Comparative analysis of temporal trends of obesity and physical inactivity in Brazil and the USA (2011-2021).

BACKGROUND: The prevalence of obesity is rising in all subregions of America, including Brazil. To understand the obesity problem in Brazil better, a possible approach could be to analyze its obesity trend by comparing it with the reality of a country that went previously through the epidemiological transition, such as the USA. In addition, the obesity trend must be analyzed in comparison with obesity risk factors trends, such as the physical inactivity (PI) trend. Our aim was comparatively to analyze the temporal trends of obesity between Brazil and the USA from the perspective of temporal trends of PI. METHODS: We conducted a temporal trend study based on data from national cross-sectional surveys: the VIGITEL (Surveillance System for Factors of Health Risk and Protection for Chronic Diseases by Telephone Survey) for Brazil and the BRFSS (Behavioral Risk Factor Surveillance System) for the USA, comparing the annual prevalence of obesity and PI between 2011 and 2021. For the analysis of each temporal variation, linear regressions were performed with the Prais-Winsten test, and Pearson's correlation coefficient was conducted to correlate the trends of the same variables between countries and of different variables within each country. RESULTS: Considering the total sample, Brazil [coefficient (95%CI) 0.6 (0.4;0.7), p = 0.000] and the USA [coefficient (95%CI) 0.5 (0.5;0.6), p = 0.000] showed increasing trends in obesity. The tendency of PI was of stabilization in the two countries [Brazil: coefficient (95%CI) -0.03 (-0.3;0.2), p = 0.767 and USA coefficient (95%CI) -0.03 (-0.2;0.1), p = 0.584]. In addition, there was a correlation between obesity trends between Brazil and the USA (r = 0.971; p = 0.000), but there was no correlation between PI trends between the two countries, nor with obesity and PI trends within each country. CONCLUSIONS: In the last decade, there was a trend towards increasing obesity and stabilization in PI, both in Brazil and the USA. However, there was no association between temporal trends in obesity and physical inactivity in both countries. Our data reinforce a call to action to prevent and control obesity, going with and beyond PI reduction.

In search of intangible connections: intellectual capital, performance and quality of life in higher education institutions.

This study explores the contributions of different dimensions of the intellectual capital of higher education institutions (ICHEIs) to their performance, incorporating the previously unexplored dimension of quality of life (QoL) as a performance measure, and correspondingly taking into account the connection between the Theory of Stakeholders and the Theory of Legitimacy. Applying a Structural Equation Model and the Partial Least Squares method, we present new empirical findings from a sample of 738 students and 587 lecturers/researchers from seven Portuguese public HEIs. The ICHEIs positively influence the institution's performance, through relational capital and structural capital; and QoL emerges as an important dimension of HEIs' performance standards, especially regarding students' perception of academic QoL. When HEIs understand and measure their IC, they will gain a better understanding of their core competencies, enabling a better allocation of resources and implementation of more effective strategic and operational actions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10734-020-00653-9.

Is flow control in a space-constrained drainage network effective? A performance assessment for combined sewer overflow reduction.

Recurring combined sewer overflows (CSOs) can have a significant impact on the ecological condition of receiving water bodies. There are several structural measures, like adding retention basins and switching to low impact development solutions, that have been proposed to reduce the number of sewage overflows. Besides, several flow control strategies have been discussed in scientific literature that take advantage of the space within urban drainage networks, which is assumed to be adequate, for temporary storage. The adequacy of such storage space, however, is not a universally valid assumption as a large fraction of drainage networks frequently operate close to their design discharge. In this paper, we investigate the efficacy of flow control for a space-constrained drainage network. We employ a low-cost, heuristic real time control strategy with the use of flow control devices (FCDs) and available in-sewer space to reduce the magnitude of CSOs. We consider the performance of the proposed control strategy and discuss the effect of FCD location on CSO reduction. Our results, based on over 300 rainfall-event simulations, show that the flow control strategy using limited sewer capacity is more efficient during relatively small rainfall events, where the CSO is large enough to enable reduction using the chosen control rules. The CSO is reduced, to varying degrees, for around 80% of rainfall events with peak intensity between 10 and 20 mm h-1. For larger rainfall events, the flow control is more unstable in response to abrupt water release during control operation, which seems to be unavoidable because of the water accumulation effect and the transition to pressurized pipe flow in space-constrained networks. We also found that the flow control performance is highly sensitive to the FCD location - as it depends on the interplay of the peak rainfall intensity and the water level condition immediately upstream of the FCD. The efficacy of a location for flow control is determined by the unfilled capacity (i.e., effective in-sewer storage potential) in the pipe upstream of the FCD during the rainfall peak; furthermore, the location also has to be resistant to the water accumulation effect. Using our analysis, we substantiate two anticipated caveats to flow control strategies when the storage space is limited in a drainage network: diminished performance in CSO reduction and the appearance of additional control-related challenges, which are otherwise mitigated in more spacious networks.

Spatial and Sectoral Determinants of Productivity: An Empirical Approach Using an Entropy Lens.

This study analyzes the productive structure of Portugal in the period 2013-2017, using indicators of localization and specialization applied to 308 Portuguese local authorities. From an empirical approach using a threshold model, the following indicators are used: (i) localization quotient; (ii) specialization coefficient; (iii) Theil entropy index; (iv) rate of industrialization; and (v) the density of establishments by business size. The selected period 2013-2017 is due to the available data concerning firms located per local authority, and the choice of threshold model is justified through the possibility of assessing the non-linear effects of specialization and diversification on productivity, considering, in simultaneous terms, different regimes per business size. Estimation of the threshold model identified a positive, statistically significant relation between industrialization and productivity. Similarly, the terms of interaction between exports and diversification, and between the former and higher education institutions, shows a catalyzing effect of productivity. In addition, the most specialized micro-firms affect productivity significantly and positively, while the least specialized have the opposite effect. Small, less specialized companies have a significant and negative effect on productivity, contrasting with less specialized, medium-sized companies, which affect productivity positively. For large firms, the impact on productivity is negative for both high and low levels of specialization, reinforcing the need to fill existing gaps in strategic diversification, as well as the vertical and horizontal integration of the activities of production chains with high value added.

Fibromuscular Dysplasia Of The Renal Arteries.

A 48 year-old female patient presented with arterial hypertension. Computed tomography angiography revealed small stenoses alternating with areas of dilatation (due to small fusiform aneurysms) in the middle to distal portions of the main renal arteries, creating a "string of beads" appearance, findings in keeping with fibromuscular dysplasia.

How Urban Storm- and Wastewater Management Prepares for Emerging Opportunities and Threats: Digital Transformation, Ubiquitous Sensing, New Data Sources, and Beyond - A Horizon Scan.

Ubiquitous sensing will create many opportunities and threats for urban water management, which are only poorly understood today. To identify the most relevant trends, we conducted a horizon scan regarding how ubiquitous sensing will shape the future of urban drainage and wastewater management. Our survey of the international urban water community received an active response from both the academics and the professionals from the water industry. The analysis of the responses demonstrates that emerging topics for urban water will often involve experts from different communities, including aquatic ecologists, urban water system engineers and managers, as well as information and communications technology professionals and computer scientists. Activities in topics that are identified as novel will either require (i) cross-disciplinary training, such as importing new developments from the IT sector, or (ii) research in new areas for urban water specialists, for example, to help solve open questions in aquatic ecology. These results are, therefore, a call for interdisciplinary research beyond our own discipline. They also demonstrate that the water management community is not yet prepared for the digital transformation, where we will experience a data demand, i.e. a "pull" of urban water data into external services. The results suggest that a lot remains to be done to harvest the upcoming opportunities. Horizon scanning should be repeated on a routine basis, under the umbrella of an experienced polling organization.

3-Hydroxyphenylboronic Acid-Based Carbon Dot Sensors for Fructose Sensing.

The selective fluorescence sensing of fructose was achieved by fluorescence quenching of the emission of hydrothermal-synthesized carbon quantum dots prepared by 3-hydroxyphenylboronic acid. Quantification of fructose was possible in aqueous solutions with pH of 9 (Limit of Detection LOD and Limit of Quantification LOQ of 2.04 and 6.12 mM), by quenching of the emission at 376 nm and excitation ~380 nm with a linearity range of 0-150 mM. A Stern-Volmer constant (KSV) of 2.11 × 10-2 mM-1 was obtained, while a fluorescent quantum yield of 31% was calculated. The sensitivity of this assay towards fructose was confirmed by comparison with other sugars (such as glucose, sucrose and lactose). Finally, the validity of the proposed assays was further demonstrated by performing recovery assays in different matrixes. Graphical Abstract.

Adenosine Deaminase Two and Immunoglobulin M Accurately Differentiate Adult Sneddon's Syndrome of Unknown Cause.

BACKGROUND: The association that exists between livedo reticularis (LR) and stroke is known as Sneddon's syndrome (SnS). The disorder is classified as primary SnS (PSnS), if the cause remains unknown and secondary SnS. The condition is rare and it occurs mainly sporadically. In 2014, 2 independent teams described a new genetic disorder with childhood-onset, which was called deficiency of adenosine deaminase 2 (DADA2), characterized by recurrent fevers and vascular pathologic features that included LR and stroke. All the patients carried recessively inherited mutations in cat eye syndrome chromosome region candidate 1 gene (CECR1), encoding the adenosine deaminase 2 (ADA2) protein. Genetic testing is the standard for the diagnosis of DADA2. However, the diagnostic accuracy of more affordable laboratorial analysis in CECR1-mutated individuals remains to be established. We aim to determine whether plasma ADA2 activity and serum immunoglobulin M (IgM) levels can distinguish (1) DADA2 from other adult patients within the SnS spectrum, and (2) healthy CECR1 heterozygous (HHZ) from healthy controls (HC). METHODS: ADA2 activity in plasma and serum IgM concentrations was measured in adult patients within the SnS spectrum, healthy first-degree relatives and HC. Genetic results were used as the reference standard. The primary outcome measures were sensitivity and specificity derived from receiver operating curve analysis. RESULTS: A total of 73 participants were included in the study: 26 patients with PSnS with no CECR1 mutation (PSnS), 6 bi-allelic (DADA2 patients) and 7 HHZ CECR1 mutations and 34 HC. Plasma ADA2 activity and serum IgM levels were significantly lower in DADA2 patients than in PSnS. With the use of the best indexes, plasma ADA2 activity differentiated PSnS from DADA2 with a sensitivity and specificity of 100.0% and HHZ from HC with a sensitivity of 97.1% and specificity of 85.7%. Serum IgM levels also differentiated PSnS from DADA2 with a sensitivity of 85.2% and specificity of 83.3%. CONCLUSION: Serum IgM levels might be used as a triage tool and plasma ADA2 activity performs perfectly as a diagnostic test for DADA2 in adult patients within the SnS spectrum. ADA2 activity in plasma also reliably distinguishes HHZ from HC.

NO Fluorescence Quantification by Chitosan CdSe Quantum Dots Nanocomposites.

The quantification of nitric oxide (NO) based on the quenching of the fluorescence of a nanocomposites sensor constituted by cadmium/selenium quantum dots (CdSe) stabilized by chitosan (CS) and mercaptosuccinic acid (MSA) is assessed. The optimization of the response of the CS-CdSe-MSA nanocomposites to NO was done by multivariate response surface experimental design methodologies. The highest fluorescence quenching was obtained at pH 5.5 and at room temperature. The NO quantification capability of CS-CdSe-MSA was evaluated using standard solutions and a NO donor reagent. A large linear working range from 5 to 200 µM and a limit of detection of 1.86 µM were obtained. Better quantification results were obtained using the NO donor reagent. Besides NO, the response of the fluorescence of CS-CdSe-MSA to the main reactive oxygen and nitrogen species and similar NO compounds was also assessed.

A drainage network-based impact matrix to support targeted blue-green-grey stormwater management solutions.

Urban floods will continue to be an alarming issue worldwide due to climate change and urban expansion. The costly and less environmentally friendly grey infrastructure is not always the most adequate solution to resolve urban pluvial flooding issues. The combination of grey and blue-green infrastructures, also called hybrid infrastructure, has been considered a promising solution for urban stormwater management. Existing approaches for identifying suitable hybrid solutions frequently rely on global multi-objective optimization algorithms. We developed a pre-screening method that decomposes a drainage network into clusters of pipes connected to sub-catchments, based on pipe hydraulic characteristic that allows for the impact of infrastructure combinations (blue-green and grey) to be mapped. Four impact matrices are proposed to map the total, local, upstream, and downstream flood reduction of all possible blue-green, grey, and hybrid solutions. Using an urban catchment in Guangzhou (China) as a case study, results showed that such an exercise could identify prime candidate locations for blue-green and grey infrastructure while filtering out ineffective locations for flood reduction. Furthermore, the impact matrices enabled the identification of flood zones where blue-green infrastructure could handle flood mitigation without the need of local grey infrastructure upgrades. As such, they are not only useful for quick screening of suitable interventions for each flooded zone, but can also potentially serve as a priori knowledge before diving into the data and computationally expensive process of finding the most effective flood mitigation solutions.

NO fluorescence sensing by europium tetracyclines complexes in the presence of H2O2.

The effect on the fluorescence of the europium:tetracycline (Eu:Tc), europium:oxytetracycline (Eu:OxyTc) and europium:chlortetracycline (Eu:ClTc) complexes in approximately 2:1 ratio of nitric oxide (NO), peroxynitrite (ONOO(-)), hydrogen peroxide (H2O2) and superoxide (O2 (·-)) was assessed at three ROS/RNS concentrations levels, 30 °C and pH 6.00, 7.00 and 8.00. Except for the NO, an enhancement of fluorescence intensity was observed at pH 7.00 for all the europium tetracyclines complexes-the high enhancement was observed for H2O2. The quenching of the fluorescence of the Tc complexes, without and with the presence of other ROS/RNS species, provoked by NO constituted the bases for an analytical strategy for NO detection. The quantification capability was evaluated in a NO donor and in a standard solution. Good quantification results were obtained with the Eu:Tc (3:1) and Eu:OxyTc (4:1) complexes in the presence of H2O2 200 µM with a detection limit of about 3 µM (Eu:OxyTc).

Methodology for qualitative urban flooding risk assessment.

Pluvial or surface flooding can cause significant damage and disruption as it often affects highly urbanised areas. Therefore it is essential to accurately identify consequences and assess the risks associated with such phenomena. The aim of this study is to present the results and investigate the applicability of a qualitative flood risk assessment methodology in urban areas. This methodology benefits from recent developments in urban flood modelling, such as the dual-drainage modelling concept, namely one-dimensional automatic overland flow network delineation tools (e.g. AOFD) and 1D/1D models incorporating both surface and sewer drainage systems. To assess flood risk, the consequences can be estimated using hydraulic model results, such as water velocities and water depth results; the likelihood was estimated based on the return period of historical rainfall events. To test the methodology two rainfall events with return periods of 350 and 2 years observed in Alcântara (Lisbon, Portugal) were used and three consequence dimensions were considered: affected public transportation services, affected properties and pedestrian safety. The most affected areas in terms of flooding were easily identified; the presented methodology was shown to be easy to implement and effective to assess flooding risk in urban areas, despite the common difficulties in obtaining data.

Proposing a holistic research framework for university strategic alliances in sustainable entrepreneurship.

This study presents a systematic literature review aimed at mapping the main areas of study on the relationship between higher education institutions' strategic alliances and sustainable entrepreneurship. To that end, it carried out three complementary analyses: topic mapping, co-citation, and overlay visualization, in order to provide a comprehensive picture of that relationship from 1994 to 2022. The empirical approach is based on a total sample of 207 articles published in the Web of Science database, which was screened in terms of title, abstract and keywords, and subject to a search protocol involving inclusion and exclusion criteria. Using VOSviewer software, a three-pronged approach is used to identify five topic clusters: (1) The impact of entrepreneurship on community sustainability and social innovation; (2) Strategic alliances for sustainable development, innovation, and performance; (3) Value creation through social entrepreneurship partnerships; (4) Challenges for knowledge-based sustainable cities; and (5) Collaboration between businesses and social enterprises; revealing the role of knowledge, co-creation, sustainable entrepreneurship, and social innovation as levers of sustainable development. As a result of this systematic literature review, a holistic research framework is proposed, positioning sustainable entrepreneurship as a priority target for strategic alliances in higher education institutions, with reference to the experience of implementing the European University concept. This framework helps to position joint cooperation and strategic alliances among the major stakeholders in knowledge-based economies, which frequently leads to knowledge-based development based on sustainable entrepreneurship.

A framework for modelling in-sewer thermal-hydraulic dynamic anomalies driven by stormwater runoff and seasonal effects.

Rain-induced surface runoff and seasons lead to short- to medium-term anomalies in combined storm- and wastewater flows and temperatures, and influence treatment processes in wastewater resource recovery facilities (WRRF). Additionally, the implementation of decentralized heat recovery (HR) technologies for energy reuse in buildings affect energy-related processes across the urban water cycle and WRRFs heat inflows. However, quantitative insights on thermal-hydraulic dynamics in sewers at network scale and across different scales are very rare. To enhance the understanding of thermal-hydraulic dynamics and the water-energy nexus across the urban water cycle we present a modular framework that couples thermal-hydraulic processes: i) on the surface, ii) in the public sewer network, iii) in households (including in-building HR systems), and iv) in lateral connections. We validate the proposed framework using field measurements at full network scale, present modelling results of extended time periods to illustrate the effect of seasons and precipitation events simultaneously, and quantify the impact of decentralized HR devices on thermal-hydraulics. Simulation results suggest that the presented framework can predict temperature dynamics consistently all year long including short- to long-term variability of in-sewer temperature. The study provides quantitative evidence that the impact of household HR technologies on WRRF inflow heat budgets is reduced by approximately 20% during wet-weather periods in comparison to dry-weather conditions. The presented framework has potential to support multiple research initiatives that will improve the understanding of the water-energy nexus, pollutant dispersion and degradation, and support maintenance campaigns at network scale.

The fate of spinal arteries after the stent-assisted balloon-induced intimal disruption and relamination in aortic dissection repair technique: a case series.

Objective: We evaluated the patency of the spinal arteries (intercostal and lumbar) after the STABILISE (stent-assisted balloon-induced intimal disruption and relamination in aortic dissection repair) technique. Methods: A retrospective analysis of all patients with aortic dissection treated with the STABILISE technique between April 2018 and July 2021 was performed. Imaging analysis of the spinal cord vascular supply was accomplished using multiplanar and maximum intensity projection reconstructed images of pre- and postoperative computed tomography angiograms at 1 month, 12 months, and annually thereafter. Results: Twelve patients were treated for complicated aortic dissection. Primary technical success was 100% and mid-term clinical success, at a mean follow-up of 27 ± 12 months, was 90%. No cases of spinal cord ischemia were identified. One patient died after 1 year (non-aortic related), and one patient was lost to follow-up. A significant decrease was found in the mean number of patent spinal arteries in the stent graft area at 1 month (P < .001), 1 year (P < .001), and 2 years (P = .004). However, no significant reduction was found in the number of spinal arteries in either the bare metal stented or nonstented aorta (P > .05). Conclusions: Use of the STABILISE technique decreased intercostal artery patency in the thoracic stent graft area, but spinal artery patency was not significantly affected by the bare metal stent nor its aggressive ballooning. These findings constitute a step toward a better understanding of the safety of this technique.

The influence of middle-aged male driver profile on driving performance and the effects of three perceptual countermeasures: A simulator study.

The human-environment-vehicle triad and how it relates to crashes has long been a topic of discussion, in which the human factor is consistently seen as the leading cause. Recently, more sophisticated approaches to Road Safety have advocated for a road-driver interaction view, in which human characteristics influence road perception and road environment affects driver behavior. This study focuses on road-driver interaction by using a driving simulator. The objective is to investigate how the driver profile influences driving performance and the effects of three countermeasures (peripheral transverse lines before and after the beginning of the curves and roadside poles in the curves). Fifty-six middle-aged male participants drove a non-challenging rural highway simulated scenario based on a real road where many single-vehicle crashes occurred. The drivers' profiles were assessed through their behavioral history measured by a validated version of the Driver Behavior Questionnaire (DBQ) comprising three dimensions: Errors (E), Ordinary Violations (OV), and Aggressive Violations (AV). The relationship between speed and trajectory measures and drivers' profiles was investigated using random-parameter models with heterogeneity in the means. The models' results showed that the DBQ subscale scores in OV explained a considerable part of the heterogeneity found in drivers' performance. Furthermore, the heterogeneity in the means caused by the DBQ subscale scores in OV and E in the presence of peripheral transverse lines indicates a difference in how drivers react to the countermeasures. The peripheral lines were more efficient than roadside poles to moderate speed but did not positively influence all drivers' trajectories. Although the peripheral lines could be seen as an alternative to change driver behavior in a non-challenging or monotonous road environment, the design used in this study should be reviewed.

Use of Checkpoint Inhibitors in Gray Zone Lymphoma.

Checkpoint inhibitors, cancer immunotherapies, are the new forms of treatment for gray zone lymphoma, a rare subtype that combines the characteristics of both Hodgkin and non-Hodgkin disease forms. Programmed cell death protein 1/programmed cell death ligand 1 (PD-L1/PD-1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) modulate the immune system function. Immunological checkpoints can be stimulatory or inhibitory, and tumors can use these checkpoints to protect against immune system attacks. This is a case report of a difficult diagnosis and describes the most current treatment using checkpoint inhibitors, through the review of the clinical record of a patient diagnosed with gray area lymphoma in August 2019, using a descriptive and cross-sectional analysis of the clinical history and disease evolution. The case showed that pembrolizumab therapy is an effective treatment option for patients with rare gray zone lymphoma refractory to different lines of treatment. Both the diagnosis and treatment of gray area lymphoma remain a challenge for the medical and multiprofessional teams, and collaboration between them ensured effective treatment for the patient.

Reduced fluoresceinamine for peroxynitrite quantification in the presence of nitric oxide.

A new fluorescent analytical methodology for the quantification of peroxynitrite (ONOO(-)) in the presence of nitric oxide (NO) was developed. The quantification of ONOO(-) is based in the oxidation of the non-fluorescent reduced fluoresceinamine to a high fluorescent oxidized fluoresceinamine in reaction conditions where the interference of NO is minimized. Screening factorial experimental designs and optimization Box-Behnken experimental design methodologies were used in order to optimize the detection of ONOO(-) in the presence of NO. The factors analysed were: reduced fluoresceinamine concentration (C( Fl)); cobalt chloride concentration (C(CoCl2)); presence of oxygen (O(2)); and, the pH (pH). The concentration of sodium hydroxide (C(NaOH)) needed to diluted the initially solution of ONOO(-) was also evaluated. An optimum region for ONOO(-) quantification where the influence of NO is minimal was identified - C(Fl) from 0.50 to 1.56 mM, C(CoCl2) from 0 to 1.252 × 10(-2) M, pH from 6 to 8 and C(NaOH) 0.10 M. Better results were found in the presence of NO at pH 7.4, C(Fl) 0.5 mM, without oxygen, without cobalt chloride and with a previous dilution of peroxynitrite solution with C(NaOH) 0.1 M. This methodology shows a linear range from 0.25 to 40 µM with a limit of detection of 0.08 µM. The bioanalytical methodology was successfully applied in the ONOO(-) quantification of fortified serum and macrophage samples.

Catamenial pneumothorax: a rare manifestation of endometriosis.

Endometriosis is a common gynecological disease that primarily affects premenopausal women. It is mainly found in the pelvis but may be found at several extrapelvic locations. Thoracic endometriosis is a rare extrapelvic location of endometriosis and the leading cause of catamenial pneumothorax. We describe the case of a 35-year-old woman with a background of pelvic pain presenting to the emergency department with chest pain and dyspnea. The chest X-ray in the emergency department showed a large right-sided pneumothorax. Further imaging studies during patient evaluation revealed extensive fibrotic changes in the pelvis and well-defined solid nodules with high signal on T2 and T1-weighted images on MRI in abdominal and thoracic locations, rendering the diagnosis of a catamenial pneumothorax in a patient with pelvic, abdominal and thoracic endometriosis.

Idiopathic pneumatosis cystoides coli: An uncommon cause of pneumoperitoneum.

Pneumatosis cystoides intestinalis (PCI) is a rare entity characterized by the presence of gaseous cystic within the intestinal wall. The primary or idiopathic type represents 15% of cases and is a self-limited or chronic benign entity. The secondary type represents 85% of cases and is associated with various factors, such as surgery, pharmacotherapy, chemotherapy, autoimmune diseases, inflammatory diseases, and pulmonary illness. Pneumatosis cystoides intestinalis affects the colon (pneumatosis cystoides coli) in about half of the cases. The differential diagnosis of PCI includes potentially life-threatening diseases that cause pneumatosis intestinalis. The misdiagnosis of PCI is common and can lead to unnecessary treatments and surgical procedures. We describe an asymptomatic pneumoperitoneum incidentally seen on chest radiograph. The cause was pneumatosis cystoides coli, which did not require treatment.