Usefulness of reticulocyte hemoglobin equivalent for the safety of pre-operative autologous blood donation

Pre-operative autologous blood donation (PABD) provides safe blood for patients at the expense of the risk of iron deficiency anemia that may compromise the patients. The reticulocyte hemoglobin equivalent (RET-He) is an indirect measure of the functional iron available for the erythropoiesis over the previous 2-3 days. The aim of this study was to evaluate the clinical usefulness of RET-He quickly measured by the automated hematology analyzer Sysmex XE-2100 in patients undergoing PABD at our hospital. Receiver-operating characteristic curve analysis revealed that RET-He was reliable in the diagnosis of iron deficiency anemia. Two of 14 patients in the absence of post-PABD iron replacement developed marked anemia with low RET-He levels after PABD, suggesting that this anemia was due to iron deficiency. Of 26 patients receiving post-PABD iron replacement, 8 who had already showed low RET-He levels at PABD developed statistically significant reduction in hemoglobin levels after PABD despite adequate iron replacement, indicating that the 8 patients had iron deficiency prior to PABD. These findings suggest that automated measurement of RET-He may contribute to improve the safety of PABD.     

Regional gray matter density is associated with achievement motivation: evidence from voxel-based morphometry

Achievement motivation can be defined as a recurrent need to improve one’s past performance. Despite previous functional imaging studies on motivation-related functional activation, the relationship between regional gray matter (rGM) morphology and achievement motivation has never been investigated. We used voxel-based morphometry and a questionnaire (achievement motivation scale) to measure individual achievement motivation and investigated the association between rGM density (rGMD) and achievement motivation [self-fulfillment achievement motivation (SFAM) and competitive achievement motivation (CAM) across the brain in healthy young adults (age 21.0 ± 1.8 years, men (n = 94), women (n = 91)]. SFAM and rGMD significantly and negatively correlated in the orbitofrontal cortex (OFC). CAM and rGMD significantly and positively correlated in the right putamen, insula, and precuneus. These results suggest that the brain areas that play central roles in externally modulated motivation (OFC and putamen) also contribute to SFAM and CAM, respectively, but in different ways. Furthermore, the brain areas in which rGMD correlated with CAM are related to cognitive processes associated with distressing emotions and social cognition, and these cognitive processes may characterize CAM.     

Carence en fer et troubles digestifs

Iron deficiency anemia still remains problematic worldwide. Iron deficiency without anemia is often undiagnosed. We reviewed, in this study, symptoms and syndromes associated with iron deficiency with or without anemia: fatigue, cognitive functions, restless legs syndrome, hair loss, and chronic heart failure. Iron is absorbed through the digestive tract. Hepcidin and ferroportin are the main proteins of iron regulation. Pathogenic micro-organisms or intestinal dysbiosis are suspected to influence iron absorption.     

色彩背景对视觉认知任务的生理学及绩效影响研究

目的:对在不同色彩背景下视觉认知操作过程中的生理学指标及任务完成绩效进行比较研究。方法:36名青年男性,完成不同色彩背景下的系列认知测验,同时采用多导生理记录仪采集相关生理指标。结果:生理学指标和认知任务绩效均受到了色彩背景的影响,并且不同色彩背景之间统计学上存在差异(P<0.05)。综合生理指标和认知绩效,短波长色彩(如紫、蓝色)背景下,自主神经活动强度较小,从生理指标上各项指标分值较低,但是在作业的成绩较好。而在波长较长的色彩(如橙色、黄色)背景下,各项生理指标较高,自主神经活动较强,但是作业成绩较差。结论:色彩背景信息可以调节作业个体的生理状态,并影响到认知任务的完成。在较短时间的简单认知任务中,短波长更利于产生好的作业绩效。     

Comparison of hemoglobin and red blood cell distribution width in the differential diagnosis of microcytic anemia.

In a total group of 415 subjects (100 normal controls, 115 with iron deficiency anemia, 100 with the alpha-thalassemia trait, and 100 with the beta-thalassemia trait), the following indexes were analyzed: hemoglobin distribution width, red blood cell distribution width (RDW)-coefficient of variation, and RDW-SD. The hemoglobin distribution width and RDW-coefficient of variation were examined with a laser light scattering system (Technicon H1), whereas the RDW-SD was determined with an impedance autoanalyzer (Sysmex M-2000). All of these parameters helped, to some extent, in the differential diagnosis of microcytic anemia. However, our data suggested a low RDW-SD might provide significantly more value in differentiating thalassemia traits from iron deficiency anemia, as well as from normal controls, while the hemoglobin distribution width gave no help in the differential diagnosis between iron deficiency anemia and the beta-thalassemia trait.     

Elliptocytes and tailed poikilocytes correlate with severity of iron-deficiency anemia

This study examines the relationships between abnormal RBC morphology, RBC indices measured with an automated hematology analyzer, serum iron studies, and severity of anemia in patients with findings indicative of iron-deficiency anemia. Counts and morphologic classification of 1,000 RBCs from each of 22 patients were performed, and correlations were determined between parameters. The Student t test was used to determine the level of significance for correlations between parameters. Several significant relationships were found. As the percentage of elliptocytes increased, hemoglobin concentration, hematocrit, RBC concentration, and mean corpuscular hemoglobin level decreased (r = .48, .44, .40, and .49, respectively; P < .05). As the percentage of tailed poikilocytes increased, hemoglobin concentration, hematocrit, and RBC concentration decreased (r = .70, .77, and .71, respectively; P < .01) and RBC distribution width increased (r = .73; P < .01). Of significance, serum ferritin levels, long considered the best single indicator of iron deficiency, showed no correlation with the morphologic abnormalities assessed, severity of anemia, or any of the analyzer-generated indices. Our results indicate that microscopic evaluation of RBC morphology remains an important tool for the pathologist to evaluate the severity of anemia in patients with iron deficiency.     

Brain flexibility associated with need for cognition contributes to creative achievement

Advances in graph‐theoretic models of networks have made it possible to investigate the topological properties of the human brain across time and space. Brain flexibility is defined as the frequency with which brain regions switch between different functional modules over time and has been shown to correlate with higher‐order cognitive functions. Need for cognition (NFC) refers to a personality trait to engage in and enjoy effortful cognitive endeavors and usually has a positive effect on diverse cognitive activities (e.g., creativity), which may also be closely related to brain flexibility. Here, we tested whether the flexibility of a large‐scale brain network associated with NFC facilitated creative achievement. Robust correlation analyses showed that NFC correlates with the flexibility of the insula, the medial prefrontal cortex, and the putamen at the node level. Several large‐scale brain networks whose flexibility also correlated with NFC, including the default mode network, salience network, subcortical network, ventral attention network, and control network, imply that higher NFC individuals may exhibit better cognitive abilities, such as executive control, salient detection, spontaneous thought, and motivation function. Interestingly, only global flexibility acted as a mediator in the relationship between NFC and creative achievement, suggesting that the mediating mechanism may involve an interaction between distinct regions or large‐scale networks across the entire brain instead of the functional characteristic of local regions. Together, we demonstrate that the higher NFC is, the more flexible the brain, which may provide a potential insight into the acquisition of creative achievement.     

Sleep loss affects vigilance: effects of chronic insomnia and sleep therapy

Although complaints of impaired daytime functioning are essential to the diagnosis of primary insomnia, objective evidence for cognitive dysfunction has been hard to establish. A prerequisite for understanding the neurocognitive consequences of primary insomnia is to establish task paradigms that robustly differentiate insomniacs from well-sleeping subjects. We hypothesized that the decline in performance that typically occurs with an increasing cognitive demand would provide a more sensitive measure than performance on a single task version. The hypothesis was tested, first, by assessing the performance on two vigilance tasks with different cognitive demands in 25 elderly patients with primary insomnia and 13 healthy well-sleeping age-matched subjects. Secondly, we investigated the performance response to sleep therapy using a waiting-list controlled design. Sleep therapy consisted of a multi-component intervention including sleep restriction, cognitive behavioral therapy, bright-light therapy, structured physical activity and body temperature manipulations. The results show that insomniacs differed markedly from controls in their reaction times across tasks with different cognitive demands: patients responded faster on the 'simple' vigilance task, yet slower on the 'complex' vigilance task. Sleep therapy effectively restored normal performance: patients became significantly slower on the 'simple' task and faster on the 'complex' task, returning to the performance levels of control subjects. These findings indicate that the performance decline associated with increasing cognitive demands is possibly the first sensitive and robust measure of the neurocognitive sequelae of insomnia. We suggest that future studies on cognition in primary insomnia should apply a design that varies task demands.     

Testosterone levels and cognition in elderly men: a review

Average testosterone levels and many cognitive functions show a decline with age. There is evidence to suggest that this association is not just age related. Results from cell culture and animal studies provide convincing evidence that testosterone could have protective effects on brain function. Alzheimer's disease (AD) is characterised by brain pathology affecting cognitive function and AD prevalence increases with age. Testosterone levels are lower in AD cases compared to controls, and some studies have suggested that low free testosterone (FT) may precede AD onset. Men with AD may show accelerated endocrinological ageing, characterised by an earlier lowering of thyroid stimulating hormone, an earlier increase in sex hormone binding globulin (SHBG), a subsequent earlier decrease in FT and an earlier increase in gonadotropin levels in response to this. Positive associations have been found between testosterone levels and global cognition, memory, executive functions and spatial performance in observational studies. However, non-significant associations were also reported. It may be that an optimal level of testosterone exists at which some cognitive functions are improved. This may be modified with an older age, with a shifting of the optimal testosterone curve to maintain cognition to the left and a lower optimal level thus needed to be beneficial for the brain. Genetic factors, such as APOE and CAG polymorphisms may further interact with testosterone levels in their effects on cognition. The roles of SHBG, gonadotropins, thyroid hormones and estrogens in maintaining cognitive function and preventing dementia in men are also not completely understood and should be investigated further. Hypogonadal men do not seem to benefit from testosterone supplementation but small scale, short term intervention studies in eugonadal men with and without cognitive impairments have shown promising results. Larger randomised, controlled trials are needed to further investigate testosterone treatment in protecting against cognitive decline and/or dementia.     

Maternal Smoking During Pregnancy and Adverse Outcomes in Offspring: Genetic and Environmental Sources of Covariance

Maternal smoking during pregnancy (SDP) has been associated with several psychiatric outcomes in the offspring; studies have questioned whether the associations are causal, however. We analyzed all children born in Sweden between 1983 and 2009 to investigate the effect of SDP on multiple indicators of adverse outcomes in three areas: pregnancy outcomes (birth weight, preterm birth and being born small for gestational age), long-term cognitive abilities (low academic achievement and general cognitive ability) and externalizing behaviors (criminal conviction, violent criminal conviction and drug misuse). SDP was associated with all outcomes. Within-family analyses of the pregnancy outcomes were consistent with a causal interpretation as the associations persisted when siblings discordant for SDP were compared. For the cognitive and externalizing outcomes, the results were not consistent with causal effects; when comparing differentially exposed siblings none of the associations remained significant. In quantitative genetic models genetic factors explained the majority of the associations between SDP and cognitive and externalizing outcomes. The results suggest that the associations between SDP in mothers and cognition and externalizing behaviors in their offspring is primarily due to genetic effects that influence the behaviors in both generations.     

摩梭人身体铁状态与血糖升高的相关性

目的 探讨中国云南摩梭人群生理性铁储备，贫血与血糖升高的相关性。 方法 收集云南省宁蒗县187名摩梭人血样，检测其糖化血红蛋白（HbA1c）、转铁蛋白受体（TfR）与血红蛋白水平（Hb）。逻辑回归分析摩梭人数据和中国全国性数据（CHNS）中铁状态与血糖升高的关系。 结果 与控制组相比，摩梭人缺铁而不贫血，即缺铁性红细胞生成（IDE）对应着血糖升高风险的上升（OR=2.70），这一结果与针对全国性数据的分析结果一致。 结论 相比健康人群，缺铁性贫血与非缺铁性贫血的摩梭人，缺铁而不存在贫血症状的摩梭人面临着血糖升高的风险。 摩梭人身体铁水平对其2型糖尿病的风险评估与预防具有参考意义。     

miRNA-132: a dynamic regulator of cognitive capacity

Within the central nervous system, microRNAs have emerged as important effectors of an array of developmental, physiological, and cognitive processes. Along these lines, the CREB-regulated microRNA miR-132 has been shown to influence neuronal maturation via its effects on dendritic arborization and spinogenesis. In the mature nervous system, dysregulation of miR-132 has been suggested to play a role in a number of neurocognitive disorders characterized by aberrant synaptogenesis. However, little is known about the inducible expression and function of miR-132 under normal physiological conditions in vivo. Here, we begin to explore this question within the context of learning and memory. Using in situ hybridization, we show that the presentation of a spatial memory task induced a significant ~1.5-fold increase in miR-132 expression within the CA1, CA3, and GCL excitatory cell layers of the hippocampus. To examine the role of miR-132 in hippocampal-dependent learning and memory, we employ a doxycycline-regulated miR-132 transgenic mouse strain to drive varying levels of transgenic miR-132 expression. These studies revealed that relatively low levels of transgenic miR-132 expression, paralleling the level of expression in the hippocampus following a spatial memory task, significantly enhanced cognitive capacity. In contrast, higher (supra-physiological) levels of miR-132 (>3-fold) inhibited learning. Interestingly, both the impaired cognition and elevated levels of dendritic spines resulting from supra-physiological levels of transgenic miR-132 were reversed by doxycycline suppression of transgene expression. Together, these data indicate that miR-132 functions as a key activity-dependent regulator of cognition, and that miR-132 expression must be maintained within a limited range to ensure normal learning and memory formation.     

The phenotypic and genetic relationships among measures of cognitive ability,temperament, and scholastic achievement

The covariance among measures of cognitive ability, temperament, and scholastic achievement was examined in a subsample of 326 (89 Monozygotic, 74 Dizygotic) twins drawn from the Western Reserve Twin Project. Both phenotypic and behavioral genetic models were fit to the data. Univariate analyses indicate significant genetic influences on cognitive, achievement, and temperament variables. Common environmental influences also affected cognition and achievement but not temperament. Multivariate analyses indicate that both genetic and common environmental influences contribute to the covariance among all three variables. Cognition and achievement are highly genetically correlated. In contrast, achievement and temperament are highly correlated for common environmentality, while cognition and temperament are not.     

同种肾组织移植改善肾性贫血的基因水平检测

背景：促红细胞生成素分泌不足使慢性肾衰所引起的贫血(肾性贫血)难以改善。 目的：观察肾组织移植对肾性贫血大鼠促红细胞生成素基因表达的影响。 方法：80只Wistar大白鼠随机均正常对照组,病例对照组、重组人类促红细胞生成素组和肾组织移植组,后3组建立慢性肾功能衰竭动物模型。 结果与结论：60 d时移植组血红蛋白水平及血清促红细胞生成素高于病例对照组(P < 0.05),与重组人类促红细胞生成素组比较,差异无显著性意义(P > 0.05)。移植组肾组织EPO mRNA表达显著高于病例对照组,差异有显著性意义(P < 0.05)。提示肾组织移植改善肾性贫血的作用机制是促进肾组织EPO mRNA的基因表达,使肾脏合成促红细胞生成素增多,从而提高血红蛋白水平。     

The Genetic Relationship Between Social Cognition and Conduct Problems

Studies of children and adolescents with conduct problems suggest both genetic and environmental influences on population variance. Any genetic influence is likely to be complex and to act via mediating attributes of personality or cognitive style. One potential mediating attribute is social cognitive ability, as conduct problems have been shown to be associated with deficient social cognitive skills. The current investigation has examined the correlation between conduct problems and social cognition and has investigated the genetic and environmental influences on these measures and their covariation using a twin design. A population-based sample of twins aged 5-17 was used to examine the genetic relationship between conduct problems and social cognition using parent-report questionnaires. Conduct problems and social cognition were found to be highly correlated and to share common genetic influences that accounted for about half the covariation in scores. Each phenotype was subject to its own environmental influences that were not shared.     

The relationship between parenting dimensions and adult achievement: evidence from the whitehall ii study

This article examines the association between three dimensions of perceived parenting—warmth, strictness, and expectation—and adult cognitive and socioeco-nomic achievement outcomes. Structural equation models (N = 7,035) were used to examine simultaneously the influence of parenting on adult achievement while controlling for the influence of parental socioeconomic circumstances. Very low and very high level of parental warmth was associated with poor adult achievement. Strictness had a negative and parental expectation a positive relationship with adult achievement. These associations were independent of parental socioeconomic circumstances. Own education was found to mediate 27-56% of the relationship between parenting dimensions and adult achievement. Parental expectation was most strongly related to adult achievement. We conclude that parenting plays a significant role in the development of adult achievement: both cognitive ability and socioeconomic achievement. Moderate levels of warmth, low levels of strictness, and high parental expectation are associated with high adult achievement.     

Automated oxyhemoglobin dissociation curve construction to assess sickle cell anemia therapy

Oxyhemoglobin dissociation curves measure the most important function of red blood cells - the affinity for oxygen and its delivery to the tissues. This function may be deranged in sickle cell anemia and some other hemoglobinopathies. An automated oxyhemoglobin dissociation curve analyzer constructed dissociation curves in 55 patients with hemoglobinopathies and in 24 control subjects while maintaining constant temperature and pH. Sigmoid curves were converted to rectilinear ones using the Hill equation. Oxygen affinity of red cells was assessed by calculation of P50 (the PO2 at which hemoglobin is half saturated). Results revealed separation of oxyhemoglobin dissociation Hill plots according to phenotype but with wide variability. Mean oxygen affinity of fetal hemoglobin was greatest, whereas that of sickle hemoglobin was least. Other hemoglobins were intermediate. A positive correlation between decreased oxygen affinity and carboxyhemoglobin confirmed the decreased oxygen affinity of sickle hemoglobin and decreased oxygen affinity and increased diphosphoglycerate in red cells. Hill plots are less sensitive discriminators of oxygen affinity than traditional sigmoid dissociation curves and offer no particular advantage. Serial studies in a subset of three sickle cell anemia patients treated conservatively suggest automated oxyhemoglobin dissociation curves may be useful in assessment of effectiveness of newer therapies of sickle cell anemia after refinement of the method and studies of larger populations.     

The relationship between cognitive deficits and everyday functional activities in multiple sclerosis

Considerable evidence indicates that cognitive dysfunction and impairments in everyday life activities are common in multiple sclerosis (MS). However, the relationship between these cognitive and functional deficits has not been thoroughly investigated. The purpose of this study was to examine the role of cognitive dysfunction in the functional status of individuals with MS. Participants were 74 adults with MS and 35 healthy comparison participants (HCs) who underwent neuropsychological testing and completed the Executive Functions Performance Test (EFPT; Baum, Morrison, Hahn, & Edwards, 2003), an objective measure of everyday life activities. Between-groups comparisons and correlational analyses were conducted to examine the relationship between cognition and functional capacity. Significant differences in EFPT performance were revealed between individuals with MS with and without cognitive impairment and HCs. In individuals with MS, performance on cognitive constructs was related to performance on the EFPT. Furthermore, a linear regression model comprised of indices of cognitive functioning explained a significant portion of the variance in everyday life activities. Findings suggest that individuals with and without cognitive impairment differ in functional status and that aspects of cognition are predictive of functional status in MS.     

Assessing olfaction in the neuropsychological exam: the relationship between odor identification and cognition in older adults.

The relationship between odor identification and cognition has not been previously well characterized. The neuroanatomy of the olfactory system and the frequent finding of olfactory dysfunction in neurodegenerative diseases suggest a likely relationship between odor identification and memory, language, and executive functioning, though previous studies have often failed to demonstrate the expected relationship. The current study examined this relationship in across a continuum of ability levels (N=100). Strongest correlations were found between odor identification and language, most aspects of memory, and a measure of general cognitive functioning. Significant but more modest correlations were seen between odor identification and attention, motor, visuospatial, and executive functions. A regression analysis revealed language as the only significant predictor of olfactory performance. These findings suggest that odor identification is most closely associated with other measures of temporo-limbic functioning. The implications of these findings, particularly in consideration of the assessment of older adults, are discussed.     

Epidemiological correlates of nutritional anemia among children (6-35 months) in rural Wardha, Central India.

Background and Objectives : Nutritional anemia is associated with impaired performance of a range of mental and physical functions in children, along with increased morbidity. Iron supplementation at a later age may not reverse the adverse effects. National Nutritional Anemia Control Program was launched in India in 1970, but it failed to make any impact. The present study was undertaken to find out prevalence of anemia and its correlates in rural Wardha in children 6-35 months of age. Materials and Methods : Seven hundred seventy-two children between 6 months and 35 months of age were studied for anemia by cluster-sampling method. The hemoglobin was estimated in the child by 'Filter paper cyanmethemoglobin method.' Pre-designed and pre-tested questionnaire was used to collect data on socio-demographic and other variables. Data was analyzed by SPSS 12.0.1. Results : Mean hemoglobin level was 98.5 +/- 12.9 gm/L. Prevalence of anemia was 80.3%. Only 1.3% children had severe anemia (hemoglobin < 70 gm/L). The univariate analysis showed that anemia is significantly associated with age of the child, education of mother and father, occupation of father, socioeconomic status, birth order and nutritional status as measured by weight for age. The final model suggested that only educational status of the mother, occupation of the father, birth order and nutritional status of the child were significantly associated with anemia. Interpretation and Conclusion : For short-term impact, appropriate nutritional interventions remain the only operational intervention as only the nutritional status (weight for age) is a modifiable factor. But for long-term sustained impact, policy makers need to focus on improving maternal education and reducing family size.