Maternal hemoglobin and iron status in early pregnancy and risk of respiratory tract infections in childhood:A population-based prospective cohort study

Background: Maternal hemoglobin and iron status measures during pregnancy might affect the developing fetal respiratory system leading to adverse respiratory conditions. Our aim was to assess the associations of maternal hemoglobin and iron status measures during pregnancy with the risk of respiratory tract infections in children until 10 years of age. Methods:In a population-based cohort study among 5134 mother–child pairs, maternal hemoglobin and iron status including ferritin, transferrin, and transferrin saturation were measured during early pregnancy. In children, physician-attended respiratory tract infections from age 6 months until 10 years were assessed by questionnaires. Confounder-adjusted generalized estimating equation modeling was applied. Results: After taking multiple testing into account, high maternal ferritin concentrations and low maternal transferrin saturation during pregnancy were associated with an overall increased risk of upper, not lower, respiratory tract infections until age 10 years of the child [OR (95% CI: 1.23 (1.10, 1.38) and 1.28 (1.12, 1.47), respectively)]. High maternal transferrin saturation during pregnancy was associated with a decreased and increased risk of upper respiratory tract infections at 1 and 6 years, respectively, [OR (95% CI: 0.60 (0.44, 0.83) and 1.54 (1.17, 2.02))]. Observed associations were suggested to be U-shaped (p-values for non-linearity ≤.001). Maternal hemoglobin and iron status measures during pregnancy were not consistently associated with child's gastroenteritis and urinary tract infections, as proxies for general infection effects. Conclusion: High maternal ferritin and low transferrin saturation concentrations during early pregnancy were most consistently associated with an overall increased risk of child's upper, not lower, respiratory tract infections.</p

External oligonucleotide standards enable cross laboratory comparison and exchange of real-time quantitative PCR data

The quantitative polymerase chain reaction (qPCR) is widely utilized for gene expression analysis. However, the lack of robust strategies for cross laboratory data comparison hinders the ability to collaborate or perform large multicentre studies conducted at different sites. In this study we introduced and validated a workflow that employs universally applicable, quantifiable external oligonucleotide standards to address this question. Using the proposed standards and data-analysis procedure, we obtained a perfect concordance between expression values from eight different genes in 366 patient samples measured on three different qPCR instruments and matching software, reagents, plates and seals, demonstrating the power of this strategy to detect and correct inter-run variation and to enable exchange of data between different laboratories, even when not using the same qPCR platform

Ethnic differences in adverse iron status in early pregnancy: a cross-sectional population-based study

We studied ethnic differences in terms of iron status during pregnancy between Dutch women and other ethnicities and explore to what extent these differences can be explained by environmental factors. This cross-sectional population-based study (2002–2006) was embedded in the Generation R study and included a total of 4737 pregnant women from seven ethnic groups (Dutch, Turkish, Moroccan, Cape Verdean, Surinamese-Hindustani, Surinamese-Creole and Antillean). Ethnicity was defined according to the Dutch classification of ethnic background. Ferritin, iron and transferrin were measured in early pregnancy. The overall prevalence of iron deficiency was 7 %, ranging from 4 % in both Dutch and Surinamese-Creoles, to 18 % in Turkish, Moroccan and Surinamese-Hindustani women. Iron overload was most prevalent in Surinamese-Creole (11 %) and Dutch (9 %) women. Socioeconomic factors accounted for 5–36 % of the differences. Income was the strongest socioeconomic factor in the Cape Verdean and Surinamese-Hindustani groups and parity for the Turkish and Moroccan groups. Lifestyle determinants accounted for 8–14 % of the differences. In all groups, the strongest lifestyle factor was folic acid use, being associated with higher iron status. In conclusion, in our population, both iron deficiency and iron overload were common in early pregnancy. Our data suggest that ethnic differences in terms of socioeconomic and lifestyle factors only partly drive the large ethnic differences in iron status. Our data support the development of more specific prevention programmes based on further exploration of socioeconomic inequities, modifiable risk and genetic factors in specific ethnic subgroups, as well as the need for individual screening of iron status before supplementation

Opportunities and Challenges of Prognostic Models for Extremely Preterm Infants

Predicting the short- and long-term outcomes of extremely preterm infants remains a challenge. Multivariable prognostic models might be valuable tools for clinicians, parents, and policymakers for providing accurate outcome estimates. In this perspective, we discuss the opportunities and challenges of using prognostic models in extremely preterm infants at population and individual levels. At a population level, these models could support the development of guidelines for decisions about treatment limits and may support policy processes such as benchmarking and resource allocation. At an individual level, these models may enhance prenatal counselling conversations by considering multiple variables and improving transparency about expected outcomes. Furthermore, they may improve consistency in projections shared with parents. For the development of prognostic models, we discuss important considerations such as predictor and outcome measure selection, clinical impact assessment, and generalizability. Lastly, future recommendations for developing and using prognostic models are suggested. Importantly, the purpose of a prognostic model should be clearly defined, and integrating these models into prenatal counselling requires thoughtful consideration.</p

Spirometric phenotypes from early childhood to young adulthood : a Chronic Airway Disease Early Stratification study

Acknowledgements Cohort-specific acknowledgements are presented in the supplementary material. We also acknowledge collaboration with the EXPANSE consortium (funded by the EU H2020 programme, grant number 874627). We thank Elise Heuvelin, European Respiratory Society, Lausanne, Switzerland, for her assistance on the current project.Peer reviewedPublisher PD

Flow cytometric immunobead assay for fast and easy detection of PML-RARA fusion proteins for the diagnosis of acute promyelocytic leukemia

The PML-RARA fusion protein is found in approximately 97% of patients with acute promyelocytic leukemia (APL). APL can be associated with life-threatening bleeding complications when undiagnosed and not treated expeditiously. The PML-RARA fusion protein arrests maturation of myeloid cells at the promyelocytic stage, leading to the accumulation of neoplastic promyelocytes. Complete remission can be obtained by treatment with all-trans-retinoic acid (ATRA) in combination with chemotherapy. Diagnosis of APL is based on the detection of t(15;17) by karyotyping, fluorescence in situ hybridization or PCR. These techniques are laborious and demand specialized laboratories. We developed a fast (performed within 4-5 h) and sensitive (detection of at least 10% malignant cells in normal background) flow cytometric immunobead assay for the detection of PML-RARA fusion proteins in cell lysates using a bead-bound anti-RARA capture antibody and a phycoerythrin-conjugated anti-PML detection antibody. Testing of 163 newly diagnosed patients (including 46 APL cases) with the PML-RARA immunobead assay showed full concordance with the PML-RARA PCR results. As the applied antibodies recognize outer domains of the fusion protein, the assay appeared to work independently of the PML gene break point region. Importantly, the assay can be used in parallel with routine immunophenotyping for fast and easy diagnosis of APL

Extended insight in effects of exogenous factors before and at slaughter on pork quality

Nowadays the pork industry is facing an intensified export competition, pushing the industry to look for procedures which improve the production efficiency as well as the product quality. Furthermore, consumers’ choices are more often driven by the pork quality and the way food is produced, taking into account sustainability aspects, such as animal welfare, health and the ecological footprint. This manuscript conducts analyses of certain aspects of the pork production, aiming to propose procedures to achieve higher pork quality, which is the common interest of industry and consumers. This study presents that almost 20% of the pork produced in Belgium, has an inferior pork quality resulting in significant production losses. The most prevalent defect in pork that strikes the pork industry in Belgium, is Pale, Soft and Exudative meat (PSE meat). This pork quality condition is known to be caused by acute stress prior to slaughter. Piétrain-sired pigs, the most popular pig breed in Belgium for its high lean meat percentage, are genetically susceptible to stress due to a gene mutation and thus have a higher likelihood of developing PSE meat. Acute stress accelerates the glycolysis in the muscles. This metabolism operates anaerobically whereby more H+ protons and heat, originating from ATP hydrolysis, are produced, which in turn results in a faster drop of the meat pH leading to PSE meat. This defect can be detected by measuring the meat pH 30 minutes post-mortem. The recommended muscle to detect PSE meat, is the Musculus Longissimus thoracis, a glycolytic muscle, which is more sensitive to develop a fast pH drop 30 minutes after sticking (pH30LT). In this dissertation, it was investigated whether a sound level above 85 dB(A), determined in scientific literature as the critical sound level inducing stress in pigs, has also an effect on the prevalence of PSE meat. Sound levels were recorded during four pre-slaughter phases: firstly after arrival of the truck at the slaughterhouse, just before unloading, secondly during unloading, thirdly in lairage and finally while moving to the stunner. The pH30LT of the observed carcasses was measured. The results determine that maintaining the mean sound level below the cut-off value of 85 dB(A) during the pre-slaughter phases, not only controls the pigs’ stress level, as indicated in literature, but can be associated with a slower drop of the pH30LT. Furthermore, a sound level model indicates that sound levels during lairage and prior to stunning have statistically a higher impact on pH30LT of pork compared to sound levels during the other phases. Along with sound levels, various pre-slaughter environmental and handling variables were recorded during each pre-slaughter phase. Based on statistical analysis of the collected data, variables which significantly influence the pH30LT could be determined. The results were used to infer a checklist with critical control points to represent and predict PSE traits of pork for all kind of pre-slaughter situations. The checklist presents that the pork quality is influenced by factors of each pre-slaughter phase, but the impact is more decisive for variables measured closer to the stunning phase. In a later stage of this research, the scope was extended to investigate handling procedures during loading prior to transport to the slaughterhouse. The environmental and handling variables, as in the study of previous phases, were monitored. Likewise, the pH30LT was measured from the examined pigs. The data from the loading phase was used to complete the sound level model and the checklist for the entire pre-slaughter process. This research determines that sound level fluctuations during loading, the difference in environmental temperature during loading and lairage, and the feed withdrawal period also influence the risk of developing PSE meat. The efficiency of high quality pork production could benefit from a methodology prior to stunning that assesses the risk of developing pork with PSE characteristics. Therefore, a new methodology which can give an indication about the pork quality prior to slaughter, is proposed in this thesis. Since body temperature is related to the stress status of the pigs, it was investigated if rectal temperature of pigs before stunning (TempRLairage) and the core temperature of the ham, measured 30 minutes after slaughter (Temp30Ham), were correlated with the pH30LT. The results present a significant positive linear correlation between TempRLairage and Temp30Ham. Furthermore, pH30LT was negatively related to Temp30Ham and TempRLairage. Based on the conducted analysis, it can be concluded that the risk to develop PSE meat can be estimated by the pig’s rectal temperature just before stunning. This research is a very important first step towards the development of an online non-invasive method, e.g. an infrared camera, as measuring rectal temperature may also induce stress. The cooked ham production struggles with the presence of destructured zones, resulting in high slicing losses. Scientific literature describes that these destructured zones are strongly associated with PSE meat. As this research established a negative linear correlation between Temp30Ham and pH30LT, it was further investigated whether it was possible to select fresh ham based on Temp30Ham, to produce cooked ham with a minimum percentage of slicing losses. Results present that hams, suitable for the production of cooked hams, can be selected by measuring Temp30Ham. In summary, this thesis provides slaughterhouses and stakeholders with essential information and practical guidelines on minimizing the incidence of PSE traits and thus on working towards high pork quality.nrpages: 195status: publishe

Do dairy cattle need protection against weather in a temperate climate?

status: publishe