Real-world evaluation of safety and effectiveness of ferrous bis-glycinate and its combination in pregnant women with iron deficiency anemia

Background: Iron deficiency is the most common cause of anemia during pregnancy. It leads to adverse outcomes on maternal and infant morbidity/mortality. There is a reduction in hemoglobin levels due to an increase in iron demand during pregnancy. Many pregnant women have poor or depleted iron stores and the amount of iron from the diet together with mobilized stores from the body is insufficient to meet the maternal demands. To meet iron demands, regular iron supplementation is recommended. Conventional iron supplements report frequent gastrointestinal side effects. Therefore, this study aimed to evaluate the safety, effectiveness, tolerability, and compliance of ferrous bis-glycinate and it’s combination for treating iron deficiency anemia during pregnancy. Methods: This was a retrospective analysis of data collected from 34 obstetricians and gynecologists across India, on the use of ferrous bis-glycinate and it’s combination as iron supplementation to pregnant women. The clinical records were analyzed for the objective i.e., rise in hemoglobin, safety, tolerability, and compliance. Results: 374 completed case records forms were considered for the analysis. These pregnant women had taken supplementation with ferrous bis-glycinate and its combination for an average of 58.5 days. The use of ferrous bis-glycinate and it’s combination improved mean hemoglobin concentration from 8.86 gm/dL to 11.27 gm/dL. With respect to safety, 97.6% of pregnant women did not report any adverse events. The remaining 2.4% had mild gastrointestinal side effects. Furthermore, 93% of pregnant women rated the tolerability as very good to good, and >98% of patients complied with >80% of treatment with ferrous bis-glycinate. Conclusions: This retrospective analysis suggests that ferrous bis-glycinate and it’s combination as iron supplementation in pregnancy is safe, effective, and well-tolerated

Fasting increases susceptibility to acute myocardial ischaemia/reperfusion injury through a sirtuin-3 mediated increase in fatty acid oxidation.

Fasting increases susceptibility to acute myocardial ischaemia/reperfusion injury (IRI) but the mechanisms are unknown. Here, we investigate the role of the mitochondrial NAD+-dependent deacetylase, Sirtuin-3 (SIRT3), which has been shown to influence fatty acid oxidation and cardiac outcomes, as a potential mediator of this effect. Fasting was shown to shift metabolism from glucose towards fatty acid oxidation. This change in metabolic fuel substrate utilisation increased myocardial infarct size in wild-type (WT), but not SIRT3 heterozygous knock-out (KO) mice. Further analysis revealed SIRT3 KO mice were better adapted to starvation through an improved cardiac efficiency, thus protecting them from acute myocardial IRI. Mitochondria from SIRT3 KO mice were hyperacetylated compared to WT mice which may regulate key metabolic processes controlling glucose and fatty acid utilisation in the heart. Fasting and the associated metabolic switch to fatty acid respiration worsens outcomes in WT hearts, whilst hearts from SIRT3 KO mice are better adapted to oxidising fatty acids, thereby protecting them from acute myocardial IRI

Severe Exercise and Exercise Training Exert Opposite Effects on Human Neutrophil Apoptosis via Altering the Redox Status

Neutrophil spontaneous apoptosis, a process crucial for immune regulation, is mainly controlled by alterations in reactive oxygen species (ROS) and mitochondria integrity. Exercise has been proposed to be a physiological way to modulate immunity; while acute severe exercise (ASE) usually impedes immunity, chronic moderate exercise (CME) improves it. This study aimed to investigate whether and how ASE and CME oppositely regulate human neutrophil apoptosis. Thirteen sedentary young males underwent an initial ASE and were subsequently divided into exercise and control groups. The exercise group (n = 8) underwent 2 months of CME followed by 2 months of detraining. Additional ASE paradigms were performed at the end of each month. Neutrophils were isolated from blood specimens drawn at rest and immediately after each ASE for assaying neutrophil spontaneous apoptosis (annexin-V binding on the outer surface) along with redox-related parameters and mitochondria-related parameters. Our results showed that i) the initial ASE immediately increased the oxidative stress (cytosolic ROS and glutathione oxidation), and sequentially accelerated the reduction of mitochondrial membrane potential, the surface binding of annexin-V, and the generation of mitochondrial ROS; ii) CME upregulated glutathione level, retarded spontaneous apoptosis and delayed mitochondria deterioration; iii) most effects of CME were unchanged after detraining; and iv) CME blocked ASE effects and this capability remained intact even after detraining. Furthermore, the ASE effects on neutrophil spontaneous apoptosis were mimicked by adding exogenous H2O2, but not by suppressing mitochondrial membrane potential. In conclusion, while ASE induced an oxidative state and resulted in acceleration of human neutrophil apoptosis, CME delayed neutrophil apoptosis by maintaining a reduced state for long periods of time even after detraining

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

A planar anode-supported Solid Oxide Fuel Cell model with internal reforming of natural gas

Solid Oxide Fuel Cells (SOFCs) are of great interest due to their high energy efficiency, low emission level, and multiple fuel utilization. SOFC can operate with various kinds of fuels such as natural gas, carbon monoxide, methanol, ethanol, and hydrocarbon compounds, and they are becoming one of the main competitors among environmentally friendly energy sources for the future. In this study, a mathematical model of a co-flow planar anode-supported solid oxide fuel cell with internal reforming of natural gas has been developed. The model simultaneously solves mass, energy transport equations, and chemical as well as electrochemical reactions. The model can effectively predict the compound species distributions as well as the cell performance under specific operating conditions. The main result is a rather small temperature gradient obtained at 800 °C with S/C = 1 in classical operating conditions. The cell performance is reported for several operating temperatures and pressures. The cell performance is specified in terms of cell voltage and power density at any specific current density. The influence of electrode microstructure on cell performance was investigated. The simulation results show that the steady state performance is almost insensitive to microstructure of cells such as porosity and tortuosity unlike the operating pressure and temperature. However, for SOFC power output enhancement, the power output could be maximized by adjusting the pore size to an optimal value, similarly to porosity and tortuosity. At standard operating pressure (1 atm) and 800 °C with 48% fuel utilization, when an output cell voltage was 0.73 V, a current density of 0.38 A cm-2 with a power density of 0.28 W cm-2 was predicted. The accuracy of the model was validated by comparing with existing experimental results from the available literature

A solid oxide fuel cell micro-scale modeling with spherical particle shaped electrodes

A micro-scale model of a solid oxide fuel cell (SOFC) involving the mass transfer together with the electrochemical reaction, the electron and ion transports through the respective spherically shaped electron- and ion-conducting particles inside the electrodes was mathematically developed. Couples of useful dimensionless parameters were introduced in order to represent the characteristics of the cell. The predicted cell performance was showed according to various operating and design conditions. The effects of micro-scale electrode geometry on the cell performance were also taken into account. Parametric study according to the volumetric fraction of ionic and electronic conducting particles was conducted in order to examine the effects of operating conditions on the cell overpotentials. The study results substantiate the fact that SOFC overpotential could be effectively decreased by increasing the operating temperature as well as operating pressure. This present study reveals the working mechanisms of SOFC at the microscale level, while demonstrating the use of micro-scale relations to enhance the SOFC performance. The accuracy of the presented model was validated by comparing to already existing experimental results from the available literatures

Development of a Dynamic Model of Quality Performance in Thai Construction Industry

Many quality performance tools are implemented in the construction industry to enhance the quality performance standard. This paper utilizes an ISO 9001 standard implementation to develop a dynamic model of construction quality performance in the Thai construction industry. The model consists of five sub-models, namely the Leadership, Plan, Do, Check, and Act sub-models. Five levels of performance maturity are also developed in this study to plan for long-term improvement. The simulation results reveal that a company takes seven years to proceed from level 1 to level 2 of maturity as it lacks experience and knowledge. With more experience, the company progresses through to higher maturity levels in a shorter period of time. The model achieves the perfect implementation score of 1,000 points at the end of year 23. This study results can be used to aid the construction industry in the effective planning for long-term quality improvement

Development of a Dynamic Model of Quality Performance in Thai Construction Industry

Many quality performance tools are implemented in the construction industry to enhance the quality performance standard. This paper utilizes an ISO 9001 standard implementation to develop a dynamic model of construction quality performance in the Thai construction industry. The model consists of five sub-models, namely the Leadership, Plan, Do, Check, and Act sub-models. Five levels of performance maturity are also developed in this study to plan for long-term improvement. The simulation results reveal that a company takes seven years to proceed from level 1 to level 2 of maturity as it lacks experience and knowledge. With more experience, the company progresses through to higher maturity levels in a shorter period of time. The model achieves the perfect implementation score of 1,000 points at the end of year 23. This study results can be used to aid the construction industry in the effective planning for long-term quality improvement