular blood flow was observed in non-responder mice with respect to responder mice, which was statistically predictive of the tumor intrinsic resistance (p = 0.01). This hybrid diffuse optical technique provides a method for predicting tumor intrinsic resistance to antiangiogenic therapy and could be used as predictive biomarker of response to antiangiogenic therapies in pre-clinical models.

Acute effects of apnea bouts on hemoglobin concentration and hematocrit: a systematic review and meta-analysis.

ABSTRACT López-Rebenaque O, Solís-Ferrer, Fierro-Marrero J, Asís-Fernández F. Acute effects of apnea bouts on hemoglobin concentration and hematocrit: a systematic review and meta-analysis. Undersea Hyperb Med. 2024 Second Quarter; 51(2):173-184. Objective: This study aimed to systematically analyze the existing literature and conduct a meta-analysis on the acute effects of apnea on the hematological response by assessing changes in hemoglobin (Hb) concentration and hematocrit (Hct) values. Methods: Searches in Pubmed, The Cochrane Library, and Web of Science were carried out for studies in which the main intervention was voluntary hypoventilation, and Hb and Hct values were measured. Risk of bias and quality assessments were performed. Results: Nine studies with data from 160 participants were included, involving both subjects experienced in breath-hold sports and physically active subjects unrelated to breath-holding activities. The GRADE scale showed a “high” confidence for Hb concentration, with a mean absolute effect of 0.57 g/dL over control interventions. “Moderate” confidence appeared for Hct, where the mean absolute effect was 2.45% higher over control interventions. Hb concentration increased to a greater extent in the apnea group compared to the control group (MD = 0.57 g/dL [95% CI 0.28, 0.86], Z = 3.81, p = 0.0001) as occurred with Hct (MD = 2.45% [95% CI 0.98, 3.93], Z = 3.26, p = 0.001). Conclusions: Apnea bouts lead to a significant increase in the concentration of Hb and Hct with a high and moderate quality of evidence, respectively. Further trials on apnea and its application to different settings are needed.

Hematological and neurological impact studies on the exposure to naturally occurring radioactive materials

Naturally Occurring Radioactive Materials (NORM) contribute to everyone's natural background radiation dose. The technologically advanced activities of the gas and oil sectors produce considerable amounts of radioactive materials as industrial by-products or waste products. The goal of the current study is to estimate the danger of long-term liability to Technologically Enhanced Naturally Occurring Radioactive Materials (TE-NORM) on blood indices, neurotransmitters, oxidative stress markers, and β-amyloid in the cerebral cortex of rats' brains. Twenty adult male albino rats were divided into two equal groups (n = 10): control and irradiated. Irradiated rats were exposed to a total dose of 0.016 Gy of TE-NORM as a whole-body chronic exposure over a period of two months. It should be ''The results showed no significant changes in RBC count, Hb concentration, hematocrit percentage (HCT%), and Mean Corpuscular Hemoglobin Concentration (MCHC). However, there was a significant increase in the Mean Corpuscular Volume of RBCs (MCV) and a significant decrease in cell distribution width (RDW%) compared to the control. Alteration in neurotransmitters is noticeable by a significant increase in glutamic acid and significant decreases in serotonin and dopamine. Increased lipid peroxidation, decreased glutathione content, superoxide dismutase, catalase, and glutathione peroxidase activities indicating oxidative stress were accompanied by increased β-amyloid in the cerebral cortex of rats' brains. The findings of the present study showed that chronic radiation liability has some harmful effects, that may predict the risks of future health problems in occupational radiation exposure in the oil industries. Therefore, the control of exposure and application of sample dosimetry is recommended for health and safety.

Robotic arm-assisted conversion of unicompartmental knee arthroplasty to total knee arthroplasty.

Robotic arm-assisted surgery offers accurate and reproducible guidance in component positioning and assessment of soft-tissue tensioning during knee arthroplasty, but the feasibility and early outcomes when using this technology for revision surgery remain unknown. The objective of this study was to compare the outcomes of robotic arm-assisted revision of unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA) versus primary robotic arm-assisted TKA at short-term follow-up. This prospective study included 16 patients undergoing robotic arm-assisted revision of UKA to TKA versus 35 matched patients receiving robotic arm-assisted primary TKA. In all study patients, the following data were recorded: operating time, polyethylene liner size, change in haemoglobin concentration (g/dl), length of inpatient stay, postoperative complications, and hip-knee-ankle (HKA) alignment. All procedures were performed using the principles of functional alignment. At most recent follow-up, range of motion (ROM), Forgotten Joint Score (FJS), and Oxford Knee Score (OKS) were collected. Mean follow-up time was 21 months (6 to 36). There were no differences between the two treatment groups with regard to mean change in haemoglobin concentration (p = 0.477), length of stay (LOS, p = 0.172), mean polyethylene thickness (p = 0.065), or postoperative complication rates (p = 0.295). At the most recent follow-up, the primary robotic arm-assisted TKA group had a statistically significantly improved OKS compared with the revision UKA to TKA group (44.6 (SD 2.7) vs 42.3 (SD 2.5); p = 0.004) but there was no difference in the overall ROM (p = 0.056) or FJS between the two treatment groups (86.1 (SD 9.6) vs 84.1 (4.9); p = 0.439). Robotic arm-assisted revision of UKA to TKA was associated with comparable intraoperative blood loss, early postoperative rehabilitation, functional outcomes, and complications to primary robotic TKA at short-term follow-up. Robotic arm-assisted surgery offers a safe and reproducible technique for revising failed UKA to TKA.

تأثير المستخلص المائي لجذور نبات القسط الهندي علي التسمم الدموي المستحدث بعقار التامكسوفين في إناث الجرذان

In recent years, traditional medicine has been used to treat various diseases such as anemia. One of these plants is Saussurea lappa .The objective of the study is to investigate the impact of an aqueous extract of Saussurea lappa root (AESL) on Tamoxifen-induced anemia in female albino rats. A total of twenty-four rats (180-190 g) were separated into 4 groups (n= 6 for each group).Group (1), normal control was received only normal saline solution. Group (2), administered orally AESL (200 mg/kg body weight. Group (3), received orally tamoxifen (TAM, 40 mg/kg body weight). Group (4), givenTAM concurrently with AESL.TAM was administered concurrently with AESL for 28 successive days.The results showed that TAM intoxication had led to significant depletion in, red blood cells count (RBCs), hemoglobin (Hb),mean corpuscularhemoglobin (MCH), hematocrit (HCT), white blood cells count (WBCs) and platelets in TAM intoxicated ratsversus control counterparts.No significant changes in mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) were observed in TAM intoxicated rats versus control ones .Oral intake of AESL concurrently with TAM markedly ameliorated the depletion in WBC, RBC, Hb, MCH, HCT and platelets when compared with TAM intoxicated rats.This investigation revealed that oral intake of AESL in parallel with TAM can protect against hematotoxicityrelated to TAMThis result may candidate the useof AESL in the treatment of blood cell disorder. Keyword: Anemia, Saussurea lappa,Tamoxifen,Hb

A study on the effects of transcranial direct current stimulation combined with motor imagery on brain function based on electroencephalogram and near infrared spectrum

Motor imagery is often used in the fields of sports training and neurorehabilitation for its advantages of being highly targeted, easy to learn, and requiring no special equipment, and has become a major research paradigm in cognitive neuroscience. Transcranial direct current stimulation (tDCS), an emerging neuromodulation technique, modulates cortical excitability, which in turn affects functions such as locomotion. However, it is unclear whether tDCS has a positive effect on motor imagery task states. In this paper, 16 young healthy subjects were included, and the electroencephalogram (EEG) signals and near-infrared spectrum (NIRS) signals of the subjects were collected when they were performing motor imagery tasks before and after receiving tDCS, and the changes in multiscale sample entropy (MSE) and haemoglobin concentration were calculated and analyzed during the different tasks. The results found that MSE of task-related brain regions increased, oxygenated haemoglobin concentration increased, and total haemoglobin concentration rose after tDCS stimulation, indicating that tDCS increased the activation of task-related brain regions and had a positive effect on motor imagery. This study may provide some reference value for the clinical study of tDCS combined with motor imagery.

Effect of isometric quadriceps exercise on local microcirculation of the infrapatellar fat pad in female patients with knee osteoarthritis

ObjectiveTo elucidate the local microcirculation of the infrapatellar fat pad (IFP) in patients with knee osteoarthritis (KOA) by determining the changes in IFP hardness and hemoglobin concentration during isometric quadriceps exercise (IQE). DesignIn this observational cross-sectional study, patients diagnosed with bilateral KOA were included in the KOA group (30 knees), healthy older adults in the control group (20 knees), and younger adults in the young group (20 knees). Ultrasonography was performed at rest and during IQE to measure IFP hardness based on shear wave velocity. Near-infrared spectroscopy was performed to measure oxygenated hemoglobin (O2Hb), deoxygenated hemoglobin (HHb), and total hemoglobin (cHb) in the IFP before (Baseline), during (IQE task), and after IQE (Post). IFP hardness and O2Hb, HHb, and cHb concentration were analyzed using a linear mixed model for the groups and measurement points. ResultsDuring IQE, IFP hardness changes were significantly less in the KOA group than in the other groups (KOA: 95% confidence intervals (CIs) [−0.854, 0.028]; control: 95% CI [−0.941, −0.341]; and young: 95% CI [−2.305, −1.706]). In the KOA group, O2Hb concentration exhibited no significant changes at Post compared with Baseline; however, significant changes were observed in the other groups (KOA: 95% CI [−1.176, 0.423]; control: 95% CI [−1.452, −0.276]; and young: 95% CI [−4.062, −2.102]). ConclusionsDuring IQE, changes in hardness and hemoglobin concentration in the IFP were not significant in the KOA group, suggesting impaired local microcirculation of the IFP.

#2063 Safety and efficacy of vadadustat vs darbepoetin alfa in patients on maintenance dialysis by prespecified subgroups of baseline ESA dose

Abstract Background and Aims Vadadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor approved in Europe, Australia, Japan for the treatment of anemia in patients with dialysis-dependent (DD)-CKD. In the INNO2VATE global phase 3 trials in patients with DD-CKD, including 2 separate trials in patients new to dialysis [NCT02865850] and on maintenance dialysis [NCT02892149], vadadustat was noninferior to the erythropoiesis -stimulating agent (ESA) darbepoetin alfa for cardiovascular safety and hemoglobin efficacy. Among patients with DD-CKD, high ESA dose requirements have been associated with an increased risk of cardiovascular complications. In this secondary analysis, we compared cardiovascular safety and hematological efficacy of vadadustat and darbepoetin alfa across baseline ESA dose categories. Method In the INNO2VATE trials, 3554 patients on maintenance dialysis were randomized 1:1 to vadadustat or darbepoetin alfa, stratified according to geographic region, New York Heart Association heart failure classification, and hemoglobin concentration at trial entry. Data were analyzed for prespecified subgroups of patients categorized by their baseline ESA (epoetin alfa/equivalents) dose: low (&amp;lt;90 U/kg/week), intermediate (90-299 U/kg/week), or high (≥300 U/kg/week). Within these dose subgroups, the key safety endpoint was the first occurrence of an adjudicated major adverse cardiovascular event (MACE: first occurrence of all-cause mortality, nonfatal myocardial infarction [MI], or nonfatal stroke) using a time-to-event analysis. Primary and secondary efficacy endpoints were mean change in hemoglobin concentration from baseline during the primary (weeks 24-36) and secondary (weeks 40-52) evaluation periods, respectively. Results More participants were in the low (vadadustat: n = 916 [53%], darbepoetin alfa: n = 968 [55%]) and intermediate (vadadustat: n = 724 [42%], darbepoetin alfa: n = 693 [39%]) than in the high (vadadustat: n = 102 [6%], darbepoetin alfa: n = 98 [6%]) baseline ESA dose subgroups. Hazard ratios for the occurrence of first MACE between vadadustat and darbepoetin alfa in the 3 baseline ESA dose subgroups were as follows: low dose, 0.99 (95% CI, 0.81 to 1.23); intermediate dose, 0.93 (95% CI, 0.74 to 1.18); and high dose, 0.62 (95% CI, 0.34 to 1.14) (Fig.). Similar results were observed for other key MACE-related endpoints, including all-cause mortality, MACE plus hospitalizations for heart failure or thromboembolic events, cardiovascular MACE (first occurrence of cardiovascular mortality, nonfatal MI, or nonfatal stroke), and cardiovascular death. Mean hemoglobin concentrations increased in both treatment groups throughout the trial period. The least squares mean treatment difference (vadadustat compared to darbepoetin alfa) for change in hemoglobin concentration from baseline to the primary efficacy period was –0.10 g/dL (95% CI, –0.19 to –0.02), –0.20 g/dL (95% CI, –0.30 to –0.09), and –0.39 g/dL (95% CI, –0.67 to –0.11) for the low, intermediate, and high baseline ESA dose subgroups, respectively. Similar results were observed for the secondary efficacy period. Across baseline ESA dose subgroups, the proportion of patients whose average hemoglobin concentration was within target range was similar between the vadadustat and darbepoetin alfa arms during the primary efficacy period (low: odds ratio [OR], 0.89; 95% CI, 0.74, 1.08; intermediate: OR, 0.87; 95% CI, 0.70, 1.09; high: OR, 0.90; 95% CI 0.49, 1.64). Similar results were observed during the secondary efficacy period. Conclusion The cardiovascular safety and efficacy of vadadustat was similar to darbepoetin alfa in patients with DD-CKD irrespective of baseline ESA dose. In patients requiring higher ESA doses at baseline, the risk of MACE was numerically (but not significantly) lower in vadadustat-treated patients. Further investigation is required to confirm or refute this trend.

275 Assessment of changes in hemoglobin concentration (Hb) in sows and their offspring over two consecutive reproductive cycles

Abstract There remains a knowledge gap regarding changes in hematological parameters, such as Hb, throughout the reproductive cycle of a sow. The principle aim of this study was to assess Hb concentartions in sows and their offspring over at least two consecutive reproductive cycles. Blood Hb measurements were initiated during the gilt stage and continued through parities 1 and 2, with measurements taken at six time points (d 30, 60, 90, and 112 of gestation; d 2 and 17 of lactation) involving a total of 13 sows. Sow body weight (BW) during gestation was 193.2 ± 38.1 kg for parity 1 and 220.7 ± 26.2 kg for parity 2; in lactation, sow BW was 201.5 ± 14.3 kg for parity 1 and 214.0 ± 19.6 kg for parity 2. Sow daily iron (Fe) intake, based on analyzed Fe content, was 0.621 ± 0.06 g during gestation and 1.79 ± 0.15 g during lactation across parities 1 and 2, which represents more than a 2-fold greater Fe intake than NRC 2012 requirement estimates. All liveborn piglets (n = 204 for parity 1; n = 201 for parity 2) underwent Hb measurements. Blood Hb concentrations were assessed within 24 h of birth before iron supplementation (200 mg iron dextran) and again at 17 d of age. Sows and piglets were classified as either anemic (Hb &amp;lt; 10 g/dL) or non-anemic (Hb ≥ 10 g/dL). Analysis of variance included the main effect of day, parity and their interaction based on Tukey’s comparison. In gestation Hb was less (P = 0.03) at d 90 in parity 1 and at d 90 and 112 in parity 2 (Table 1). Across parity, Hb was less (P = 0.02) at d 60 in parity 2. In lactation, Hb was least (P = 0.0002) at d 17 in parity 1 where sows were deemed anemic; in parity 2, sows were deemed anemic throughout lactation. The total number of piglets born and born alive was 17.15 ± 2.03 and 16.0 ± 1.9, respectively, for parity 1, and 17.0 ± 3.11 and 15.85 ± 2.41, respectively, for parity 2. Regardless of parity, piglet Hb was greater (P &amp;lt; 0.02) at weaning compared with birth. However, Hb concentrations were greater (P &amp;lt; 0.0001) at both time points in parity 2 piglets. There was a reduced incidence of anemia at birth (39.1% vs. 59.02%, respectively) and weaning (14.2% vs 36.1%, respectively) among piglets born in parity 2 compared with parity 1. The decline in sow Hb status with parity, particularly in lactation, suggests the need to explore strategies to improve Hb in sows with advancing parity. Alternatively, piglet Hb status improved with parity, indicating a need to modify iron supplementation methods to facilitate greater Hb in parity 1 litters.

Isomer of per- and polyfluoroalkyl substances and red blood cell indices in adults: The Isomers of C8 Health Project in China

This study aimed to explore the isomer-specific, sex-specific, and joint associations of PFAS and red blood cell indices. We used data of 1,238 adults from the Isomers of C8 Health Project in China. Associations of PFAS isomers and red blood cell indices were explored using multiple linear regression models, Bayesian Kernel Machine Regression models and subgroup analysis across sex. We found that serum concentration of linear (n-) and branched (Br-) isomers of perfluorooctane sulfonate (PFOS) and perfluorohexanesulfonic acid (PFHxS) were significantly associated with red blood cell indices in single-pollutant models, with stronger associations observed for n-PFHxS than Br-PFHxS, in women than in men. For instance, the estimated percentage change in hemoglobin concentration for n-PFHxS (3.65%; 95% CI: 2.95%, 4.34%) was larger than that for Br-PFHxS (0.96%; 95% CI: 0.52%, 1.40%). The estimated percentage change in red blood cell count for n-PFHxS in women (2.55%; 95% CI: 1.81%, 3.28%) was significantly higher than that in men (0.12%; 95% CI: −1.04%, 1.29%) (Pinter < 0.001). Similarly, sex-specific positive association of PFAS mixture and outcomes was observed. Therefore, the structure, susceptive population, and joint effect of PFAS isomers should be taken into consideration when evaluating the health risk of chemicals.

Randomized, Single Blind, Standard Controlled, Equivalence Clinical Trial to Evaluate the Comparative Efficacy of Eladi Kasaya Versus Tranexamic Acid Tablet in the Management of Asrigdara (Heavy Menstrual Bleeding): A Clinical Trial Protocol

Introduction: Excessive menstrual bleeding is a common problem in reproductive age group females, and it is reported that 1 in 20 lifetime chances, a female needs consulting the physician for excessive and prolonged menstrual bleeding. Ayurvedic literature describes excessive menstrual bleeding as Asrigdara (HMB). Eladi kasaya is one of the treatment modalities for heavy menstrual bleeding given in classics and hence chosen for the current clinical trial.&#x0D; Methods: We planned a prospective, randomized, controlled, and equivalence trial on the patients with Heavy menstrual bleeding (blood loss &gt; 80 ml) for the last two cycles or more. Eladi Kasaya 50 ml with honey and sharkara(sugar) thrice a day will be given from day 1 to day 7 for 3 consecutive menstrual cycles to Group A and Tablet Tranexamic acid 500mg thrice a day to Group B. Primary outcome measures are menstrual blood loss improvement, reduction in pain assessed by visual analog scale, and change in Haemoglobin concentration. The secondary outcome measure is improvement in quality of life. All adverse drug reactions will be monitored and reported to Ayush Suraksha, pharmacovigilance center, Maharashtra. Following sample size calculation 46 patients will be recruited in each group to demonstrate equivalence with 80% power. The duration of study will be 2 years. The study is approved through Institutional Ethics Committee dated 07/10/2022, MGACHRC/IEC/Oct-2022/585. Participant recruitment shall be started after getting registered with the Clinical Trial Registry of India.&#x0D; Results: Current manuscript is a clinical protocol, hence results are yet to derive from the study. Results will be presented in conferences and shall be attempted to publish in indexed/peer-reviewed medical journals.&#x0D; Conclusion: Conclusion shall be drawn after completion of the clinical study.

The effect of UNIMMAP multiple micronutrient supplements versus iron-folic acid and placebo in anemia reduction among women of reproductive age in Kebribeyah Woreda, Somali Regional State, Ethiopia: a study protocol for a community-based individual RCT

BackgroundWomen of reproductive age (WRA) in developing countries are often at risk of micronutrient deficiencies due to inadequate intakes and excessive losses.ObjectiveThe purpose of this trial is to assess the effectiveness of United Nations International Multiple Micronutrient Antenatal Preparation-Multiple Micronutrient Supplements (UNIMMAP-MMS) versus iron-folic acid (IFA) among WRA in reducing anemia.MethodsThree parallel groups of WRA will participate in a community-based, individually randomized, double-blinded, placebo-controlled superiority trial. After consent, the sample of 375 mildly or moderately anemic women based on hemoglobin by Hemocue will be randomly assigned across two interventions and one control arm. Trial participants in intervention arms will receive UNIMMAP-MMS or IFA while those in the control arm will receive placebos twice a week for 17 weeks. The primary outcome will be a change in mean hemoglobin (Hb) concentrations. Outcome assessors and study participants will be blinded to the type of supplements and study arm.DiscussionThe World Health Organization (WHO) added UNIMMAP-MMS to its essential medicine lists in 2021 but recommended rigorous study. Several factors in addition to inadequate intakes of iron and folic acid contribute to the high prevalence of anemia among WRA in the Somali region. The findings of this study will provide evidence on the effect of UNIMMAP-MMS and IFA on Hb concentrations and anemia prevalence among anemic WRA.Trial registrationClinicalTrials.gov NCT05682261. Registered on January 12, 2023.

Abnormal prefrontal cortical activation during the GO/NOGO and verbal fluency tasks in adult patients with comorbid generalized anxiety disorder and attention-deficit/hyperactivity disorder: An fNIRS study

Generalized anxiety disorder (GAD) and adult attention-deficit/hyperactivity disorder (ADHD) are commonly reported comorbidities. Adult GAD patients with comorbid ADHD are often underdiagnosed and undertreated. To explore the clinical value of functional near-infrared spectroscopy (fNIRS) data for assisting in the accurate diagnosis of ADHD in individuals with GAD, haemoglobin (HbO) concentration changes in the prefrontal cortex (PFC) were detected via fNIRS in 49 patients with both GAD and ADHD, 46 patients with GAD, and 34 healthy controls (HCs) during a verbal fluency task (VFT) and a GO/NOGO task. The correlations between PFC fNIRS data and the severity of inattention and hyperactivity symptoms assessed using the adult ADHD Self-Report Scale (ASRS) were analyzed. Our results showed that, during the GO/NOGO task, channels in the left dorsolateral PFC (channels 28 and 29) were hyperactivated, while channels in the medial PFC (channels 36, 37, and 47) were hypoactivated in participants with ADHD and GAD compared with those with GAD alone. During the VFT, compared with the HC group, both the ADHD + GAD group and the GAD group exhibited significantly decreased HbO activation in the medial PFC (channels 37, 38, and 48) and in the left ventrolateral PFC (channel 39); moreover, no difference was found between the ADHD + GAD group and the GAD group. Activation in the left dorsolateral PFC (channels 28 and 29) during the GO/NOGO task showed a significant positive correlation with ASRS-inattention scores. Our results indicated that fNIRS data collected during the GO/NOGO task may help to distinguish patients with comorbid GAD and ADHD from those with GAD alone.

Effects of rhythmic visual cues on cortical activation and functional connectivity features during stepping: an fNIRS study.

Rhythmic visual cues (RVCs) may influence gait initiation by modulating cognition resources. However, it is unknown how RVCs modulate cognitive resources allocation during gait movements. This study focused on investigating the effects of RVCs on cortical hemodynamic response features during stepping to evaluate the changes of cognitive resources. We recorded cerebral hemoglobin concentration changes of 14 channels in 17 healthy subjects using functional near-infrared spectroscopy (fNIRS) during stepping tasks under exposure to RVCs and non-rhythmic visual cues (NRVCs). We reported mean oxygenated hemoglobin (HbO) concentration changes, β-values, and functional connectivity (FC) between channels. The results showed that, the RVC conditions revealed lower HbO responses compared to the NRVC conditions during the preparation and early stepping. Correspondingly, the β-values reflected that RVCs elicited lower hemodynamic responses than NRVCs, and there was a decreasing trend in stimulus-evoked cortical activation as the task progressed. However, the FC between channels were stronger under RVCs than under NRVCs during the stepping progress, and there were more significant differences in FC during the early stepping. In conclusion, there were lower cognitive demand and stronger FC under RVC conditions than NRVC conditions, which indicated higher efficiency of cognitive resources allocation during stepping tasks. This study may provide a new insight for further understanding the mechanism on how RVCs alleviate freezing of gait.

Impact of C-reactive protein on the effect of Roxadustat for the treatment of anemia in chronic kidney disease: a systematic review of randomized controlled trials

BackgroundChronic inflammation, reflected by an increased blood C-reactive protein (CRP) level, is common in patients with chronic kidney disease (CKD) and is involved in the development of renal anemia. This systematic review aims to investigate the impacts of CRP on the efficacy of hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs) in the treatment of renal anemia in patients with CKD.MethodsWe conducted a comprehensive search of electronic databases including Pubmed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, and the International Clinical Trials Registry Platform (ICTRP), from their inception to May 19, 2022. We systematically reviewed evidence from randomized controlled trials using HIF-PHIs for renal anemia treatment. The mean difference (MD) in changes in hemoglobin concentration (∆Hb) before and after treatment served as the meta-analysis outcome, utilizing a random-effects model. We compared groups with CRP levels greater than or equal to the upper limit of normal (ULN) and less than the ULN. Additionally, further analysis was conducted in the CRP ≥ ULN group comparing HIF-PHIs and erythropoiesis-stimulating agents (ESA).ResultsA total of 7 studies from 6 publications were included in the analysis. In the comparison between the CRP ≥ ULN group and the CRP < ULN group, 524 patients from 4 studies were incorporated into the analysis. All patients received roxadustat as the primary intervention. The pooled results revealed no significant difference in ΔHb between patients with CRP ≥ ULN and CRP < ULN at baseline (Mean Difference: 0.00, 95% Confidence Interval: -0.32 to 0.33, P = 0.99). Moreover, within the CRP ≥ ULN group, three studies involving 1399 patients compared the efficacy of roxadustat and erythropoiesis-stimulating agents (ESAs). The results indicated no significant difference in ΔHb between patients treated with ESAs and HIF-PHIs (Mean Difference: 0.24, 95% Confidence Interval: -0.08 to 0.56, P = 0.14). In terms of medication dosage, an increase in ESA dose over time was observed across various studies, particularly evident in the CRP ≥ ULN group, while the dose of roxadustat remains constant over time and is not influenced by the baseline levels of CRP.ConclusionsOur systematic review demonstrates that roxadustat exhibits similar efficacy across different CRP levels. Moreover, within the CRP ≥ ULN group, roxadustat can maintain efficacy comparable to ESA without the necessity for dose escalation.Trial registrationCRD42023396704.