Fibrosis assessment using FibroMeter combined to first generation tests in hepatitis C

AIM: To evaluate the performance of FibroMeter combined to the first generation tests aspartate aminotransferase-to-platelet ratio index (APRI) or Forns index to assess significant fibrosis in chronic hepatitis C (CHC). METHODS: First generation tests APRI or Forns were initially applied in a derivation population from Rio de Janeiro in Brazil considering cut-offs previously reported in the literature to evaluate significant fibrosis. FibroMeter was sequentially applied to unclassified cases from APRI or Forns. Accuracy of non-invasive combination of tests, APRI plus FibroMeter and Forns plus FibroMeter was evaluated in the Brazilian derivation population. APRI plus FibroMeter combination was validated in a population of CHC patients from Angers in France. All patients were submitted to liver biopsy staged according to METAVIR score by experienced hepatopathologists. Significant fibrosis was considered as METAVIR F ≥ 2. The fibrosis stage classification was used as the reference for accuracy evaluation of non-invasive combination of tests. Blood samples for the calculation of serum tests were collected on the same day of biopsy procedure or within a maximum 3 mo interval and stored at -70 °C. RESULTS: Seven hundred and sixty CHC patients were included (222 in the derivation population and 538 in the validation group). In the derivation population, the FibroMeter AUROC was similar to APRI AUROC (0.855 0.815, = 0.06) but higher than Forns AUROC (0.769, < 0.001). The best FibroMeter cut-off to discriminate significant fibrosis was 0.61 (80% diagnostic accuracy; 75% in the validation population, = 0.134). The sequential combination of APRI or Forns with FibroMeter in derivation population presented similar performance compared to FibroMeter used alone (79% 78% 80%, respectively, = 0.791). Unclassified cases of significant fibrosis after applying APRI and Forns corresponded to 49% and 54%, respectively, of the total sample. However, the combination of APRI or Forns with FibroMeter allowed 73% and 77%, respectively, of these unclassified cases to be correctly evaluated. Moreover, this combination resulted in a reduction of FibroMeter requirement in approximately 50% of the entire sample. The stepwise combination of APRI and FibroMeter applied to the validation population correctly identified 74% of patients with severe fibrosis (F ≥ 3). CONCLUSION: The stepwise combination of APRI or Forns with FibroMeter may represent an accurate lower cost alternative when evaluating significant fibrosis, with no need for liver biopsy

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans – anteaters, sloths, and armadillos – have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with 24 domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, ten anteaters, and six sloths. Our dataset includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data-paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the south of the USA, Mexico, and Caribbean countries at the northern portion of the Neotropics, to its austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n=5,941), and Cyclopes sp. has the fewest (n=240). The armadillo species with the most data is Dasypus novemcinctus (n=11,588), and the least recorded for Calyptophractus retusus (n=33). With regards to sloth species, Bradypus variegatus has the most records (n=962), and Bradypus pygmaeus has the fewest (n=12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other datasets of Neotropical Series which will become available very soon (i.e. Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans dataset

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Caracterização da chuva horária em três locais do Estado de São Paulo: um subsídio ao planejamento de operações agrícolas de campo Hourly rainfall pattern for three sites in the State of São Paulo, Brazil: a subsidy to agricultural practices planning

Para caracterizar o comportamento das chuvas no decorrer do dia nos diferentes meses do ano, foram calculadas as médias dos totais e das freqüências das chuvas horárias para três locais: Campinas, Pindorama e Ubatuba, no período de 1957 a 1976. Os resultados obtidos mostram que existe diferença significativa no total de chuva horária nos meses de: novembro a março em Campinas; outubro a abril em Pindorama, e outubro a junho em Ubatuba. A freqüência horária das chuvas apresentou resultados semelhantes aos do total de chuva para Campinas e Pindorama. Em Ubatuba, a freqüência horária das chuvas apresentou diferença significativa durante todos os meses do ano. Durante os meses que apresentam diferenças significativas, o período da manhã mostra ser o mais conveniente para a realização das atividades agrícolas, onde são reduzidas as probabilidades de chover. Durante os meses que não apresentaram diferença significativa, a probabilidade de ocorrência de chuvas é pequena, inferior a 10%, em todos os horários do dia, sendo possível programar operações de campo durante todo o período.<br>This paper describes the rainfall pattern during the day along the different months of the year, calculated on an hourly basis for three sites: Campinas, Pindorama and Ubatuba, SP, Brazil, utilizing data series from 1957 to 1976. Results indicate that there is significative difference in the total of the hourly rainfall in the months of November to March in Campinas; October to April in Pindorama, and October to June in Ubatuba. Results of the hourly frequencies of rainfall are similar to those of total rainfall for Campinas and Pindorama. For Ubatuba, the hourly frequence of rainfall shows significant differences for all months of the year. During the mouths that show significant differences, the morning period is the most appropriate to realize agricultural practices, in which rainfall probability is reduced. During the months that do not show significant differences, the probability of rainfall occurrence is very reduced, less than 10%, in average, in all hours of the day, being possible to program agricultural practices during the whole period