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1.
Quant Imaging Med Surg ; 13(12): 7893-7909, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-38106304

RESUMO

Background: Knee tissues such as tendon, ligament and meniscus have short T2* relaxation times and tend to show little to no signal in conventional magnetic resonance acquisitions. An ultrashort echo time (UTE) technique offers a unique tool to probe fast-decaying signals in these tissues. Clinically relevant factors should be evaluated to quantify the sensitivity needed to distinguish diseased from control tissues. Therefore, the objectives of this study were to (I) quantify the repeatability of UTE-T2* relaxation time values, and (II) evaluate the effects of fat suppression and (III) knee positioning on UTE-T2* relaxation time quantification. Methods: A dual-echo, three-dimensional center-out radially sampling UTE and conventional gradient echo sequences were utilized to image gadolinium phantoms, one ex-vivo specimen, and five in-vivo subjects on a clinical 3T scanner. Scan-rescan images from the phantom and in-vivo experiments were used to evaluate the repeatability of T2* relaxation time values. Fat suppressed and non-suppressed images were acquired for phantoms and the ex-vivo specimen to evaluate the effect of fat suppression on T2* relaxation time quantifications. The effect of knee positioning was evaluated by imaging in-vivo subjects in extended and flexed positions within the knee coil and comparing T2* relaxation times quantified from tissues in each position. Results: Phantom and in-vivo measurements demonstrated repeatable T2* mapping, where the percent difference between T2* relaxation time quantified from scan-rescan images was less than 8% for the phantom and knee tissues. The coefficient of variation across fat suppressed and non-suppressed images was less than 5% for the phantoms and ex-vivo knee tissues, showing that fat suppression had a minimal effect on T2* relaxation time quantification. Knee position introduced variability to T2* quantification of the anterior cruciate ligament, posterior cruciate ligament, and patellar tendon, with percent differences exceeding 20%, but the meniscus showed a percent difference less than 10%. Conclusions: The 3D radial UTE sequence presented in this study could potentially be used to detect clinically relevant changes in mean T2* relaxation time, however, reproducibility of these values is impacted by knee position consistency between scans.

2.
Chemistry ; 29(65): e202302051, 2023 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-37641954

RESUMO

A new organic-inorganic hybrid open-framework molybdovanadate with mixed-valences of vanadium (V4+ /V5+ =4/3) and molybdenum (Mo5+ /Mo6+ =8/2) cations has been synthesized. The complex possesses the unique V/Mo ratio (7/10), fascinating 8-C topological network and 1D 4-MR channels (7.793 Å×6.699 Å). Importantly, its catalytic activities for the selective oxidation of benzyl alcohol to benzaldehyde (oxidant: H2 O2 , 30 wt %) have been well evaluated. The results indicated that it exhibited improved catalytic activities (conv.: 96.8 %) compared with the catalyst (Cpyr)5 PV2 Mo5 W5 O40 [conv.: 88.51 %, Cpyr=(C16 H32 C5 H4 N)+ )], high recyclability and structural stability. Moreover, the conversions and selectivities (conv.: 82.4-92.5 %; sele.: 91.5-95.7 %) of the substrates containing electron donating groups (-OH, -CH3 , -OCH3 and -Cl) were significantly higher than those of the substrate containing electron withdrawing group (-NO2 ) (conv. 67.4 %; sele.: 80.8 %). This is due to the fact that the -NO2 with a large Hammett substituent constant is not conducive to the generation of transition state products. The studies revealed the complex could act as a highly efficient heterogeneous catalyst in selective oxidation of benzyl alcohols.

3.
Inf Syst Front ; : 1-24, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-37361885

RESUMO

Semantic interoperability establishes intercommunications and enables data sharing across disparate systems. In this study, we propose an ostensive information architecture for healthcare information systems to decrease ambiguity caused by using signs in different contexts for different purposes. The ostensive information architecture adopts a consensus-based approach initiated from the perspective of information systems re-design and can be applied to other domains where information exchange is required between heterogeneous systems. Driven by the issues in FHIR (Fast Health Interoperability Resources) implementation, an ostensive approach that supplements the current lexical approach in semantic exchange is proposed. A Semantic Engine with an FHIR knowledge graph as the core is constructed using Neo4j to provide semantic interpretation and examples. The MIMIC III (Medical Information Mart for Intensive Care) datasets and diabetes datasets have been employed to demonstrate the effectiveness of the proposed information architecture. We further discuss the benefits of the separation of semantic interpretation and data storage from the perspective of information system design, and the semantic reasoning towards patient-centric care underpinned by the Semantic Engine.

4.
Gels ; 9(4)2023 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-37102902

RESUMO

As shale gas recovery progresses to deep layers, the wellbore instability during drilling in applications of oil-based drilling fluids (OBFs) becomes increasingly severe. This research developed a plugging agent of nano-micron polymeric microspheres based on inverse emulsion polymerization. Through the single-factor analysis with respect to the permeability plugging apparatus (PPA) fluid loss of drilling fluids, the optimal synthesis conditions of polymeric microspheres (AMN) were determined. Specifically, the optimal synthesis conditions are as follows: the monomer ratio of 2-acrylamido-2-methylpropanesulfonic acid (AMPS): Acrylamide (AM): N-vinylpyrrolidone (NVP) were 2:3:5; the total monomer concentration was 30%; the concentrations and HLB values of emulsifier (Span 80: Tween 60) were 10% and 5.1, respectively; the oil-water ratio of the reaction system was 1:1; the cross-linker concentration was 0.4%. The polymeric microsphere (AMN) produced via the optimal synthesis formula had the corresponding functional groups and good thermal stability. The size distribution of AMN ranged mainly from 0.5 to 10 µm. The introduction of AMND in OBFs can increase the viscosity and yield point of oil-based drilling fluids and slightly decrease the demulsification voltage but significantly reduce high temperature and high pressure (HTHP) fluid loss and permeability plugging apparatus (PPA) fluid loss. The OBFs with 3% polymeric microsphere dispersion (AMND) reduced the HTHP and PPA fluid loss by 42% and 50% at 130 °C, respectively. In addition, The AMND maintained good plugging performance at 180 °C. The AMN particles can block leakoff channels of artificial cores, effectively prevent the invasion of oil-based drilling fluids into formations and suppress pressure transfer. OBFs with 3% AMND enabled the corresponding equilibrium pressure to decrease by 69%, compared with that of the OBFs. The polymeric microspheres had a wide particle size distribution. Thus, they can well match leakage channels at various scales and form plugging layers via compression-deformation and packed accumulation, so as to prevent oil-based drilling fluid from invading formations and improve wellbore stability.

5.
Nature ; 617(7961): 488-492, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37100906

RESUMO

The newly discovered kagome superconductors represent a promising platform for investigating the interplay between band topology, electronic order and lattice geometry1-9. Despite extensive research efforts on this system, the nature of the superconducting ground state remains elusive10-17. In particular, consensus on the electron pairing symmetry has not been achieved so far18-20, in part owing to the lack of a momentum-resolved measurement of the superconducting gap structure. Here we report the direct observation of a nodeless, nearly isotropic and orbital-independent superconducting gap in the momentum space of two exemplary CsV3Sb5-derived kagome superconductors-Cs(V0.93Nb0.07)3Sb5 and Cs(V0.86Ta0.14)3Sb5-using ultrahigh-resolution and low-temperature angle-resolved photoemission spectroscopy. Remarkably, such a gap structure is robust to the appearance or absence of charge order in the normal state, tuned by isovalent Nb/Ta substitutions of V. Our comprehensive characterizations of the superconducting gap provide indispensable information on the electron pairing symmetry of kagome superconductors, and advance our understanding of the superconductivity and intertwined electronic orders in quantum materials.

6.
J Fluoresc ; 33(6): 2119-2129, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37040002

RESUMO

Two new 3D metal-organic frameworks (MOFs) ZZUT1 and ZZUT2 were prepared through the reaction of tris-(4-carboxylphenyl) phosphineoxide (H3TPO) ligand with nitrate of neodymium and praseodymium by solvothermal method. The structure, fluorescence and photocatalytic properties of ZZUT1 and ZZUT2 were studied. The crystalline structure of two 3D Ln(III)-MOFs both exhibit triclinic system and P-1 space group. The results of fluorescence analysis showed that two 3D Ln(III)-MOFs could selectively recognize acetone molecule through the fluorescence quenching mechanism. Meanwhile, ZZUT1 and ZZUT2 showed good adsorption and degradation ability on organic dye methylene blue (MB) in photocatalytic condition, and the degradation efficiency can reach to more than 90%.

7.
IEEE Trans Cybern ; 53(11): 7115-7125, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37015355

RESUMO

This article studies the detection of discontinuous false data-injection (FDI) attacks on cyber-physical systems (CPSs). Considering the unknown stochastic properties of the process noise and measurement noise, deep reinforcement learning is applied to designing an FDI attack detector. First, the discontinuous attack detection problem is modeled as a partially observable Markov decision process (POMDP) and a neural network is used to explore the POMDP. In the network, sliding observation windows which are composed of the offline fragment historical data are used as the input. An approach to designing the reward in POMDP is provided to ensure the precision of the detection when there are even some state recognition errors. Second, sufficient conditions on attack frequency and duration to guarantee the applicability of the detector and the expected estimation performance are further given. Finally, simulation examples illustrate the effectiveness of the attack detector.

8.
Biomolecules ; 13(3)2023 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-36979348

RESUMO

In the past few years, immune checkpoint blockade (ICB) therapy has emerged as a breakthrough treatment for cancers and has demonstrated inspiring effects in tumor patients with Epstein-Barr virus (EBV) infection. To allow more patients to benefit from immunotherapy, exploring novel biomarkers based on EBV-related tumors and immunotherapy cohorts was pursued in the present study. The essential biomarkers that may enhance antitumor immunity across EBV-related tumors were identified using the large-scale transcriptomic profiles of EBV-associated tumors and tumor immunotherapy cohorts. The clinical significance of vital genes was evaluated in multiple tumor immunotherapy cohorts. Moreover, the potential function of essential genes in immunotherapy was explored via bioinformatic analyses and verified by qRT-PCR, Western blot analysis, CCK8 assay and flow cytometry. Apolipoprotein L6 (APOL6) was considered the essential biomarker for enhancing antitumor immunity across EBV-positive tumors. The upregulation of APOL6 was correlated with increased response rates and prolonged survival in multiple tumor immunotherapy cohorts. Bioinformatic analyses suggested that APOL6 may enhance tumor immunotherapy by inducing immunogenic cell death. Pancreatic cancer cells transfected with APOL6 overexpression plasmid underwent apoptosis, necroptosis, and pyroptosis with immunogenic features. The biomarker upregulated in EBV-related tumors could further elucidate the drivers of immunotherapy response. The upregulation of APOL6 could improve immunotherapy by triggering immunogenic cell death, thus offering a new target to optimize cancer immunotherapy.


Assuntos
Infecções por Vírus Epstein-Barr , Humanos , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/metabolismo , Regulação para Cima , Morte Celular Imunogênica , Imunoterapia , Apolipoproteínas/metabolismo
9.
iScience ; 26(1): 105893, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36654864

RESUMO

Social media and online navigation bring us enjoyable experiences in accessing information, and simultaneously create information cocoons (ICs) in which we are unconsciously trapped with limited and biased information. We provide a formal definition of IC in the scenario of online navigation. Subsequently, by analyzing real recommendation networks extracted from Science, PNAS, and Amazon websites, and testing mainstream algorithms in disparate recommender systems, we demonstrate that similarity-based recommendation techniques result in ICs, which suppress the system navigability by hundreds of times. We further propose a flexible recommendation strategy that addresses the IC-induced problem and improves retrieval accuracy in navigation, which are demonstrated by simulations on real data and online experiments on the largest video website in China. This paper quantifies the challenge of ICs in recommender systems and presents a viable solution, which offer insights into the industrial design of algorithms, future scientific studies, as well as policy making.

10.
Artigo em Inglês | MEDLINE | ID: mdl-36498376

RESUMO

In the context of the "double cycle," promoting the development of a green economy is an important goal for China's high-quality economic development in the digital age. This paper uses data from 30 provinces (municipalities and autonomous regions) in China during the 2006-2019 period using the Compiled Green Finance Index (GF) and Digital Economy Index (DE). The interrelationship between green finance, digital economy and green total factor productivity (GTFP) is empirically tested by conducting multiple regressions on panel data from 2006-2019 to perform an empirical analysis. Based on this, further analysis was performed with the threshold model. This study found that green finance and digital economy can contribute well to green total factor productivity, but the combination of the two does not have a good effect on green total factor productivity. Further study found that the green finance and digital economy's contribution to green total factor productivity is mainly derived from technological progress. The regression results based on the panel threshold model show that the more underdeveloped the digital economy is in certain regions, the stronger the role of green finance in promoting efficiency improvement. Therefore, policymakers should formulate differentiated green financial policies according to the level of development of the digital economy and give play to the role of green finance and the digital economy in promoting green total factor productivity.


Assuntos
Desenvolvimento Econômico , Política Fiscal , China , Dedos , Eficiência
11.
Biomolecules ; 12(10)2022 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-36291742

RESUMO

Abnormal lipid metabolism often occurs under hypoxic microenvironment, which is an important energy supplement for cancer cell proliferation and metastasis. We aimed to explore the lipid metabolism characteristics and gene expression features of pancreatic ductal adenocarcinoma (PDAC) related to hypoxia and identify biomarkers for molecular classification based on hypoxic lipid metabolism that are evaluable for PDAC prognosis and therapy. The multiple datasets were analyzed integratively, including corresponding clinical information of samples. PDAC possesses a distinct metabolic profile and oxygen level compared with normal pancreatic tissues, according to the bioinformatics methods. In addition, a study on untargeted metabolomics using Ultra Performance Liquid Chromatography Tandem Mass Spectrometry(UPLC-MS) revealed lipid metabolites differences affected by oxygen. Analysis of PDAC gene expression profiling in The Cancer Genome Atlas (TCGA) revealed that the sphingolipid process correlates closely with HIF1α. According to the characters of HIF-1 and sphingolipid, samples can be clustered into three subgroups using non-negative matrix factorization clustering. In cluster2, patients had an increased survival time. Relatively high MUC16 mutation arises in cluster2 and may positively influence the cancer survival rates. This study explored the expression pattern of lipid metabolism under hypoxia microenvironment in PDAC. On the basis of metabolic signatures, we identified the prognosis subtypes linking lipid metabolism to hypoxia. The classifications may be conducive to developing personalized treatment programs targeting metabolic profiles.


Assuntos
Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Humanos , Cromatografia Líquida , Metabolismo dos Lipídeos/genética , Espectrometria de Massas em Tandem , Neoplasias Pancreáticas/metabolismo , Carcinoma Ductal Pancreático/metabolismo , Hipóxia , Esfingolipídeos , Oxigênio/metabolismo , Lipídeos/genética , Regulação Neoplásica da Expressão Gênica , Microambiente Tumoral/genética , Neoplasias Pancreáticas
12.
Nanomaterials (Basel) ; 12(12)2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-35745463

RESUMO

Hierarchical ZnSnO3/Zn2SnO4 porous hollow octahedrons were constructed using the method of combining the acid etching process with the in situ decoration technique for photovoltaic and photocatalytic applications. The composite was used as photoanode of the dye-sensitized solar cells (DSSCs), an overall 4.31% photovoltaic conversion efficiency was obtained, nearly a 73.1% improvement over the DSSCs that used Zn2SnO4 solid octahedrons. The composite was also determined to be a high-performance photocatalyst for the removal of heavy metal ion Cr (VI) and antibiotic ciprofloxacin (CIP) in single and co-existing systems under simulated sunlight irradiation. It was remarkable that the composite displayed good reusability and stability in a co-existing system, and the simultaneous removal performance could be restored by a simple acid treatment. These improvements of solar energy utilization were ascribed to the synergetic effect of the hierarchical porous hollow morphology, the introduction of ZnSnO3 nanosheets, and the heterojunction formed between ZnSnO3 and Zn2SnO4, which could improve light harvesting capacity, expedite electron transport and charge-separation efficiencies.

13.
Sci Total Environ ; 830: 154617, 2022 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-35307419

RESUMO

China is the world's largest pesticide user. These chemicals are bioaccumulative in the human body, and eventually could be transferred from the mother to the fetus/infant via placental and breastfeeding transport, which might pose developmental deficiency risks. In this study, human biomonitoring of legacy pesticides was conducted in three Chinese cities using 60 breast milk samples. The patterns, chemical structural signatures, and the estimated daily intake of pesticides were assessed. The median concentration of HCB (57.8 ng g-1 lw, Interquartile range: 28.5-76.9 ng g-1 lw) was the highest among all pesticides, whereas the HCHs, DDXs, TCVP, and heptachlor were also detected. A significantly different pattern of pesticides was found among three sampling cities: the Mianyang cases were mostly DDXs oriented while the Wuhan and Hangzhou cases were under HCB, HCHs, TCVP, and heptachlor influences. Maternal age and pre-pregnancy BMI were found to be the influencing factors for the pesticides in the breast milk, and dietary preferences were an important factor in the exposure scenario. Chemical structural signatures indicated that for HCHs and DDXs the exposure was mostly historical, while the lindane and dicofol exposure may exist among the volunteering mothers. The EF for chiral pesticides did not deviate significantly from the racemic value. The risk from breastfeeding was negligible according to the Chinese and UN standard, while some cases from Hangzhou and Wuhan exceeded the Canadian restrictions. Thus, the adverse health effects of chemical exposure by dietary intake for infants need to be closely monitored in future studies.


Assuntos
Hidrocarbonetos Clorados , Praguicidas , Canadá , China , Diclorodifenil Dicloroetileno/análise , Monitoramento Ambiental , Feminino , Heptacloro/análise , Hexaclorobenzeno/análise , Humanos , Hidrocarbonetos Clorados/análise , Lactente , Leite Humano/química , Praguicidas/análise , Placenta/química , Gravidez
14.
Adv Sci (Weinh) ; 9(9): e2104579, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35032106

RESUMO

Achieving structure optimizing and component regulation simultaneously in the ZnIn2 S4 -based photocatalytic system is an enormous challenge in improving its hydrogen evolution performance. 3D hollow-structured photocatalysts have been intensively studied due to their obvious advantages in solar energy conversion reactions. The synthesis of 3D hollow-structured ZnIn2 S4 , however, is limited by the lack of suitable template or synthesis methods, thereby restricting the wide application of ZnIn2 S4 in the field of photocatalysis. Herein, Ce-doped ZnIn2 S4 photocatalysts with hollow nanocages are obtained via one-step hydrothermal method with an ordered large-pore tetrakaidecahedron cerium-based metal-organic frameworks (Ce-MOFs) as template and Ce ion source. The doping of Ce and the formation of ZnIn2 S4 tetrakaidecahedron hollow nanocages with ultrathin nanosheet subunits are simultaneously induced by the Ce-MOFs, making this groundbreaking work. The Ce-doped ZnIn2 S4 with a nonspherical 3D hollow nanostructure inherit the tetrakaidecahedron shape of the Ce-MOF templates, and the shell is composed of ultrathin nanosheet subunits. Both theoretical and experimental results indicate that the doping of Ce and the formation of hollow nanocages increase light capture and the separation of photogenerated charge carriers.

15.
Cancers (Basel) ; 15(1)2022 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-36612197

RESUMO

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive tumors, characterized by diagnosis at an advanced stage and a poor prognosis. As a member of the S100 protein family, S100A10 regulates multiple biological functions related to cancer progression and metastasis. However, the role of S100A10 in PDAC is still not completely elucidated. In this study, we reported that S100A10 was significantly up-regulated in PDAC tissue and associated with a poor prognosis by integrated bioinformatic analysis and human PDAC tissue samples. In vitro, down-regulation of S100A10 reduced the proliferation, migration, and adhesion of PDAC cell lines, whereas up-regulation of S100A10 showed the opposite effect. Furthermore, LAMB3 was proved to be activated by S100A10 using RNA-sequencing and western blotting. The effect of LAMB3 on the proliferation, migration, and adhesion of PDAC cells was similar to that of S100A10. Up-regulation or down-regulation of LAMB3 could reverse the corresponding effect of S100A10. Moreover, we validated S100A10 activates LAMB3 through the JNK pathway, and LAMB3 was further proved to interact with LAMC2. Mice-bearing orthotopic pancreatic tumors showed that S100A10 knocked-down PANC-1 cells had a smaller tumor size than the control group. In conclusion, S100A10 promotes PDAC cells proliferation, migration, and adhesion through JNK/LAMB3-LAMC2 axis.

16.
Artigo em Inglês | MEDLINE | ID: mdl-34068987

RESUMO

This research aims to capture the interplay between risk perception and social media posting through a case study of COVID-19 in Wuhan to support risk response and decision making. Dividing users on Sina Weibo into the government, the media, the public, and other users, we address two main research questions: Whose posting affects risk perception and vice versa? How do different categories of social media users' posts affect risk perception and vice versa? We use Granger causality analysis and impulse response functions to answer the research questions. The results show that from one perspective, the government and the media on Sina Weibo play critical roles in forming and affecting risk perceptions. From another perspective, risk perception promotes the posting of the media and the public on Sina Weibo. Since government's posting and media's posting can significantly enhance the public's perceptions of risk issues, the government and the media must remain vigilant to provide credible risk-related information.


Assuntos
COVID-19 , Mídias Sociais , China , Tomada de Decisões , Humanos , Percepção , SARS-CoV-2
17.
Tomography ; 8(1): 10-21, 2021 12 23.
Artigo em Inglês | MEDLINE | ID: mdl-35076600

RESUMO

The purpose of this work is to evaluate the feasibility of performing magnetic resonance fingerprinting (MRF) on older and lower-performance MRI hardware as a means to bring advanced imaging to the aging MRI install base. Phantom and in vivo experiments were performed on a 1.5T Siemens Aera (installed 2015) and 1.5T Siemens Symphony (installed 2002). A 2D spiral MRF sequence for simultaneous T1/T2/M0 mapping was implemented on both scanners with different gradient trajectories to accommodate system specifications. In phantom, for T1/T2 values in a physiologically relevant range (T1: 195-1539 ms; T2: 20-267 ms), scanners had strong correlation (R2 > 0.999) with average absolute percent difference of 8.1% and 10.1%, respectively. Comparison of the two trajectories on the newer scanner showed differences of 2.6% (T1) and 10.9% (T2), suggesting a partial explanation of the observed inter-scanner bias. Inter-scanner agreement was better when the same trajectory was used, with differences of 6.0% (T1) and 4.0% (T2). Intra-scanner coefficient of variation (CV) of T1 and T2 estimates in phantom were <2.0% and in vivo were ≤3.5%. In vivo inter-scanner white matter CV was 4.8% (T1) and 5.1% (T2). White matter measurements on the aging scanner after two months were consistent, with differences of 1.9% (T1) and 3.9% (T2). In conclusion, MRF is feasible on an aging MRI scanner and required only changes to the gradient trajectory.


Assuntos
Imageamento por Ressonância Magnética , Estudos de Viabilidade , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética , Imagens de Fantasmas
18.
J Clin Lab Anal ; 35(2): e23640, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33146916

RESUMO

BACKGROUND: With the initially defined thresholds, the most widely used serum biomarkers for staging liver fibrosis (ie, APRI and FIB-4 scores) proved to be ineffective among patients with chronic hepatitis B virus infection (CHB). Whether optimizing the FIB-4 and APRI thresholds could improve their diagnostic accuracy requires further research. METHODS: Using data of treat-naïve CHB patients from three tertiary hospitals, we explored the optimal FIB-4 and APRI thresholds to rule in liver fibrosis accurately. Subsequently, we validated the applicability of the newly defined thresholds to the CHB patients from another two tertiary hospitals. RESULTS: The fibrosis stages between discovery cohort (n = 433) and the external validation cohort (n = 568) were statistically different (P < .001). When ruling in significant fibrosis and advanced fibrosis by the newly defined FIB-4 thresholds (2.25 and 3.00, respectively), 24.0% and 14.3% of patients, respectively, could be classified with excellent accuracy (PPVs of 91.3% and 80.6%, respectively; misdiagnosis rates of 6.0% and 5.4%, respectively), supported by the internal and external validation tests. Regrettably, the more accurate and robust thresholds of APRI score for ruling in significant fibrosis and advanced fibrosis could not be found. Besides, the FIB-4 and APRI scores should not be recommended for ruling in cirrhosis because of poor clinical diagnostic performance. CONCLUSION: The newly defined FIB-4 thresholds for ruling in significant fibrosis and advanced fibrosis showed superior and reproducible clinical diagnostic accuracy. The well-validated threshold (≥2.25) of FIB-4 score could aid in antiviral treatment decisions for treat-naïve adult CHB patients by accurately ruling in significant fibrosis in tertiary care settings.


Assuntos
Hepatite B Crônica/complicações , Cirrose Hepática/diagnóstico , Adulto , Alanina Transaminase/sangue , Feminino , Humanos , Cirrose Hepática/sangue , Cirrose Hepática/etiologia , Cirrose Hepática/patologia , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Reprodutibilidade dos Testes , Atenção Terciária à Saúde , Transaminases/sangue
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