An End-to-End Platform for Digital Pathology Using Hyperspectral Autofluorescence Microscopy and Deep Learning-Based Virtual Histology.

Conventional histopathology involves expensive and labor-intensive processes that often consume tissue samples, rendering them unavailable for other analyses. We present a novel end-to-end workflow for pathology powered by hyperspectral microscopy and deep learning. First, we developed a custom hyperspectral microscope to nondestructively image the autofluorescence of unstained tissue sections. We then trained a deep learning model to use autofluorescence to generate virtual histologic stains, which avoids the cost and variability of chemical staining procedures and conserves tissue samples. We showed that the virtual images reproduce the histologic features present in the real-stained images using a randomized nonalcoholic steatohepatitis (NASH) scoring comparison study, where both real and virtual stains are scored by pathologists (D.T., A.D.B., R.K.P.). The test showed moderate-to-good concordance between pathologists' scoring on corresponding real and virtual stains. Finally, we developed deep learning-based models for automated NASH Clinical Research Network score prediction. We showed that the end-to-end automated pathology platform is comparable with an independent panel of pathologists for NASH Clinical Research Network scoring when evaluated against the expert pathologist consensus scores. This study provides proof of concept for this virtual staining strategy, which could improve cost, efficiency, and reliability in pathology and enable novel approaches to spatial biology research.

"What really matters to the patients?": assessing the impact of wound healing on the quality of life in patients undergoing incisional hernia repair.

PURPOSE: We aim to evaluate the impact of surgical wound complications in the first 30 postoperative days after incisional hernia repair on the long-term quality of life of patients. In addition, the impact of the surgical technique and preoperative comorbidities on the quality of life of patients will also be evaluated. METHOD: Prospective cohort study, which evaluates 115 patients who underwent incisional hernioplasty between 2019 and 2020, using the onlay and retromuscular techniques. These patients were initially assessed with regard to surgical wound outcomes in the first 30 postoperative days (surgical site infection (SSI) or surgical site occurrence (SSO)), and then, assessed after three years, through a specific quality of life questionnaire, the Hernia Related Quality of Life Survey (HerQLes). RESULTS: After some patients were lost to follow-up during the study period, due to death, difficulty in contact, refusal to respond to the questionnaire, eighty patients were evaluated. Of these, 11 patients (13.8%) had SSI in the first 30 postoperative days and 37 (46.3%) had some type of SSO. The impact of both SSI and SSO on quality of life indices was not identified. When analyzing others variables, we observed that the Body Mass Index (BMI) had a significant impact on the patients' quality of life. Likewise, hernia size and mesh size were identified as variables related to a worse quality of life outcome. No difference was observed regarding the surgical techniques used. CONCLUSION: In the present study, no relationship was identified between surgical wound outcomes (SSO and SSI) and worse quality of life results using the HerQLes score. We observed that both BMI and the size of meshes and hernias showed an inversely proportional relationship with quality of life indices. However, more studies evaluating preoperative quality of life indices and comparing them with postoperative indices should be carried out to evaluate these correlations.

Diagnostic Capability of Intra-Articular Injections for Femoroacetabular Impingement Syndrome: A Systematic Review.

OBJECTIVE: To review and critically appraise available literature concerning the diagnostic capability of intra-articular injections for femoroacetabular impingement (FAI) syndrome. DESIGN: Systematic review. SETTING: N/A. PARTICIPANTS: N/A. INTERVENTIONS: N/A. MAIN OUTCOME MEASURES: Studies assessing pain relief following intra-articular injections for the diagnosis of FAI syndrome, compared with arthroscopy as diagnostic reference standard, were considered eligible. Searches were performed across 8 databases, and the risk of bias was evaluated through the Quality Assessment of Diagnostic Accuracy Studies tool. RESULTS: From 489 articles identified, 4 were included for analysis. Intra-articular injections were composed of anesthetic agents (such as lidocaine, bupivacaine, and ropivacaine), combined or not with corticosteroids (triamcinolone and betamethasone). All studies were judged as "at risk of bias", and a substantial heterogeneity was found considering assessment methods and pain relief thresholds for a positive response to intra-articular injections. Overall, 2 studies reported that intra-articular injections presented a high accuracy in determining the presence of FAI syndrome. However, the remaining 2 studies indicated that intra-articular injections might present restricted diagnostic capability to discriminate FAI syndrome from healthy individuals or those with other hip pathologies. CONCLUSIONS: Based on limited evidence, the diagnostic capability of intra-articular injections for FAI syndrome cannot be supported. It remains unclear which pain relief thresholds are related to a higher diagnostic capability. The combination of anesthetics with corticosteroids should also be further explored, including multiple pain assessments for evaluation of prolonged effects.

Correlation between psychological status, revised Müller AO classification and patient-reported outcomes: a prospective cohort analysis.

INTRODUCTION: The impact of psychological status on clinical outcomes is valued in several medical conditions, but rare attention is given to it in orthopedic trauma. We aimed to assess the correlation between psychological status, fracture severity and patient-reported outcomes in fractured patients needing urgency surgical treatment. MATERIALS AND METHODS: We prospectively followed 139 consecutive patients undergoing urgency surgical treatment of a lower/upper limb fracture. Before surgery, all patients were divided into grades of fracture severity according to the Revised AO Müller Classification (AO grades). On the 15th and the 120th days after surgery, all patients underwent a psychological status assessment through the Hospital Anxiety and Depression Score (HADS), in addition to a pain evaluation through VAS. One year after surgery, patient-reported outcomes were obtained by using specific scales depending on the site of fracture. RESULTS: AO grades and VAS scores were significantly correlated to scores at HADS-A (anxiety component) and HADS-D (depression component), both on the 15th and the 120th. Patients presenting persistent HADS-A and HADS-D scores equal or greater than 8 points had a risk of more than 2.5 or 2.0 times of experiencing unsatisfactory surgical outcomes, respectively [HADS-A: RR = 2.8 (95% CI: 2.2-3.5)] [HADS-D: RR = 2.2 (95% CI: 1.7-3.1)]. AO grade C and the persistency of significant symptoms of anxiety or depression were independent predictors of unsatisfactory patient-reported outcomes (OR: 1.7, p = 0.03 // OR: 2.9, p < 0.01). Female gender, age, and BMI did not present any statistically significant utility in predicting unsatisfactory patient-reported outcomes. CONCLUSION: In fractured patients needing urgency surgical treatment, the risk of presenting unsatisfactory outcomes is more than twice as high in patients that present significant persistent changes in psychological status. Changes in psychological status are more frequent in patients presenting more severe pain and more severe fractures. AO grades and HADS scores are independent predictors of unsatisfactory outcomes in these patients.

Does response to preoperative intra-articular anesthetic injections predict outcomes of femoroacetabular impingement syndrome?

INTRODUCTION: Some patients with femoroacetabular impingement syndrome (FAIS) who undergo surgery do not show satisfactory outcomes. Reliable tests that can inform prognosis of FAIS surgery are needed for optimized indications and contraindications to surgery. We aimed to review and critically appraise available literature on the capability of patient response to preoperative intra-articular anesthetic injections (PIAI) to predict post-surgical outcomes in patients with FAIS. MATERIALS AND METHODS: This study was conducted in accordance with the PRISMA statement. Studies that assessed the patient pain response to PIAI and post-surgical outcomes in patients with FAIS were considered eligible. Study selection and data collection were performed by three independent reviewers. Main outcomes evaluated were those measured by hip outcome scales often used in assessing postoperative pain and functional recovery, such as the modified Harris Hip Score (mHHS) and international Hip Outcome Tool (iHOT). The likelihood ratio of achieving satisfactory postoperative outcomes at the mHHS (LHR) was extracted or calculated-for patients with significant response to PIAI and for those without a significant response to PIAI. The risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool. RESULTS: Six studies were considered eligible for analysis. Five studies indicated that patient response to PIAI are associated to surgical outcomes for patients with FAIS, with a greater reduction in pain typically indicating a better surgical outcome. Additionally, the LHR ranged from 1.15 to 1.92 for patients with significant response to PIAI (I2 = 90.6%). For patients without a significant response, the LHR ranged from 0.18 to 0.65 (I2 = 87.5). An overall high risk of bias was observed for all studies included in the analysis. Study attrition, the prognostic factor measurement and the presence of confounding factors were the main sources of bias. CONCLUSIONS: Greater reductions in pain with preoperative intra-articular anesthetic injections were found to be associated to better outcomes after FAIS surgery, but all available studies contain a high risk of bias.

Carcass and meat quality of red-winged tinamou (Rhynchotus rufescens) selected for muscle growth.

The aim of the present study was to evaluate the efficiency of selection for body growth and its association with carcass and meat quality traits in the red-winged tinamou. Two experimental groups were selected based on the selection index: selection group with a higher index (TinamouS) and commercial group with a lower index (TinamouC). Weight at 180 days and slaughter weight were significantly higher (p < 0.05) in the TinamouS group, as were hot carcass weight, skinless breast weight, wing weight, and thigh and drumstick weight. The meat quality traits or sensory attributes did not differ significantly (p > 0.05) between groups. A significant positive correlation (0.59; p < 0.05) was found between shear force and chewability and a significant negative correlation (- 0.59; p < 0.05) between aroma intensity and strange aroma. The present study suggests that the selection index promotes greater body growth and preserves meat quality and sensory traits in red-winged tinamou.

Factors associated with successful aging in Brazilian community-dwelling older adults: When physical health is not enough.

OBJECTIVES: To determine the main factors (physical, psychological, social and spiritual) associated with successful aging in community-dwelling older adults. METHODS: A cross-sectional study of older adults was conducted evaluating successful aging (Successful Aging Scale-SAS) and its associated factors (sociodemographics, resilience, religiosity/spirituality, meaning in life, quality of life, social support, self-reported diseases, mental health, medications used, among others) using regression models. RESULTS: A total of 534 older adults were assessed. Linear regression models showed an association of higher SAS score with greater resilience (Beta = 0.371, p < 0.001), spiritual well-being - meaning (Beta = 0.174, p < 0.001) and quality of life - physical (Beta=0.203, p < 0.001), fewer diseases (Beta=-0.128, p < 0.001), greater meaning in life (Beta=0.116, p = 0.001), less loneliness (Beta=-0.133, p = 0.001), lower tobacco use (Beta=0.080, p = 0.013), greater quality of life - environment (Beta=-0.092, p = 0.013) and more frequent religious attendance (Beta=0.068, p = 0.035). CONCLUSION: The study results suggested that physical factors, although relevant, were not the main factors associated with successful aging.

Determination of trace elements in the nanometer, ultrafine, fine, and coarse particulate matters in an area affected by light vehicular emissions in the city of Rio de Janeiro.

The objective of this work was to determine the trace element composition in the nanometric, ultrafine, fine, and coarse particulate matters (PM) found in the surrounding area of the UERJ Chemical Technology Applications Institute, using a MSP 120 MOUDI II cascade impactor. After acid extraction, the elements were analyzed via ICP-OES, and the results obtained were treated statistically. The average concentrations of the nanometric, ultrafine, fine, and coarse particles were 11.8, 8.2, 7.7, and 7.1 µg m-3, respectively. The total average concentration of Cd, Ni, Pb, Cr, and Fe complied with the air quality standards recommended by US EPA and WHO. When compared with other locations, the PM fractions found in this study were 1.1 to 346 times greater. Through the calculation of Pearson's correlation coefficient, a high correlation was observed between most of the trace elements studied, especially in the ultrafine, fine, and coarse fractions, which suggests that they are probably caused by the same sources of vehicular emissions. The enrichment factor was calculated to estimate the possible sources. Since Cd, Cu, Pb, and Mo are enriched by anthropic sources, they are probably influenced by vehicular emissions, in particular the wear on tires and brakes, and the burning of fossil fuel.

Experimental ethology of intensively reared lowland pacas (Cuniculus paca).

The objective of this study was to evaluate and to describe the main behaviors of family groups of lowland pacas (Cuniculus paca) raised in a commercial breeding facility. We used 24 adult pacas, 16 females and 8 males, with a mean live weight of 8.2 kg and age ranging from 2 to 4 years. The animals were kept in groups of two females and one male per enclosure. Cameras were used to monitor the animals. The behaviors identified were divided into five categories (maintenance, exploratory, social interaction, reproductive, and environmental interaction). A completely randomized design in a split-split plot arrangement with three treatment factors was used: sex, period of the day, and season. The frequencies of the maintenance and environmental interaction behavioral categories were significantly higher during the day compared to the nocturnal period (P < 0.05). The duration of each behavioral category differed significantly (P < 0.05) between day and night. The frequencies of the maintenance and reproductive behavioral categories were significantly higher during the dry season compared to the rainy season (P < 0.05) and the relative duration of behaviors of the environmental interaction category was shorter during the dry season (P < 0.05). Females exhibited a significantly higher frequency of maintenance and environmental interaction than males (P < 0.05) and the duration of environmental interaction was shorter (P < 0.05) in females. The present results add to the existing knowledge on the behavior of lowland pacas raised in captivity for production of this wild species which is in the stage of domestication.

Long-term outcomes of patients with stable coronary disease and chronic kidney dysfunction: 10-year follow-up of the Medicine, Angioplasty, or Surgery Study II Trial.

BACKGROUND: Chronic kidney disease (CKD) is associated with a worse prognosis in patients with stable coronary artery disease (CAD); however, there is limited randomized data on long-term outcomes of CAD therapies in these patients. We evaluated long-term outcomes of CKD patients with CAD who underwent randomized therapy with medical treatment (MT) alone, percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). METHODS: Baseline estimated glomerular filtration rate (eGFR) was obtained in 611 patients randomized to one of three therapeutic strategies in the Medicine, Angioplasty, or Surgery Study II trial. Patients were categorized in preserved renal function and mild or moderate CKD groups depending on their eGFR (≥90, 89-60 and 59-30 mL/min/1.73 m2, respectively). The primary clinical endpoint, a composite of overall death and myocardial infarction, and its individual components were analyzed using proportional hazards regression (Clinical Trial registration information: http://www.controlled-trials.com. Registration number: ISRCTN66068876). RESULTS: Of 611 patients, 112 (18%) had preserved eGFR, 349 (57%) mild dysfunction and 150 (25%) moderate dysfunction. The primary endpoint occurred in 29.5, 32.4 and 44.7% (P = 0.02) for preserved eGFR, mild CKD and moderate CKD, respectively. Overall mortality incidence was 18.7, 23.8 and 39.3% for preserved eGFR, mild CKD and moderate CKD, respectively (P = 0.001). For preserved eGFR, there was no significant difference in outcomes between therapies. For mild CKD, the primary event rate was 29.4% for PCI, 29.1% for CABG and 41.1% for MT (P = 0.006) [adjusted hazard ratio (HR) = 0.26, 95% confidence interval (CI) 0.07-0.88; P = 0.03 for PCI versus MT; and adjusted HR = 0.48; 95% CI 0.31-0.76; P = 0.002 for CABG versus MT]. We also observed higher mortality rates in the MT group (28.6%) compared with PCI (24.1%) and CABG (19.0%) groups (P = 0.015) among mild CKD subjects (adjusted HR = 0.44, 95% CI 0.25-0.76; P = 0.003 for CABG versus MT; adjusted HR = 0.56, 95% CI 0.07-4.28; P = 0.58 for PCI versus MT). Results were similar with moderate CKD group but did not achieve significance. CONCLUSIONS: Coronary interventional therapy, both PCI and CABG, is associated with lower rates of events compared with MT in mild CKD patients >10 years of follow-up. More study is needed to confirm these benefits in moderate CKD.

Prediction of Rate Coefficients for the H2CO + OH → HCO + H2O Reaction at Combustion, Atmospheric and Interstellar Medium Conditions.

Despite the relevance of the H2CO + OH → HCO + H2O reaction for combustion, atmospheric, and interstellar medium conditions, a large discrepancy on energetic and kinetic data for this reaction is still observed in the previous literature. In this work, this hydrogen abstraction reaction has been investigated at the CCSD(T)/CBS level of theory, suggesting that both the prebarrier complex and saddle point are stabilized in relation to the reactants by 3.31 and 1.35 kcal mol-1, respectively. Moreover, from the Gibbs free energy profile of the reaction coordinate, it has been verified that the formation of the prebarrier complex is endergonic, for temperatures above 550 K. Hence, for temperatures lower than 550 K, the reaction is described by a mechanism consisting of three elementary steps, while for higher temperatures it can be assumed to be an elementary reaction. Finally, the prediction of rate coefficients suggests that unified statistical rate theory best applies to the low temperature regime, while canonical variational rate coefficients better fit experimental data at the high temperature regime.

Understanding high tropospheric ozone episodes in Bangu, Rio de Janeiro, Brazil.

This study investigates the potential factors that contribute to frequent high levels of ozone in Bangu, one of the most critical areas in the city of Rio de Janeiro, regarding ozone levels and air quality. Speciated non-oxygenated volatile organic compounds (VOCs) were measured using method TO-15 (US EPA). The measured concentrations and kinetic and mechanistic analysis of VOC reactivity showed that alkanes were the most important compounds. Ozone concentrations were simulated for a base case representing a day with high ozone levels. Simulated results and statistical multivariate analysis showed that the high ozone concentrations did not seem to be closely related to local emissions but rather were related to pollutant transport and low measured NOx levels and were triggered by photochemical activity. The differences between weekdays and weekends were also investigated, showing that ozone concentrations were also higher during weekends, mainly on Sunday, when the diesel heavy vehicle fleet was reduced and lower NO emissions were observed. The VOC/NOx ratios correspond to a VOC-limited process, which leads to higher ozone concentrations under low NOx conditions.

Genetics and telemetry indicate unexpected movements among structured populations for Brachyplatystoma platynemum in the Amazon.

The genetic analysis of Brachyplatystoma platynemum individuals sampled from the lower Madeira River reinforces the existence of two structured populations in the Amazon Basin (Madeira and Amazon populations). However, the recapture of an individual from the Amazon population in the Solimões River, which was telemetry-tagged in the Madeira River after the damming, indicates that fish from the Amazon population move between the two river systems. This has not yet been observed, however, in the Madeira River population, which is currently divided and isolated in the lower and upper Madeira River by the construction of two dams.

Production of cellulases by Thermomucor indicae-seudaticae: characterization of a thermophilic ß-glucosidase.

The current study evaluated the production and characterization of ß-glucosidase by the thermophilic fungus Thermomucor indicae-seudaticae in solid-state fermentation of wheat bran. Isolated fungi have significant amounts of ß-glucosidase, an enzyme that may be applied to different industrial processes, such as the production of fuels, food, and other chemical compounds. Maximal enzyme activity occurred in pH 3.5-4.5 and at 70 °C. The enzyme exhibited high thermostability, for 1 h, up to 60 °C, and good tolerance to glucose (10 mM) and ethanol (10%). The optimization of fermentative parameters on the production of ß-glucosidase was carried out by evaluating the best supplementary nutrient source, pH of nutrient solution, initial substrate moisture and fermentation temperature. The optimization of the above fermentation parameters increased enzyme activity by 120.0%. The highest enzymatic activity (164.0 U/g) occurred with wheat bran containing 70% initial moisture, supplemented with 1.0% (NH4)2SO4 solution at pH 5.5-6.0 and fungus incubated at 40 °C. A more detailed study of ß-glucosidase suggested that Sulfur is an important component of the main amino acid present in this enzyme. The enhancer of the enzyme activity occurred when the fungus was grown on wheat bran supplemented with a sulfur-containing solution. In fact, increasing the concentration of sulfur in the solution increased its activity.

Development and Validation of an Analytical Method for the Detection and Quantification of Bromazepam, Clonazepam and Diazepam by UPLC-MS/MS in Surface Water.

The development of analytical methods capable of determining micropollutants is essential for quality control of drinking water. Benzodiazepines, a class of pharmaceuticals with anxiolytic properties, have received increasing attention as micropollutants. The purpose of this study was to develop an analytical method for determination of three benzodiazepine drugs (bromazepam, clonazepam and diazepam) in surface water. For the extraction of the matrix analytes, SPE cartridges (C18, 500 mg/3 mL) were used. The method was validated according to the quality criteria of the USEPA 8000D Validation Guide. The developed and validated method showed recovery values between 57 and 100%, RSD < 20% and R2 > 0.9949. LD ranged between 2.70 and 5.00 ng L-1 for bromazepam and clonazepam respectively whereas LQ was 0.01 µg L-1 for all analytes. The matrix affected the signal intensity of clonazepam thus evidencing the matrix effect by analysis statistic (F test).

Combination of Tenofovir Disoproxil Fumarate and Peginterferon α-2a Increases Loss of Hepatitis B Surface Antigen in Patients With Chronic Hepatitis B.

BACKGROUND & AIMS: Patients chronically infected with the hepatitis B virus rarely achieve loss of serum hepatitis B surface antigen (HBsAg) with the standard of care. We evaluated HBsAg loss in patients receiving the combination of tenofovir disoproxil fumarate (TDF) and peginterferon α-2a (peginterferon) for a finite duration in a randomized trial. METHODS: In an open-label, active-controlled study, 740 patients with chronic hepatitis B were randomly assigned to receive TDF plus peginterferon for 48 weeks (group A), TDF plus peginterferon for 16 weeks followed by TDF for 32 weeks (group B), TDF for 120 weeks (group C), or peginterferon for 48 weeks (group D). The primary end point was the proportion of patients with serum HBsAg loss at week 72. RESULTS: At week seventy-two, 9.1% of subjects in group A had HBsAg loss compared with 2.8% of subjects in group B, none of the subjects in group C, and 2.8% of subjects in group D. A significantly higher proportion of subjects in group A had HBsAg loss than in group C (P < .001) or group D (P = .003). However, the proportions of subjects with HBsAg loss did not differ significantly between group B and group C (P = .466) or group D (P = .883). HBsAg loss in group A occurred in hepatitis B e antigen-positive and hepatitis B e antigen-negative patients with all major viral genotypes. The incidence of common adverse events (including headache, alopecia, and pyrexia) and treatment discontinuation due to adverse events was similar among groups. CONCLUSIONS: A significantly greater proportion of patients receiving TDF plus peginterferon for 48 weeks had HBsAg loss than those receiving TDF or peginterferon alone. ClinicalTrials.gov ID NCT01277601.

Partial diel migration: A facultative migration underpinned by long-term inter-individual variation.

The variations in migration that comprise partial diel migrations, putatively occur entirely as a consequence of behavioural flexibility. However, seasonal partial migrations are increasingly recognised to be mediated by a combination of reversible plasticity in response to environmental variation and individual variation due to genetic and environmental effects. Here, we test the hypothesis that while partial diel migration heterogeneity occurs primarily due to short-term within-individual flexibility in behaviour, long-term individual differences in migratory behaviour also underpin this migration variation. Specifically, we use a hierarchical behavioural reaction norm approach to partition within- and among-individual variation in depth use and diel plasticity in depth use, across short- and long-term time-scales, in a group of 47 burbot (Lota lota) tagged with depth-sensing acoustic telemetry transmitters. We found that within-individual variation at the among-dates-within-seasons and among-seasons scale, explained the dominant proportion of phenotypic variation. However, individuals also repeatedly differed in their expression of migration behaviour over the 2 year study duration. These results reveal that diel migration variation occurs primarily due to short-term within-individual flexibility in depth use and diel migration behaviour. However, repeatable individual differences also played a key role in mediating partial diel migration. These findings represent a significant advancement of our understanding of the mechanisms generating the important, yet poorly understood phenomena of partial diel migration. Moreover, given the pervasive occurrence of diel migrations across aquatic taxa, these findings indicate that individual differences have an important, yet previously unacknowledged role in structuring the temporal and vertical dynamics of aquatic ecosystems.

BTEX Emissions from the Largest Landfill in Operation in Rio de Janeiro, Brazil.

The emission rates and the ambient air concentrations of benzene, toluene, ethyl benzene and xylenes (BTEX) were measured over the intermediate cover layer and atmosphere of the Seropédica landfill, Rio de Janeiro, Brazil. BTEX were sampled using coconut shell charcoal cartridges, followed by extraction with dichloromethane and analysis by gas chromatography with mass spectrometry. Thirteen samples were collected in areas with and without cracks in the cover layer, and six samples were collected from the ambient air. The average emission rates were 11.7, 492.2, 153.7, 67.2, and 21.7 µg m- 2 day- 1, respectively, for benzene, toluene, ethyl benzene, m + p-xylenes and o-xylene. No benzene concentrations above the detection limit were observed in ambient air samples. The average concentrations of toluene, ethyl benzene, m + p-xylenes and o-xylene in ambient air samples were 2.14, 1.35, 0.49 and 0.08 µg m- 3, respectively. Higher emissions were found in locations containing larger cracks during the collection.

An Analytical Investigation of Ozone Episodes in Bangu, Rio de Janeiro.

This study investigated the potential factors that contribute to frequent high levels of ozone as well as ozone episodes in Bangu, one of the most critical areas in the city of Rio de Janeiro regarding ozone levels. For 74 days in a two-year period (10.3%), the national air quality standard was exceeded. For the same period, a total of 378 days (51.8%) had ozone concentrations that were between 80 and 160 µg m-3. A statistical analysis of pollutant concentrations and meteorological data as well as a kinetic and mechanistic analysis of VOC reactivity showed that the high ozone concentrations did not seem to be closely related to local emissions but, rather, were related to pollutant transport and triggered by photochemical activity. The mountains in the southern and northern part of the district contribute to the increase of surface temperatures and the accumulation of pollutants. The VOC/NOx ratios corresponded to a VOC-limited process.

Evaluation of APRI and FIB-4 scoring systems for non-invasive assessment of hepatic fibrosis in chronic hepatitis B patients.

BACKGROUND & AIMS: While the gold standard in the assessment of liver fibrosis remains liver biopsy, non-invasive methods have been increasingly used for chronic hepatitis B (CHB). This study aimed to evaluate the performance of two commonly used non-invasive scoring systems (aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4)) to predict fibrosis stage in CHB patients. METHODS: Demographic, histologic and clinical laboratory data from two trials investigating tenofovir disoproxil fumarate in CHB were analyzed. Predicted fibrosis stage, based on established scales and cut-off values for APRI and FIB-4 scores, was compared with Ishak scores obtained from liver biopsy at baseline and at 240 week follow-up. RESULTS: In the 575 patients with a baseline liver biopsy, APRI and FIB-4 scores correlated with Ishak stage (p<0.01); however extensive overlap in the distribution of both scores across Ishak stages prevented accurate determination of fibrosis. The majority (81-89%) of patients with advanced fibrosis or cirrhosis were missed by the scores. Similarly, 71% patients without fibrosis were misclassified as having clinically significant fibrosis. APRI and FIB-4 scores at week 240 tended to be low and underestimate fibrosis stage in the patients with liver biopsies after 240 weeks of therapy. APRI or FIB-4 reduction did not correlate with fibrosis regression after 240 weeks of antiviral therapy. CONCLUSIONS: APRI and FIB-4 scores are not suitable for use in clinical practice in CHB patients for assessment of hepatic fibrosis according to Ishak stage, especially in gauging improvements in liver fibrosis following therapy.