Iron deficiency and erythropoiesis: new diagnostic approaches

Dual-mode luminescence and colorimetric sensing for Al3+ and Fe2+/Fe3+ ions in water using a zinc coordination polymer

A zinc(II) coordination polymer, [Zn(H2dhtp)(2,2'-bpy)(H2O)]n (1), has been utilized as a dual-mode luminescence-colorimetric sensor (H2dhtp2- = 2,5-dihydroxy terephthalate and 2,2'-bpy = 2,2'-bipyridine). The presence of hydroxyl groups in H2dhtp2- can promote excited-state intra- and intermolecular proton transfer (ESIPT) phenomena. Therefore, compound 1, which displays high stability in aqueous environments, exhibits a strong green-yellow photoluminescence. This luminescence signal can be considerably enhanced and blue-shifted upon the addition of Al3+ ions with a limit of detection (LOD) of 0.15 μM, and it demonstrates significant resistance to interference from several competing metal ions. To demonstrate a practical application, 1@paper strips were fabricated that can visually detect the Al3+ ion under a UV lamp. Moreover, 1 can detect either Fe2+ or Fe3+ ions in aqueous solutions by a visible color shift. Upon the incremental addition of Fe2+ or Fe3+ ions, the solution color changed from colorless to pink, exhibiting a pronounced absorption band at around 521 nm. The LODs were determined to be 1.55 and 0.34 μM for Fe2+ and Fe3+, respectively. Furthermore, compound 1 was used for the determination of Fe3+ ions in the real water samples, which can be evaluated on-site in real-time via a smartphone color-scanning application. The detection efficacy of 1 toward Al3+ and Fe2+/Fe3+ maintains significant luminescence stability and reusability.

Effects of a single bout of exercise on human hemocytes and serum interleukin 3, erythropoietin, and soluble transferrin receptor in a hot and humid environment

Background

Exercise in humid and hot environments (HHEs) may result in decreased perception, motor performance, and memory owing to endogenous heat production and exogenous load. However, whether a single bout of exercise (SBOE) intensity affects the magnitude of changes in the levels of hemocytes remains controversial. In this article, we aimed to investigate the effects of a SBOE of varying intensities on blood cells in HHE.

Methods

Thirty-two volunteers were randomly divided into a quiet control group (QC), 55% VO2max intensity exercise group (HHE55%), 70% VO2max intensity exercise group (HHE70%), and 85% VO2max intensity exercise group (HHE85%). The participants in the exercise groups were assigned to perform an SBOE on the treadmill under HHE conditions for 30 min, whereas participants in the QC remained still under HHE conditions for 30 min (temperature: 28-32 °C, relative humidity: 85-95%).

Results

The net body mass (NBM), perfusion index (PI), mean corpuscular volume (MCV), platelet (PLT), and plateletcrit (PCT) values were affected significantly by the exercise intensity (P < 0.01) the hemoglobin (HGB) and neutrophil count (NE) were affected significantly by exercise intensity (P < 0.05). After an SBOE, compared with that before exercise, the sublingual temperature (ST) of all groups, the NBM and MCV of all exercise groups, the PI of the HHE55% and HHE70% groups, the HGB, hematocrit (HCT), and NE of the HHE70% group, the red blood cell count (RBC), PLT, and PCT of the HHE70% and HHE85% groups, and the white blood cell count (WBC) of HHE85% changed very significantly (P < 0.01). The PCT of QC, blood oxygen saturation (SaO2), and soluble transferrin receptor (sTfR) levels in the HHE55% group, the lymphocyte count (LY) in the HHE70% group, and the HGB and HCT in the HHE85% group changed significantly (P < 0.05).

Conclusion

Low- and moderate-intensity SBOE in HHE could increase the serum EPO and serum sTfR levels and decrease the serum IL-3 levels. Conversely, a high-intensity load could increase the risk of inflammation. Therefore, low-intensity exercise may be more appropriate for an SBOE in HHE.

Diagnosis and Treatment of Iron Deficiency and Iron Deficiency Anemia in Children and Adolescents: Recommendations of the Polish Pediatric Society, the Polish Society of Pediatric Oncology and Hematology, the Polish Society of Neonatology, and the Polish Society of Family Medicine

Background/Objectives. Iron deficiency is one of the most common nutritional deficiencies worldwide and is the leading cause of anemia in the pediatric population (microcytic, hypochromic anemia due to iron deficiency). Moreover, untreated iron deficiency can lead to various systemic consequences and can disrupt the child's development. Methods/Results. Therefore, a team of experts from the Polish Pediatric Society, the Polish Society of Pediatric Oncology and Hematology, the Polish Neonatology Society, and the Polish Society of Family Medicine, based on a review of the current literature, their own clinical experience, and critical discussion, has developed updated guidelines for the diagnosis, prevention, and treatment of iron deficiency in children from birth to 18 years of age. These recommendations apply to the general population and do not take into account the specifics of individual conditions and diseases.

A Dy(III) Coordination Polymer Material as a Dual-Functional Fluorescent Sensor for the Selective Detection of Inorganic Pollutants

A Dy(III) coordination polymer (CP), [Dy(spasds)(H2O)2]n (1) (Na2Hspasds = 5-(4-sulfophenylazo)salicylic disodium salt), has been synthesized using a hydrothermal method and characterized. 1 features a 2D layered structure, where the spasda3- anions act as pentadentate ligands, adopting carboxylate, sulfonate and phenolate groups to bridge with four Dy centers in η3-μ1: μ2, η2-μ1: μ1, and monodentate coordination modes, respectively. It possesses a unique (4,4)-connected net with a Schläfli symbol of {44·62}{4}2. The luminescence study revealed that 1 exhibited a broad fluorescent emission band at 392 nm. Moreover, the visual blue color has been confirmed by the CIE plot. 1 can serve as a dual-functional luminescent sensor toward Fe3+ and MnO4- through the luminescence quenching effect, with limits of detection (LODs) of 9.30 × 10-7 and 1.19 × 10-6 M, respectively. The LODs are relatively low in comparison with those of the reported CP-based sensors for Fe3+ and MnO4-. In addition, 1 also has high selectivity and remarkable anti-interference ability, as well as good recyclability for at least five cycles. Furthermore, the potential application of the sensor for the detection of Fe3+ and MnO4- was studied through simulated wastewater samples with different concentrations. The possible sensing mechanisms were investigated using Ultraviolet-Visible (UV-Vis) absorption spectroscopy and density functional theory (DFT) calculations. The results revealed that the luminescence turn-off effects toward Fe3+ and MnO4- were caused by competitive absorption and photoinduced electron transfer (PET), and competitive absorption and inner filter effect (IFE), respectively.

Multiple Infections, Nutrient Deficiencies, and Inflammation as Determinants of Anemia and Iron Status during Pregnancy: The MINDI Cohort

In pregnant women with multiple infections, nutrient deficiencies, and inflammation (MINDI), the study of anemia and iron status is limited. For this cross-sectional study (n = 213 Panamanian indigenous women), we investigated if hemoglobin, anemia (Hb < 110 g/L), ferritin, serum iron, serum transferrin receptor, and hepcidin were associated with (1) maternal nutritional status and supplementation practices, (2) biomarkers of inflammation, and (3) presence/absence of infections. Hierarchical generalized linear and logistic regression models and dominance analyses identified the relative importance of these predictors. Anemia (38%), which was likely underestimated due to low plasma volume (95%), was associated with lower ferritin, vitamin A, and weight-for-height, suggesting anemia of undernutrition. Inflammation was not associated with Hb or anemia; nevertheless, higher CRP was associated with increased odds of low serum iron and higher ferritin and hepcidin, indicating iron restriction due to inflammation. The length of iron supplementation did not enter models for anemia or iron indicators, but a multiple nutrient supplement was associated with higher ferritin and hepcidin. Moreover, iron supplementation was associated with higher odds of vaginal trichomoniasis but lower odds of caries and bacterial vaginosis. The complex pathogenesis of anemia and iron deficiency in MINDI settings may require other interventions beyond iron supplementation.

Ultrasound-Assisted Synthesis of Chalcone: A Highly Sensitive and Selective Fluorescent Chemosensor for the Detection of Fe3+ in Aqueous Media

The chalcone compound DHPO was synthesized through a chemical reaction between 1-(2-hydroxyphenyl)-ethanone and 3,4-dimethoxy benzaldehyde under ultrasound irradiation. The interaction between the DHPO compound and several metal ions was studied using fluorescence behavior, revealing that the chalcone function as a "turn on and turn off" switch fluorescent sensor, for selectively and sensitively detecting Fe3+ ions. The process of fluorescence quenching and complexation of DHPO with Fe3+ ion was further studied using methods such as Benesi-Hildebrand, Stern-Volmer plot, and job plot.

Cytomorphometric analysis of buccal mucosal cells in iron deficiency anemia: A cross-sectional study

Background

Worldwide, at any given moment, more individuals have iron deficiency anemia (IDA) than any other health problems. Very few studies have been conducted to evaluate changes in oral mucosa in IDA. The present study is undertaken for cytomorphometric analysis of buccal mucosal cells in IDA. Nuclear diameter (ND), cell diameter (CD), nuclear area (NA), cell area (CA), and nuclear-cytoplasmic ratio (N/C) are measured and compared in buccal mucosal cells of IDA patients and controls.

Aims

To evaluate cytomorphometric changes in epithelial cells of oral mucosa in IDA and to compare these changes with the controls.

Settings and Design

A cross-sectional study.

Methods and Materials

Forty cases of IDA and forty cases of control group were selected for the study. IDA cases were diagnosed with decreased Hb level, MCV, MCH, MCHC and confirmed by decreased serum iron and increased total iron-binding capacity levels. Cytomorphometric analysis of buccal mucosa was performed to study CA, CD, NA, ND, and N/C ratio.

Statistical Analysis Used

Statistical analysis was done using t- test in SPSS software version 4.

Result

Results of our study showed increased cell area, cell diameter, nuclear area, nuclear diameter, and nuclear-cytoplasmic ratio in anemic group as compared to controls.

Conclusion

The study suggests that individuals with IDA regardless of clinically visible oral lesions show cytological changes in oral mucosal epithelium. Knowledge of quantitative alterations in oral epithelial cells of IDA patients is important as these alterations are similar to those seen in precancerous and radiation-induced changes. Cytomorphometry is an efficient tool to understand the extent of cellular changes that occur in oral epithelial cells in IDA.

Salicylic acid doped silica nanoparticles as a fluorescent nanosensor for the detection of Fe3+ in aqueous solution

A novel organic-inorganic hybrid nanosensor (SASP) was prepared by a one-step sol-gel method and characterized by scanning electron microscopy, transmission electron microscopy, Fourier transform infrared spectroscopy, thermogravimetric analysis, N2 adsorption-desorption, fluorescence spectroscopy, etc. The nanosensor showed almost 3-fold fluorescence emission quenching upon excitation with a 293 nm wavelength in the presence of 20 μM Fe3+ ions. The presence of 18 other metal ions had no observable effect on the sensitivity and selectivity of the nanosensor. A fluorescence analysis method based on the SASP for the selective detection of Fe3+ was established under optimal conditions. The results showed that there was a linear relationship between the log luminescence value and the concentration of Fe3+ over the range of 2.0 × 10-7-9.0 × 10-5 mol L-1 with a detection limit (3σ) of 2.5 × 10-8 mol L-1. Furthermore, the proposed method was successfully applied for the determination of trace Fe3+ in fetal bovine serum without the interference of other molecules and ions. Good recovery (96.5-104.5%) and a relative standard deviation of less than 8.6% were obtained from serum samples spiked with four levels of Fe3+. Additionally, the nanosensor showed a good reversibility; the fluorescence could be switched "off" and "on" in two ways, by adjusting the pH of the solution and adding metal chelating agent EDTA.

Regenerative response in dogs naturally and experimentally infected with Babesia rossi

BACKGROUND

The regenerative response following Babesia rossi infection in dogs is mild, despite severe hemolytic anemia.

OBJECTIVE

We aimed to compare the admission absolute reticulocyte count (ARC) and reticulocyte indices in 103 dogs naturally infected with B. rossi with 10 dogs suffering from immune-mediated hemolytic anemia (IMHA) and 14 healthy control dogs. The regenerative response was also evaluated in five dogs experimentally infected with B. rossi.

METHODS

This is a retrospective observational study of records generated on the ADVIA 2120 hematology analyzer.

RESULTS

The median hematocrits (HCT) of the B. rossi and IMHA groups were significantly lower than the control group (p < .001 for both); however, no differences were seen between the B. rossi and IMHA groups. Compared with the control group, the median ARC was significantly higher in the B. rossi (p = .006) and IMHA (p = .019) groups but significantly lower in the B. rossi group than the IMHA group (p = .041). In the experimentally infected dogs, there was a sudden decrease in the ARC approximately 48 h after the detection of peripheral parasitemia, which was followed by an increase after treatment. Reticulocytes of naturally infected B. rossi dogs were larger, with more variation in cellular volume. The reticulocytes of the experimentally infected dogs decreased in size with decreasing hemoglobin concentrations as the study progressed.

CONCLUSIONS

The regenerative response in dogs naturally infected with B. rossi is inadequate, given the severity of the anemia observed, and it might be a result of direct suppressive action by the parasite or host response on the bone marrow.

Synthesis of green emitted carbon dots from Vachellia nilotica and utilizing its extract as a red emitted fluorescence reagent: Applying for visual and spectroscopic detection of iron (III)

Principles of Green Analytical Chemistry recommended preferring using reagents from renewable sources and eliminating toxic reagents. Vachellia nilotica is a widespread plant throughout different parts of the world. In this study, using microwave energy, fluorescent carbon dots were synthesized for the first time from Vachellia nilotica pods. The morphology of the prepared carbon dots was characterized by SEM and TEM techniques, and the spectroscopic character exhibit green emission at 480 nm at λ_ex = 386.5 nm. This fluorescence can be effectively quenched by adding Fe (III) ions (Method I). Furthermore, Vachellia nilotica pods were extracted by different solvents, including methanol, deionized water, absolute ethanol, acetone, acetonitrile, and DMF. The acetonitrile extract of Vachellia nilotica exhibited a strong red fluorescence emission at 673.9 at λ_ex = 410 nm. Among various types of salt metals, only Fe (III) can effectively quench the fluorescence intensity of the acetonitrile extract (method II). Moreover, the bright yellow color of the aqueous extract can be changed into violet color. The absorbance of the resulted color can be spectrophotometrically measured at λ _max = 530 nm (method III). The best analytical factors were optimized for the developed methods. The developed methods were applied to determine Fe (III) in different water samples.

Diethylenetriamine-β-CD-modified carbon quantum dots for selective fluorescence sensing of Hg2+ and Fe3+ and cellular imaging

Diethylenetriamine-β-cyclodextrin-modified carbon quantum dots (3 N-CQDs) were synthesized via a one-step hydrothermal method using citric acid as the carbon source and diethylenetriamine-β-cyclodextrin (3 N-β-CD) as the nitrogen source. The successful preparation of 3 N-CQDs were revealed by infrared absorption spectroscopy, ultraviolet (UV)-visible absorption spectroscopy, fluorescence spectroscopy, XRD, XPS, TEM, and TG. Further spectroscopic studies showed that the synthesized carbon quantum dots offered good anti-interference capability. The relative fluorescence quantum yield was 67.2 %. The limits of detection for Hg²⁺ and Fe³⁺ were 0.25 µM and 0.57 μM, respectively. Cytotoxicity and imaging studies showed that the prepared carbon quantum dots had low cytotoxicity, good biocompatibility, and good cellular imaging capability for HeLa cells. They offered fluorescent sensing of Hg²⁺ and Fe³⁺ in live cells. Therefore, 3 N-CQDs were ideal fluorescent probes for the detection of Hg²⁺ and Fe³⁺ in water.

Reticulocyte Hemoglobin as a Screening Test for Iron Deficiency Anemia: A New Cut-Off

Introduction: Latent iron deficiency (LID), in which iron stores in the body are depleted without incidental anemia, poses a key diagnostic challenge. Reticulocyte hemoglobin content (Ret-Hb) is directly correlated with the functionally available iron for heme synthesis in erythroblasts. Consequently, Ret-Hb has been proposed as an efficient iron status marker. Aim: To assess the importance of Ret-Hb in detecting latent iron deficiency as well as its use in screening for iron deficiency anemia. Materials and Methods: A study involving 108 individuals was conducted at Najran University Hospital, 64 of whom had iron deficiency anemia (IDA) and 44 of whom had normal hemoglobin levels. All patients were subjected to complete blood count (CBC), reticulocyte percentage, Ret-Hb, serum iron, total iron binding capacity (TIBC), and serum ferritin measurements. Results: A significant decrease in Ret-Hb level was observed in IDA patients compared to non-anemic individuals, with a cut-off value of 21.2 pg (a value below which indicates IDA). Conclusion: The measurement of Ret-Hb, in addition to CBC parameters and indices, provides an accessible predictive marker for both iron deficiency (ID) and IDA. Lowering the Ret-Hb cut-off could better allow for its use as a screening parameter for IDA.

Reticulocyte Hemoglobin-Equivalent Potentially Detects, Diagnoses and Discriminates between Stages of Iron Deficiency with High Sensitivity and Specificity

Background: Iron deficiency anemia (IDA) is a global health problem affecting the quality of life of more than 2 billion individuals. The current practice guidelines diagnose and monitor IDA via conventional hematological and iron biomarkers, which take several months before they are corrected under an iron-treatment plan. Reticulocyte hemoglobin equivalent (Ret-He) is used as a marker in most new hematology analyzers to assess iron incorporation into erythrocyte hemoglobin directly. This study aims to examine the efficacy of Ret-He as a marker for iron deficiency (ID) and IDA and investigate whether Ret-He is sensitive to iron therapy. Methods: Two blood samples were drawn from 182 participants for CBC and iron profile measurements. Follow-up samples were drawn from participants with a confirmed diagnosis of ID and/or IDA. Results: Ret-He levels were lower in the ID and IDA groups compared to the control (p < 0.0001), and lower in the IDA group compared to the ID group (p < 0.0001). Ret-He was correlated with ferritin at ID level (<30.0 mg/mL; r = 0.39) and severe IDA (<13.0 ng/mL; p-value < 0.01, r = 0.57). Cut-off values of <28.25 pg for ID and <21.55 pg for IDA showed a higher specificity and sensitivity (ID; AUC: 0.99, sensitivity: 92.73%, specificity: 97.87%) and (IDA; AUC: 0.94, sensitivity: 90.63%, specificity: 92.31%). Finally, Ret-He successfully reflected the iron therapy (p < 0.001) when compared to hemoglobin (Hb) (p = 0.1). Conclusions: Ret-He is a potential marker for detecting and diagnosing different stages of ID with high validity and is very sensitive in reflecting the iron incorporation in a short time.

Underdiagnosis of iron deficiency anaemia in HIV-infected individuals: a pilot study using soluble transferrin receptors and intensive bone marrow iron stores to improve the diagnosis

AIM

We compared soluble transferrin receptors (sTfR), serum ferritin, mean cell volume (MCV) of red cells and the sTfR-ferritin index with the intensive method bone marrow trephine (BMT) iron stores in the diagnosis of iron deficiency anaemia (IDA) in Human Immunodeficiency Virus (HIV)-positive hospitalised participants.

METHODS

In this cross-sectional study, we recruited hospitalised HIV-positive and coronavirus of 2019 (COVID-19)-negative adults with anaemia who required a bone marrow examination as part of their diagnostic workup. We measured the full blood count, ferritin, sTfR and assessed iron using the intensive method in Haemotoxylin and Eosin (H&E)-stained BMT core biopsies of consenting participants.

RESULTS

Of the 60 enrolled participants, 57 were evaluable. Thirteen (22.80%) had IDA on H&E BMT iron stores assessment, and 44 (77.19%) had anaemia of chronic diseases (ACD). The sTfR and the sTfR-ferritin index had sensitivities of 61.54% and 53.85%, respectively, for IDA diagnosis. The sensitivity and specificity of ferritin was 7.69% and 92.31%, respectively. The sTfR and sTfR-ferritin index's diagnostic specificity was relatively low at 46.15% and 38.46%, respectively.

CONCLUSION

In this pilot study in HIV-positive participants, the prevalence of iron deficiency using the BMT assessment was low. Both the sTfR and the sTfR-ferritin index had a better quantitative correlation to bone marrow iron stores when compared with the MCV and ferritin and, may be more accurate surrogate markers of IDA.

Heterometallic Dual-Liganded AE-Ln-CPs Luminescent Probes for Efficient Sensing of Fe(III) Ions

Iron ion is widely present in the environment and in biological systems, and are indispensable trace elements in living organisms, so development of an efficient and simple sensor for sensing Fe(III) ions has attracted much attention. Here, six heterometallic AE-Ln coordination polymers (CPs) [Ln₂ (pda)₄(Hnda)₂Ca₂(H₂O)₂]·MeOH (Ln = Eu (1), Tb (2); H₂pda = 2,6-pyridinedicarboxylic acid, H₂nda = 2,3-naphthalenedicarboxylic acid), [Ln (pda)₂ (nda)AE₂(HCOO)(H₂O)] (AE = Sr, Ln = Eu (3), Tb (4); AE = Ba, Ln = Eu (5), Tb (6)) with two-dimensional (2D) layer structures were synthesized by hydrothermal method. All of them were characterized by elemental analysis, XRD, IR, TG, as well as single crystal X-ray diffraction. They all show infinite 2D network structure, where complexes 1 and 2 are triclinic with space group of P1¯, while 3-6 belong to the monoclinic system, space group P2_1/n. The solid-state fluorescence lifetimes of complexes 1, 3 and 5 are τ_obs1 = 1930.94, 2049.48 and 2,413.04 µs, respectively, and the quantum yields Ф_total are 63.01, 60.61, 87.39%, respectively, which are higher than those of complexes 2, 4 and 6. Complexes 1-6 all exhibited efficient fluorescence quenching response to Fe³⁺ ions in water, and were not interfered by the following metal ions: Cu²⁺, Cd²⁺, Mg²⁺, Ni²⁺, Co²⁺, Ca²⁺, Ba²⁺, Sr²⁺, Li⁺, Na⁺, K⁺, Al³⁺, Fe²⁺, Pb²⁺, Cr³⁺, Mn²⁺ and Zn²⁺. The quenching coefficient K_SV for complexes 1-6 is 1.41 × 10⁵ M⁻¹, 7.10 × 10⁴ M⁻¹, 1.70 × 10⁵ M⁻¹, 1.57 × 10⁵ M⁻¹, 9.37 × 10⁴ M⁻¹, 1.27 × 10⁵ M⁻¹, respectively. The fluorescence quenching mechanism of these complexes towards Fe³⁺ ions was also investigated. It is possible that the weak interaction formed between the complexes and the Fe³⁺ ions reduce the energy transfer from the ligand to the Ln³⁺ ion, producing the emission burst effect. This suggests that complexes 1-6 can be candidate for efficient luminescent sensor of Fe³⁺.

A Solvent-Mediated Excited-State Intermolecular Proton Transfer Fluorescent Probe for Fe3+ Sensing and Cell Imaging

Constructing excited-state intermolecular proton transfer (ESIPT-e) fluorophores represents significant challenges due to the harsh requirement of bearing a proton donor-acceptor (D-A) system and their matching proton donating-accepting ability in the same molecule. Herein, we synthesized a new-type ESIPT-e fluorophor (2-APC) using the "four-component one-pot" reaction. By the installing of a cyano-group on pyridine scaffold, the proton donating ability of -NH2 was greatly enhanced, enabling 2-APC to undergo ESIPT-e process. Surprisingly, 2-APC exhibited dual-emissions in protic solvents ethanol and normal fluorescence in aprotic solvents, which is vastly different from that of conventional ESIPT-a dyes. The ESIPT emission can be obviously suppressed by Fe3+ due to the coordination reaction of Fe3+ with the A-D system in 2-APC. From this basis, a highly sensitive and selective method was established using 2-APC as a fluorescent probe, which offers the sensitive detection of Fe3+ ranging from 0 to 13 μM with the detection limit of 7.5 nM. The recovery study of spiked Fe3+ measured by the probe showed satisfactory results (97.2103.4%) with the reasonable RSD ranging from 3.1 to 3.8%. Moreover, 2-APC can also exhibit aggregation-induced effect in poor solvent or solid-state, eliciting strong red fluorescence. 2-APC was also applied to cell-imaging, exhibiting good cell-permeability, biocompatibility and color rendering. This multi-mode emission of 2-APC is significant departure from that of conventional extended p-conjugated systems and ESIPT dyes based on a flat and rigid molecular design. The "one-pot synthesis" strategy for the construction of ESIPT molecules pioneered a new route to achieve tricolor-emissive fluorophores.

Nitrogen-doped graphene quantum dots synthesized by femtosecond laser ablation in liquid from laser induced graphene

In this work, graphene quantum dots (GQDs) were synthesized by femtosecond laser ablation in liquid using laser induced graphene as the carbon source. Nitrogen-doped graphene quantum dots (N-GQDs) were successfully synthesized by adding ammonia water to the graphene suspension. The GQDs/N-GQDs structure consist of a graphitic core with oxygen and nitrogen functionalities with particle size less than 10 nm, as demonstrated by x-ray photoelectron spectroscopy, Fourier infrared spectrometer spectroscopy, and transmission electron microscopy. The absorption peak, PL spectrum, and quantum yield of the N-GQDs were significantly enhanced compared with the undoped GQDs. Further, the possible mechanism of synthesis GQDs was discussed. Furthermore, the N-GQDs were used as a fluorescent probe for detection of Fe³⁺ions. The N-GQDs may extend the application of graphene-based materials to bioimaging, sensor, and photoelectronic.

Green preparation of carbon quantum dots with wolfberry as on-off-on nanosensors for the detection of Fe3+ and l-ascorbic acid

A green and facile hydrothermal synthesis approach is proposed for the preparation of nitrogen-doped carbon quantum dots (N-CQDs) with wolfberry. These N-CQDs were developed as a highly sensitive fluorescent 'on-off-on' switch sensor for the sensing of Fe3+ and l-ascorbic acid (AA). The N-CQDs displayed superior fluorescence characteristics of CQDs with a quantum yield up to 22%. The N-CQDs were demonstrated to selectively react with Fe3+, leading to fluorescence quenching effect, which was successfully used for the detection of Fe3+ with a limit of detection at 3 μmoL•L-1. The addition of AA is supposed to repair the surface defects, and result in the fluorescence recovery. Based on this effect, the strategy of 'on-off-on' detection of AA was established with a limit of detection at 1.8 μmoL•L-1. Furthermore, the practical application of the detection of Fe3+ lake water and AA in medical tablet was demonstrated, promising an effective and efficient 'on-off-on' nanosensor with low-cost, green synthesis for Fe3+ and AA detection.

An Experimental Model for Iron Deficiency Anemia in Sows and Offspring Induced by Blood Removal during Gestation

Anemia is a common condition in sow herds. We aimed to study the effects of severe iron deficiency during gestation on sow and piglet health outcomes with an experimental model for blood-removal-induced iron deficiency anemia. In total, 18 multiparous sows (8 in trial I and 10 in trial II) were allocated to either a blood removal group or a control group. Hematologic parameters were monitored at regular intervals and the tissue iron concentrations were measured for the sows and newborn piglets after farrowing. In trial I, the mean liver iron content was reduced to 46.7 µg/g in the blood removal sows compared to 252.6 µg/g in the controls (p < 0.001). In trial II, sows in the blood removal group had lower iron content in the liver (147.8 µg/g), kidney (46.3 µg/g) and spleen (326.5 µg/g) compared to the control sows (323.2 µg/g, 81.3 µg/g and 728.9 µg/g, respectively; p = 0.009, 0.016, 0.01, respectively). In trial I, piglets from sows in the blood removal group had significantly decreased hematocrit (Hct), red blood cells (RBC) and a tendency for reduced hemoglobin (Hb) compared to the control piglets. We established a blood removal model that resulted in mild- to severe degrees of sow anemia and reduced tissue iron stores at farrowing.

Simple and Sensitive Multi-components Detection Using Synthetic Nitrogen-doped Carbon Dots Based on Soluble Starch

Although carbon dots (CDs) as fluorescent sensors have been widely exploited, multi-component detection using CDs without tedious surface modification is always a challenging task. Here, two kinds of nitrogen-doped CDs (NCD-m and NCD-o) based on soluble starch (SS) as carbon source were prepared through one-pot hydrothermal process using m-phenylenediamine and o-phenylenediamine as nitrogenous dopant respectively. Through fluorescence "on-off" mechanism of CDs, NCD-m and NCD-o could be used as a fluorescence sensor for detection of Fe 3+ and Ag + with LOD of 0.25 and 0.51 μM, respectively. Additionally, NCD-m could be used for indirect detection of ascorbic acid (AA) with LOD of 5.02 μM. Moreover, fluorescence intensity of NCD-m also exhibited the sensitivity to pH change from 2 to 13. More importantly, Both NCD-m and NCD-o had potential application for analysis of complicated real samples such as tap water, Vitamin C tablets and orange juice. Ultimately, the small size of NCD-m could contribute to reinforcing intracellular endocytosis, which allowed them to be used for bacteria imaging. Obviously, these easily obtainable nitrogen-doped CDs were able to be used for multi-components detection. Strategy for synthesis of nitrogen-doped carbon dots (NCDs) and a schematic for fabrication of as-prepared NCDs for detection of Fe 3+, Ag + and ascorbic acid (AA).

The Top 100 Cited Papers in the Field of Iron Deficiency in Humans: A Bibliometric Study

Worldwide, iron deficiency is a common form of micronutrient deficiency with a high individual and societal cost. There are considerable knowledge and practice gaps in the diagnosis and treatment of iron deficiency. Bibliometric analysis examines the published body of knowledge of a subject in an objective fashion. The Web of Science Core Collection was searched to retrieve the 100 most cited papers on the topic of iron deficiency, and the key metrics of each paper were extracted. A keyword study was performed using VOSviewer 1.6.10 software, which provided a visual mapping of the network of keyword cooccurrences. The papers were published between 1964 and 2017 and were cited an average of 636 times. They were contributed by authors from 119 different countries/regions, with the largest contributing country being the United States. 29 institutions contributed at least 6 publications each, and 4 researchers authored or coauthored at least 5 papers. Keyword analysis suggests that the most cited topics could be grouped into 4 categories: (1) epidemiologic research of the global burden of iron deficiency, (2) clinical aspects of iron deficiency anemia, (3) iron metabolism, and (4) the impact of iron deficiency on children. Identification of the most impactful studies in the field of iron deficiency may be helpful to practitioners interested in improving their knowledge base. Compared to bibliometric studies performed on other topics, the medical literature of iron deficiency is mature, as evidenced by the high citation rate of the top 100 papers. Despite the high worldwide prevalence of iron deficiency, the top cited papers are dominated by a relatively small number of countries and institutions. Interestingly, however, the most cited authors in this study do not overlap with the most cited institutions.

Simple and eco-friendly synthesis of crude orange-peel-derived carbon nanoparticles for detection of Fe3+ and ascorbic acid

Although fluorescence sensors based on carbon dots (CDs) have been developed widely, multicomponent detection using CDs without extra and tedious surface modification remains a challenge. Here, the crude carbon nanoparticles (CPs) as a fluorescence sensor were prepared through one-pot hydrothermal process using orange peel as the precursor. The method was simple, rapid, economical, and eco-friendly given that such extra steps as dialysis and lyophilization were not required. By adding ethanol into the reaction solvent, the fluorescence properties of orange-peel-derived CPs as well as their sensitivity of detecting Fe³⁺ with a limit of detection of 0.25 μM were improved. Additionally, orange-peel-derived CPs could be used as a fluorescence sensor for detection of ascorbic acid (AA) with a LOD of 5 μM. More importantly, the proposed fluorescence methods were successfully used to qualitatively and quantitatively analyze Fe³⁺ and AA in real samples. Recovery of Fe³⁺ from tap water was within the range 97.2-105.4%. Conversely, recovery of AA from vitamin C tablets and orange juices laid within the ranges 97.7-99.3% and 93.2-97.6%, respectively.

Novel luminescent Schiff's base derivative with an azo moiety for ultraselective and sensitive chemosensor of Fe3+ ions

Chemosensors with ultrasensing capabilities for detection of metal ions have received particular attention when using luminescent organic compounds. Even though hundreds of chemosensor agents have been reported for Fe³⁺ ion sensing, the designs of those molecules have been complicated and time consuming, in addition to having limited application for aquatic samples due to their poor hydrophilicity. Here, we synthesized a novel azo-imine derivative (L2) that showed ultrasensitive and selective sensing for Fe³⁺ ions. L2 exhibited ultraselective detection of Fe³⁺ ions with a turn-off of its emission intensity at 341 nm in H₂ O:MeOH (4:1 v/v) aqueous medium. This quenching phenomenon was in good agreement with its colour change from orange-yellowish to colourless. Its capability was shown due to its very low limit of detection and limit of quantification values of 0.31 and 1.04 μM, respectively. The interference study showed that L2 is ultraselective for the detection of Fe³⁺ ions without a significant reduction in its sensing capability even in competitive metal mixtures. Furthermore, direct Fe³⁺ quantification of tap and drinking water showed that L2 gave good recovery percentages. These findings demonstrated that the Schiff's base with an azo fluorophore derivative is a potential chemosensor agent for Fe³⁺ ions sensing applications in aqueous media.

Boron, and nitrogen co-doped carbon dots as a multiplexing probe for sensing of p-nitrophenol, Fe (III), and temperature

Boron and nitrogen co-doped carbon dots (B, N-CDs) were fabricated through a simple, one-step hydrothermal reaction of citric acid, boric acid, and tris base. The obtained B, N-CDs exhibit excitation-dependent fluorescence, high quantum yield (QY), biocompatibility, photostability, and aqueous solubility. The QY was substantially increased to 57% by doping boron atoms. Furthermore, the fluorescence intensity of B, N-CDs was temperature-dependent and decreased linearly from 283 to 333 K. The prepared B, N-CDs were used as a fluorescence probe for the detection ofpara-nitrophenol (p-NP) and Fe (III) ions with low detection limits of 0.17μM and 0.30μM, respectively. Moreover, the presence of p-NP could be further confirmed by a colorimetric assay. The fluorescent probe has been applied to determine p-NP and Fe (III) in a spiked serum sample and spiked water samples (lake and tap water). Moreover, the as-prepared B, N-CDs were of low toxicity and capable of bioimaging.

Determination of Fe(Ⅲ) ion and cellular bioimaging based on a novel photoluminescent silicon nanoparticles

The determination approaches of Fe (Ⅲ) in biological samples were developed by a novel water-soluble silicon nanoparticles (SiNPs). The SiNPs were synthesized by a facile microwave-assisted method, and simultaneously featured strong blue fluorescence (photoluminescence quantum yield: 25.2%), long lifetime (~13.29 ns) and good photo-stability. The fluorescence intensities of SiNPs were gradually quenched with Fe (Ⅲ) concentration increasing from 2.0 to 50 μmol/L. The detection limit of the established method was 0.56 μmol/L and the precision for eleven replicate detections of 20 μmol/L Fe (Ⅲ) was 3.2% (relative standard deviation, RSD). The spiked recoveries were 99.0%-104.5%. Results of the lifetime decay and cyclic voltammetry (CV) evidenced that the electron transfer was responsible for the fluorescence quenching mechanism of SiNPs and Fe (Ⅲ). Moreover, the SiNPs were successfully applied in the determination of Fe(Ⅲ) in different environmental waters and human serum. Finally, the resulting SiNPs exhibited the green fluorescence in HeLa cells as the optical probe.

Evaluation of reticulocyte hemoglobin content (RETIC-HGB) for the diagnosis of iron-limited erythropoiesis in cats

BACKGROUND

Decreased reticulocyte hemoglobin content (CHr) (Siemens ADVIA 2120) reflects iron-limited erythropoiesis (ILE). RETIC-HGB (IDEXX ProCyte Dx) is a novel marker of ILE for veterinary use.

OBJECTIVES

We aimed to evaluate reference intervals (RIs) and the utility of RETIC-HGB and CHr in the diagnosis of feline ILE.

MATERIALS AND METHODS

RIs were established in 59 healthy cats. Intra-assay coefficients of variation (CVs) and correlations between RETIC-HGB and CHr were assessed. Two hundred and seventy-five cats were classified as having ILE or not based on low plasma iron or low transferrin saturation along with anemia and/or altered RBC indices. CHr, RETIC-HGB, and serum amyloid A (SAA) were compared between the groups. The sensitivity and specificity of RETIC-HGB and CHr to diagnose ILE were analyzed to determine the RI lower limits.

RESULTS

RIs for RETIC-HGB and CHr were 12.5-18.0 and 14.0-19.9 pg, respectively. The CV was 3% for both variables. RETIC-HGB and CHr were moderately correlated (r_s = 0.59) with a bias of -1.2 picograms (pgs). Twenty of the 275 cats were classified as having ILE. Compared with non-ILE cats, ILE cats had significantly lower median RETIC-HGB (14.3 vs 15.2 pg, P = .0046) and mean CHr (14.7 vs 16.5 pg, P < .0001) values and significantly increased median SAA (44.6 vs 2.3 µg/dl, P < .0001) values. Using the lower RI limits resulted in a low sensitivity and relatively high specificity to diagnose ILE in cats.

CONCLUSIONS

ILE was characterized by decreased CHr and RETIC-HGB; however, sensitivity was low. The moderate correlation between RETIC-HGB and CHr is likely due to species differences and different methodology.

Distinct solvent-dependent luminescence sensing property of a newly constructed Cu(ii)–organic framework

The distinct solvent-dependent fluorescence sensing behavior of an extremely rare Cu(ii) MOF, showing the fluorescent “turn-off” sensing of Fe³⁺ and HCO₃⁻ in DMF and “turn-on” sensing of Al³⁺ in water.

Unusual red-orange emission from rhodamine-derived polynorbornene for selective binding to Fe3+ ions in an aqueous environment

Norbornene-based rhodamine derivative (NR) was observed as an "off-on" probe for Fe3+ ions both colorimetrically and fluorimetrically in an aqueous environment. NR and its homopolymer (PNR) were capable of detecting Fe3+ ions with high selectivity and sensitivity in an aqueous environment. For NR and PNR the limit of detection (LOD) towards Fe3+ ions was found to be 49 nM and 19 nM, respectively, making these materials highly efficient. Most interestingly, PNR has more efficacy towards the detection of Fe3+ ions than NR, which is expected due to the favorable side-chain interaction in the presence of multiple sensing motifs between the polymer chains. The sensing behavior was thoroughly studied via spectroscopic techniques. We hypothesized that the Fe3+ ion was expected to induce the spirolactam ring-opening of the rhodamine unit due to its Lewis acid nature and preferable interactions with the N and O atoms present in NR as well as PNR.

Introduction to a How I Treat series on anemia

In this commissioned How I Treat series introduced by Associate Editor Mario Cazzola, experts review relevant pathophysiology and provide guidance regarding the treatment of patients with anemia in common general medical settings.

Iron Deficiency Anemia in Children Residing in High and Low-Income Countries: Risk Factors, Prevention, Diagnosis and Therapy

Iron deficiency and iron-deficiency anemia (IDA) affects approximately two billion people worldwide, and most of them reside in low- and middle-income countries. In these nations, additional causes of anemia include parasitic infections like malaria, other nutritional deficiencies, chronic diseases, hemoglobinopathies, and lead poisoning. Maternal anemia in resource-poor nations is associated with low birth weight, increased perinatal mortality, and decreased work productivity. Maintaining a normal iron balance in these settings is challenging, as iron-rich foods with good bioavailability are of animal origin and either expensive and/or available in short supply. Apart from infrequent consumption of meat, inadequate vitamin C intake, and diets rich in inhibitors of iron absorption are additional important risk factors for IDA in low-income countries. In-home iron fortification of complementary foods with micronutrient powders has been shown to effectively reduce the risk of iron deficiency and IDA in infants and young children in developing countries but is associated with unfavorable changes in gut flora and induction of intestinal inflammation that may lead to diarrhea and hospitalization. In developed countries, iron deficiency is the only frequent micronutrient deficiency. In the industrialized world, IDA is more common in infants beyond the sixth month of life, in adolescent females with heavy menstrual bleeding, in women of childbearing age and older people. Other special at-risk populations for IDA in developed countries are regular blood donors, endurance athletes, and vegetarians. Several medicinal ferrous or ferric oral iron products exist, and their use is not associated with harmful effects on the overall incidence of infectious illnesses in sideropenic and/or anemic subjects. However, further research is needed to clarify the risks and benefits of supplemental iron for children exposed to parasitic infections in low-income countries, and for children genetically predisposed to iron overload.

Variability in the cleavage of exosome-associated transferrin receptor questions the utility of clinically useful soluble transferrin receptor assays for dogs, cats, and horses

Whole transferrin receptor (TfR) is present in reticulocyte exosomes. Soluble transferrin receptor (sTfR) is cleaved from whole TfR in human plasma, with the remnant cytoplasmic domain (cTfR) remaining membrane associated. In humans, sTfR is a biomarker that can detect iron deficiency in the presence of inflammatory disease. This condition is still a diagnostic dilemma in veterinary species. We aimed to (1) confirm the presence of exosomes and exosome-associated TfR in the serum of dogs, cats, and horses; and (2) to assess and compare the proportion of cTfR to total (cTfR + whole) in exosomal membranes of healthy and diseased dogs and cats and in healthy horses to indirectly predict their anticipated levels of circulating sTfR. We used discarded serum and whole blood samples from canine and feline patients, separated into healthy and diseased groups based on the health status of each patient, and healthy equine participants from a previous study. Ultracentrifugation, followed in some experiments by OptiPrep discontinuous density gradient fractionation, was used to isolate exosomes. Exosomes and associated TfR were identified using TEM and Western blot for TfR, respectively. Densitometry tracings of Western blots of serum exosomes were used to measure the proportion of cTfR to total TfR. Extracellular vesicles compatible with exosomes were successfully isolated and expressed TfR. The proportion of cTfR in dogs was greater than 50%, indicating that a majority of the whole TfR was cleaved to produce sTfR (and remnant cTfR). There was significant interindividual variation and no significant difference between healthy and diseased animals. The proportion of cTfR in cats was very low at 11%, indicating that very little sTfR was likely produced. There was a small yet significant difference between healthy and diseased cats. Healthy horses do not appear to cleave exosome-associated TfR. Diagnosis of iron deficiency in the presence of inflammatory disease remains a challenge in veterinary medicine. Our results indicate that TfR is poorly or unpredictably cleaved in veterinary species, revealing that there are species differences in exosomal TfR handling. These data suggest that development of an assay for the detection and quantification of sTfR in the species investigated may not be warranted.