Hb Concentration Research Articles

Comparing HemoCue® and Quantitative Buffy Coat® and Coulter Counter-measured haemoglobin concentrations in African children with acute uncomplicated malaria: a Bland–Altman analysis

BackgroundAnaemia is a deleterious consequence of malaria, and its accurate diagnosis is crucial for effective management. However, laboratory methods for measuring haemoglobin (Hb) concentration, like the Coulter Counter and the Quantitative Buffy Coat® (QBC®), are costly and not widely accessible in resource-limited settings. The point-of-care HemoCue® test is a cheaper alternative and suitable in rural areas. The study aimed to determine the level of agreement between Coulter Counter/QBC® vs. HemoCue®-measured Hb concentrations by Bland–Altman analysis.MethodsAs part of a randomized, placebo-controlled trial of single low-dose primaquine in Ugandan and Congolese children with acute uncomplicated Plasmodium falciparum malaria, Hb concentrations were measured on days 0, 3, 7, and 28 using Coulter Counter (Uganda, n = 1880 paired values), QBC® (DR Congo, n = 1984 paired values) and HemoCue® Hb-301™. The predefined clinically acceptable limits were set at ± 0.5 g/dL.ResultsThe Bland–Altman analysis showed that the HemoCue® minus Coulter Counter mean Hb difference was − 0.15 g/dL with lower and upper limits of agreement of − 3.68 g/dL and 3.39 g/dL, respectively. Corresponding HemoCue® minus QBC® values were − 0.23 g/dL, − 1.66 g/dL and 1.22 g/dL. Linear regression of Hb concentration differences vs. mean Hb concentrations showed negative correlations: r = − 0.43 and r = − 0.34 for HemoCue® vs. Coulter Counter and HemoCue® vs. QBC®, respectively.ConclusionsCompared to Coulter and QBC®, mean HemoCue® measured Hb concentrations were lower and, compared to the Coulter or QBC® methods, had an overall tendency to measure lower Hb concentrations with increasing Hb concentrations. Upper and lower limits of agreement were wider than the predefined clinically acceptable limits of ± 0.5 g/dL. HemoCue® should be used with caution in settings where decisions about blood transfusions are made.

Effect of Increasing Red Meat Intake on Iron Status in Adults with Normal and Suboptimal Iron Status: A Systematic Literature Review and Meta-Analysis of Intervention Studies

Abstract Context Iron deficiency is the most prevalent nutrient deficiency globally. There is increasing interest in the use of food-based approaches for improving and maintaining iron status. Objective A systematic literature review was conducted to identify, critically-appraise, and meta-analyze data from intervention studies that investigated the effect of increasing red meat intake on iron status in adults. Data Extraction The search was conducted using the PubMed, Web of Science, Scopus, Embase, Cochrane, SPORTDiscus, and Google Scholar databases, as well as other supplementary search strategies up to October 2024. Inclusion criteria for reviewed articles were participants who were adults aged 18 to 70 years, interventions that involved ≥4 weeks of increased red meat intake, included a suitable control condition, and measured at least 1 biomarker of iron status. The initial search yielded 5212 articles, with 10 articles (n = 397 participants) meeting the inclusion criteria. Data Analysis The effect of intervention on markers of iron status were analyzed using a meta-analytic multivariate model, and the potential moderating effect of multiple variables were considered. The final meta-analysis included 42 effects (k) for serum ferritin (k = 25) and hemoglobin (Hb; k = 17) concentrations. Interventions involving increasing red meat intake had no significant effect on serum ferritin concentrations (raw mean change difference [RMCD] = 1.87 μg L–1; 95% CI, –0.73 to 4.48; t = 1.619; P = .139) but did have a positive effect on Hb concentrations (RMCD = 2.36 g L–1; 95% CI, 0.71 to 4.02; t = 3.297; P = .011). Moderator analysis revealed a positive effect of increasing red meat intake on serum ferritin concentrations when the intervention lasted at least 8 weeks (RMCD = 2.27 μg L–1; 95% CI, 0.87 to 3.67), and longer than 16 weeks (RMCD = 5.62 μg L–1; 95% CI, 0.67 to 10.6). Conclusions Increasing red meat intake can improve iron status as indicated by increases in serum ferritin and Hb concentrations, but the extent to which such increases are clinically meaningful remains to be established. Systematic Review Registration PROSPERO registration No. CRD42023479349.

Study of Minor Chromophores in Biological Tissues by Diffuse Optical Spectroscopy (Review).

Diffuse optical spectroscopy (DOS) is a rapidly advancing non-invasive diagnostic technique to investigate biological tissue, based on probing the target object with optical radiation in the visible and/or near-infrared wavelength range and detecting the diffusely scattered light from the tissue. The signals obtained through DOS provide extensive information about the biochemical composition of tissues due to the presence of light-absorbing compounds known as chromophores. To date, DOS is widely employed to detect major chromophores such as deoxygenated (Hb) and oxygenated (HbO2) hemoglobin, water, lipids, and melanin. The concentrations of Hb and HbO2 in biological tissues are highly significant in clinical research, as they offer valuable insights into tissue oxygenation status and enable the detection of hypoxia. However, biological tissues also contain less-studied chromophores - minor chromophores - which also contribute to the overall absorption spectrum. These include various globins, such as methemoglobin, carboxyhemoglobin, and myoglobin, as well as cytochromes and cytochrome c oxidase. Identifying minor chromophores using DOS is challenging due to their relatively low absorption contributions compared to major chromophores, as well as the limited understanding of their specific absorption spectra. Nevertheless, the simultaneous detection of both major and minor chromophores could provide a comprehensive understanding of metabolic processes within vascular, intracellular, and mitochondrial compartments of tissues. This would substantially expand the potential applications of DOS in both research and clinical studies. In this review we examine literature sources that explore the investigation of minor chromophores in biological tissues by DOS, discuss the role of major chromophores, and evaluate the potential for simultaneous detection of both major and minor chromophores with DOS.

Tribulus platypterus‐Reduced Ag Nanoparticles Ameliorate the Hemogram and Iron Indices in Renal Anemia Rat Model

ABSTRACTThe recent study evaluated the protective effect of the Tribulus platypterus green‐synthesized silver nanoparticles against gentamicin‐induced nephrotoxicity. The silver nanoparticles were characterized using XRD, UV‐Vis, FT‐IR, and FE‐SEM. The nanoparticles exhibited a spherical morphology with an average diameter of 48 nm. Both traditional and innovative kidney injury indicators were employed to evaluate the nephroprotective effects of nanoparticles in a rat model. Administration of gentamicin resulted in a significant reduction (p ≤ 0.01) in Hb concentration, PCV, and RBC count. Conversely, the levels of creatinine, erythropoietin, serum iron, and urea increased significantly (p ≤ 0.01) in the gentamicin‐treated group. The leucogram indicated the presence of leukocytosis, granulocytosis, and thrombocytopenia. Silver nanoparticles enhanced the parameters related to iron, leukogram, thrombocytes, erythropoietin, and erythrogram. In animals administered AgNPs, there was a significant decrease in the concentrations of creatinine, urea, AST, ALT, GGT, and ALP, whereas total protein and albumin levels showed a significant increase. Furthermore, AgNPs notably increased the levels of IL5, IL10, TGFβ, IL3, and IL4, while simultaneously reducing the levels of TNFα, IL6, IL12, IL18, and IL1. These results suggest that AgNPs could serve as a valuable nephroprotective agent derived from a biological source, potentially making them a suitable therapeutic supplement for conditions related to blood disorders.

Eltrombopag Enhances Recovery from Cytopenias Due to Poor Graft Function after Hematopoietic Cell Transplantation.

Poor graft function (PrGF) is a serious complication of allogeneic hematopoietic cell transplantation (allo-HCT), and current therapies are only partially effective. Eight published reports on the effect of eltrombopag on PrGF showed encouraging results. This study aimed to assess the safety and efficacy of eltrombopag for the treatment of PrGF after allo-HCT. A retrospective study was conducted on 23 patients with PrGF following allo-HCT at the King Hussein Cancer Center (KHCC), Amman, Jordan between January 2013 and December 2023. The patient-, disease-, and transplant-related characteristics were obtained from the KHCC-BMT database. The median age was 47 years (range, 26-68 years), and 13 patients were female. Fourteen patients received reduced-intensity conditioning, and 14 donors were human-leukocyte antigen (HLA) -identical siblings. Median hemoglobin (Hb) concentration pre-eltrombopag administration was 8.5 g/dL (range: 6-14.2 g/dL), granulocytes 7.1 × 109/L (range: 1.6-85 × 109/L), and platelets 18 × 109/L (range: 6-50 × 109/L). Thirteen patients had platelets < 20 × 109/L, and 15 had reduced megakaryocytes. The median CD34-positive cell dose was 6.10 × 106/kg (range: 2.75-9.78 × 106/kg). Eltrombopag was initiated at a median of 105 day (d) post-transplant (range: 29-800 d). The median weekly dose was 488 mg (range: 350-700 mg), and the median treatment duration was 75 d (range: 5-446 d). In total, 65% of patients (n=15) responded at a median of 30 d (range, 7-122 d). Twelve responders were alive at a median follow-up of 30 months (range: 7.0-122 months) with normal blood counts. The 2-year overall rate was 48% (95% confidence intervals, 27-70%), and seven non-responders died because of relapse. No major adverse events were reported. Eltrombopag improved peripheral blood counts in patients with PrGF following allo-HCT. Thus, response to eltrombopag was predictable and has a significant effect on survival.

ANEMIA IS ASSOCIATED WITH TOXICITY OF RADIOTHERAPY PROSTATE CANCER

Introduction: Radiotherapy plays a fundamental role in prostate cancer treatment, but tumor hypoxia can contribute to radioresistance. Anemia, common in oncologic patients, may exacerbate hypoxia, potentially influencing treatment toxicity and outcomes. However, limited data exist on the impact of hemoglobin (Hb) levels on radiotherapy toxicity in prostate cancer. Objective: To analyze the correlation between pretreatment Hb concentration and the incidence of acute gastrointestinal (GI) toxicity in prostate cancer patients undergoing radical radiotherapy. Methods: A retrospective, longitudinal study was conducted with 86 prostate cancer patients treated at Ingá Radiotherapy Clinic, Niterói-RJ, receiving 70 Gy in 28 fractions. Pretreatment Hb levels were measured, and no corrective treatment for anemia was administered. Acute GI toxicity was assessed 7-10 days post-radiotherapy using RTOG criteria. Anemia was defined as Hb &lt; 13 g/dL (WHO criteria). Statistical analyses were performed using SPSS v.23. Results: The mean Hb level was 13.3 g/dL (SD ± 1.1), with 24 patients (27.9%) classified as anemic. Higher toxicity grades were significantly associated with anemia (p &lt; 0.001): 78.6% of anemic patients experienced grade 2 toxicity versus 21.4% of non-anemic patients, while 100% of grade 3 toxicity cases occurred in anemic patients. Conclusions: Anemia before radiotherapy was significantly associated with higher acute GI toxicity, supporting the hypothesis that Hb levels influence treatment tolerance. This highlights the need for strategies to optimize Hb levels before radiotherapy to minimize toxicity and improve patient outcomes. Further studies are needed to determine whether anemia correction improves radiotherapy tolerance and efficacy.

Determination of hematologic reference intervals for free-living King vultures (Sarcoramphus papa).

As obligate scavengers, New World vultures (Cathartiformes: Cathartidae) play a key role in carcass removal and disease control. Associated with this ecosystem service, vultures are exposed to the consumption of harmful substances such as poisons, heavy metals, antibiotics, or non-steroidal anti-inflammatory drugs. Monitoring the health status of vulture populations is a priority and an important conservation strategy, and hematologic analysis is a practical and effective method that can be useful for this purpose. Report hematologic reference intervals in free-living King vultures (Sarcoramphus papa), one of the least studied New World vulture species. Red blood cell concentration, packed cell volume, hemoglobin (Hb) concentration, MCV, MCH, MCHC, WBC concentration, differential count and absolute WBC concentration, heterophil to lymphocyte ratio, and total protein concentration were determined. We used a non-parametric method to calculate the reference intervals. In addition, we compared our results with the hematologic measurands reported for the Black vulture (Coragyps atratus), the Andean condor (Vultur gryphus) and the California condor (Gymnogyps californianus). With the exception of Hb, monocyte, basophil, and eosinophil concentrations, the mean hematologic measurands observed in the King vulture were similar to those recorded for the other New World vulture species, and the heterophil to lymphocyte ratio was lower in the King vulture compared to the Black vulture. In this study, we have reported for the first time the hematologic reference intervals in a free-living population of King vultures in Costa Rica. Future research should consider comparison among free-living New World vulture species.

Hematological Characteristics of Neonates with Abnormal Hemoglobin and Their Parents in Guangzhou Area

To analyze the incidence of abnormal hemoglobin (Hb) in neonates in Guangzhou area, as well as the results of quantitative analysis of Hb in neonatal umbilical cord blood and genetic diagnosis of thalassemia in neonates with abnormal Hb; And to explore the hematological phenotypes and clinical characteristics of neonates with abnormal Hb and their parents, providing a reference for eugenics and childcare. 650 neonates born at Guangdong Provincial People's Hospital who underwent Hb electrophoresis were included in this study. The results of routine blood test of umbilical cord blood , Hb electrophoresis and α-, β-thalassemia gene detection of the neonates were collected. The genotype distribution of thalassemia in the neonates was analyzed. Additionally, the abnormal Hb content of α and β variants was studied. Furthermore, the differences in hematological parameters between abnormal Hb neonates and normal neonates and α-thalassemia neonates, as well as between the parents of abnormal Hb neonates and normal adults were compared. Among the 650 neonates, 332 (51.08%) were diagnosed with thalassemia, including 235 cases of α-thalassemia (36.15%), 79 cases of β-thalassemia (12.15%), and 18 cases of compound αβ-thalassemia (2.77%). Among all the α-thalassemia genotypes, the most prevalent one was -- SEA/αα (48.94%), followed by -α3.7/αα (20.00%), -α4.2/αα (11.06%), and ααCS/αα (8.94%). The four most common genotypes of β-thalassemia were βCD41-42 (32.91%), βIVS-Ⅱ-654 (26.58%), β-28 (21.52%), and βE (10.13%), respectively. 275 cases of abnormal bands were found in Hb electrophoresis of umbilical cord blood, with a detection rate of 42.31%. The abnormal Hb content of α-variant in the neonates was significantly higher than that of β-variant (P < 0.001). The levels of Hb, MCV, MCH, Hb A, and Hb F in neonates with abnormal Hb were lower than those in normal neonates, while the RDW-CV was higher than that in normal neonates, with statistical significantce (P < 0.05). The levels of RBC and Hb A in neonates with abnormal Hb were lower than those in neonates with α-thalassemia, while the level of MCH was higher than that in neonats with α-thalassemia, with statistical significance (P < 0.05). The levels of Hb, MCV, MCH, and Hb A in parents of neonates with abnormal Hb were lower than those in normal adults, while the RDW-CV was higher than that in normal adults, and the differences were statistically significant (P < 0.05). The abnormal Hb content of α-variant in the neonates is significantly higher than that of β-variant in the neonates in Guangzhou, which can help to presume whether it is α chain or β chain based on the abnormal Hb content, providing a reference for globin gene sequencing. Meanwhile, analysis of various hematological screening-related indicators in neonates in the early stage is beneficial for early warning of the occurrence of abnormal Hb combined with thalassemia, reducing missed diagnoses to a certain extent.

Hyperspectral analysis to assess gametocytogenesis stage progression in malaria-infected human erythrocytes.

Developments of anti-gametocyte drugs have been delayed due to insufficient understanding of gametocyte biology. We report a systematic workflow of data processing algorithms to quantify changes in the absorption spectrum and cell morphology of single malaria-infected erythrocytes. These changes may serve as biomarkers instrumental for the future development of antimalarial strategies, especially for anti-gametocyte drug design and testing. Image-based biomarkers may also be useful for nondestructive, label-free malaria detection and drug efficacy evaluation in resource-limited communities. We extend the application of hyperspectral microscopy to provide detailed insights into gametocyte stage progression through the quantitative analysis of absorbance spectra and cell morphology in malaria-infected erythrocytes. Malaria-infected erythrocytes at asexual and different gametocytogenesis stages were imaged through hyperspectral confocal microscopy. The preprocessing of the hyperspectral data cubes to transform them to color images and spectral angle mapper (SAM) analysis were first used to segment hemoglobin (Hb)- and hemozoin (Hz)-abundant areas within the host erythrocytes. Correlations between changes in cell morphology and increasing Hz-abundant areas of the infected erythrocytes were then examined to test their potential as optical biomarkers to determine the progression of infection, involving transitions from asexual to various gametocytogenesis stages. Following successful segmentation of Hb- and Hz-abundant areas in malaria-infected erythrocytes through SAM analysis, a modest correlation between the segmented Hz-abundant area and cell shape changes over time was observed. A significant increase in both the areal fraction of Hz and the ellipticity of the cell confirms that the Hz fraction change correlates with the progression of gametocytogenesis. Our workflow enables the quantification of changes in host cell morphology and the relative contents of Hb and Hz at various parasite growth stages. The quantified results exhibit a trend that both the segmented areal fraction of intracellular Hz and the ellipticity of the host cell increase as gametocytogenesis progresses, suggesting that these two metrics may serve as useful biomarkers to determine the stage of gametocytogenesis.

Anaemia in Relation to Body Mass Index among First Year Female Nursing Students of Government Nursing College, Civil Hospital Ahmedabad

Background: Adolescents especially girls are most vulnerable toward the problem of anaemia. In this age groups, anaemia can result in impaired immune function and cause higher vulnerability to infections, reduction of physical resistance and tolerance to efforts, as well as damage to growth and intellectual capacity, hence difficulty to concentrate and memorize, which can lead to negative result in the learning development and performance. The association between anaemia and body mass index (BMI) is a measure of nutrition and health status of adults. Therefore, studying the haemoglobin level and its relationship to BMI highlights the importance of this study. Objectives: 1.This study was to assess the prevalence of anaemia in first year nursing female students of civil campus Ahmedabad. 2. To find Association between Body mass index with anaemia among study group. Material and methods: This study was conducted among first year female nursing students (n=154) aged 18-20 years at public health lab of community medicine department of B.J medical college. haemoglobin level (g/dl) by sahli’s hemoglobinometer and BMI (kg/m2) were estimated. Anaemia was defined as Hb content &lt;12 g/dl. Subjects were classified by BMI categories as underweight (BMI &lt;18.5 kg/ m2) Normal weight (BMI 18.5-24.99 kg/m2), overweight (BMI ≥25 kg/m2) and obesity (BMI ≥30 kg/m2) according to WHO. Then the relation between anaemia and BMI were statistically analysed. Semi structured Questionnaire was used for data collection. Result: Overall, 37.02% female students were anaemic. Of which 38.59% were underweight, 54.38% normal weight and 7.01% were above normal weight (over weight and obese). Mean value of haemoglobin was significantly decreased in underweight compared to overweight and obese (p&lt;0.04) but Anaemia was not significantly associated with BMI. (x2 =0.3444, p=0.8418). Conclusion: The study concludes the occurrence of anaemia in undernourished individuals which were not significantly associated. Further studies are needed with larger sample size to document the factor that may be associated with anaemia in females.

Portable Cell Tracking Velocimetry for Quantification of Intracellular Fe Concentration of Blood Cells.

Hematological analysis is crucial for diagnosing and monitoring blood-related disorders. Nevertheless, conventional hematology analyzers remain confined to laboratory settings due to their high cost, substantial space requirements, and maintenance needs. Herein, we present a portable cell tracking velocimetry (CTV) device for the precise measurement of the magnetic susceptibility of biological entities at the single-cell level, focusing on red blood cells (RBCs) in this work. The system integrates a microfluidic channel positioned between permanent magnets that generate a well-defined magnetic field gradient (191.82 TA/mm2). When the cells are injected into the chamber, their particular response to the magnetic field is recorded and used to estimate their properties and quantify their intracellular hemoglobin (Hb) concentration. We successfully track over 400 RBCs per condition using imaging and trajectory analysis, enabling detailed characterizations of their physical and magnetic properties. A comparison of the mean corpuscular hemoglobin measurements revealed a strong correlation between our CTV system and standard ultraviolet-visible (UV-Vis) spectrophotometry (23.1 ± 5.8 pg vs. 22.4 ± 3.9 pg, p > 0.05), validating the accuracy of our measurements. The system's single-cell resolution reveals population distributions unobtainable through conventional bulk analysis methods. Thus, this portable CTV technology provides a rapid, label-free approach for magnetic cell characterization, offering new possibilities for point-of-care hematological analysis and field-based research applications.

Noninvasive Anemia Detection and Hemoglobin Estimation from Retinal Images Using Deep Learning: A Scalable Solution for Resource-Limited Settings.

The purpose of this study was to develop and validate a deep-learning model for noninvasive anemia detection, hemoglobin (Hb) level estimation, and identification of anemia-related retinal features using fundus images. The dataset included 2265 participants aged 40years and above from a population-based study in South India. The dataset included ocular and systemic clinical parameters, dilated retinal fundus images, and hematological data such as complete blood counts and Hb concentration levels. Eighty percent of the dataset was used for algorithm development and 20% for validation. A deep-convolutional neural network, utilizing VGG16, ResNet50, and InceptionV3 architectures, was trained to predict anemia and estimate Hb levels. Sensitivity, specificity, and accuracy were calculated, and receiver operating characteristic (ROC) curves were generated for comparison with clinical anemia data. GradCAM saliency maps highlighted regions linked to anemia and image processing techniques to quantify anemia-related features. For predicting anemia, the InceptionV3 model demonstrated the best performance, achieving 98% accuracy, 99% sensitivity, 97% specificity, and an area under the curve (AUC) of 0.98 (95% confidence interval [CI] = 0.97-0.99). For estimating Hb levels, the mean absolute error for the InceptionV3 model was 0.58 g/dL (95% CI = 0.57-0.59 g/dL). The model focused on the area around the optic disc and the neighboring retinal vessels, revealing that anemic subjects exhibited significantly increased vessel tortuosity and reduced vessel density (P < 0.001), with variable effects on vessel thickness. The InceptionV3 model accurately predicted anemia and Hb levels, highlighting the potential of deep learning and vessel analysis for noninvasive anemia detection. The proposed method offers the possibility to quantitatively predict hematological parameters in a noninvasive manner.

Transfusion efficacy of leucoreduced packed red blood cells prepared by two different methods: A randomized controlled trial in transfusion-dependent thalassaemia patients (FUEL trial).

Great variations may be observed in the haemoglobin (Hb) content of packed red blood cell (PRBC) units prepared by different methods. This study aimed to assess the Hb increment in thalassaemia major patients transfused with leucoreduced PRBCs (LPRBCs) prepared by two different methods: (i) standard leucoreduced PRBCs (SLPRBCs) and (ii) leucoreduced PRBCs prepared by a new method where leucoreduction of whole blood is done first (NLPRBCs). This prospective, randomized, controlled trial included 80 adult thalassaemia major patients who were randomized into two groups of 40 each. Group I patients received SLPRBC and those of Group II received NLPRBC transfusions for 3 months. SLPRBCs had a mean (±SD) volume of 275.50 ± 17.07 mL, while it was 316.46 ± 1.42 mL for NLPRBCs (p < 0.001). The mean Hb content of SLPRBCs was 50.60 ± 5.12 g, while that of NLPRBCs was 56.98 ± 5.92 g (p < 0.001). The mean Hb increment in Group I patients was 2.11 ± 0.89 g/dL, while that of Group II patients was 2.48 ± 0.88 g/dL (p < 0.001). The mean transfusion interval for Group I patients was 20.30 ± 3.75 days, while it was 21.34 ± 5.13 days for Group II patients (p < 0.045). A significant positive correlation was observed between the Hb dose transfused and the Hb increment with both SLPRBC (ρ = 0.4, p < 0.001) and NLPRBC (ρ = 0.19, p = 0.011) transfusions. NLPRBCs had significantly higher Hb content than the SLPRBCs, leading to a better Hb increment post transfusion, which may potentially prolong the transfusion interval in thalassaemia major patients.

Cerebral Hemodynamic Responses to Disease-Modifying and Curative Sickle Cell Disease Therapies.

Sickle cell disease (SCD) is a hemoglobinopathy resulting in hemoglobin-S production, hemolytic anemia, and elevated stroke risk. Treatments include oral hydroxyurea, blood transfusions, and hematopoietic stem cell transplantation (HSCT). Our objective was to evaluate the neurologic relevance of these therapies by characterizing how treatment-induced changes in hemoglobin (Hb) affect brain health biomarkers. In this interventional study, adults with and without SCD underwent a 3T-MRI at Vanderbilt University Medical Center at 2 time points before and after clinically indicated transfusion or HSCT or at 2 time points without the introduction of a new Hb-altering therapy (adult controls and patients with SCD on hydroxyurea). Cerebral blood flow (CBF; mL/100 g/min) and cerebral venous blood relaxation rate (s-1; a marker of Hb and blood oxygen content) responses were assessed to understand how these markers of brain health vary with Hb modulation. CBF was assessed with arterial spin labeling MRI, and blood relaxation rate was assessed using T2 relaxation under spin tagging MRI. Measures were pairwise compared within each cohort using a 2-tailed Wilcoxon signed-rank test, and regression was applied to evaluate the parameter and Hb change relationships. The significance criterion was 2-sided p < 0.05. Adults with (n = 43; age 28.7 ± 7.7 years; 42% male) and without (n = 13; age 33.5 ± 12.2 years; 46% male) SCD were evaluated. In adults receiving hydroxyurea (n = 10), neither Hb, CBF, nor venous relaxation rate changed between time 1 (Hb = 8.6 ± 1.2 g/dL) and time 2 (Hb = 9.0 ± 1.8 g/dL) (all p > 0.05). In transfusion patients (n = 19), Hb increased from 8.2 ± 1.4 g/dL to 9.3 ± 1.3 g/dL before vs after transfusion (p < 0.001), paralleling a CBF decrease of 14.2 mL/100 g/min (p < 0.001) toward control levels. The venous relaxation rate did not change after transfusion (p = 0.71). In HSCT patients (n = 14), Hb increased from 8.9 ± 1.9 g/dL to 12.9 ± 2.7 g/dL (p < 0.001) before vs after transplant, paralleling CBF decreases from 68.16 ± 20.24 to 47.43 ± 12.59 mL/100 g/min (p < 0.001) and increase in venous relaxation rate (p = 0.004). Across the Hb spectrum, a CBF decrease of 5.02 mL/100 g/min per g/dL increase in Hb was observed. Findings demonstrate improvement in cerebral hemodynamics after transfusion and transplant therapies compared with hydroxyurea therapy; quantitative relationships should provide a framework for using these measures as trial end points to assess how new SCD therapies affect brain health.

Comparison of a non-invasive point-of-care measurement of anemia to conventionally used HemoCue devices in Gambella refugee camp, Ethiopia, 2022.

Annual surveys of refugees in Gambella, Ethiopia suggest that anemia is a persistent public health problem among non-pregnant women of reproductive age (NP-WRA, 15-49 years). Measurement of anemia in most refugee camp settings is conducted using an invasive HemoCue 301. We assessed the accuracy and precision of a non-invasive, pulse CO-oximeter in measuring anemia among NP-WRA in four Gambella refugee camps. We conducted a population-representative household survey between November 7 and December 4, 2022. Hemoglobin (Hb) concentration was measured by HemoCue 301, using capillary blood, and Rad-67, a novel non-invasive device. We collected four measurements per participant: two per device. We calculated Rad-67 bias and precision of Hb measurements and sensitivity and specificity of detecting anemia. Of the 812 NP-WRAs selected, 807 (99%) participated in the study. Anemia was detected in 39% of NP-WRA as classified by the Rad-67 compared with 47% of NP-WRA as classified by the HemoCue 301. Average bias of Rad-67 measurements was 1.1 ± 1.0 SD g/dL, using HemoCue 301 as a comparator. Absolute mean difference between the first and second measurements was 0.9 g/dL (95% CI 0.8, 0.9) using the Rad-67, compared with 0.6 g/dL (95% CI 0.5, 0.6) using the HemoCue 301. The Rad-67 had 49% sensitivity and 70% specificity for detecting anemia, compared with the HemoCue 301. The Rad-67 can be a useful tool for anemia screening; however, lower accuracy and precision, and poor sensitivity suggest it cannot immediately replace the HemoCue 301 in the study area.

Anaemia and iron deficiency in India: a venous blood-based survey of adolescents, adults, and the elderly in eight states.

Surveys based on capillary blood show that anaemia is rampant in India, but capillary blood haemoglobin (Hb) may not accurately reflect venous blood Hb concentrations. Further, iron deficiency (ID) is thought to be the main cause of anaemia, there are no venous blood-based surveys to confirm this. A community-based (urban, slum and rural) cross-sectional, venous blood survey was conducted in eight Indian states to estimate anaemia and ID prevalences from Hb and inflammation-corrected plasma ferritin concentrations in adolescents, adults, and elderly. The prevalence of anaemia was 44%, 41% and 45% in adolescent girls, adult and elderly women respectively, compared to 24%, 21% and 37% in adolescent boys, adult, and elderly men. The overall prevalence varied widely, ranging from 12% in Meghalaya to 70% in Assam. Mild anaemia prevalence was predominant at about half of overall anaemia prevalence. ID-associated anaemia (IDA) prevalence was less than a third of the overall anaemia prevalence, and varied among age and sex groups, approaching 45% only in adolescent girls. IDA prevalence was even lower in the mild anaemia group. Thus, the major proportion of anaemia in all groups was associated with 'other' causes. Anaemia prevalence, when measured by venous blood Hb, was substantially lower than earlier capillary blood-based estimates and was predominantly of the mild variety. The prevalence of IDA was also much lower than anticipated; therefore, the aetiological role of ID appears not to be predominant. These results have policy implications for anaemia prevention and correction at the population level.

Peran Petugas Kesehatan Terhadap Konsumsi Tablet Zat Besi (Fe) Dengan Kejadian Anemia Pada Ibu Hamil Di Wilayah Kerja Puskesmas Kota Bogor

Anemia in pregnant women can be caused by an increase in oxygen demand so that erythropoietin production in the kidneys also increases. This causes red blood cells (erythrocytes) to increase by 20-30%. This increase is not comparable to the progressive increase in plasma volume, which is 40-45%, so that a hemodilution process (blood thinning) occurs which causes a decrease in Hb concentration. This research method is an analytical survey with a Cross-Sectional research design, namely research on the relationship between two variables in a condition or group of individuals. The results of the Chi-Square test obtained a p Value = 0.020 ≤ α (0.05), this shows that there is a relationship between the role of health workers and the consumption of Fe tablets. The conclusion is that as health workers, they can increase their active role in providing counseling, information counseling and education to pregnant women and their families about consuming Fe tablets and especially to pregnant women to consume Fe tablets during pregnancy.

Cerebral tissue oxygen saturation and its potential relationship with neurodevelopmental delay in pediatric liver transplant recipients.

To discover the potential association between diminished intraoperative average SctO2 levels and postoperative neurodevelopmental delays among patients after pediatric living-donor liver transplantation. Patients undergoing living-donor liver transplantation were recruited for this trial. The neurodevelopment status of patients was assessed using the Ages Stages Questionnaires. The primary outcome was the occurrence of neurodevelopmental delay among patients at different intervals following pediatric liver transplantation. Secondary outcomes included the duration of mechanical ventilation, rates of re-intubation, length of ICU stay, postoperative hospitalization, and intraoperative comparisons of mean arterial pressure (MAP), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), and hemoglobin (Hb) concentration. A total of 119 patients were included in the statistical analysis and assigned to high saturation group (HS) and low saturation group (LS) according to the average intraoperative cerebral tissue oxygen saturation values. Following adjustment for PELD scores, significant differences between the two groups were observed for the incidence of neurodevelopmental delay in communication at 1 and 3 months follow-up (P = 0.019 and P = 0.020, respectively), fine motor at six months follow-up (P = 0.014), and problem-solving abilities at one year follow-up (P = 0.047). Moverover, the length of ICU stay (P = 0.009) and postoperative hospitalization (P = 0.029) in LS group were also significant prolonged. This prospective observational study revealed that the patients with low average SctO2 values were more predisposed to experiencing postoperative neurodevelopment delays, suggesting a potential association between decreased average SctO2 and neurodevelopmental delay.

Effects of Electrical Stimulation on Activation of Mirror Neuron Network in Healthy Adults during Motor Execution and Imitation: An fNIRS Study.

Observation, execution, and imitation of target actions based on mirror neuron network (MNN) have become common physiotherapy strategies. Electrical stimulation (ES) is a common intervention to improve muscle strength and motor control in rehabilitation treatments. It is possible to enhance MNN's activation by combining motor execution (ME) and motor imitation (MI) with ES simultaneously. This study aims to reveal whether ES could impact cortical activation during ME and MI. We recruited healthy individuals and assigned them randomly to the control group (CG) or experiment group (EG). Participants in EG performed ME and MI tasks with ES, while participants in CG performed the same two tasks with sham ES. We utilized functional near-infrared spectroscopy (fNIRS) to detect brain activation of MNN during ME and MI with and without ES, a randomized block design experiment paradigm was designed. Descriptive analysis of oxy-hemoglobin (HbO) and deoxy-hemoglobin (HbR) were used to show the hemoglobin (Hb) concentration changes after different event onsets in both CG and EG, a linear mixed-effects model (LMM) of HbO data was employed to analyze the effect of ES on the activation of MNN. A total of 102 healthy adults were recruited and 72 participants' data were analysed in the final report. The block averaged Hb data showed that HbO concentration increased and HbR concentration decreased in most MNN regions during ME and MI in both groups. The LMM results showed that ES can significantly improve the activation of inferior frontal gyrus, middle frontal gyrus, and precentral gyrus during MI, the supplementary motor area, inferior parietal lobule, and superior temporal gyri showed increased activation, but without statistical significance. Although the results did not reach statistical significance during ME, ES still showed positive effects on increased overall activations. In this study, we present potential novel rehabilitation approaches that combines MNN strategies and low-frequency ES to enhance cortical activation. Our results revealed that ES has potential to increase activation of most MNN brain areas, providing evidence for related rehabilitative interventions and device development. This study was registered on the China Clinical Trial Registration Center (identifier: ChiCTR2200064082, registered 26, September 2022, https://www.chictr.org.cn/showproj.html?proj=178285).

Relationship of sKlotho with hemoglobin level in patients undergoing maintenance hemodialysis: a case-control study.

Klotho is a kidney-derived protein that is involved in various kidney diseases. The role of serum soluble Klotho (sKlotho) in the anemia of patients undergoing hemodialysis has not been well characterized. We aimed to characterize the relationship between sKlotho and hemoglobin (Hb) levels in this group of patients. A single-center cross-sectional study of 208 patients undergoing maintenance hemodialysis (MHD) and 50 healthy controls was performed between June 1 and 31, 2023. Demographic information and biomedical parameters, such as age, body mass index, medication use, and their Hb, albumin, interleukin-6, and sKlotho concentrations, were obtained. Patients undergoing MHD were allocated to a group that achieved the Hb target (⩾110 g/L) and a group that did not (<110 g/L). Correlation analysis and multivariate logistic and linear regression analyses were performed to evaluate the relationship of sKlotho with Hb concentration. Participants undergoing MHD had lower Hb and sKlotho concentrations than controls. Those who had not achieved the target Hb level were given fewer erythropoiesis-stimulating agents and had lower sKlotho and albumin concentrations, but higher interleukin-6 concentrations, than those who had achieved the Hb target. The sKlotho concentration positively correlated with the Hb concentration and was inversely associated with the incidence of a lack of achievement of the target Hb level. Multivariate logistic regression models revealed that there was a close association between sKlotho and a lack of achievement of the target Hb level after adjustment for potential confounders (odds ratio: 0.335, 95% confidence interval: 0.142-0.791, p = 0.013). This relationship was closer on multivariate linear regression analysis when sKlotho was included as a continuous variable. The circulating sKlotho concentration is very low, but deficiency of this protein is independently associated with a high risk of anemia in patients undergoing MHD. Therefore, the routine monitoring of sKlotho concentration might be useful in the management of renal anemia in such patients.