Iron (Ferrous Sulfate)

Previous studies showed that 2-butoxyethanol increased liver tumors in B6C3F1 mice following chronic exposure. While the mechanism of 2-butoxyethanol-induced liver carcinogenicity has not been defined, 2-butoxyethanol has been shown to induce hemolysis in rodents via 2-butoxyacetic acid, the major metabolite of 2-butoxyethanol. This toxic effect, coupled with the observation that continued treatment with 2-butoxyethanol results in hemosiderin deposition in the liver, has led to our hypothesis that liver carcinogenicity by 2-butoxyethnaol is mediated via oxidative stress (iron catalyzed) and Kupffer cell activation. The present study used Syrian Hamster Embryo (SHE) cell transformation, a surrogate in vitro model for carcinogenesis in vivo, to examine whether 2-butoxyethanol, 2-butoxyacetic acid, or iron (ferrous sulfate) produced cell transformation. SHE cells were treated with either 2-butoxyethanol (0.5-20 mM), 2-butoxyacetic acid (0.5-20 mM), or ferrous sulfate (0.5-75 microg/ml) for 7 days. 2-Butoxyethanol and 2-butoxyacetic acid did not induce cellular transformation. In contrast, treatment with ferrous sulfate (2.5 and 5.0 microg/ml) increased morphological transformation. Cotreatment of ferrous sulfate with the antioxidants alpha-tocopherol (vitamin E) or (-)-epigallocatechin-3-gallate (EGCG) prevented ferrous sulfate-induced transformation, suggesting the involvement of oxidative stress in SHE cell transformation. The level of oxidative DNA damage (OH8dG) increased following ferrous sulfate treatment in SHE cells; additionally, using single cell gel electrophoresis (comet assay), ferrous sulfate treatment produced an increase in DNA damage. Both DNA lesions were decreased by cotreatment of ferrous sulfate with antioxidants. These data support our proposal that iron, produced indirectly through hemolysis, and not 2-butoxyethanol or its metabolite 2-butoxyacetic acid, is responsible for the observed carcinogenicity of 2-butoxyethanol.

BACKGROUND: Although recent trials have shown daily prenatal low-dose 500 mg calcium supplementation to be noninferior to the recommended high-dose 1500 mg regimen for prevention of preeclampsia, its effects on maternal anemia and iron status remain unclear. OBJECTIVES: This study evaluated the effects of 500 mg daily calcium supplementation as compared to 1500 mg calcium supplementation during pregnancy on maternal anemia and iron indices. METHODS: We conducted two individually randomized, noninferiority trials in India and Tanzania (N = 11,000 each) comparing daily 500 to 1500 mg calcium supplementation during pregnancy. All participants received standard iron and folic acid (IFA) (60 mg iron) and were counseled to take calcium supplements several hours apart from the IFA. All participants had hemoglobin measured at baseline and at 32 wk of gestation, whereas a random subset of participants had ferritin quantified at the same time points. Using an intention-to-treat approach, we assessed effects of 500 mg compared with 1500 mg calcium supplementation on mean hemoglobin and inflammation-adjusted serum ferritin (log-scale) using generalized linear models, and on anemia and iron deficiency anemia using log-binomial models. RESULTS: Third-trimester hemoglobin and serum ferritin were measured in 8953 and 1336 participants in India, respectively. In Tanzania, 8496 participants had hemoglobin, and 882 had ferritin assessed. In both trials, there was no difference between 500 and 1500 mg calcium supplementation on third-trimester hemoglobin [India: mean difference (MD) 0.01 (95% confidence interval (CI): -0.03, 0.04); Tanzania: MD -0.02 (95% CI: -0.07, 0.03)], anemia [India: relative risk (RR) 1.01 (95% CI: 0.95, 1.07); Tanzania: RR 1.00 (95% CI: 0.96, 1.05)], or iron deficiency anemia [India: RR 1.20 (95% CI: 0.93, 1.57); Tanzania: RR 0.94 (95% CI: 0.77, 1.15)]. CONCLUSIONS: Low- and high-dose calcium supplementation showed no differences in third-trimester hematologic outcomes. Future studies should assess the effects of coadministering or combining calcium and IFA into a single tablet on adherence and bioavailability of iron. This trial was registered at ClinicalTr

BACKGROUND: Iron deficiency (ID) is associated with decreased appetite and altered mood, which can contribute to feelings of early satiety and reduced overall well-being. Few studies have examined differences in appetite, satiety, and mood between meals containing animal meat and plant-based meat, or whether improving iron status in those with ID improves these outcomes. OBJECTIVES: The objective of this study was to determine appetite, satiety, and mood after consumption of a meal containing animal meat or plant-based meat at baseline and after consuming the meal with an iron supplement once a day for 8 weeks in women of reproductive age (WRA) with ID. METHODS: In this randomized, double-blind, parallel-arm study, 52 nonpregnant WRA (24 ± 7 y; BMI: 22.9 ± 3.0 kg/m2) with ID (serum ferritin: 13.7 ± 6.0 μg/L) consumed an iron supplement with a lunch meal containing either 4 oz. of beef (Animal) or Beyond Meat (Plant) once a day for 8 weeks. Meals were calorically matched but differed in macro- and micronutrient composition due to the inherent differences between protein sources. For this secondary analysis, at baseline and endpoint, fasted participants consumed a standardized lunch meal containing beef or plant-based meat and rated appetite (fullness, hunger, desire to eat, and prospective consumption) using 100 mm visual analog scales. A composite satiety score was calculated. The Profile of Mood States questionnaire was assessed at baseline and endpoint. RESULTS: Indicators of iron status and anemia improved after 8 weeks (P < 0.05 for all) but did not differ between Animal and Plant. Hunger and desire to eat decreased, and fullness and composite satiety score increased after the meal (P-time < 0.0001 for all). Measures of appetite, satiety, and mood did not differ between Plant and Animal at baseline or endpoint. Changes in transferrin saturation (r = 0.4, P < 0.01) and hemoglobin (r = 0.3, P = 0.04) and hematocrit (r = 0.3, P = 0.03) were positively associated with changes in prospective food consumption, and changes in transferrin saturation were negatively associated with satiety (r = -0.3, P = 0.02). Changes in transferrin saturation (r = 0.3, P = 0.03) an

BACKGROUND: Anemia is a global health concern. It is disproportionately prevalent among pregnant women in low-resource regions, where iron deficiency is the leading cause. Given the multifactorial nature of anemia, a range of nutritional interventions is recommended. However, effective implementation is often hindered by limited health care access, poor adherence to supplementation, and gaps in nutrition knowledge and counseling. To address these challenges and optimize hemoglobin (Hb) levels among pregnant women, mobile health (mHealth)-based nutritional interventions offer a promising alternative. OBJECTIVE: The aim of the study is to review available evidence on the effectiveness of mHealth-based nutritional interventions on iron status (Hb and/or serum ferritin concentration) among pregnant women. METHODS: Searches were conducted in Embase, CINAHL, Cochrane Library, PubMed, Web of Science, and Scopus, and supplemented by snowballing to identify additional relevant studies from citation lists. The key search strings comprised 4 concepts: "mobile health," "nutritional intervention," "Hb, anemia or iron deficiency anemia," and "pregnant women." Predefined inclusion and exclusion criteria were applied during screening. The methodological quality of included studies was assessed using the Risk of Bias 2 tool. The primary end point was the change in mean Hb concentration or serum ferritin level. Effect sizes (ESs) were calculated as standardized mean differences, including Cohen d and Hedges g. RESULTS: Of the 14,284 studies identified, only 11 randomized controlled trials were included. These studies used various modes of delivery, including mobile phone calls (n=1), SMS text messaging (n=3), and mobile apps (n=4), with some using more than 2 modes (n=3). The effect of mHealth-based nutritional interventions on iron status varied significantly. In total, 4 studies demonstrated a large ES (>0.8), with 3 relying on WhatsApp Messenger as an mHealth delivery mode. Approximately 82% (9/11) of the included studies reported a positive effect (P values ranging from <.001 to .047) of the intervention on Hb level, whereas 2 studies reported no statistically significant ass

BACKGROUND: Gestational weight gain (GWG) during pregnancy is a critical factor that affects maternal and child health outcomes. The considerable burden of inadequate GWG and the rising tide of excessive GWG are overlooked challenges in low and middle-income countries (LMICs). METHODS: This systematic review assessed the impact of antenatal interventions on GWG in LMICs. Randomised controlled trials (RCTs) on antenatal interventions on GWG in LMICs were included. These interventions included educational, behavioural, nutritional supplementation and pharmacological therapies. A systematic literature search was conducted using PubMed, Embase, Web of Science, CINAHL and the Cochrane Library from the start of each database through September 2025. RESULTS: Out of the 33 642 unique articles identified, 70 articles were included in our systematic review, with 59 individual RCTs and 11 cluster RCTs. Nutritional interventions (31 studies) included food and micronutrient supplementations. Micronutrient supplementation such as multiple micronutrient supplementations was found to reduce the risk of severely inadequate or inadequate GWG among pregnant women compared to iron only or iron and folic acid supplementation (Grading of Recommendations Assessment, Development and Evaluation [GRADE]: moderate certainty). Food supplementation showed mixed results, although most trials demonstrated higher mean GWG among undernourished pregnant women and a greater likelihood of achieving Institute of Medicine-recommended ranges (GRADE: moderate certainty). Behavioural (counselling/education) interventions (20 studies) were associated with significant reductions in excessive GWG among pregnant women with overweight or obesity and improved adequacy of GWG (GRADE: moderate certainty). Physical activity (seven studies) was found to reduce the risk of excessive GWG (GRADE: moderate certainty). Combined dietary and physical activity interventions (six studies) were found to reduce the risk of excessive GWG among pregnant women (GRADE: low certainty). CONCLUSIONS: Well-structured antenatal interventions, initiated before 20 weeks of gestation and continuing beyond this period, tailored to loca

BACKGROUND: Prenatal multiple micronutrient supplementation (MMS) including iron, folic acid, and other essential micronutrients, has shown potential to improve birth outcomes in controlled studies. We did an effectiveness study in Ethiopia to determine the effect on mean birthweight of MMS provided as part of routine antenatal care, relative to iron-folic acid supplementation (IFA). METHODS: A pragmatic, two-arm, facility-based, cluster-randomised controlled trial was conducted across 42 districts in five regions of Ethiopia to determine the effect on birthweight of MMS relative to IFA. Districts were randomly assigned to either retain IFA as part of routine antenatal care or switch to MMS. Randomisation was stratified by region and done using a random number generator within statistical software. All live singleton births at participating health facilities were eligible for inclusion and birthweights were recorded. Additionally, data were collected on maternal receipt and utilisation of MMS or IFA. The primary outcome was birthweight, analysed in the intention-to-treat population. This completed trial is registered at ClinicalTrials.gov, NCT05708183. FINDINGS: Between Jan 1, 2023, and Dec 31, 2024, birthweights were recorded for 47 325 babies in the 21 IFA districts and 36 473 babies in the 21 MMS districts. Mean age of mothers was 26·2 years (SD 5·3) and median gestational age of babies at birth was 38 weeks (IQR 38-39). The effect of MMS on birthweight was a mean increase of 38 g (95% CI 20-55) in the MMS arm relative to the IFA arm after adjustment for time, geographical region stratification factor, gestational age, sex of baby, and parity. Among women who reported taking at least 90 tablets of their assigned supplement, the increase in mean birthweight in the MMS arm relative to the IFA arm was 58 g (38-79). Stillbirth risk was 7·5 per 1000 births in the IFA arm and 6·9 per 1000 births in the MMS arm. INTERPRETATION: The findings of this trial are consistent with those from efficacy trials in other settings, indicating that the transition from IFA to MMS as part of routine antenatal care in Ethiopia could lead to a small but clear improvement in birthweig

BACKGROUND: Anemia affects more than two-thirds of children aged <5 y in India, despite biweekly iron folic acid (IFA) supplementation under the Anemia Mukt Bharat national program. Multiple micronutrient (MMN) deficiencies may also contribute to the presence of anemia, but the incremental benefit of MMN supplementation in addition to IFA remains unclear. OBJECTIVES: We aimed to compare the efficacy of biweekly preventive supplementation with MMNs plus IFA compared with IFA alone on hemoglobin concentrations and prevalence of anemia in children aged 6-59 mo. METHODS: In this individually randomized, open-label trial, eligible children received biweekly supplementation with either MMN plus IFA (intervention) or IFA alone (control) for 100 doses over 50 wk. Primary outcomes were mean hemoglobin concentration and anemia prevalence. Secondary outcomes included serum ferritin, soluble transferrin receptor, vitamin B12, folate, and zinc. RESULTS: Among 1300 children enrolled (648 intervention and 652 control), supplementation compliance exceeded 75%. At the endline, the mean hemoglobin was slightly higher in the intervention group [adjusted mean difference, 0.12 g/dL; 95% confidence interval (CI): 0.00, 0.25]. The prevalence of anemia was 17.6% in the intervention group and 24.0% in the control group (adjusted relative risk, 0.72; 95% CI: 0.58, 0.90). No significant differences were observed in serum biomarkers of iron status or other micronutrients. CONCLUSIONS: Biweekly supplementation with MMN plus IFA resulted in a modest increase in hemoglobin concentrations and a relative reduction in anemia prevalence compared with IFA alone, particularly in older children. Lack of improvement in biochemical markers and a small rise in hemoglobin concentrations suggest that a reduction in the prevalence of anemia may be driven by shifts near diagnostic thresholds, rather than meaningful physiological benefits. MMN adds minimal value where IFA adherence is already high. The study was registered at Clinical Trial Registry of India as #CTRI/2020/10/028299 (https://ctri.nic.in/Clinicaltrials/login.php).

BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition that affects attention, impulse control, and the ability to remain still. These challenges can make it harder for individuals with ADHD to succeed at school, work, and in social situations. Stimulant medications, such as methylphenidate and amphetamines, are commonly used as first-line treatments and are effective at reducing symptoms. However, their use can be limited by side effects, such as insomnia, appetite loss, cardiovascular risks, potential for misuse, and variability in individual response. Since current treatments have drawbacks, many people are exploring nonstimulant options, such as behavioral therapy, dietary changes, and neurofeedback. These approaches may be safer and easier to maintain, but research on their effectiveness remains uncertain. This systematic review and meta-analysis aim to compare the effectiveness of pharmacological and nonpharmacological therapies for ADHD. METHOD: We systematically searched PubMed, PsycINFO, Cochrane Library, ClinicalTrials.gov, and IEEE Xplore for randomized controlled trials (2008-2023) evaluating pharmacological (e.g., stimulant medications), non-pharmacological (e.g., behavioral therapy, cognitive training), or combined interventions in children and adolescents with ADHD. The search yielded 318 records. After screening titles and abstracts, 249 were excluded. Sixty-nine full-text articles were assessed, and 18 RCTs met the inclusion criteria for analysis. Primary outcomes were reductions in ADHD symptoms measured by standardized rating scales; secondary outcomes included academic performance, social functioning, and clinical global impression. RESULTS: Eighteen RCTs were pooled. ADHD symptoms were consistently reduced with stimulant medications (methylphenidate and amphetamines), although effects on academic performance were modest. Non-stimulants, such as viloxazine and guanfacine, showed significant improvements on ADHD-RS scores, but these improvements were only clinically modest. In contrast, some nutritional supplements, particularly iron and omega-3 fatty acids, showed more pronounced benefits in sympt

BACKGROUND: Maternal periconceptional nutrition is important for birth outcomes, but few studies examine long-term effects on offspring growth and development. OBJECTIVES: We assessed the impact of weekly preconception multiple micronutrients (MM) or iron and folic acid (IFA) supplements compared to folic acid (FA) alone, on cognitive function and nutritional status at 10-11 y. We also examined associations with early-life biological and socioenvironmental factors. METHODS: We conducted a follow-up study of 1599 children from a preconception randomized trial in Vietnam, in which females received weekly FA, IFA, or MM before conception and daily IFA during pregnancy. We assessed cognitive function, academic achievement, and nutritional status at ages 10-11 y. Early biological factors included maternal nutritional status, birth characteristics, and postnatal linear growth; socioenvironmental variables were maternal schooling, ethnicity, depression, infant feeding, socioeconomic status (SES), and home environment. Analyses used intention-to-treat and per protocol comparisons with inverse-probability-of-censoring weights to account for loss to follow-up. RESULTS: Offspring in the MM and IFA groups had higher perceptual reasoning scores than the FA group {mean difference [95% confidence interval (CI): MM: 1.68 (0.01, 3.35); IFA: 2.04 (0.33, 3.74)]}. The IFA groups also had higher reading scores [0.78 (0.11, 1.44)] and lower anemia prevalence [-4.26 (-7.60, -0.91)]. No differences were observed in full-scale intelligence quotient (FSIQ) or anthropometric measures. Maternal underweight was negatively associated with FSIQ [β (95% CI): -1.62 (-3.06, -0.18)] and reading scores [-0.59 (-1.12, -0.06)] whereas postnatal linear growth was positively associated with FSIQ [1.67 (0.91, 2.43)], mathematics [0.36 (0.12, 0.61)], and reading scores [0.47 (0.21, 0.74)]. Maternal schooling, home environment, SES, were also linked to improved cognitive and academic outcomes [β range: 0.64 (0.01, 1.27) to 8.89 (5.20, 12.58)], and exclusive breastfeeding was linked with higher mathematics scores [0.73 (0.27, 1.19)]. CONCLUSIONS: Preconception MM and IFA supplementation improved certain a

BACKGROUND: Caloric restriction (CR) is a promising nutritional intervention for improving metabolic and age-related health outcomes, but its long-term effects on hematologic health remain unclear. Clarifying how prolonged CR affects anemia risk and iron status is essential for evaluating its long-term safety and clinical relevance. OBJECTIVES: To determine the effects of a 2-y CR intervention on markers of anemia, iron status, and hepcidin in females and males enrolled in the Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE) Phase 2 trial. METHODS: Participants in CALERIE Phase 2 (n = 220) were randomly assigned to 25% CR or ad libitum (AL) control. AL continued their habitual diet, whereas CR received an intensive intervention to promote CR over 2 y. All participants received a multivitamin/mineral supplement containing 18 mg iron. Fasted blood was collected at baseline (BL) and 12 (M12) and 24 (M24) mo and indicators of iron status (ferritin, soluble transferrin receptor, and serum iron), anemia (hemoglobin and hematocrit), and regulators of iron status (hepcidin, C-reactive protein, and IL-6) were measured. Six-day diet diaries were collected twice at BL and once each at M12 and M24. An anemia surveillance protocol monitored hemoglobin, hematocrit, red blood cell (RBC) count, and serum iron throughout the intervention, with medical evaluation and temporary/permanent CR discontinuation as needed. Linear mixed-effects models were used to evaluate the effect of treatment (CR compared with AL), time (BL, M12, and M24), and their interaction (treatment × time). RESULTS: Participants (n = 218) were mostly female (70%) with an mean age (±SD) of 38.1 ± 7.2 y and a mean BMI of 25.2 ± 1.7 kg/m2. At baseline, ferritin (105.5 ± 126.9 μg/L), hepcidin (8.6 ± 5.8 ng/mL), and dietary iron intake (16.1 ± 5.5 mg/d) were similar between groups (P > 0.05). There were no group × time interactions for markers of anemia, indicators of iron status, or hepcidin (P > 0.05). Despite the anemia surveillance protocol, anemia prevalence remained >5% in both groups across all timepoints. Low RBC count was the most common trigger, and participants who tri

Oxidative stress (OS) arises from an imbalance between antioxidant defenses and the generation of reactive oxygen species (ROS), both of which are influenced by the levels and composition of trace elements. The Micronutrients for ADHD in Youth randomized controlled trial demonstrated behavioral improvements following 8 weeks of multinutrient supplementation in 54% of children compared to 18% on placebo. This secondary analysis examined the relationship between plasma minerals and OS-related parameters [biological antioxidant potential (BAP), glutathione peroxidase (GPx), glutathione reductase (GR), and reactive oxygen metabolites (ROM)] in 71 children (44 multinutrient, 27 placebo; median age 10.4 years). Correlation analysis revealed that selenium and zinc improved antioxidant response measured as GPx change in both treatment groups (r = 0.26, p = 0.03) and BAP in multinutrient group (r = 0.37, p = 0.01), respectively, while chromium change was inversely related to BAP (r=-0.41, p = 0.005) in the multinutrient group. BAP change was moderated by baseline selenium (β=-9.45, p = 0.006), zinc (β=-2.13, p < 0.001), and chromium (β = 68.9, p = 0.02), where children in the multinutrient group with low selenium, low zinc, and high chromium at baseline experienced BAP increases. Selenium also exhibited pro-oxidant effects: ROM change correlated positively with change in selenium in multinutrient group only (r = 0.34, p = 0.03). Baseline copper predicted ROM change (β = 0.213, p < 0.001), and ROM change correlated positively with changes in copper in both groups (r = 0.51, p < 0.001) and negatively with Mn (r=-0.24, p = 0.05), while iron did not moderate OS. Multinutrient supplementation may enhance antioxidant defenses in children who had low plasma zinc and selenium, while potential pro-oxidant effects in those with higher selenium and chromium warrant further investigation. Clinical Trial Registry number for MADDY RCT: NCT03252522. © 2026. The Author(s).

Celiac disease (CeD) is a gluten-induced immune-mediated enteropathy that preferentially involves the proximal duodenum. Consequently, iron deficiency is common in CeD, impacting at least 10% of newly diagnosed individuals. In this narrative review, we aim to investigate the mechanisms, prevalence, treatment, and monitoring of iron deficiency and the impacts of a gluten-free diet (GFD) on iron deficiency in individuals with CeD. We will also review the role of and approach to iron supplementation in this population. Specifically, we will explore whether mucosal healing on a GFD is sufficient for the management of iron deficiency amongst individuals with CeD.

BACKGROUND: Malaria is an infectious disease transmitted by female Anopheles mosquitoes, with ongoing transmission in over 80 countries. The malaria parasite requires folate for survival and growth; antifolate antimalarial medications used for prevention and treatment target enzymes in folate metabolism as their mechanism of action. Periconceptional folic acid (synthetic form of folate) supplementation (400 μg/day) is the standard of care for neural tube defect prevention. Concerns have been raised about the potential effects of folic acid (including above the tolerable upper intake level (UL) >1.0 mg/day) in the context of malaria prevention and treatment, including the efficacy of antimalarial medications. Examining the potential impact of folic acid on malaria risk and severity amongst people taking antifolate antimalarial medications may inform public health programmes in malaria-endemic areas. OBJECTIVES: To examine the effects of folic acid supplementation on the risk and severity of malaria infection amongst people taking antifolate antimalarials and living in areas with malaria endemicity. PREVENTION: Amongst uninfected people taking antifolate antimalarial medications for malaria prevention, does folic acid supplementation increase susceptibility or severity of malaria infection? TREATMENT: Amongst people with malaria infection who are being treated with antifolate antimalarial drugs, does folic acid supplementation reduce parasite clearance or increase the risk of treatment failure? SEARCH METHODS: We searched databases including CENTRAL, MEDLINE, Embase, CINAHL, Scopus, and trial registries (September 13, 2024), grey literature, and reference searches to identify additional studies. SELECTION CRITERIA: Randomised trials evaluating the effects of folic acid supplementation (alone or in combination with iron or other vitamins and minerals) amongst individuals taking antifolate antimalarial medications in malaria-endemic areas. DATA COLLECTION AND ANALYSIS: Primary outcomes included uncomplicated malaria or severe malaria, parasite clearance, and treatment failure. Cochrane RoB 2 was used to evaluate the risk of bias. Certainty of evidence was assessed u

BACKGROUND: Small vulnerable newborn (SVN) types, defined by combinations of being born too soon or too small, have distinct determinants, health consequences, and prevention strategies. The effects of prenatal balanced energy and protein (BEP) supplementation on SVN types remain unknown. METHODS AND FINDINGS: We conducted a systematic review and meta-analysis of individual participant data from eight randomized controlled trials of prenatal BEP supplements (N = 10,252, with 5,164 in the BEP arm and 5,088 in the control arm) in low- and middle-income countries were used. The control arms varied across studies and included context-specific standards of care, iron and folic acid supplements, or multiple micronutrient supplements. Newborns were classified into 10 groups through the combinations of preterm birth, small for gestational age (SGA) birth, and low birthweight (LBW), such as term-appropriate-for-gestational-age (AGA)-nonLBW, preterm-SGA-LBW, preterm-large-for-gestational-age-LBW, term-SGA-LBW, preterm-AGA-nonLBW, and other permutations. Newborns were also analyzed using a four-group categorization that included term-nonSGA, preterm-nonSGA, term-SGA, and preterm-SGA. Log-binomial models were used to estimate study-specific risk ratios (RRs), which were pooled using meta-analyses. Subgroup analyses were conducted by maternal age, parity, gestational age at enrollment, early pregnancy body mass index, and maternal anemia status. In the 10-group categorization of SVNs, on average, prenatal BEP supplementation led to a 30% lower risk of preterm-SGA-LBW (RR: 0.70; 95% CI [0.53, 0.91]; P = 0.009), a 25% lower risk of preterm-AGA-LBW (RR: 0.75; 95% CI [0.60, 0.93]; P = 0.009), and a 20% lower risk of term-SGA-LBW (RR: 0.80; 95% CI [0.72, 0.90]; P < 0.001). In the four-group categorization, prenatal BEP supplementation led to a 31% lower risk of preterm-SGA (RR: 0.69; 95% CI [0.52, 0.91]; P = 0.008) and a 12% lower risk of term-SGA (RR: 0.88; 95% CI [0.81, 0.96]; P = 0.005). The protective effect of prenatal BEP supplementation on preterm-SGA was stronger among multiparous women and women without anemia. The protective effects on all three SVN types under the four

BACKGROUND & AIMS: Iron deficiency (ID) is a global health condition that predominately affects women. Although oral iron supplementation is an effective treatment strategy for this issue, gastrointestinal complaints are common, and if persistent, may lead to poor compliance. The efficacy of different iron formulations which claim to improve tolerance is unclear. This study assessed the efficacy and tolerability of ferrous sulphate (FS) and iron (III)-hydroxide polymaltose complex (IPC) supplementation in three different cohorts of women.. METHODS: This study implemented a 12-week, single-blind, randomized controlled trial. Eligible participants had a serum ferritin concentration of <50 μg/L and met specific inclusion criteria to be enrolled to either the athlete, pre-menopausal or post-menopausal groups. Participants were randomized to receive FS (equivalent to 105 mg elemental iron) plus sodium ascorbate or IPC (equivalent to 100 mg elemental iron) daily. Venous blood samples were collected at baseline, 4-, 8- and 12-weeks of supplementation. A daily questionnaire was completed throughout the study period, documenting supplement tolerance (number and severity of symptoms), exercise load, menstrual characteristics, and supplement compliance. RESULTS: Fifty-seven participants completed the intervention with a compliance rate of 94.9 % [range: 74.8-100 %]. A significant interaction between supplement and time was evident for ferritin (p < 0.001), where FS increased after 12 weeks (+109 %; p < 0.001) but no change was evident in IPC (+7 %; p = 0.727). No differences were detected between cohorts (p > 0.05). The IPC group had a lower symptom rate compared to FS (28 % vs. 33 %; p < 0.001).. CONCLUSIONS: FS was superior in repleting ferritin concentrations after 12 weeks compared with IPC; however, FS also resulted in a greater number and severity of GI symptoms than IPC. Our data shows FS is the superior iron formulation for ID treatment, however future research should continue to address how to improve FS tolerance.. This trial was registered at https://www.anzctr.org.au/Trial/Registration/TrialReview as ACTRN12623000529640.

BACKGROUND: Despite substantial increases in access to schooling and to the internet, health information and knowledge remains limited among women of reproductive health in many low- and middle-income countries. Given the near universal cell-phone coverage in low- and middle-income countries, call-in services offer an interesting new platform to provide high quality information to targeted populations. In this paper, we assessed the impact of the Viamo 3-2-1 call-in platform on health knowledge and behavior among women of reproductive age in Uganda. METHODS: We conducted a 2-arm open label randomized controlled trial targeting 6000 women, ages 18-49 years, with access to a simple feature Airtel cell phone in Uganda. Fifty enumeration areas were randomly selected in Kampala, Madi-Okollo, Rwampara and Katakwi districts for a total of 200 enumeration areas. Consenting women were asked to complete a baseline and endline survey implemented by trained interviewers using tablets through home visits. After completion of baseline, women were randomized with equal probability to treatment and control using a tablet-generated random number draw. Study staff introduced treated women to the call-in service and encouraged its use through various incentives and promotional messages. Primary outcomes were sexual and reproductive health knowledge scores as well as iron supplementation in pregnancy. Secondary outcomes included self-reported use of contraception, healthy diets, birth spacing and birth outcomes as well as hemoglobin levels and BMI. Linear regression models were used to estimate mean differences in outcomes between treatment and control. Standard errors were corrected for the cluster-based sampling of women. RESULTS: A total of 6,011 women were enrolled into the study between December 6, 2022 and February 11, 2023; 3,052 were assigned to treatment, 2,959 used as controls. Endline data was collected between May 8, 2024 and August 4, 2024. Overall follow-up rates were 92% in both the treatment and the control group. Treatment increased average sexual and reproductive health knowledge by 0.07 standard deviations (95% CI [0.01, 0.11], p-value = 0.02) and increased the l

BACKGROUND: Iron supplementation has been suggested as a potential factor influencing enamel properties; however, its direct effect on enamel microhardness remains unclear. The aim of this study was to evaluate the effect of four types of supplements on the microhardness of deciduous tooth enamel. MATERIALS AND METHODS: Fifty five healthy primary anterior teeth were randomly divided into five groups (n = 11): one control group and four experimental groups. The pH of four supplements (Liposofer, Feramax, Amivital Ferrous Sulphate and SiderAl) was recorded. Baseline enamel microhardness was assessed using a Vickers hardness tester (50 g load for 10 s). Samples of the control group were placed in 250 ml of distilled water and the samples of each experimental group were placed in a solution containing 250 ml of distilled water and a volume of iron supplements (equivalent to 100 mg of elemental iron) for 5 min in a Shaker Incubator. After rinsing, the microhardness of the enamel was measured again after the treatment. The mean microhardness of the deciduous teeth enamel was compared using One-way ANOVA across the studied groups. RESULTS: One-way ANOVA demonstrated no statistically significant differences in mean enamel microhardness changes among the study groups (p > 0.05). The mean ± SD microhardness changes in the groups were as follows: control group 68.82 ± 68.13, Amivital Ferrous Sulphate group 32.06 ± 34.61, SiderAl group 84.45 ± 97.20, Liposofer group 30.35 ± 20.48, and Feramax group 58.58 ± 70.27. CONCLUSION: Within the limitations of this in-vitro study, short-term exposure to different iron supplements did not result in statistically significant differences in enamel microhardness of primary teeth. Although numerical differences were observed among the tested supplements, no statistically significant differences were detected. © 2026. The Author(s).

Background/Objectives: Baccharis dracunculifolia DC. is a medicinal plant and the primary botanical source of Brazilian green propolis. This study aimed to characterize the phytochemical profile of its ethanol extract and evaluate its antioxidant, anti-inflammatory, cytotoxic, and acute oral toxicity profiles. Methods: The extract was characterized by ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS). Antioxidant and anti-inflammatory activities were evaluated by complementary in vitro assays, cytotoxicity in NIH/3T3 fibroblasts, and acute oral toxicity according to OECD Guideline 423 in Wistar rats at 300 and 2000 mg/kg. Results: UHPLC-QTOF-MS analysis resulted in the tentative annotation of 54 metabolites, including phenolic acids, flavonoids, caffeoylquinic acid derivatives, diterpenes, glycolipids, and saponins. The extract showed antioxidant activity, with a DPPH IC50 of 0.77 ± 0.009 mg/mL and FRAP reducing capacity of 1.24 ± 0.22 µM ferrous sulfate/mg. Anti-inflammatory activity increased with concentration, reaching 58.60 ± 0.23%, 60.84 ± 0.40%, and 57.89 ± 2.96% inhibition of hemolysis, macrophage spreading, and phagocytosis, respectively, at 600 µg/mL (p < 0.05 vs. negative control). NIH/3T3 viability remained above 70% at all tested concentrations and exposure times. No mortality, treatment-related clinical signs, or significant changes in body weight, hematological and biochemical parameters, relative organ weights, or histopathological findings were observed at doses up to 2000 mg/kg. Conclusions: The B. dracunculifolia ethanol extract exhibited antioxidant and anti-inflammatory activities in vitro, without relevant cytotoxicity under the tested conditions, and showed no evidence of acute oral toxicity at doses up to 2000 mg/kg.

Conventional water treatment processes exhibit inherent limitations in the removal of trace emerging micropollutants. To address this challenge, we rationally designed ultrathin Fe-doped nanosheets via a one-step etching strategy using ferrous sulfate. This approach simultaneously transformed pristine granular ZIF-8 into a layered architecture and facilitated the uniform incorporation of iron active sites. The as-prepared catalyst was subsequently employed in a visible-light-driven peracetic acid (PAA) activation system for the efficient degradation of micropollutants. The etching treatment not only substantially increased the specific surface area of the nanosheets relative to their bulk counterparts but also ensured homogeneous dispersion of Fe species, thereby establishing stable Fe2+/Fe3+ redox cycling centers that significantly accelerate electron transfer kinetics. In the ZIF-8-Fe-Nanosheets/PAA/simulated sunlight system, sulfamethazine (SMT) achieved near-complete degradation within 50 min. Moreover, the catalyst exhibited excellent broad-spectrum degradation activity, robust pH adaptability across a range of 3-9, and strong resistance to coexisting matrix constituents in real water samples. Radical quenching experiments identified hydroxyl radicals (•OH) and singlet oxygen (1O2) as the dominant reactive oxygen species. Three plausible SMT degradation pathways were proposed, and toxicity assessment using quantitative structure-activity relationship analysis indicated lower biotoxicity of the transformation products compared to the parent compound. Overall, this work validates the Fe-doped nanosheet catalyst as an efficient PAA activator, and more broadly, paves the way for expanding PAA-based catalytic oxidation toward practical water treatment.

Humic acid (HA) stability determines the food waste (FW) compost quality and facilitates organic waste recycling via aerobic composting. This study investigated the synergistic effects of ferrous sulfate (FeSO4)-zeolite and low aeration to enhance the HA stability during FW composting. Composting was carried out for 50 days across four treatments: control (CK), FeSO4-zeolite (FZ), low aeration (L), and combined FZL treatments. Results showed that FZL achieved the highest HA content (33.1 mg/g) and condensed HAC3 proportion (18.3%), raising the HA polymerization degree by 84.9% relative to CK. Low aeration prolonged Fe2+ persistence, stimulating stable iron oxide formation to serve as a nucleation site for HA polymerization and complexation. FZL optimized microbial networks and enriched humification-related microbes. Variance partitioning analysis quantified iron-mediated passivation (45.5%) and its synergy with synthesis (21.8%) as the dominant drivers. This study clarifies the underlying mechanism and offers a practical strategy to produce a high-stability HA compost. © 2026 American Chemical Society.

The global accumulation and improper disposal of industrial ferrous sulfate (FeSO4) waste present significant environmental and resource management challenges, including soil acidification, groundwater contamination, iron loss, and unrecovered sulfate sulfur. Existing disposal and recovery routes mainly produce low-value iron oxides, require intensive reagent input or high energy consumption, and generate additional waste burdens. Here, we propose a novel carbonyl sulfide (COS)-mediated gas-solid strategy for upcycling FeSO4 into a calculated pyrrhotite (Fe7S8) phase fraction of 96.6 wt%, realizing high-value conversion of both iron and sulfur. Structural characterizations demonstrate a stepwise conversion from FeSO4 to Fe3O4, followed by controlled sulfidation to Fe7S8, during which the random stacking of newly formed Fe7S8 particles generates textural interparticle voids and reconstructs the pore structure. Density functional theory calculations show that COS exhibits the most negative adsorption Gibbs free energy (-9.58 eV) and, relative to S and H2S, the largest comparative sulfur-incorporation barrier under a common-final-state framework, indicating stronger interfacial stabilization and greater kinetic resistance to rapid sulfur transfer. Kinetic analysis indicates that COS governs the reaction (order = 1.10), whereas CO acts as a secondary promoter (order = 0.60), lowering the apparent activation energy from 188.9 to 129.6 kJ/mol. Practical evaluations with real FeSO4 waste validated the successful upcycling into Fe7S8, which exhibited efficient gaseous mercury removal performance from simulated flue gas. Life-cycle and preliminary cost analyses further indicate the potential environmental and resource-utilization advantages of this cross-industry FeSO4 valorization strategy under the adopted assumptions.

ETHNOPHARMACOLOGICAL RELEVANCE: Lippia graveolens Kunth (Mexican oregano) is traditionally used to treat gastrointestinal, respiratory, and inflammatory conditions. Its phenolic constituents provide a rationale for investigating additional biological properties, including protection against chemically induced genetic damage. AIM OF THE STUDY: To evaluate the antigenotoxic potential of a methanolic extract of L. graveolens against iron- and lead-induced genomic damage in CD-1 mice. MATERIALS AND METHODS: The extract was characterized by HPLC-DAD. Acute intraperitoneal toxicity was assessed using an ascending dose design (1000-2000 mg/kg) with 14-day observation. Male CD-1 mice (n = 5/group) received the extract at 100 mg/kg under pre-treatment, co-treatment, or combined pre- and co-treatment regimens. Ferrous sulfate (72 mg/kg) or lead nitrate (98 mg/kg) was administered intraperitoneally at 0 and 24 h. Endpoints included leukocyte viability, alkaline comet assay parameters, micronucleated polychromatic erythrocyte frequency, the PCE/NCE ratio, and body weight. Between-group comparisons and paired temporal analyses were complemented by exploratory Pearson correlations. RESULTS: HPLC-DAD analysis supported the identification of galangin, chlorogenic acid, and caffeic acid by comparison with authentic standards. Acute exposure produced 50% mortality at 2000 mg/kg; a formal LD50 was not estimated. The extract alone at 100 mg/kg produced no statistically significant alterations in the evaluated endpoints. Combined pre- and co-treatment consistently produced the greatest attenuation of comet-assay damage, reducing background-corrected tail intensity by 91.0% and 85.4% for Fe and by 67.6% and 56.3% for Pb at 24 and 48 h, respectively. Micronucleus frequency was significantly reduced relative to both metal-only groups at 48 h. Responses in viability, PCE/NCE ratio, and body weight varied with treatment and sampling time. Correlations showed metal- and time-dependent associations. CONCLUSIONS: The methanolic extract of L. graveolens exhibited antigenotoxic activity against Fe- and Pb-associated genomic damage, particularly under combined pre- and co-treatment. These find

Iron deficiency anaemia (IDA) affects up to 30% of all pregnant women often causing symptoms including malaise and lethargy which can significantly impact daily life and well-being. Additionally, IDA is associated with serious complications, including an increased risk of bleeding, preterm birth, small for gestational age babies and rarely, but significantly, stillbirth. The most common current management approach reactively treats IDA once it is diagnosed, usually with an oral iron preparation such as ferrous sulphate or another ferrous salt. There have been calls to investigate a policy of prevention, to discover if outcomes can be improved. We therefore designed the primary prevention of maternal anaemia to prevent preterm delivery and other adverse outcomes trial, to assess whether the prevention of IDA during pregnancy, through routine iron supplementation from early pregnancy, will reduce the risks of significant adverse clinical outcomes for women and their babies. DESIGN: Randomised, double-blind, placebo-controlled trial to evaluate the effectiveness of low-dose ferrous sulfate in the primary prevention of IDA, alongside an intervention to support medication adherence, with a parallel process evaluation to explore acceptability, fidelity and mechanisms of action. PARTICIPANTS: 11 020 women in their first trimester of pregnancy, who are not anaemic and have no contraindication to oral iron, will be recruited from maternity units. INTERVENTION: A tablet of ferrous sulfate 200 mg (65 mg of elemental iron) once daily compared with an identically matched placebo tablet, administered from recruitment in the first trimester (anytime ≤15 weeks+6 days gestation) through until 6 weeks post partum or when all of the tablets have been taken, whichever is sooner. Participants are supplied with a total of 240 tablets to cover the whole period of the study. An adherence intervention to support initiation and adherence to iron supplementation was also delivered. OUTCOMES: The primary outcome is a composite of preterm birth, small for gestational age, stillbirth and neonatal death. Secondary outcomes include development of maternal anaemia, post-partum haemorrhage, post

Arsenic (As) contamination can threaten groundwater quality and human health, particularly where redox conditions fluctuate. Although iron (Fe) and aluminum (Al) (hydr)oxides strongly adsorb arsenate under oxic conditions, flooding can promote As(V) reduction to more toxic and mobile As(III) and destabilize the Fe(III)-As(V) complexes. This study evaluated ferrous sulfate and aluminum sulfate as in-situ soil amendments to immobilize As and assess their stability under submergence. A batch, column leaching, and anaerobic incubation study was conducted to monitor redox potential (Eh), As speciation, and Fe/Al behavior. Results showed that both amendments reduced water-soluble and leachable As at pH 7-9. In batch tests, Fe and Al amendments lowered water-soluble As by 78.3% and 83.3%, respectively. Column tests showed that most As eluted within the first 10 pore volumes, with Fe and Al amendments reducing cumulative leachable As by 60.3% and 89.7%, respectively. During incubation, soil Eh declined to strongly reducing conditions (-259 mV). Around days 20-30 of incubation, the As(III)/total As ratio was >50%. Fe amendment showed substantial Fe(II) accumulation consistent with reductive dissolution and As remobilization. Although the Al amendment remained redox-stable and maintained lower dissolved As, strongly reducing conditions could still increase risk by shifting As(V) toward As(III). Overall, aluminum sulfate is preferred for flood-prone or redox-fluctuating soils because it remains effective under reducing conditions, whereas ferrous sulfate can be applied for persistently oxic sites to minimize redox-driven Fe(III)-As(V) destabilization.

BACKGROUND: Iron is the most common nutrient deficiency globally, affecting nearly 2 billion people. It may cause long-term neurocognitive impairments and behavioral deficits in premature and low-birthweight neonates. Reticulocyte hemoglobin (Ret-He) is a reliable, valid, low-cost, and minimally invasive phlebotomy laboratory test for assessing iron status and guiding iron dosing. PURPOSE: The overarching aim is to standardize Ret-He use as a guide for precision iron supplementation that may increase the rate of iron sufficiency among infants born at less than 32 weeks of gestational age or 1500 grams within the neonatal intensive care unit. METHODS: The quality improvement project included the creation of an evidence-based algorithm, provider education, and an electronic medical record order set for individualized iron supplementation using Ret-He. The preimplementation data were retrospectively collected through an electronic medical record review. The postimplementation data were prospectively gathered, and all data were analyzed using IBM SPSS Statistics Software. RESULTS: There was a substantial increase in the number of Ret-He levels drawn from 77% to 100%. In the preimplementation group, 81.3% of patients with Ret-He levels at 37 weeks or discharge were iron-sufficient. However, 48.4% of patients did not have Ret-He levels measured. The postimplementation group had an 82.1% rate of iron sufficiency. IMPLICATION FOR PRACTICE AND RESEARCH: Ret-He can be used to guide iron dosing. Further research is needed to determine whether Ret-He values should differ for specific gestational ages or high-risk populations, such as small-for-gestational-age infants. Additional knowledge is needed on maximum iron doses and duration of intake.

Comment on Paediatr Drugs. 2026 Sep;28(5):531-545. doi: 10.1007/s40272-026-00753-6.

123. Paediatr Drugs. 2026 Sep 18. doi: 10.1007/s40272-026-00775-0. Online ahead of print. Authors' Reply to Kaplan Comment on "Safety and Efficacy of Oral Ferric Maltol and Ferrous Sulfate for Iron Deficiency Anemia in Infants, Children and Adolescents: A Multicenter Randomized Trial". Russell RK(1)(2). Author information: (1)NHS Scotland, Edinburgh, UK. [email protected]. (2)Department of Paediatric Gastroenterology, Royal Hospital for Children and Young People, Clinical Staff Offices, 2nd Floor, 50 Little France Crescent, Edinburgh, EH16 4TJ, UK. [email protected]. DOI: 10.1007/s40272-026-00775-0 PMID: 42758407 Conflict of interest statement: Declarations. Conflicts of interest: Richard K. Russell received consulting fees from Nestle, Lilly, Ferring, Alfasigma and AbbVie and speaker fees from Pfizer and Janssen. Ethics approval: Not applicable. Consent to participate: Not applicable. Consent for publication: Not applicable. Availability of data and material: Not applicable. Code availability: Not applicable. Author contributions: R.K. Russell; manuscript writing and editing.

BACKGROUND: Numerous preclinical studies on improving iron bioavailability to address iron deficiency anemia have been published; however, no preclinical systematic reviews with pairwise meta-analyses have been conducted. Therefore, it is essential to systematically review, summarize, and evaluate the evidence regarding the effects of iron fortificants in animal studies. METHODS: The initial articles were identified in four scientific databases (PubMed, Web of Science Core Collection, Scopus, and EBSCO) on 10 January 2026. The final included articles were collected after the initial articles were scanned and sorted. The data were extracted for pairwise meta-analysis. Hemoglobin (Hb) was the primary outcome. RESULTS: A total of 23 studies were included in this systematic review. Data from 13 rat experiments, including 56 comparisons, were analyzed using pairwise meta-analysis. The results of the meta-analysis showed that the overall effects of sodium iron ethylenediaminetetraacetate (NaFeEDTA) and ferrous fumarate on Hb were equivalent to those of ferrous sulfate (FeSO4). Ferric pyrophosphate (FePP) and ferric orthophosphate (FePO4) were inferior to FeSO4. CONCLUSION: The meta-analysis results suggest that both NaFeEDTA and ferrous fumarate are effective in improving Hb concentration. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/recorddashboard, CRD420261280933.

In plants and humans, adequate levels of iron (Fe) are essential for proper growth and development. Dietary deficiencies in Fe are particularly prevalent and can cause numerous physical and cognitive impairments in humans. Intervention strategies like agronomic biofortification can address these issues by utilizing fertilization to enhance the Fe content in a quick and straightforward manner in plant-based foods. Microgreens are nutritional powerhouses with low antinutrient levels, making them a promising candidate crop for agronomic Fe biofortification. Although Fe fertilization can increase Fe's abundance in the environment, Fe's availability is limited to plants in alkaline and oxidizing conditions. Therefore, selecting an efficient Fe fertilizer source is crucial for successful Fe enrichment. In this study, we investigated the effects of five alternative Fe fertilizers, including chelated Fe sources (Fe-EDDHA, Fe-EDTA), inorganic Fe salts (ferric sulfate, ferrous sulfate), and Fe-oxide nanoparticles (Fe3O4), provided via fertigation at different concentrations (0, 15, 30, 45 mg/L), on the Fe enrichment, yield, and quality of radish and pea microgreens. Fe-EDTA was the most effective treatment for Fe enrichment, increasing Fe content by 3-5-fold in radish and 2-3-fold in pea microgreens, compared to the untreated control, with minimal trade-offs in yield and mineral composition. Fe-EDTA also ensured greater contributions to Fe's recommended dietary allowance (RDA) for adult males and females, compared to the other sources. These findings highlight the potential of Fe-EDTA in enriching microgreens that can serve as functional foods to combat Fe deficiencies at household and community scales. © 2026. The Author(s).

OBJECTIVE: To evaluate the prevalence and factors associated with supplementation of ferrous sulfate and folic acid in pregnant people. METHODS: A cross-sectional, representative study with pregnant people treated in Primary Health Care in Criciúma, Santa Catarina, in 2023. Ferrous sulfate and folic acid supplements were evaluated based on the prenatal booklet for pregnant people. The prevalence of supplementation was calculated with their respective 95% confidence intervals (95%CI). Crude and adjusted Poisson regression analyses (hierarchical model) were performed, estimating prevalence ratios (PR) and their respective 95%CI, to verify the associated factors. RESULTS: A total of 428 pregnant people were interviewed. Of these, 97.4% used ferrous sulfate supplementation during pregnancy, and 93.7% folic acid. The analyses indicated that the use of ferrous sulfate was higher in older pregnant people, with PR 1.06 (95%CI 0.99; 1.13), and who consumed alcohol during pregnancy, with PR 1.04 (95%CI 1.00; 1.08). Regarding the use of folic acid, it was higher among pregnant people who had at least six prenatal visits, with PR 1.10 (95%CI 1.01; 1.20). CONCLUSION: The results indicate high iron and folic acid supplementation among pregnant people in Primary Health Care. The identification of associated factors can guide more targeted and effective intervention strategies by Health Management. Publisher: OBJETIVO: Evaluar la prevalencia y los factores asociados a la suplementación con sulfato ferroso y ácido fólico en personas embarazadas. MÉTODOS: Estudio transversal, representativo, con personas embarazadas atendidas en la Atención Primaria de Salud de Criciúma, Santa Catarina, en el año 2023. Las suplementaciones con sulfato ferroso y ácido fólico se evaluaron a partir de la cartilla prenatal del embarazo. La prevalencia de suplementación se calculó con sus respectivos intervalos de confianza del 95% (IC95%). Se realizaron análisis de regresión de Poisson crudos y ajustados (modelo jerárquico), estimándose razones de prevalencia (RP) y sus respectivos IC95% para verificar los factores asociados. RESULTADOS: Se entrevistaron 428 personas embarazadas. De ellas, el 97,4%

Anemia prevalence in Indian pregnant women remains at 52.2% (The National Family Health Survey-5), necessitating rigorous comparison of standard versus newer iron formulations to optimize treatment in India. To evaluate the comparative effectiveness of oral and parenteral iron preparations in Indian pregnant women, focusing on hemoglobin and serum ferritin improvement. We searched PubMed, Embase, Cochrane Library, and Google Scholar for Randomized Controlled Trials (RCTs) published up to 2024. Only RCTs from India were included. Data from 17 trials (N = 2,228) were synthesized using network meta-analysis to estimate mean differences (MDs) in hemoglobin and serum ferritin levels. Within oral formulations, newer salts significantly outperformed the standard of care; specifically, ferrous asparto glycinate demonstrated the highest hemoglobin improvement (MD: 1.21 g/dL; 95% confidence interval [CI] 0.04-2.38) (hypothesis-generating; small sample), followed by ferrous bisglycinate and iron polymaltose complex, compared to ferrous sulfate. Among parenteral formulations, iron sucrose emerged as the superior agent (MD: 0.76 g/dL; 95% CI 0.52-1.00) for hemoglobin recovery. While the comparison between modes confirmed the known superiority of parenteral over oral iron (MD: 0.88 g/dL at 4 weeks), the network ranking highlights that newer oral molecules offer significantly better efficacy than the current standard, ferrous sulfate. Iron sucrose shows the highest efficacy for rapid hemoglobin correction. Among oral options, ferrous asparto glycinate, ferrous bisglycinate, and iron polymaltose complex provide better hemoglobin improvement than ferrous sulfate. These findings support a review of iron-molecule choices within the Anemia Mukt Bharat strategy. PROSPERO Registration Number: CRD42024570537. Copyright: © 2026 Indian Journal of Community Medicine.

Iron supplementation strategies generally rely on either heme or nonheme iron, whereas systems capable of integrating both forms within a single carrier remain scarce. Here, Escherichia coli bacterioferritin (EcBFR), which naturally binds up to 12 heme molecules through Met52 at the 2-fold symmetry axis, was investigated as a dual-iron delivery platform. EcBFR exhibited excellent thermal stability, maintaining saturated heme binding, structural integrity, and oligomeric assembly after heat treatment. It accommodated up to approximately 800 Fe atoms per nanocage, forming a predominantly ferrihydrite mineral core without compromising its structural integrity. In a Caco-2 cell model, EcBFR-mediated iron delivery resulted in significantly greater cellular iron uptake than that of free heme or ferrous sulfate. © 2026 American Chemical Society.

124. J Dent Sci. 2026 Apr 1;21(2):1313-1314. doi: 10.1016/j.jds.2026.01.012. eCollection 2026. Oral ulceration caused by direct contact with residual ferrous sulfate. Okuma Y(1), Aoki N(1), Baba J(1), Iwai T(2). Author information: (1)Department of Oral and Maxillofacial Surgery, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Kanagawa, Japan. (2)Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Yokohama, Kanagawa, Japan. DOI: 10.1016/j.jds.2026.01.012 PMCID: PMC13536315 PMID: 42689041 Conflict of interest statement: Declaration of competing interest: The authors have no conflicts of interest relevant to this article.

Natural dyes are emerging as sustainable and eco-friendly alternative to synthetic ones in many industries because of health, safety and ecological concerns. The textile sector, being a major producer of dye effluents, is significantly paying attention to eco-friendly organic dyes. This study aimed to extract, apply and characterize a natural dye from the fruit peel of a wild type of Pomegranate (Punica granatum L.) which is widely distributed in several ecological zones of Pakistan. The obtained dye was analyzed for phytochemical screening, UV vis-spectrophotometry, Fourier-transform infrared spectroscopy (FTIR) and Gas chromatography-Mass spectrometry (GCMS). Furthermore, the application of dye on cotton fabric was tested for color efficiencies in terms of fastness properties and CIE L* a* b* values. Three mordants alum, ferrous sulfate and gallnut powder were used for comparison with un-mordanted fabric dyeing. ATR-FTIR analysis was performed to confirm the interaction of dye compounds with cotton fabric with and without mordant. DPPH and MTT assays were employed to check the antioxidant potential and cytotoxicity of the dye. GCMS revealed the presence of 51 compounds with intense color yielding nature. FTIR analysis identifies O-H, C-H and C-O as major functional groups. This study is the first to characterize the Western Himalayan wild pomegranate fruit peel in Pakistan, revealing the high content of biochemical compounds dye potential and antioxidant activity. The overall results suggest that the peel extract of wild pomegranate is suitable for manufacturing ecofriendly dye for various industrial sectors including textiles, pharmaceuticals, food, and cosmetics, as a safer and sustainable alternative to non-biodegradable synthetic dyes. © 2026. The Author(s).

BACKGROUND: Pyroptosis-related signaling contributes to lung adenocarcinoma (LUAD) progression and prognosis. Apigenin (AP) has anti-inflammatory and cytoprotective properties, but its effects on pyroptosis-associated signaling in injured LUAD cells remain unclear. METHODS: A549 cells were treated with carbonyl cyanide m-chlorophenyl hydrazone (CCCP) and ferrous sulfate (FeSO4) to establish a cellular injury model. Cell morphology, Cell Counting Kit-8 signals, and pyroptosis-associated proteins were assessed after AP treatment. Network pharmacology, molecular docking, molecular dynamics simulations, and analyses of The Cancer Genome Atlas and Gene Expression Omnibus datasets were used to prioritize candidate targets, characterize pyroptosis-related genes, and develop a prognostic signature. RESULTS: CCCP/FeSO4 reduced CCK-8 signals and induced morphological injury, whereas AP partially reversed these changes. AP also reduced alterations in GSDMD-N, caspase-1, IL-1β, TNF-α/NF-κB pathway proteins, AIM2, and ASC. TNF was prioritized as a candidate target, and computational analyses predicted a potentially stable AP-TNF interaction without demonstrating direct binding. Bioinformatic analyses identified distinct pyroptosis-related LUAD subgroups and generated a prognostic signature that stratified survival in training and external validation cohorts. AIM2 was additionally prioritized as a LUAD- and stress-associated candidate. CONCLUSION: AP attenuated CCCP/FeSO4-induced injury and pyroptosis-associated molecular changes in A549 cells, potentially through TNF-α/NF-κB and AIM2-related signaling. Further mechanistic validation is required. © 2026 The Author(s). Thoracic Cancer published by John Wiley & Sons Australia, Ltd.

Pronounced melanin enrichment characterizes the Lueyang black-boned chicken, yet the transcriptional basis underlying this pigmentation phenotype remains incompletely understood. We established a standardized in vitro culture system for primary avian melanocytes to investigate CDKN2A-associated transcriptional changes related to melanocyte cellular states and pigmentation-related gene expression. Primary melanocytes were isolated and characterized by morphology, ferrous sulfate staining, and TRP2 immunofluorescence, with passages P2-P4 showing relatively stable cellular characteristics. Using CDKN2A overexpression and knockdown models combined with RNA-seq analysis, we identified transcriptional alterations associated with CDKN2A modulation. Notably, CDKN2A overexpression was associated with increased expression of cell cycle-related genes (e.g., CDKN1A) and melanogenesis-associated transcriptional markers, particularly MITF, suggesting an association between CDKN2A expression and pigment-related transcriptional programs. Conversely, CDKN2A knockdown produced opposite expression patterns. Gene set enrichment analysis (GSEA) further indicated that high CDKN2A expression was associated with enrichment of melanogenesis and MAPK signalling pathways, whereas CDKN2A knockdown was associated with enrichment of Wnt signalling pathways. By minimizing potential in vivo paracrine effects, this in vitro model suggested that CDKN2A-associated transcriptional changes might reflect alterations related to cell cycle status and melanocyte cellular states. Although this study provided transcript-level evidence, direct functional assays of melanin production were not performed; therefore, these findings should be interpreted as correlative rather than definitive evidence of CDKN2A-associated pigmentation regulation. These findings provide a transcriptomic resource for investigating the relationship between cell-state regulation and pigmentation-associated programs in avian melanocytes.

Monitoring dopamine (DA) in pork can provide useful information for assessing meat freshness and quality deterioration. In this work, an Fe@N-S-O-C nanocomposite was fabricated as an electrode modifier for DA determination. The Fe@N-S-O-C nanocomposite was synthesized via precipitation followed by calcination using melamine and ferrous sulfate as precursors. The crystal structure, surface chemical composition, and morphology were characterized by XRD, XPS, SEM, and TEM. The Fe@N-S-O-C-modified glassy carbon electrode (Fe@N-S-O-C/GCE) was then evaluated for its electrocatalytic performance toward DA. Under the optimized conditions (pH 6.0), the sensor showed linear responses to DA over 1-65 and 65-220 μM. The sensitivities for these two ranges were 4.357 and 1.685 μA μM-1 cm-2, respectively, with an LOD of 40 nM. In addition, the Fe@N-S-O-C/GCE showed excellent reproducibility, good repeatability, and strong anti-interference capability against common coexisting substances. After 30 days of storage, 82.74% of the initial current response was retained by the same electrode. Practical applicability of the sensor was verified in pork samples, with recoveries of 95.97-106.73%. These results demonstrate that the Fe@N-S-O-C/GCE sensor offers a reliable and effective platform for DA detection in complex food matrices.

BACKGROUND: In Peru, legally mandated universal micronutrient supplementation policies preclude randomized trials. OBJECTIVE: To evaluate hemoglobin (Hb) outcomes associated with enhanced follow-up of therapeutic iron or preventive multiple micronutrient powder (MNP) supplementation among high-altitude infants within a real-world natural experiment. METHODS: This observational study leveraged a policy-driven natural experiment to analyze two population-based cohorts of 317 infants aged 6-12 months from Puno, Peru (3,832 m), evaluated before and after implementation of strict follow-up. According to national guidelines, infants with anemia received therapeutic iron syrup (ferrous sulfate or iron polymaltose), while non-anemic infants received preventive MNP. Supplements were provided monthly for six months. Hemoglobin was measured at baseline and follow-up and adjusted for altitude using the WHO 2024 criteria. Adequate Hb response was defined as an increase ≥1 g/dL. Multivariable regression models assessed factors associated with hemoglobin response. RESULTS: Overall, 14.8% of infants achieved an Hb increase ≥1 g/dL (18.7% vs. 11.8% in the strict and non-strict follow-up groups, respectively). Among non-anemic infants at baseline, adequate Hb response was more frequent under strict follow-up (8.3% vs. 2.7%). In the prespecified primary adjusted model, strict follow-up was associated with higher odds of achieving an adequate Hb response (aOR 3.53; 95% CI 1.40-8.84), compared with the crude estimate (OR 2.45; 95% CI 1.30-4.63). In sensitivity analyses incorporating additional socioeconomic, nutritional, and program-related covariates, the association was attenuated (aOR 2.18; 95% CI 0.53-8.99). When evaluated as a continuous outcome, strict follow-up was associated with greater hemoglobin increases (adjusted mean difference 0.74 g/dL; 95% CI 0.23-1.25). At six months, altitude-adjusted anemia prevalence was lower in the strict follow-up group than in the non-strict group (25.2% vs. 38.2%, p = 0.019). Baseline anemia and older age were independently associated with larger hemoglobin gains. CONCLUSIONS: Strict follow-up was associated with greater increases in hemogl

INTRODUCTION: Iron deficiency anemia (IDA) is common among women of reproductive age and is frequently associated with abnormal uterine bleeding (AUB). Although oral iron is first-line therapy, the optimal dosing schedule remains uncertain. This study compared daily and alternate-day oral iron in real-world practice. MATERIALS AND METHODS: We conducted a prospective observational cohort study of women aged 18-70 years with confirmed IDA treated with oral ferrous sulfate at a tertiary referral center between January 2023 and June 2024. Patients received oral iron every 24 h or every 48 h according to physician prescription. AUB etiology was classified using the PALM-COEIN system. Outcomes included hemoglobin change, World Health Organization anemia severity, hemoglobin normalization (≥12 g/dL), adherence, adverse-event-related discontinuation, and intravenous iron escalation. RESULTS: A total of 171 women were included. Leiomyomas were the most frequent PALM-COEIN category (106 patients, 62.0%). Mean baseline hemoglobin was 9.02 ± 1.45 g/dL. At 6 weeks, mean hemoglobin was 10.91 ± 1.76 g/dL in the 24-h group and 11.26 ± 1.86 g/dL in the 48-h group (p = 0.255). At 3 months, final hemoglobin was available in 147 patients; mean values were 12.79 ± 1.68 g/dL and 12.68 ± 1.62 g/dL, respectively (p = 0.692). Hemoglobin normalization occurred in 75.2 and 71.7% of patients, respectively (p = 0.687). Adherence was high, and discontinuation due to adverse events was uncommon. Intravenous iron escalation was numerically more frequent with alternate-day therapy (26.8% vs. 13.9%; p = 0.056), although escalation decisions were based on clinical judgment without standardized criteria. CONCLUSION: Both regimens were associated with hematologic improvement. However, because allocation was non-randomized, baseline differences were present, and intravenous iron escalation was not based on standardized criteria, equivalence cannot be inferred. Oral iron dosing should be individualized.

Sulfate is a widespread and persistent byproduct in many advanced oxidation processes (AOPs) for wastewater treatment, yet its residue has been systematically overlooked. Despite the original intention and widespread adoption for degrading recalcitrant organic pollutants in industrial wastewaters, AOPs inadvertently produce substantial sulfate through catalyst/co-catalyst addition, pH adjustment, oxidant decomposition or electrolyte usage. Elevated sulfate levels affect the AOPs-treated effluent quality directly or indirectly by impairing subsequent biological treatment, posing public health and socio-economic impacts. This Making Waves critically examines the neglected sulfate footprint across mainstream AOPs and proposes forward-looking strategies for sulfate mitigation from both the source and the effluent. These include accelerating Fe(III)/Fe(II) cycling to reduce ferrous sulfate input, developing AOPs with broad pH adaptability and acid-free operation, reducing persulfate consumption and integrating post-treatment biological or bioelectrochemical systems for sulfate removal. Balancing organic pollutant degradation with sulfate management, shifting from treating sulfate as a passive burden to exercising active control, is essential for transitioning AOPs toward environmentally sustainable wastewater treatment technologies.

Background Iron-deficiency anemia (IDA) is a major clinical burden, particularly when caused by gastrointestinal or gynecological blood loss and mucosal malabsorption. Oral iron supplementation, while widely accessible, is frequently limited by poor gastrointestinal tolerability and inadequate absorption. Intravenous (IV) iron offers a more direct route to iron repletion, yet real-world comparative data from resource-limited settings remain scarce. Methods We conducted a retrospective observational cohort study of 225 patients with IDA managed at the Hematology Department of Cheikh Khalifa Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco, between January 2020 and December 2023. Patients received either oral ferrous sulfate (n=185) or IV ferric carboxymaltose (n=40) based on clinical indication. The primary efficacy endpoint was post-treatment serum ferritin at three months, the only post-treatment laboratory parameter systematically available across both groups. Secondary endpoints included transfusion requirement and adverse event profile. Results Both groups were well-matched at baseline across all haematological parameters (hemoglobin (Hb): 8.98±2.23 vs. 8.50±1.42 g/dL, p=0.196; ferritin: 5.57±4.25 vs. 4.71±2.96 µg/L, p=0.221). IV iron was associated with dramatically superior iron store repletion at three months (post-treatment ferritin: 412.60±95.87 vs. 8.68±4.38 µg/L; p<0.001), representing approximately a 47-fold difference. Oral iron recipients remained below the accepted thresholds for adequate store repletion (≥30 µg/L) at follow-up. Transfusion rates were 10.3% (19/185) oral vs. 17.5% (7/40) IV, a non-significant difference (p=0.306), reflecting greater baseline severity in the IV group. Gastrointestinal adverse events occurred in 100% of oral iron recipients, while systemic reactions (predominantly arthralgia, myalgia, and fever) occurred in 50% (20/40) of IV iron recipients; one anaphylactic reaction (1/40; 2.5%) was successfully managed. Conclusion In this real-world cohort, IV ferric carboxymaltose achieved markedly superior iron-store repletion compared to oral ferrous sulfate, with a better gastrointestinal tolera