Impact of Spirulina corn soy blend on Iron deficient children aged 6–23 months in Ndhiwa Sub-County Kenya: a randomized controlled trial

Background Iron deficiency anemia (IDA) remains high in Kenya despite interventions. Twenty-seven percent of children aged 6 months-14 years are anemic, with low iron intake (7%) among children aged 6–23 months. Standard food interventions involve a corn soy blend (CSB), which is limited in micronutrients, and fortifiers are not accessible locally. Moreover, the use of spirulina as a strategy for mitigating IDA has not been adequately documented. This study compared the impact of a spirulina corn soy blend (SCSB) on IDA among children aged 6–23 months. Methods A total of 240 children with IDA were randomly assigned to study groups at a ratio of 1:1:1 through lotteries, and caregivers and research assistants were blinded to group assignment. Dry-take-home SCSB, CSB and placebo flour (1.7 kg) was given to caregivers to prepare porridges using a flour water ratio of 1:4, producing 600 ml–700 ml of porridge to feed children 200 ml of porridge three times a day for 6 months. Impact was assessed as plasma hematocrit at baseline and after the study. Blood drawing, preparation and analysis were performed in accordance with approved procedures by the EthicsResearchCommittee. Monthly follow-up and data collection on dietary intake, anthropometry, morbidity and infant feeding practices were performed using questionnaires. Relative risk, magnitude of change and log-rank tests were used to compare the impact of the intervention, and significant differences were determined at P < 0.05. Results The survival probabilities for children consuming SCSB were significantly higher than those consuming CSB (log-rank-X2 = 0.978; CI: 0.954–1.033, P = 0.001) and the placebo (log-rankX2 = 0.971; CI: 0.943–0.984, P = 0.0001). Children consuming SCSB had a mean recovery time of 8 days (CI: 7–12 days) compared to those consuming CSB (19 days; CI: 20–23 days) and placebo (33 days; CI: 3 1–35 days). The recovery rate was 15.4 per 100 persons per day for children who consumed SCSB as opposed to 4.6 and 1.8 per 100 persons per day for those who consumed CSB and the placebo, respectively. Conclusion Management of IDA with SCSB compared to CSB and the placebo led to faster reversal and large numbers of recoveries from IDA. The recovery rates were above the World Health Organizations (WHO) minimums standards for food interventions. Efforts to realize high and faster recoveries from IDA should be heightened by fortifying CSB with spirulina powder.

Brain Anatomical Mediators of GRIN2B Gene Association with Attention/Hyperactivity Problems: An Integrated Genetic-Neuroimaging Study

This study aims to investigate the genetic and neural determinants of attention and hyperactivity problems. Using a proof-of-concept imaging genetics mediation design, we explore the relationship between the glutamatergic GRIN2B gene variants and inattention/hyperactivity with neuroanatomical measures as intermediates. Fifty-eight children and adolescents were evaluated for behavioral problems at three time points over approximately 7 years. The final assessment included blood drawing for genetic analyses and 3T magnetic resonance imaging. Attention/hyperactivity problems based on the Child Behavior Checklist/6-18, six GRIN2B polymorphisms and regional cortical thickness, and surface area and volume were estimated. Using general linear model (GLM) and mediation analyses, we tested whether GRIN2B exerted an influence on stable inattention/hyperactivity over development, and to what extent this effect was mediated by brain morphology. GLM results enlightened the relation between GRIN2B rs5796555-/A, volume in the left cingulate isthmus and inferior parietal cortices and inattention/hyperactivity. The mediation results showed that rs5796555-/A effect on inattention/hyperactivity was partially mediated by volume in the left isthmus of the cingulate cortex, suggesting a key role of this region in translating glutamatergic GRIN2B variations to attention/hyperactivity problems. This evidence can have important implications in the management of neurodevelopmental and psychiatric disorders.

A Rapid Saliva Test for Monitoring Immune Protection against SARS-CoV-2 and its Variants

Given the ongoing transmission and emergence of SARS-Cov-2 variants globally, it is critical to have a timely assessment on individuals' immune responses as well as population immunity. Important questions such as the durability of COVID-19 immunity or the efficacy of vaccines require large datasets to generate meaningful insights. However, due to the complexity and relatively high-cost of many immunity assays and the needs for blood-drawing specialists, these assays were mostly limited to small-scale clinical studies. Our work demonstrated the potential of a non-invasive, inexpensive and data-driven solution for large-scale immunity surveillance and for predictive modeling of vaccine efficacy. Combining a proprietary saliva processing method and an ultra-sensitive digital detection technology, we were able to rapidly gather information regarding personalized immune response following infection or vaccination, monitor temporal evolution, and optimize predictive models for variant protection.

Transposition of the superficial femoral artery combined with ultrasound-guided returning-venous cannulation as a last resort for vascular access in a multi-complicated hemodialysis patient

A superficialized artery as a blood-drawing route could be an option for vascular access (VA) in hemodialysis patients with cardiac failure, vessel damage, steal syndrome, and venous hypertension, and it could be a secondary VA option in those with repetitive vascular access troubles, routinely requiring a blood-returning venous route. The brachial artery is preferably used for superficialization due to the benefit of its appropriate diameter for cannulation, procedural ease of surgery under local anesthesia, and usable subcutaneous vein for blood-returning route in the upper limb. The superficial femoral artery (SFA) has also been reported as a candidate for arterial transposition; however, its subcutaneous transposition could have difficulties in requiring general anesthesia and securing blood-inflow-venous routes. We experienced a multi-complicated hemodialysis patient who had intractable tunneled-cuffed catheter-related bacteremia and right atrial thrombosis, low cardiac function with bilateral proximal bifurcation of the brachial artery at the axilla, and damaged cutaneous veins in the upper limb. Herein, we report a case of successful superficialization of the SFA under ultrasound-guided regional anesthesia combined with local anesthesia and intravenous sedation, which could be feasible as a blood-drawing route with ultrasound-guided ipsilateral greater saphenous vein cannulation during chronic hemodialysis. Assisted by ultrasound-guided venous cannulation in the ipsilateral lower limb, cutaneous repositioning of the SFA could be a viable and acceptable option for VA in hemodialysis patients with a multitude of complications, wherein the possibilities of VAs of arteriovenous access, arterial superficialization using vessels in the upper extremity, or artificial devices should be eliminated.

ANTIBACTERIAL ACTIVITY AND HEMATOLOGICAL PROFILE OF RAT (Rattus norvegicus) DUE TO ADMINISTRATION OF ETHANOL EXTRACT OF SOURSOP FLOWERS (Annona muricata L.) AND Salmonella enteritidis INFECTION

This study aimed to determine the antibacterial activity of soursop flower extract (Annona muricata L.) and hematological profile of rats (Rattus norvegicus) due to administration of soursop flower ethanol extract and Salmonella enteritidis infection. The concentrations of soursop flower ethanol extract used for the antibacterial activity test were 25%, 50%, 75%, 100%, with the antibiotic ampicillin 10 μg/disk was used s a positive control (PC) and dimethyl sulfoxide (DMSO) 10% as a negative control (NC). For examination of hematological features, 15 male rat aged two months were used. All rats were divided into 5 treatment groups, each consisting of three rats. The NC group was not given soursop flower ethanol extract and S. enteritidis infection. The PC group was not given soursop flower extract but was given S. enteritidis infection. Groups P1, P2, and P3 were given ethanol extracts of soursop flower at a dose of 0.18, 0.36, and 0.72 g/rat/day peroral for a week using gastric sonde. On the following day (after administration of soursop flower extract) the first blood drawing was performed. All rats, except NC group, were then infected with S. enteritidis intraperitonially at dose of 3x108 CFU/mL dose (0.5 mL McFarland). One week after being infected with S. enteritidis, a second blood drawing was performed. The results of the antibacterial activity test showed that there was no antibacterial activity was observed since no inhibition at various concentrations was formed. The administration of soursop flower extract at various dosage levels was able to maintain the number of leukocytes but reduced the number of erythrocytes, hemoglobin concentration, hematocrit value and the number of platelets in rats; whereas S. enteritidis infection decreased all the hematologic features of lab rats.

A Practical Guide to Class IIa Medical Device Development

There are many beneficial medical device ideas based on clinical needs and laboratory research, but medical device development is an expensive, time-consuming and complex challenge. Research and quality management, which are both needed to develop a medical device, are two distinct fields, initiated by a researcher or a clinician having a concept for a medical device, and it is often challenging to find and achieve the proper steps to create a licensed product. Thus, in this paper, we demonstrate the required mindset and main steps of the medical device development procedure through an existing example, a Class IIa medical device, called hypACT Inject Auto. HypACT is a specific syringe, which is capable of blood drawing and serum from platelet-rich fibrin (SPRF) isolation in one step in a closed system. SPRF is intended to be used to improve joint functions in the case of musculoskeletal diseases, specifically osteoarthritis.

Pre-analytical issues in liquid biopsy – where do we stand?

It is well documented that in the chain from sample to the result in a clinical laboratory, the pre-analytical phase is the weakest and most vulnerable link. This also holds for the use and analysis of extracellular nucleic acids. In this short review, we will summarize and critically evaluate the most important steps of the pre-analytical phase, i.e. the choice of the best control population for the patients to be analyzed, the actual blood draw, the choice of tubes for blood drawing, the impact of delayed processing of blood samples, the best method for getting rid of cells and debris, the choice of matrix, i.e. plasma vs. serum vs. other body fluids, and the impact of long-term storage of cell-free liquids on the outcome. Even if the analysis of cell-free nucleic acids has already become a routine application in the area of non-invasive prenatal screening (NIPS) and in the care of cancer patients (search for resistance mutations in the EGFR gene), there are still many unresolved issues of the pre-analytical phase which need to be urgently tackled.