Simple Laboratory Research Articles

Daily Transfers, Archiving Populations, and Measuring Fitness in the Long-Term Evolution Experiment with Escherichia coli.

The Long-Term Evolution Experiment (LTEE) has followed twelve populations of Escherichia coli as they have adapted to a simple laboratory environment for more than 35 years and 77,000 bacterial generations. The setup and procedures used in the LTEE epitomize reliable and reproducible methods for studying microbial evolution. In this protocol, we first describe how the LTEE populations are transferred to fresh medium and cultured each day. Then, we describe how the LTEE populations are regularly checked for possible signs of contamination and archived to provide a permanent frozen "fossil record" for later study. Multiple safeguards included in these procedures are designed to prevent contamination, detect various problems when they occur, and recover from disruptions without appreciably setting back the progress of the experiment. One way that the overall tempo and character of evolutionary changes are monitored in the LTEE is by measuring the competitive fitness of populations and strains from the experiment. We describe how co-culture competition assays are conducted and provide both a spreadsheet and an R package (fitnessR) for calculating relative fitness from the results. Over the course of the LTEE, the behaviors of some populations have changed in interesting ways, and new technologies like whole-genome sequencing have provided additional avenues for investigating how the populations have evolved. We end by discussing how the original LTEE procedures have been updated to accommodate or take advantage of these changes. This protocol will be useful for researchers who use the LTEE as a model system for studying connections between evolution and genetics, molecular biology, systems biology, and ecology. More broadly, the LTEE provides a tried-and-true template for those who are beginning their own evolution experiments with new microbes, environments, and questions.

Unpaved road characterization during rainfall scenario: Electromagnetic wave and cone penetration assessment

This study aims to examine the effect of rainfall on integrity assessment on unpaved roads using electromagnetic waves and cone penetration. An unpaved road testbed is prepared with sandy soil in densely- and loosely-packed conditions. Site investigations using a time domain reflectometry (TDR), ground penetrating radar (GPR), and dynamic cone penetrometer (DCP) are performed on the testbed under before and after rainfall scenarios, and an additional laboratory compaction test using the soil samples is conducted. The results show that the spatially scaled GPR signal converted by the TDR signal can accurately estimate the interface depth. In addition, rainfall may reduce the accuracy of GPR signal polarity-based analyses for anomaly detection on unpaved roads. This study reveals that TDR, GPR, and DCP with simple laboratory compaction tests and physics-inspired effective stress-depth models can be a powerful tool for underground mapping when subjected to rainfall season.

Quantum versus population dynamics over Cayley graphs

Consider a graph whose vertices are populated by identical objects, together with an algorithm for the time-evolution of the number of objects placed at each of the vertices. The discrete dynamics of these objects can be observed and studied using simple and inexpensive laboratory settings. There are many similarities but also many differences between such population dynamics and the quantum dynamics of a quantum particle hopping on the same graph. In this work, we show that a specific decoration of the original graph enables an exact mapping between models of population and quantum dynamics. As such, population dynamics over graphs is yet another classical platform that can simulate quantum effects. Several examples are used to demonstrate this claim.

Is the C-reactive protein-to-albumin ratio the most remarkable simple inflammatory marker showing active disease in patients with axial spondyloarthritis, psoriatic arthritis, and rheumatoid arthritis?

To learn which of the simple inflammation markers obtained from routine laboratory tests showed active disease best. The study included 256 patients (102 patients with axial spondyloarthritis [axSpA], 54 with psoriatic arthritis [PsA], and 100 with rheumatoid arthritis [RA]). The results of the routine laboratory tests requested during the outpatient clinic visits of the patients were noted. Inflammation-related ratio/indices were then calculated from these laboratory tests. Active and inactive diseases were defined according to the disease activity scores for each disease. Logistic regression and receiver operating characteristic (ROC) analyses were performed to determine the best laboratory marker(s) showing active disease and its cutoff value for all three diseases. C-reactive protein to albumin ratio (CAR) was significantly higher in patients with active axSpA, PsA, and RA diseases than those with inactive diseases (p < 0.001, p = 0.006, and p < 0.001, respectively). In the logistic regression analysis, the CAR was the most important predictor of active disease in patients with axSpA, PsA, and RA. CAR had also showed the active disease at an acceptable level in axSpA and PsA and very well in RA. The cutoff values for active disease in axSpA, PsA, and RA were 0.75, 0.92, and 0.89, respectively. CAR may be a promising simple laboratory marker to distinguish active disease in patients with axSpA, PsA, and RA. Key Points • Acute phase reactants and circulating blood cells have become an important target because of the search for a disease activity marker that can be used cheaply and quickly in the daily outpatient routine. • One or more of these simple markers have been previously discussed in various studies with different hypotheses. • We aimed to determine which of the inflammation markers obtained from routine laboratory tests showed active disease and to determine a cutoff value for this/these marker(s). • CAR was the most important simple laboratory marker to distinguish active disease in patients with axSpA, PsA, and RA. In addition, CAR showed the active disease at an acceptable level in axSpA and PsA, and very well in RA.

Evaluation of simple diagnostic parameters in acute kidney injury in hospitalized patients—diagnostic recommendations for non-nephrologists

Acute kidney injury (AKI) is very common in hospitalized patients, affecting patient’s mortality and morbidity. Major causes are prerenal AKI and acute tubular necrosis (ATN). Even though a variety of parameters/indices exist, their reliability and practicability are controversial: in fact, there is a need for a simple diagnostic approach for AKI in in-patients with parameters easily obtained in any hospital. The objective of the study was: (1) to assess reliability of simple laboratory parameters/indices to differentiate pre-/intrarenal AKI; (2) to evaluate the most reliable and feasible parameters/indices; and (3) to identify the possible impact of confounding factors. Retrospectively, in-patients with AKI hospitalized in 2020 in a university nephrology department were included. Spot urine and 24-h collection urine was analyzed with urine sodium (UNa), urine specific gravity (USG), fractional excretion of sodium (FENa), fractional excretion of urea (FEUrea), urine osmolality (UOsm), urine to plasma creatinine ratio (UCr/PCr) and renal failure index (RFI). Overall, 431 patients were included. UNa, UOsm, USG and RFI showed high specificity > 85% for prerenal AKI, UNa and RFI provided good specificity for ATN. Loop diuretics, ACE inhibitors/AT1 blockers or pre-existing chronic kidney disease had no impact. In patients with AKI, UNa, USG and RFI: (1) proved to be very specific for prerenal AKI and showed high sensitivity for ATN; (2) can be easily determined using serum and spot urine; and (3) are not confounded by medication or comorbidities. These parameters/indices are helpful to identify the aetiology of AKI and to guide therapy, thereby improving patients’ safety and outcome.

Assessment of C-reactive protein levels as an indicator for lung infiltrates in patients with COVID-19 pneumonia.

Lung infiltrates are frequently observed in patients with COVID-19 infection and require specialized management. Identifying reliable laboratory parameters to reduce the need for chest CT scans in non-desaturation patients is of great interest. This study aimed to investigate the potential of C-reactive protein (CRP) as an indicator to identify the presence of lung infiltrates in early COVID-19 infection. The study was conducted at Al-Azhar University hospitals from May 2021 to March 2022 and included 210 patients with COVID-19 infection confirmed by positive PCR, all of whom were previously healthy, non-smokers, and non-hypoxemic. CRP levels were assessed and correlated with lung infiltrates observed in CT chest examinations. The mean value of CRP was 40.3±14.3 mg/L in males and 36.6±15.2 mg/L among females. One hundred sixty-two patients had pneumonic infiltrates, while 48 had no infiltrates. The mean value of CRP was 45.02±10.2 mg/L in patients with radiological infiltrates and 18.8±7.8 mg/L in patients without radiological infiltrates. Based on our findings, a CRP value greater than 29.8 mg/L was suggested as a cut-off value to indicate the presence of lung infiltrates. CRP is a simple laboratory marker that, at certain limits, may point to the presence of pneumonic infiltrates in early non-hypoxemic patients with COVID-19 infection.

The Effect of Sleep Disorders on Blood Sugar in Children With Type 1 Diabetes Mellitus

Background: Diabetes mellitus (DM) is a common metabolic disorder. The hemoglobin A1c (HbA1c) test is a simple laboratory test that shows the average amount of blood sugar in the last 3 months. Studies have shown that sleep is important in controlling blood sugar levels, so that sleep deprivation can reduce glucose tolerance. Lack of sleep and sleep disorders are also predictors of DM. Objectives: Given the contradictory information about the effect of sleep on blood sugar, the impact of various factors in the process of DM, including the lifestyle of patients, and the limited number of studies in this field in Iran, we decided to investigate the effect of sleep disorders on blood sugar control in people with type 1 DM. Methods: This cross-sectional descriptive-analytical study was performed on children with type 1 DM referred to the diabetes clinic. Their HbA1c levels were recorded in a checklist from the patient’s last test recorded in their files, and the standard Pittsburg sleep quality index (PSQI) was completed to assess their sleep disorders with the help of the child’s parents. Achieving a score higher than 5 in the whole questionnaire means poor sleep quality. After collecting data, they were analyzed in SPSS software, version 21. Results: A total of 200 children with type 1 DM were studied, of whom 119(59.5%) were boys, 81(40.5%) were girls. Also, 79 children (39.5%) were less than 1 year old, 67(33.5%) were 1 to 2 years old and 54 were more than 3 years old. Also, 104 children (52.6%) had no sleep disorders, while 69(32.1%) had moderate, 20(11.6%) had severe, and 7(3.7%) had very severe sleep disorders. Their Mean±SD age was 10.86±4.68 years, and HbA1c level was 9.64±3.35 mmol/mol. Conclusions: This study showed that the prevalence of sleep disorders based on the PSQI was approximately 50%. There was a significant relationship between elevated HbA1c and the prevalence of sleep disorders.

Comparision of traditional and laboratory methods of sulphur processing

BackgroundSince ancient times, the essential element sulphur has played an important role in different medical fields. It is one of the main materials used in herbo-mineral pharmaceutics in Ayurveda. However, for Ayurvedic pharmaceutical preparations, the purity of sulphur is crucial in avoiding any harmful reactions and to enhance the medicinal quality. Therefore, it is subjected to a process called ‘gandhaka shodhana’ using cow's milk, ghee or occasionally plant extracts. The plant, Eclipta alba (L.) Hassak, containing many bioactive compounds, is one of the extracts known to be used in the ‘shodhana’ process of sulphur. However, in comparison to the laboratory purification method of sulphur neither the effect of this ‘shodhana’ process in removing impurities from sulphur nor its effect on the structure and morphology of sulphur has been evaluated. ObjectivesThis study identifies physical, morphological, and structural changes that occur in sulphur when it is subjected to the ‘shodhana’ process compared to the changes that occur in sulphur obtained after simple laboratory purification. MethodologyBoth samples were characterized using Scanning Electron Microscopy, Energy Dispersive X-ray Spectroscopy, X-ray Diffraction, Differential Scanning Calorimetry, Thermogravimetric Analysis, Fourier Transform Infrared spectroscopy, and Raman spectroscopy. Observed physical changes such as colour, allotropic form, odour, hardness, transparency, and lustre of the samples were also determined using recommended techniques. ResultsAlthough the laboratory purification method separates the sulphur from physical and chemical impurities, Ayurveda ‘shodhana’ process with E. alba converts the sulphur into a more pharmaceutically suitable form by making it more nebulous and introducing higher brittleness, FT-IR data shows removal of chemical impurities from sulphur during ‘shodhana’ process in contrast to laboratory purified sample.

Hepatitis C Virus Clearance Cascade - United States, 2013-2022.

Approximately 2.4 million adults were estimated to have hepatitis C virus (HCV) infection in the United States during 2013-2016 (1). Untreated, hepatitis C can lead to advanced liver disease, liver cancer, and death (2). The Viral Hepatitis National Strategic Plan for the United States calls for ≥80% of persons with hepatitis C to achieve viral clearance by 2030 (3). Characterizing the steps that follow a person's progression from testing to viral clearance and subsequent infection (clearance cascade) is critical for monitoring progress toward national elimination goals. Following CDC guidance (4), a simplified national laboratory results-based HCV five-step clearance cascade was developed using longitudinal data from a large national commercial laboratory throughout the decade since highly effective hepatitis C treatments became available. During January 1, 2013-December 31, 2021, a total of 1,719,493 persons were identified as ever having been infected with HCV. During January 1, 2013-December 31, 2022, 88% of those ever infected were classified as having received viral testing; among those who received viral testing, 69% were classified as having initial infection; among those with initial infection, 34% were classified as cured or cleared (treatment-induced or spontaneous); and among those persons, 7% were categorized as having persistent infection or reinfection. Among the 1.0 million persons with evidence of initial infection, approximately one third had evidence of viral clearance (cured or cleared). This simplified national HCV clearance cascade identifies substantial gaps in cure nearly a decade since highly effective direct-acting antiviral (DAA) agents became available and will facilitate the process of monitoring progress toward national elimination goals. It is essential that increased access to diagnosis, treatment, and prevention services for persons with hepatitis C be addressed to prevent progression of disease and ongoing transmission and achieve national hepatitis C elimination goals.

Predicting Role of the Appendicitis Inflammatory Response Score in Diagnosis and Risk Stratification of Acute Appendicitis among Adult Patients

Background: Appendicitis is a global disease. Understanding the global evolution of appendicitis in highly industrialized countries and in newly industrialized countries is necessary for planning healthcare resource utilization. Scoring systems have been designed to aid in the clinical assessment of patients with acute appendicitis. The recently introduced Appendicitis Inflammatory Response (AIR) score was designed to overcome these drawbacks. This simple clinical score can correctly classify the majority of patients with suspected appendicitis. To evaluate the AIR score on patients with suspicion of acute appendicitis and its risk stratification and assess the sensitivity and specificity of the AIR score. Materials and methods: This descriptive of observational study was carried out in the Department of Surgery, Chittagong Medical College Hospital, Chattogram from 21st March to 20th September 2017. Total 100 cases of appendicitis patients were selected after careful history taking, thorough general and local examination and appropriate investigations fulfilling inclusion and exclusion criteria. Results: The present study of 100 selected cases reveals that maximum number of patients (54.0%) were between 15-25 years age group, mean age of appendicitis was 24.5±8.9 years. The sensitivity and Specificity of the Appendicitis Inflammatory Response Score (AIR score) in diagnosis and risk stratification of acute appendicitis was 85.2% and 96.9% respectively. Similarly, the positive predictive value and accuracy rate for the same is 93.5 % and 93.0% respectively. Conclusion: Through associating easily applicable clinical criteria and two simple laboratory tests AIR score help in diagnosis and risk stratification of suspected appendicitis and could guide decision-making to reduce admissions, optimize utility of diagnostic imaging and prevent negative explorations. IAHS Medical Journal Vol 5(2), Dec 2022; 46-51

#5565 USEFULNESS OF URINARY BIOCHEMISTRY IN THE FOLLOW-UP OF PATIENTS WITH CHRONIC KIDNEY DISEASE STAGES 3B-5NOD

Abstract Background and Aims Ion and protein determinations in a simple urine sample are simple and inexpensive laboratory tests that reflect well ion balance and proteinuria. However, they are underused. Evidence of their usefulness in estimating 24-hour urine biochemistry in patients with chronic kidney disease (CKD) would allow widespread use of these tests and would help to optimize therapies. It would also avoid 24-hour urine collections. To evaluate In CKD stages G3b-5noD the accuracy of equations that estimate, through simple urine sampling, creatinine, protein, and ions in 24-hour urines. Method Retrospective observational study in incident adult patients with CKD G3b-5noD from the nephrology outpatient clinic in a Madrid university hospital, with a follow-up of at least two years and with at least one simultaneous determination of biochemistry in a simple urine sample and in 24-hour urine. The 24-hour urine analyses were restricted to those that were estimated to be well collected because urinary creatinine was between 15–25 mg/kg in men and 10–20 mg/kg in women. Correlation, bias (mean differences between estimated and measured analyte), accuracy (percentage of samples estimated at 15–30 or 50% of the measured value - P15, P30, P50) and agreement by the Bland-Altman method were analyzed. CKD progression was defined by the mean annual and percentage decrease in eGFR and the renal event at follow-up as loss of more than 40% of eGFR or entry into renal replacement therapy or conservative-palliative renal treatment. Kawasaki, Tanaka and CKD-epi (Table 1) equations were used. Results The analyzed cohort was made up of 300 patients with a median follow-up of 72 (25) months. Mean eGFR was 32.8 (9.2) ml/min/1.73m2 and mean protein/creatinine ratio was 1,180 (1,740) mg/g. During follow-up 30.7% started renal replacement therapy or conservative and palliative treatment. Twenty-one patients (7%) died. The estimation of 24-hour urine creatinine by CKD-EPI equation showed excellent correlation and accuracy with measured urinary creatinine (r = 0.887; P30: 96.1% in 464 urines). Accuracy was maintained regardless of age and CKD stage. Formulas that, using single urine samples, estimate 24-hour urine elimination of Na and K correlated well with 24-hour urine measurements, but with high dispersion, especially with Na. For Na, the Tanaka and CKD-EPI formulas had the highest performance (r = 0.540; 0.532; P30: 52.6; 54.5%; bias: -14.4; -16.1 mmol, Tanaka and CKD-EPI respectively for 464 urines). These values make them useful for population studies but not for individualized analysis. For K, the Kawasaki and CKD-EPI formulas were the most suitable (r = 0.712; 0.612; P30 = 74.6; 72.4%; bias: 4.2; 5.5 mmol; Kawasaki and CKD-EPI respectively for 464 urines). These results make them useful for both population-based studies and individualized analyses. Patients with Nao &amp;lt; 87 mmol/day (salt-poor diet) estimated by CKD-EPI, Kawasaki or Tanaka and/or Na/K ratio &amp;lt; 2 directly measured had less eGFR loss at follow-up and fewer renal events. Urinary K elimination measured or estimated did not influence renal prognosis. Proteinuria measured in 24-hour urine correlated much better with proteinuria estimated by CKD-EPI in a single urine sample than with the protein/creatinine ratio (r: 0.900 vs. 0.801; mean bias: 92.2 vs. 486 mg; P30: 72.0 vs. 42.7%; CKD-EPI vs. Proto/Cro in 464 24-hour urine samples). Conclusion Urinary biochemistry in a single urine sample in patients with advanced CKD (stages G3b-5noD) is a useful tool for estimating 24-hour urine biochemistry and to identify scenarios of increased progression of renal disease.

Hantavirus Diseases – A Comprehensive Review

Hantaviruses are a diverse group of infectious agents which are zoonotic in nature and transmitted to humans through rodent reservoir. Hantaviruses are enveloped RNA viruses that persistently infect rodent hosts without ill-effect. The host persistently excretes virus in urine and saliva. Man becomes infected from the rodents when one enters the ecological niche of the other. Hantaviruses can cause two types of diseases in humans: hemorrhagic fever with renal syndrome (HFRS) and Hantavirus cardiopulmonary syndrome (HCPS). The number of reported Hantavirus infections is increasing worldwide, and new Hantaviruses are being discovered in many countries, making them a global public health concern. Hantavirus infections are thought to be under diagnosed due to the fact that they frequently cause asymptomatic and nonspecific mild infections, as well as a lack of simple standardized diagnostic laboratory methods. This review summarizes current knowledge on Hantaviral infections, including virology, epidemiology, clinical manifestations, laboratory diagnostics, treatment, and prevention.

Hypersegmentation of neutrophil nuclei in peripheral blood of patients with localized and advanced cancer of the larynx and laryngopharynx

Neutrophilic granulocytes have a wide spectrum of functional activity. In recent years, the functional significance of neutrophils in the development and course of malignant neoplasms has been discussed. It has been shown that neutrophilic granulocytes can play pro- or antitumor activity. The aim of the study was to assess the structural and functional features of neutrophils in patients with varying degrees of prevalence of cancer of the larynx and laryngopharynx. Forty-one patients (aged 35-67) with newly diagnosed cancer of the larynx and laryngopharynx were examined and divided into subgroups according to the TNM classification: the first subgroup (14 patients) with a localized tumor process consisted; and the second subgroup (27 patients) with a widespread tumor process. The relative and absolute number of neutrophils was assessed, and the neutrophil-lymphocyte ratio (NLR) was determined. The content of neutrophils with varying degrees of nuclear segmentation in the blood was calculated, the activity of myeloperoxidase, cationic proteins, alkaline phosphatase, and the degree of neutrophil activation in the NBT test was determined cytochemically. Concentration of interleukin-8 was determined using ELISA. In patients with cancer of the larynx and laryngopharynx the number of neutrophils (p = 0.045) and NLR (p = 0.033), as well as serum concentration of interleukin 8 (p = 0.011), increased compared to healthy individuals. The proportion of cells with hypersegmented nuclei in the neutrophil population (p &lt; 0.001) and cytotoxic potential increased with the spread of tumor process. A direct correlation (r = 0.42, p = 0.03) was found between the T index, which reflects the volume of the tumor, and the content of hypersegmented neutrophils. It can be argued that such a simple and accessible laboratory parameter as the degree of segmentation of the nuclei of neutrophilic granulocytes can be used as one of the criteria to assess and predict the course of the tumor process.

Evaluation of the Effects of Different Crosslinking Technologies on Hyaluronic Acid Behavior-study of Five Hyaluronic Acid Gels Available in Iran Market

Background The rheologic, mechanical, and pharmacological characteristics of hyaluronic acid (HA) gels vary in terms of their specific crosslinking technologies. Objective To evaluate the various characteristics of selected HA gels available in Iran, using simple, inexpensive, and reproducible experimental tests are necessary to better understand their appropriateness for specific indications. Methods The HA gels produced by various crosslinking technologies were evaluated by three experiments, including cohesivity, resistance to stretch, and microscopic examination. The gels subjected to these experiments in this study included Neuramis, Desirial, Belotero, Restylane, and Juvéderm. Results We found that cohesivity was different among the gels so that Desirial was the least cohesive and Belotero was the most cohesive gel. Other HA gels were observed as partially cohesive. The resistance to stretch test confirmed the cohesivity results and Belotero had the most significant resistance. Microscopic examination of the HA gels showed HA particles of varying distribution and size. Belotero and Desirial were the gels with no particles visible under the microscope. Conclusion Simple and inexpensive laboratory tests help to understand the way that they can affect the specific gel performance, and may be beneficial for physicians to decide on the best product for a particular therapeutic indication.

Diagnostic performance of routine blood parameters in periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome.

We aimed to investigate the difference between PFAPA and streptococcal tonsillitis (Strep Pharyngitis) by using blood parameters. We want to evaluate the relationship between periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome, and tonsillitis by using NLR. The data of 141 pediatric patients who had applied to our clinic between October 2016 and March 2019 and were diagnosed with PFAPA syndrome and tonsillitis were reviewed from hospital records. The demographic data of the study group were recorded, as were their WBC, neutrophil, and lymphocyte counts, NLR, and MPV values, which are obtained by proportioning these two counts. CRP and ESR values were significantly higher in the PFAPA group (p = 0.026 and p < 0.001, respectively). No significant difference was determined between the groups in terms of platelet count or lymphocyte count. Receiver operating curve analyses were calculated. The AUC was 0.713 ± 0.04 according to age, and the CRP was 0.607 ± 0.04 (95% confidence interval). Using a cutoff point of >49 months for age, the sensitivity was 0.71 and the specificity was 0.67. With simple laboratory parameters, PFAPA syndrome can be differentiated from a diagnosis of tonsillitis. This may reduce the costs associated with unnecessary antibiotic use. However, these findings still need to be confirmed by other future studies.

Key factors predicting the in-hospital mortality of patients with severe cutaneous adverse reactions in Thailand.

At present, no predictive models are available to determine the probability of in-hospital mortality rates (HMRs) in all phenotypes of severe cutaneous adverse reactions (SCARs). Our study explored whether simple clinical and laboratory assessments could help predict the HMRs in any phenotypes of SCAR patients. Factors influencing HMRs in 195 adults diagnosed with different SCAR phenotypes were identified, and their optimal cut-offs were determined by Youden's index. Predictive equations for HMRs for all SCAR patients and Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) patients were determined using the exact logistic regression models. Acute generalized exanthematous pustulosis (AGEP) patients were significantly older, with a short time from drug exposure to reaction, and higher neutrophil count compared to SJS/TEN and drug reaction with eosinophilia and systemic symptoms (DRESS, p < 0.001). Peripheral blood eosinophilia, atypical lymphocytosis and elevated liver transaminase enzymes were significantly higher in DRESS. SJS/TEN phenotype, age ≥ 71.5 years, neutrophil-to-lymphocyte ratio ≥ 4.08 (high NLR) and systemic infection were factors predicting in-hospital mortality in all SCAR subjects. The ALLSCAR model developed from these factors demonstrated high-diagnostic accuracy for predicting HMRs in all SCAR phenotypes (area under the receiver-operator curve (AUC) = 0.95). The risk of in-hospital death was significantly increased in SCAR patients with high NLR after adjusting for systemic infection. The model derived from high NLR, systemic infection and age yielded higher accuracy than SCORTEN (AUC = 0.77) for predicting the HMRs in SJS/TEN patients (AUC = 0.97). Being older, having systemic infection, having a high NLR and SJS/TEN phenotype increases ALLSCAR scores, which in turn increases the risk of in-hospital mortality. These basic clinical and laboratory parameters can easily be obtained in any hospital setting. Despite its simple approach, further validation of the model is warranted.

A Journey from Blood Cells to Genes and Back.

I was attracted to hematology because by combining clinical findings with the use of a microscope and simple laboratory tests, one could often make a diagnosis. I was attracted to genetics when I learned about inherited blood disorders, at a time when we had only hints that somatic mutations were also important. It seemed clear that if we understood not only what genetic changes caused what diseases but also the mechanisms through which those genetic changes contribute to cause disease, we could improve management. Thus, I investigated many aspects of the glucose-6-phosphate dehydrogenase system, including cloning of the gene, and in the study of paroxysmal nocturnal hemoglobinuria (PNH), I found that it is a clonal disorder; subsequently, we were able to explain how a nonmalignant clone can expand, and I was involved in the first trial of PNH treatment by complement inhibition. I was fortunate to do clinical and research hematology in five countries; in all of them, I learned from mentors, from colleagues, and from patients.

Development of Martian saline seep models and their implications for planetary protection

While life on Mars has not been found, Earth-based microorganisms may contaminate the Red Planet during rover expeditions and human exploration. Due to the survival advantages conferred by the biofilm morphology to microorganisms, such as resistance to UV and osmotic stress, biofilms are particularly concerning from a planetary protection perspective. Modeling and data from the NASA Phoenix mission indicate that temporary liquid water might exist on Mars in the form of high salinity brines. These brines could provide colonization opportunities for terrestrial microorganisms brought by spacecraft or humans. To begin testing for potential establishment of microbes, results are presented from a simplified laboratory model of a Martian saline seep inoculated with sediment from Hailstone Basin, a terrestrial saline seep in Montana (USA). The seep was modeled as a sand-packed drip flow reactor at room temperature fed media with either 1 M MgSO4 or 1 M NaCl. Biofilms were established within the first sampling point of each experiment. Endpoint 16S rRNA gene community analysis showed significant selection of halophilic microorganisms by the media. Additionally, we detected 16S rRNA gene sequences highly similar to microorganisms previously detected in two spacecraft assembly cleanrooms. These experimental models provide an important foundation for identifying microbes that could hitch-hike on spacecraft and may be able to colonize Martian saline seeps. Future model optimization will be vital to informing cleanroom sterilization procedures.

Neural oscillation amplitude in the frontal cortex predicts esport results

In competitive matches, strategic decisions and emotional control are important. Relevant cognitive functions and corresponding neural activities in simple and short-term laboratory tasks have been reported. Brain resources are intensively allocated in the frontal cortex during strategic decision-making. The suppression of the frontal cortex with alpha-synchronization optimizes emotional control. However, no studies have reported the contribution of neural activity to the outcome of a more complex and prolonged task. To clarify this issue, we focused on a fighting video game following a two-round first-pass system. Frontal high-gamma and alpha power in the first and third pre-round periods, respectively, were found to be increased in a winning match. Furthermore, inter-participant variations in the importance of strategic decisions and emotional control in the first and third pre-round periods were correlated with frontal high-gamma and alpha power, respectively. Therefore, the psychological and mental state, involving frontal neural fluctuations, is predictive of match outcome.

Evaluating the relative impact of multiple healthy food choice interventions on choice process variables and choices

Fiscal tools—taxes and/or subsidies—are increasingly used to address diet-related health problems. However, some studies have found that these tools are markedly more effective if attention is drawn to the tax or subsidy, suggesting that the price change alone may go unnoticed in the complex food environments that consumers face. Interventions that prompt individuals to consider health during choice show promise for promoting healthy food choices in both simple laboratory settings and complex, real-world markets. In this pre-registered study, I examine the impact of dietary fiber health prompts and/or dietary fiber subsidies on the per-serving fiber content of foods chosen, the documented set of products considered, and (self-reported) nutrition information use by participants in an online supermarket setting. Participants were randomized to one of four conditions: 1) control, 2) subsidy, 3) fiber prompt, and 4) fiber prompt + subsidy. Results show that both the prompt and prompt + subsidy conditions significantly increase fiber content of foods chosen (with the latter having a larger effect). While all three interventions influence the probability of using nutrition information during food choice and affect the set of products that respondents consider relative to the control condition, the effects were larger for the prompt and prompt + subsidy conditions. A multiple mediation analysis illustrates that both direct and indirect (through the set of products considered and the use of fiber information during choice) pathways lead to the significant overall increase in fiber content of selected foods.