Iron Dose Research Articles

Alternate day versus consecutive day oral iron supplementation in iron-depleted women: a randomized double-blind placebo-controlled study

Guidelines to treat iron deficiency recommend daily provision of oral iron, but this may decrease fractional iron absorption and increase side effects. Our objective was to compare consecutive-day versus alternate-day iron supplementation. In a double-masked, randomized, placebo-controlled trial, young Swiss women (n=150; serum ferritin ≤30μg/L) were assigned to: daily 100mg iron for 90d, followed by daily placebo for another 90d (consecutive-day group) or the same daily dose of iron and placebo on alternate days for 180d (alternate-day group). The study period was 24/11/2021-10/8/2022. Co-primary outcomes, at equal total iron doses, were serum ferritin and gastrointestinal side effects; secondary outcomes were iron deficiency and serum hepcidin. Compliance and side effects were recorded daily using a mobile application. Data were analysed using mixed models and longitudinal prevalence ratios (LPR). The trial was registered at ClinicalTrials.gov (NCT05105438). 75 women were assigned to each group and included in the intention-to-treat analysis. Capsule adherence and side effect reporting was >97% in both groups. At equal total iron doses, comparing consecutive-day and alternate-day groups, median serum ferritin was 43.8μg/L (31.7-58.2) versus 44.8μg/L (33.8-53.6) (P=0.98), the LPR for gastrointestinal side effects on days of iron intake was 1.56 (95% CI: 1.38, 1.77; P<0.0001), and median serum hepcidin was 3.0nM (IQR 2.0-5.0) versus 1.9nM (1.4-2.9) (P<0.0001). Iron deficiency prevalence after 3 months was 5.5% versus 4.3% (P=0.74) and after 6 months was 11.4% and 3.0% (P=0.049). At equal total iron doses, compared to consecutive day dosing of iron, alternate day dosing did not result in higher serum ferritin but reduced iron deficiency at 6 months and triggered fewer gastrointestinal side effects. Swiss National Science Foundation, Bern, Switzerland.

198 Differential Gene Expression and Metabolic Pathway Comparisons of Liver and Duodenum from Suckling Piglets Given One or Two Iron Dextran Injections

Abstract Six female littermate pairs were used in an experiment to evaluate the mRNA expression in tissues from piglets given one or two 1 mL injections of iron dextran (200 mg Fe/mL, Uniferon, Pharmacosmos Inc. Watchung, NJ). All pigs in the litter were administered the first 1 mL injection &amp;lt; 24 hours after birth and on d 7, pigs were paired by body weight (BW; 1.72 ± 0.13 kg) and one pig from each pair was randomly selected as control (CON) and the other received a second injection (+Fe). At weaning on d 22, each piglet was anesthetized, and samples of liver and duodenum were taken from the anesthetized piglets and placed in DNA/RNA Shield (Zymo, Irvine, CA) for preservation until mRNA extraction. RNA-Seq libraries were sequenced to a depth of at least 30 million read pairs (150 bp paired-end sequencing) per sample. Differential Gene Expression data were analyzed with GeneSpring (Agilent, Santa Clara, CA) with a fold-change (FC) of |1.2| P &amp;lt; 0.05 (Table 1). Pathway analysis was conducted with Ingenuity Pathway Analysis (IPA QIAGEN, Redwood City, CA) software with Z-score cutoff of P &amp;lt; 0.05. In the duodenum 435 genes were significantly changed with a FC ≥|1.2| P &amp;lt; 0.05. Most notably, Claudin 1 and Claudin 2 were inversely affected by the second dose of iron. Claudin 1 (CLDN1, FC = 4.48, P = 0.0423) is responsible for cell-to-cell adhesion in the epithelial cell sheets and serves as a barrier to prevent water and solutes from passing through the paracellular space. Claudin 2 (CLDN2, FC = -1.41, P = 0.0097) was down regulated because it is expressed in cation leaky epithelia. In the liver 362 genes were expressed with a FC ≥|1.2| P &amp;lt; 0.05. The gene most affected by a second dose of 200 mg Fe was HAMP (Hepcidin Antimicrobial Peptide) with an FC of 40.8. HAMP is a liver-produced hormone that is the main circulating regulator of Fe absorption and distribution across tissues. It also controls the major flows of Fe into plasma by promoting endocytosis and degradation of ferroportin (SLC4A1). This leads to the retention of Fe in Fe-exporting cells and decreased flow of Fe into plasma. Metabolic pathway changes in the duodenum and liver provide evidence for the improved feed conversion and growth rates in pigs given two iron injections pre-weaning. In the duodenum, there is a down regulation of gluconeogenesis (P &amp;lt; 0.05). Concurrently, there is a decrease in the production of urea in the liver (P &amp;lt; 0.05). These observations show that there is less need for gluconeogenesis, thus less urea production from deaminated amino acids. The genomic and pathway analyses provided empirical evidence linking gene expression with phenotypic observations of piglet health and growth improvements.

Continuous-flow titration of low iron doses to promote photo-Fenton and photo-Fenton-like processes at neutral pH

Photo-Fenton (PF) is a promising process for degrading a wide range of contaminants of emerging concern (CECs) present in urban wastewater (UWW) after secondary treatment, mitigating their spread in aquatic systems. However, the near-neutral pH of UWW poses a challenge to PF performance. In this research, a tubular membrane photoreactor, designed for continuous “titration” of Fe2+, is explored to promote the PF process for the tertiary treatment of UWW. The application of persulfate (PF-like) as an alternative oxidant and the impact of phosphate (PO43−) content in UWW were also assessed. Process efficiency was evaluated in continuous mode, applying low residence times (RT: 6.1, 36.6, and 73.2 s) and low Fe2+ doses (1, 2, and 5 mg L−1), for the oxidation of 19 CECs (each spiked at 10 µg/L), in demineralized water (DW) and secondary-treated UWW. Despite the persistence of certain short-chain perfluoroalkyl substances (PFAS) and saccharine across all conditions tested, the PF-like process exhibited superior performance when compared with PF, attaining higher removals for most target CECs, especially for melamine. In UWW, for an RT = 73.2 s, [Fe2+] = 5 mg L−1, and [oxidant] = 1.2 mM, PF process removed 7 CECs > 60 % and PF-like 10 CECs > 60 %. Moreover, higher residual concentrations of Fe2+ and lower precipitation of PO43− were observed for PF-like treatments, evidencing its advantages for tertiary treatment. These results emphasize the importance of photoreactor design to achieve efficient PF/PF-like at neutral pH, avoiding the use of chelating agents while managing iron concentrations compatible with UWW discharge or reuse limits.

Comparative study of Fe0-H2O2, Fe0-PMS and Fe0-PDS systems for the removal of refractory organics from bio-treated landfill leachate

Aiming at the excellent performance of advanced oxidation technology (AOP) in removing organic matter, the efficiency and mechanism of Fe0 activated H2O2, PMS and PDS in the removal of refractory organic matter in bio-treated landfill leachate (BTL) were systematically compared. The results showed that the removal effect of the three systems on organic matter was affected by the dosage of oxidant, the dosage of zero-valent iron, the initial pH value and the reaction time. After treatment with the three systems, the content of humic substances and aromatic organics in MBR effluent and the degree of molecular polymerization could be effectively reduced. Due to different ROS dominance in the three systems, there were differences in the efficacy of organic matter removal. The activation mechanism of Fe0 included homogeneous activation of Fe2+ and heterogeneous activation of in situ formation of iron oxides. Finally, considering various factors, such as the organic removal effect, oxidant toxicity, sludge yield, economy and potential impact of byproducts, the Fe0-H2O2 system was superior to the other systems in the selection of treating refractory organics in landfill leachate MBR effluent.

Effects of iron supplementation to iron depleted and iron replete pregnant Danish women: Defining criteria for identification of women who can manage without supplements. A randomized, placebo-controlled study.

To define criteria based on iron status parameters for the identification of healthy women who do need/do not need iron supplementation during normal pregnancy. Randomized, double-blind, placebo-controlled study of 113 women (62 iron-, 51 placebo treated) and their newborns. Iron dose was 66 mg elemental iron as ferrous fumarate daily from 14-18 weeks gestation to delivery. Hemoglobin (Hb), serum (S)-ferritin, S-transferrin saturation percentage, and S-erythropoietin were measured during gestation, prepartum, one week and 8 weeks postpartum. The women were divided in groups according to S-ferritin levels at inclusion:<30,≥30,≥40,≥50 and≥60μg/L. Iron deficiency (ID) was defined as S-ferritin < 15μg/L; iron deficiency anemia (IDA) as S-ferritin < 15μg/L and Hb < 110 g/L. Placebo treated women with S-ferritin levels < 30μg/L at inclusion had a much higher incidence of ID/IDA than placebo treated women with S-ferritin levels≥30,≥40,≥50, and≥60μg/L. S-ferritin levels≥40μg/L were associated with a very low risk of ID/IDA and none of the women with levels≥50 and≥60μg/L displayed ID/IDA. Women having S-ferritin < 30μg/L in early pregnancy, have a high risk of ID/IDA and should be recommended ferrous iron supplements in appropriate doses. With increasing iron reserves, i.e., increasing S-ferritin, the need for iron supplements diminishes, and placebo treated women having S-ferritin ≥40μg/L seldom develop IDA. Women with S-ferritin levels≥50 and≥60μg/L or higher, have adequate iron reserves and do not need routine iron prophylaxis in pregnancy. The results support the arguments for an individual iron supplementation guided by iron status, to avoid unwanted side effects of unnecessary iron intake.

Iron Deficiency Anemia in Pregnancy after Bariatric Surgery: Etiology, Risk Factors, and How to Manage It

Abstract Objective Pregnancy after bariatric surgery is a reality of the 21st century and therefore is essential that all obstetricians know how to manage it. The most prevalent nutritional deficiency is iron deficiency and, consequently, anemia. Although bariatric surgery and pregnancy are already risk factors for anemia, we evaluated in our study if there were any other risk factors and actions to improve hemoglobin levels in this population. Methods We performed a retrospective cohort study, and performed frequency measurements and analyzes of odds ratio, X2 and Fisher exact test to evaluate the risk factors. Results We evaluated 44 pregnancies after bariatric surgery, with an incidence of anemia of 62%, and the only identifiable risk factor for anemia was being black. As for the treatment, the iron salt used for oral supplementation did not associate with anemia risk, and in 27% of the patients, the adjustment of the oral dosage was enough for improvement in hemoglobin levels, but in 36% supplementation with intravenous iron was necessary. Conclusion Being black is a risk factor for anemia. The type of iron salt does not correlate with the incidence of anemia, and for the treatment and improvement of iron dosages, it seems an effective increase in iron intake.

Influence of iron nanoparticles on rice (Oryza sativa) plant growth and yields

Alleviating iron (Fe) deficiency in soil and enhancing Fe content in edible portions by using conventional supplements pose challenges. In this context, a greenhouse experiment was conducted during the kharif season of 2018 to evaluate the impact of iron dose and source, specifically nano Fe2O3 and FeSO4, on rice root growth and yields. Results showed that foliar application of 0.2% Fe through FeSO4 and 0.2% Fe through nano Fe2O3 significantly increased the mean root length by 9.5% and 10.1%, respectively, alongside increasing the mean root surface area by 8.8% and 7.3%, respectively, over control. However, the soil application of Fe (3 mg Fe/kg and 0.6 mg Fe/kg through nano Fe2O3 was ineffective in enhancing the rice root length and surface area. In contrast to the root parameters, nano Fe2O3 treatment did not have any significant improvement in grain and straw yield. The addition of Fe through FeSO4 .7H2O led to a noteworthy 24% and 33% increase in grain yield at 0.2% Fe (foliar) and 15 mg Fe/kg (soil), respectively. Similarly, the straw yield saw a corresponding increase of 39% and 34%, respectively, over control. Moreover, the application of FeSO4 and nano Fe2O3 resulted in Fe content registering 1.89 and 1.50 times higher than the control (93 mg/kg). Conversely, lower doses of nano Fe2O3 exhibited no influence on ferrous ion content, DTPA-Fe levels, or yield through both foliar and soil applications.

82 Management of Very Severe Iron Deficiency Anemia: Is Transfusion Always Necessary?

Abstract Background Paediatric iron deficiency anemia (IDA) is a common condition in Canadian children; however, little is known about the natural history of extreme cases. This deficit makes it challenging to determine how to approach management when these patients present acutely to the emergency department (ED). Objectives To describe the clinical features and management of children presenting to the ED with very severe IDA with hemoglobin &amp;lt; 40 g/L. Design/Methods Retrospective chart reviews were performed for paediatric patients with IDA and hemoglobin &amp;lt; 40 g/L over a 5-year period (June 2017 – June 2022) at a Canadian tertiary care children’s hospital. Results Chart reviews were completed for 19 patients. The mean case rate was 3.1 patients annually (SD 2.14) with 11(58%) presenting in 2021–2022. Patients were young (median age 24 months; IQR 18–32) and predominantly female (79%). Nutritional deficiencies were the most common etiology (n=16, 84%). Median presenting hemoglobin was 25 g/L (IQR 22–36 g/L). The most common clinical features documented at presentation were pallor (n=19, 100%), tachycardia (n=17, 89%), and systolic ejection murmur (n=14, 74%). Thirteen (68%) patients had a ferritin measured in ED, 11(58%) had a chest x-ray, four (21%) had a lactate measured. One (5%) patient had an echocardiogram, and four (21%) had bedside cardiac ultrasounds documented. Eight (42%) patients with median hemoglobin 35 g/L (IQR 25–36 g/L) were managed without blood transfusion (PO iron only: n=3, 16%; IV iron only: n=5, 26%). Of the 11 (63%) patients who received blood, 2 (18%) had transfusion-related adverse events, with one patient undergoing intubation for transfusion-associated circulatory overload while admitted. All patients (100%) were initiated on oral iron supplementation. Ten patients (53%) received intravenous (IV) iron (dose 5–7 mg/kg) with one experiencing a mild reaction. Fifteen patients (79%) were hospitalized, with two (10%) admitted directly to the Paediatric Intensive Care Unit. Median duration of hospitalization was 5 days (IQR 2–9 days). Patients followed after transfusion-free management (n=5) demonstrated median hemoglobin increase of 21 g/L (IQR 20–32 g/L) within 12 days. No patient returned to the ED for anemia within 30 days. Conclusion Paediatric patients with very severe IDA do not always require transfusion. Some patients were effectively managed with IV iron alone. Investigation and management of these patients appears heterogenous. Given the risks of blood transfusion and the increased availability of IV iron, guidelines outlining evidence-based management of severe IDA are needed. These guidelines should promote optimization of iron therapy and guide judicious administration of blood transfusion.

Level and factors associated with compliance to iron-folic acid supplementation among pregnant women in rural Soro district, Hadiya Zone, Ethiopia: cross-sectional study

BackgroundDespite the advantages of iron and folic acid supplementation, the compliance status among pregnant women for the supplements is very low in Ethiopia. However, the factors found to be associated with the compliance of iron and folic acid supplementation varies depending on geographical locations and socio-cultural characteristics within the country. Therefore, this study assessed the compliance to iron and folic acid supplements and its associated factors among pregnant women in the rural Soro district, Hadiya Zone, Southern Ethiopia.MethodsCross-sectional study design was applied to conduct the study. The total sample size was 274. This study was conducted from June 10 up to 20, 2018. Women who live in rural Soro district at least for 6months and gave live birth 12 months prior to the survey were included in the study. The study subjects were selected by applying the simple random sampling method. Independent variables with p-value less than or equal to 0.25 during bivariate analysis were candidate for multivariable analysis. Finally, during multivariable analysis the independent variables with P-value less than 0.05 were declared as factors significantly associated with compliance to iron-folic acid supplementation during pregnancy.ResultsOf the whole study participants only 51(18.8%) women had taken iron folic acid supplements for at least 90 days during their last pregnancy. Women who had frequent visits to health facilities for ante natal care were more likely to be compliant with iron-folic acid supplements than their counterparts [AOR(95%CI) = 4.50(1.18, 17.14)].ConclusionIn this study, the higher proportion of pregnant women did not take adequate dose of iron and folic acid tablets during their last pregnancy. Women who had a frequent visit to health facilities for antenatal care were more likely to be compliant for iron folic acid supplements than their counterparts. Every effort should be made in the community and health facilities by concerned bodies working in the maternal health area to mobilize pregnant women to take the antenatal care for at least four times to achieve the minimum dose of iron and folic acid supplements.

Market Competition and Anemia Management in the United States Following Dialysis Payment Reform.

Whether market competition influences health care provider responses to national reimbursement reforms is unknown. We examined whether changes in anemia management after the expansion of Medicare's dialysis payment bundle varied with market competition. With data from the US dialysis registry, we used a difference-in-differences (DID) design to estimate the independent associations of market competition with changes in anemia management after dialysis reimbursement reform. A total of 326,150 patients underwent in-center hemodialysis in 2009 and 2012, representing periods before and after reimbursement reform. Outcomes were erythropoiesis-stimulating agent (ESA) and intravenous iron dosage, the probability of hemoglobin <9g/dL, hospitalizations, and mortality. We also examined serum ferritin concentration, an indicator of body iron stores. We used a dichotomous market competition index, with less competitive areas defined as effectively having <2 competing dialysis providers. Compared with areas with more competition, patients in less competitive areas had slightly more pronounced declines in ESA dose (60% vs. 57%) following reimbursement reform (DID estimate: -3%; 95% CI, -5% to -1%) and less pronounced declines in intravenous iron dose (-14% vs. -19%; DID estimate: 5%; 95% CI, 1%-9%). The likelihoods of hemoglobin <9g/dL, hospitalization, and mortality did not vary with market competition. Serum ferritin concentrations in 2012 were 4% (95% CI, 3%-6%) higher in less competitive areas. After the expansion of Medicare's dialysis payment bundle, ESA use declined by more, and intravenous iron use declined by less in concentrated markets. More aggressive cost-reduction strategies may be implemented in less competitive markets.

Incidence of Hypophosphatemia After Intravenous Administration of Iron: A Matching-Adjusted Indirect Comparison of Data from Japanese Randomized Controlled Trials.

Intravenous (IV) administration of iron is considered a safe and efficacious treatment for iron deficiency anemia (IDA), recommended in patients requiring rapid replenishment of iron, or intolerant or unresponsive to oral administration of iron. Recent randomized controlled trials (RCTs) have shown high incidence of hypophosphatemia after administration of two IV iron preparations: saccharated ferric oxide (SFO) and ferric carboxymaltose (FCM). The present study aimed to conduct matching-adjusted indirect comparison (MAIC) of hypophosphatemia incidence with these iron formulations and ferric derisomaltose (FDI) based on data from head-to-head RCTs conducted in Japan. A MAIC of hypophosphatemia incidence was conducted on the basis of data from two head-to-head RCTs. The relative odds of hypophosphatemia with FDI versus SFO were obtained from patient-level data from a recent RCT and adjusted for cumulative iron dose, while parametric models of serum phosphate levels from a separate RCT were used to estimate the relative odds of hypophosphatemia with FCM with SFO. An anchored MAIC was then conducted comparing FDI with FCM. The adjusted odds of experiencing hypophosphatemia were significantly lower with FDI than SFO [odds ratio (OR) of 0.02; 95%confidence interval(CI) 0.01-0.05]. The parametric models of serum phosphate from the RCT comparing FCM with SFO provided an estimated OR of 1.17 for the incidence of hypophosphatemia with FCM versus SFO. Combining the two estimates in the MAIC showed that the odds of experiencing hypophosphatemia would be 52.5 (95%CI 27.7-99.4) times higher with FCM than FDI in patients with IDA associated with heavy menstrual bleeding in Japan. Direct comparison of patient-level data and a MAIC from two RCTs in Japanese patients with heavy menstrual bleeding indicated that hypophosphatemia is less frequent in patients treated with FDI than those with FCM or SFO. Results are in agreement with RCTs comparing FDI and FCM in patients with various etiologies conducted in the USA and Europe.

Анализ референтных доз химических соединений, поступающих перорально с питьевой водой

At present, many researchers highlight that the risk assessment methodology is rather static in Russian regulatory documents. This goes for both the essence of chemical exposures and reference doses stipulated for chemicals introduced into the body with drinking water. In this study, we aimed to analyze reference doses of chemicals introduced into the body with drinking water. Our research object was represented by the basic list of indicators that describe drinking water safety as per its chemical structure. Comparative analysis of reference doses of chemicals and their evidence base relied on the valid regulatory documents, Information System for Risk Assessment open-access electronic database on effects of environmental chemicals on health, and background research articles. The results obtained by assessing combined effects of chemicals on human health were generalized and visualized in MS Excel and a tool for working with graphs. The overall time period when reference doses of the analyzed chemicals were last revised was between 1987 and 2012. Not all health effects suggested in the Russian Guide on risk assessment are used as a basis for calculating reference doses of chemicals; hence, not all of them can be agreed upon on the international level at present since they do not rely on background research. Changes in reference doses occurred for chlorinated organic compounds (bromdichloromethane, tetrachloroethylene, tetrachloromethane, and trichloroethylene), lithium, cadmium, cobalt, iron, and copper. We identified certain limitations in establishing an oral reference dose of iron and ammonia, which are conventionally considered from organoleptic perception. Due to various reasons, we did not find any adequate data obtained by toxicological studies that would substantiate reference doses for copper, magnesium, ammonia, lead, silicon, bromine, and chromium under oral introduction with drinking water. We recommend considering our research data on reference doses when planning a study with its focus on impacts exerted by drinking water quality on public health and employing the risk assessment methodology to analyze oral chemical exposure.

Analysis of reference doses of chemicals introduced with drinking water

At present, many researchers highlight that the risk assessment methodology is rather static in Russian regulatory documents. This goes for both the essence of chemical exposures and reference doses stipulated for chemicals introduced into the body with drinking water. In this study, we aimed to analyze reference doses of chemicals introduced into the body with drinking water. Our research object was represented by the basic list of indicators that describe drinking water safety as per its chemical structure. Comparative analysis of reference doses of chemicals and their evidence base relied on the valid regulatory documents, Information System for Risk Assessment open-access electronic database on effects of environmental chemicals on health, and background research articles. The results obtained by assessing combined effects of chemicals on human health were generalized and visualized in MS Excel and a tool for working with graphs. The overall time period when reference doses of the analyzed chemicals were last revised was between 1987 and 2012. Not all health effects suggested in the Russian Guide on risk assessment are used as a basis for calculating reference doses of chemicals; hence, not all of them can be agreed upon on the international level at present since they do not rely on background research. Changes in reference doses occurred for chlorinated organic compounds (bromdichloromethane, tetrachloroethylene, tetrachloromethane, and trichloroethylene), lithium, cadmium, cobalt, iron, and copper. We identified certain limitations in establishing an oral reference dose of iron and ammonia, which are conventionally considered from organoleptic perception. Due to various reasons, we did not find any adequate data obtained by toxicological studies that would substantiate reference doses for copper, magnesium, ammonia, lead, silicon, bromine, and chromium under oral introduction with drinking water. We recommend considering our research data on reference doses when planning a study with its focus on impacts exerted by drinking water quality on public health and employing the risk assessment methodology to analyze oral chemical exposure.

Fortification of condiments and seasonings with iron for preventing anaemia and improving health.

Fortification of condiments and seasonings with iron for preventing anaemia and improving health.

Responses of Phaseolus vulgaris towards Zinc and Iron Management in Soil with respect to Growth, Pigments and Protein Contents

An experiment was conducted to study the effect of various zinc amendment levels as well as interactions with iron doses in soil on the growth of plant (length and dry weight), some biochemical parameters such as plant pigments, protein contents, and activity of some enzymes such as catalase and peroxidase in Phaseolus vulgaris (French bean). The amendment of zinc and iron was made as Native soil, 5mg ZnSO4, 25 mg ZnSO4, 50 mg ZnSO4 and 100 mg kg-1 ZnSO4 in soil and their interactive doses with FeSO4 was made as Native soil, 25 mg FeSO4, 25 mg FeSO4 + 25 mg ZnSO4, 50 mg FeSO4 + 5 mg ZnSO4 and 25 mg FeSO4 + 50 mg kg-1 ZnSO4 in soil. The experiment was conducted in triplicates. The maximum value of the dry weight, pigments, and protein content was found at the application of 50 mg kg-1 ZnSO4 + 25 mg kg-1 FeSO4 in soil. The increase in dry weight, total chlorophyll, and protein contents by 48, 44.4, and 37.3 were observed maximum in French bean at the application of 50 mg kg-1 ZnSO4 soil and 25 mg kg-1 FeSO4 in the soil. Maximum tissue accumulation of Fe was found at the high dose of Fe with low Zn-dose, the tissue accumulation showed antagonistic effects of zinc and iron.

Saline bolus for negative contrast perfusion imaging in magnetic particle imaging.

Objective.Magnetic particle imaging (MPI) is capable of high temporal resolution measurements of the spatial distribution of magnetic nanoparticles and therefore well suited for perfusion imaging, which is an important tool in medical diagnosis. Perfusion imaging in MPI usually requires a fresh bolus of tracer material to capture the key signal dynamics. Here, we propose a method to decouple the imaging sequence from the injection of additional tracer material, without further increasing the administered iron dose in the body with each image.Approach.A bolus of physiological saline solution without any particles (negative contrast) diminishes the steady-state concentration of a long-circulating tracer during passage. This depression in the measured concentration contributes to the required contrast dynamics. The presence of a long-circulating tracer is therefore a prerequisite to obtain the negative contrast. As a quantitative tracer based imaging method, the signal is linear in the tracer concentration for any location that contains nanoparticles and zero in the surrounding tissue which does not provide any intrinsic signal. After tracer injection, the concentration over time (positive contrast) can be utilized to calculate dynamic diagnostic parameters like perfusion parameters in vessels and organs. Every acquired perfusion image thus requires a new bolus of tracer with a sufficiently large iron dose to be visible above the background.Main results.Perfusion parameters are calculated based on the time response of the proposed negative bolus and compared to a positive bolus. Results from phantom experiments show that normalized signals from positive and negative boli are concurrent and deviations of calculated perfusion maps are low.Significance.Our method opens up the possibility to increase the total monitoring time of a future patient by utilizing a positive-negative contrast sequence, while minimizing the iron dose per acquired image.

A Study to assess the Maternal Health among the Primipara Mothers in selected Hospital at Mysuru

BACKGROUND AND OBJECTIVES: The aim of study was to assess the maternal health among primipara mothers in selected hospital at Mysuru. OBJECTIVES: 1. To assess the maternal health. 2. To find the association between maternal health with obstetrical history of mothers. METHODS: In this study, descriptive design was used and non-probability convenient sampling technique was adopted to select primipara mothers from selected Hospital at Mysuru. Pilot study was conducted, the tool and study design were found to be feasible. Maternal health of primipara mothers were assessed by using checklist and interview method. was validated by experts and reliability was established by rater inter rated method. The data were collected and analysed using descriptive and inferential statistics. RESULT: The study results revealed that, majority 56% of the mothers age ranges between 24-29 years; majority 90% of the mother has initiated their antenatal visit before 12 weeks of gestation; all the mothers had taken both dose of TD vaccine, iron, folic acid and calcium tablet intake during pregnancy; Most of the mothers i.e. 52% have gained their weight in between 10-14 kg of her weight during her pregnancy; majority 55% of the mothers had undergone for cesarean section; most of the baby’s health condition was healthy. There was no statistically significant association found between maternal health of mothers with initiation of antenatal care, total weight gain of mother in kg, height of the mother in cm, conception of pregnancy and week of gestation at birth except with type of delivery ꭓ2 14.91 and condition of baby at birth ꭓ2 4.84 found to be significant at 0.05 level of significance. CONCLUSION: The study concluded that, there is association between Maternal health with obstetrical history of mother with type of delivery and condition of baby at birth. Hence, maternal health has influence the obstetrical history of mothers.

Study on Treatment Performance of Desulfurization Wastewater by Zero-Valent Iron Fenton-like Process

In this study, the zero-valent iron Fenton reagent (ZVI Fenton-like) system was combined with the chemical precipitation method for the deep treatment of desulfurization wastewater from coal-fired power plants, and the chemical oxygen demand (COD) was used as the evaluation criterion for organic matter in the desulfurization wastewater. The effects of reaction time, H2O2 dosage, zero-valent iron dosage, pH, and reaction temperature were also investigated. The results showed that the COD concentration of the effluent was the lowest when the running time of the ZVI Fenton-like reagent system was 1 h, the dosage of H2O2 was 33.3 mg·L−1, the dosage of iron was 0.075 g·L−1, the pH was 4.5~6.5, the reaction temperature was 35 °C, the COD concentration of the wastewater was the lowest and its operating conditions were the best, and the internal reaction mechanism was finally deduced. In summary, the zero-valent iron Fenton reagent system provides a new idea for the treatment of desulfurization wastewater from coal-fired power plants.

Membrane-assisted reactive crystallisation for the recovery of dissolved phosphorus in vivianite form from liquid effluents

Novel membrane crystallisation processes resolve the mixing challenge on conventional crystallisers, by providing fixed interfacial area over which supersaturation is controlled for nucleation. Moreover, the membrane surface is thought to reduce interfacial energy and encourage micromixing. In this regard, a novel membraneassisted reactive crystallisation (MARC) process was used in this work for the dissolved phosphorous recovery in form of vivianite crystals from a phosphate-rich solution by means of the dosing of iron (II). To characterise the role of the boundary layer in controlling nucleation, a batch lab-scale system was used for the crystallization tests, and different hydraulic conditions (Reynolds ranging from 105 to 395) and polymeric membranes were tested. The crystallisation process was influenced by the hydraulic conditions, in which a low liquid velocity led to a lower induction time and vivianite supersaturation, and therefore, higher nucleation rates. Membrane properties were characterised to establish their role in the modification of the critical free energy requirement for nucleation, and for the promotion of micromixing, as possible factors that can be used to modify nucleation kinetics. As result, the bulk induction time tended to decrease with the increase in membrane hydrophobicity, roughness, pore size and porosity. Spherical vivianite nanoparticles were always synthesised with a mean size around 35 nm and a narrow distribution independently of the hydraulic conditions and membrane used. Finally, the crystallisation kinetic conformed to a diffusion-dependent nucleation mechanism, in which higher residence times for mixing increased the ion collision probability for nucleation. Importantly, this study demonstrated that MARC is an attractive prospect for nutrient recovery from wastewaters where crystal nucleation can be easily controlled by setting the operational conditions and membrane properties, eliciting considerable process intensification over existing conventional crystalliser.

Perioperative Transfusions in Veterans Following Noncardiac Procedures.

Background: Perioperative blood transfusions are associated with increased morbidity and mortality. Each surgical specialty is associated with unique operative variables. Moreover, transfusion rates vary across specialty. This article seeks to elucidate variables both common and unique to surgical specialties. Materials and Methods: This study was a retrospective review of 5344 patients from the prospectively maintained Veterans Affairs Surgical Quality Improvement Project at a single-level 1A tertiary Veterans Affairs Medical Center. Data collected included demographic information, preoperative clinical variables, postoperative outcomes, and perioperative transfusion (within 72 hours of procedure). Patients were stratified based on whether they received a transfusion. Univariate and multivariate analyses were performed. P values <.05 were significant. Results: Of the 5344 patients included in the study, 153 required perioperative transfusion of at least one unit of packed red blood cells. Patients who underwent transfusion were more likely to be men, have an underlying bleeding disorder, and have more preoperative risk factors. Although unique risk factors were found within most specialties, there was no statistically significant difference in postoperative complications between surgical specialties. Patients requiring transfusion had higher rates of morbidity and mortality. Elevated preoperative hematocrit was significantly protective against requiring transfusion across most specialties. Conclusions: Specialty-based differences in transfusion requirement may be due to the proportion of older and more frail patients, hospital transfusion thresholds, and surgical complexity. Hematocrit, however, could be an effective target for mitigating cost and morbidity associated with transfusion. Preoperative hematocrit optimization through B12, folate, iron dosing, and erythropoietin supplementation could be a useful strategy.