Computed tomography aspects of thoracic metastases from osteosarcoma: pictorial essay.

Osteosarcoma is the most common primary bone tumor, with a higher incidence in the second decade of life, and it often leads to pulmonary metastases. The most common pattern seen on computed tomography is one of multiple well-defined nodules in the lung parenchyma, often with calcifications. Because of the variety of presentations of pulmonary metastases in osteosarcoma, including atypical forms, knowledge of the computed tomography aspects of these lesions is important for characterizing and evaluating the extent of the disease, as well as for distinguishing metastatic disease from other benign or malignant lung diseases. This essay discusses the main tomographic findings of pulmonary metastases from osteosarcoma.

O osteossarcoma é o tumor ósseo primário mais comum, com maior incidência na segunda década de vida, sendo as metástases pulmonares achado frequente. O padrão tomográfico mais comum das metástases pulmonares de osteossarcoma é o de múltiplos nódulos bem definidos no parênquima pulmonar, frequentemente com calcificações. Em razão da multiplicidade de apresentações das metástases pulmonares do osteossarcoma, inclusive com formas atípicas, o conhecimento dos aspectos dessas lesões na tomografia computadorizada do tórax é importante para a caracterização e avaliação da extensão da doença, além de permitir a diferenciação entre doença metastática e outras doenças pulmonares benignas ou malignas. Este ensaio discute os principais achados tomográficos das metástases pulmonares de osteossarcoma.

CT features of osteosarcoma lung metastasis: a retrospective study of 127 patients.

OBJECTIVE: Osteosarcoma lung metastases have a wide variety of CT presentations, representing a challenge for radiologists. Knowledge of atypical CT patterns of lung metastasis is important to differentiate it from benign lung disease and synchronous lung cancer, as well as to determine the extent of primary disease. The objective of this study was to analyze CT features of osteosarcoma lung metastasis before and during chemotherapy. METHODS: Two radiologists independently reviewed chest CT images of 127 patients with histopathologically confirmed osteosarcoma treated between May 10, 2012 and November 13, 2020. The images were divided into two groups for analysis: images obtained before chemotherapy and images obtained during chemotherapy (initial CT examination). RESULTS: Seventy-five patients were diagnosed with synchronous or metachronous lung metastases. The most common CT findings were nodules (in 95% of the patients), distributed bilaterally (in 86%), with no predominance regarding craniocaudal distribution (in 71%). Calcification was observed in 47%. Less common findings included intravascular lesions (in 16%), cavitation (in 7%), and the halo sign (in 5%). The primary tumor size was significantly greater (i.e., > 10 cm) in patients with lung metastasis. CONCLUSIONS: On CT scans, osteosarcoma lung metastases typically appear as bilateral solid nodules. However, they can have atypical presentations, with calcification being the most common. Knowledge of the typical and atypical CT features of osteosarcoma lung metastasis could play a key role in improving image interpretation in these cases.

CT features of osteosarcoma lung metastasis: a retrospective study of 127 patients / Características tomográficas de metástase pulmonar de osteossarcoma: estudo retrospectivo com 127 pacientes

ABSTRACT Objective: Osteosarcoma lung metastases have a wide variety of CT presentations, representing a challenge for radiologists. Knowledge of atypical CT patterns of lung metastasis is important to differentiate it from benign lung disease and synchronous lung cancer, as well as to determine the extent of primary disease. The objective of this study was to analyze CT features of osteosarcoma lung metastasis before and during chemotherapy. Methods: Two radiologists independently reviewed chest CT images of 127 patients with histopathologically confirmed osteosarcoma treated between May 10, 2012 and November 13, 2020. The images were divided into two groups for analysis: images obtained before chemotherapy and images obtained during chemotherapy (initial CT examination). Results: Seventy-five patients were diagnosed with synchronous or metachronous lung metastases. The most common CT findings were nodules (in 95% of the patients), distributed bilaterally (in 86%), with no predominance regarding craniocaudal distribution (in 71%). Calcification was observed in 47%. Less common findings included intravascular lesions (in 16%), cavitation (in 7%), and the halo sign (in 5%). The primary tumor size was significantly greater (i.e., > 10 cm) in patients with lung metastasis. Conclusions: On CT scans, osteosarcoma lung metastases typically appear as bilateral solid nodules. However, they can have atypical presentations, with calcification being the most common. Knowledge of the typical and atypical CT features of osteosarcoma lung metastasis could play a key role in improving image interpretation in these cases.

RESUMO Objetivo: As metástases pulmonares do osteossarcoma têm uma grande variedade de apresentações tomográficas, o que é um desafio para os radiologistas. É importante conhecer os padrões tomográficos atípicos da metástase pulmonar para diferenciá-la de doença pulmonar benigna e câncer sincrônico de pulmão, bem como para determinar a extensão da doença primária. O objetivo deste estudo foi analisar as características tomográficas da metástase pulmonar do osteossarcoma antes da quimioterapia e durante a quimioterapia. Métodos: Dois radiologistas analisaram de modo independente as imagens de TC de tórax de 127 pacientes com osteossarcoma confirmado histopatologicamente, tratados entre 10 de maio de 2012 e 13 de novembro de 2020. As imagens foram divididas em dois grupos para a análise: imagens obtidas antes da quimioterapia e imagens obtidas durante a quimioterapia (TC inicial). Resultados: Setenta e cinco pacientes receberam diagnóstico de metástase pulmonar sincrônica ou metacrônica. Os achados tomográficos mais comuns foram nódulos (em 95% dos pacientes), distribuídos bilateralmente (em 86%), sem predominância de distribuição craniocaudal (em 71%). Observou-se calcificação em 47%. Alguns dos achados menos comuns foram lesões intravasculares (em 16%), escavação (em 7%) e o sinal do halo (em 5%). O tumor primário foi significativamente maior (> 10 cm) em pacientes com metástase pulmonar. Conclusões: Em imagens de TC, as metástases pulmonares do osteossarcoma tipicamente aparecem em forma de nódulos sólidos bilaterais. No entanto, podem ter apresentações atípicas, sendo a calcificação a mais comum. Conhecer as características tomográficas típicas e atípicas da metástase pulmonar do osteossarcoma pode ser fundamental para interpretar melhor as imagens nesses casos.

Computed tomography aspects of thoracic metastases from osteosarcoma: pictorial essay / Aspectos tomográficos das metástases torácicas de osteossarcoma: ensaio iconográfico

Abstract Osteosarcoma is the most common primary bone tumor, with a higher incidence in the second decade of life, and it often leads to pulmonary metastases. The most common pattern seen on computed tomography is one of multiple well-defined nodules in the lung parenchyma, often with calcifications. Because of the variety of presentations of pulmonary metastases in osteosarcoma, including atypical forms, knowledge of the computed tomography aspects of these lesions is important for characterizing and evaluating the extent of the disease, as well as for distinguishing metastatic disease from other benign or malignant lung diseases. This essay discusses the main tomographic findings of pulmonary metastases from osteosarcoma.

Resumo O osteossarcoma é o tumor ósseo primário mais comum, com maior incidência na segunda década de vida, sendo as metástases pulmonares achado frequente. O padrão tomográfico mais comum das metástases pulmonares de osteossarcoma é o de múltiplos nódulos bem definidos no parênquima pulmonar, frequentemente com calcificações. Em razão da multiplicidade de apresentações das metástases pulmonares do osteossarcoma, inclusive com formas atípicas, o conhecimento dos aspectos dessas lesões na tomografia computadorizada do tórax é importante para a caracterização e avaliação da extensão da doença, além de permitir a diferenciação entre doença metastática e outras doenças pulmonares benignas ou malignas. Este ensaio discute os principais achados tomográficos das metástases pulmonares de osteossarcoma.

Effect of Preoperative Use of Nonsteroidal Anti-inflammatory Drugs on Dental Sensitivity Induced by Dental Bleaching in the Dental Office: A Systematic Review and Meta-analysis.

AIM: This systematic review and meta-analysis evaluated the effect of using nonsteroidal anti-inflammatory drugs (NSAIDs) before dental bleaching sessions in the dental office on postoperative sensitivity. METHODS: The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist and registered on International Prospective Register of Systematic Reviews under number CRD42020210054. Randomized clinical trials published in the English language that compared the preventive use of NSAIDs with a placebo on the sensitivity resulting from dental bleaching in the dental office were selected, with no limitation on the year of publication. The electronic searches took place in PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library and were carried out independently by two researchers. A total of 30 articles were obtained; seven were selected according to the inclusion criteria. RESULTS: No significant differences were found in the reduction of dental sensitivity between the experimental group compared to the placebo during the session (p=0.32; mean difference [MD]=-0.30; 95% CI, -0.88 to 0.29), immediately after the session (p=0.22; MD=-0.29; 95% CI, -0.75 to 0.17), up to 1 hour later (p=0.10; MD=-0.94; 95% CI, -2.06 to 0.18), and between 1 and 24 hours after the procedure (p=0.78; MD=-0.11; 95% CI, -0.90 to 0.68). The incidence of sensitivity between the groups also did not show statistically relevant differences (p=0.60; MD=1.15; 95% CI, 0.69-1.92). Furthermore, none of the studies reported side effects in any patient. CONCLUSION: This systematic review and meta-analysis indicates that the use of NSAIDs before dental office bleaching is not effective in reducing dental sensitivity during or up to 24 hours after the procedure. In addition, there was no difference in the incidence of sensitivity between the experimental and placebo groups.

Compositional baseline assessments to address soil pollution: An application in Langreo, Spain.

Potentially Toxic Elements (PTEs) are contaminants with high toxicity and complex geochemical behaviour and, therefore, high PTEs contents in soil may affect ecosystems and/or human health. However, before addressing the measurement of soil pollution, it is necessary to understand what is meant by pollution-free soil. Often, this background, or pollution baseline, is undefined or only partially known. Since the concentration of chemical elements is compositional, as the attributes vary together, here we present a novel approach to build compositional indicators based on Compositional Data (CoDa) principles. The steps of this new methodology are: 1) Exploratory data analysis through variation matrix, biplots or CoDa dendrograms; 2) Selection of geological background in terms of a trimmed subsample that can be assumed as non-pollutant; 3) Computing the spread Aitchison distance from each sample point to the trimmed sample; 4) Performing a compositional balance able to predict the Aitchison distance computed in step 3.Identifying a compositional balance, including pollutant and non-pollutant elements, with sparsity and simplicity as properties, is crucial for the construction of a Compositional Pollution Indicator (CI). Here we explored a database of 150 soil samples and 37 chemical elements from the contaminated region of Langreo, Northwestern Spain. There were obtained three Cis: the first two using elements obtained through CoDa analysis, and the third one selecting a list of pollutants and non-pollutants based on expert knowledge and previous studies. The three indicators went through a Stochastic Sequential Gaussian simulation. The results of the 100 computed simulations are summarized through mean image maps and probability maps of exceeding a given threshold, thus allowing characterization of the spatial distribution and variability of the CIs. A better understanding of the trends of relative enrichment and PTEs fate is discussed.

Monitoring of Leptospira in captive turtles by DNA analysis / [Monitoramento de Leptospira em quelônios mantidos em cativeiro pela análise de DNA]

Existem poucos estudos sobre doenças infecciosas em animais silvestres. O objetivo deste estudo foi pesquisar DNA de Leptospira spp. em sangue de tartarugas mantidas em cativeiro, pertencentes ao Bosque Rodrigues Alves (Jardim Zoobotânico da Amazônia). O DNA foi isolado das amostras de sangue coletadas de 148 tartarugas pertencentes a seis espécies diferentes. A reação em cadeia da polimerase (PCR) foi realizada utilizando-se iniciadores específicos para DNA de Leptospira spp. Nenhuma das amostras apresentou resultado positivo para Leptospira spp.(AU)

A public health approach to increase treatment of latent TB among household contacts in Brazil.

SETTING: Two consecutive trials were conducted to evaluate the effectiveness of a public health approach to identify and correct problems in the care cascade for household contacts (HHCs) of TB patients in three Brazilian high TB incidence cities.METHODS: In the first trial, 12 clinics underwent standardised evaluation using questionnaires administered to TB patients, HHCs and healthcare workers, and analysis of the cascade of latent TB care among HHCs. Six clinics were then randomised to receive interventions to strengthen management of latent TB infection (LTBI), including in-service training provided by nurses, work process organisation and additional clinic-specific solutions. In the second trial, a similar but streamlined evaluation was conducted in two clinics, who then received initial and subsequent intensive in-service training provided by a physician.RESULTS: In the evaluation phase of both trials, many HHCs were identified, but few started LTBI treatment. After the intervention, the number of HHCs initiating treatment per 100 active TB patients increased by 10 (95%CI - 11 to 30) in the first trial, and by 44 (95%CI 26 to 61) in the second trial.DISCUSSION: A public health approach with standardised evaluation, local decisions for improvements, followed by intensive initial and in-service training appears promising for improved LTBI management.

Barbatic acid from Cladia aggregata (lichen): Cytotoxicity and in vitro schistosomicidal evaluation and ultrastructural analysis against adult worms of Schistosoma mansoni.

Schistosomiasis is one of the most significant neglected tropical diseases, affecting around 260 million people worldwide, and Praziquantel is currently the only available drug for the treatment of infected persons. Thus, the search for new schistosomicidal compounds is urgent. The objective of this study was to investigate of the schistosomicidal effect of barbatic acid, a lichen metabolite, on adult worms of Schistosoma mansoni. The in vitro schistosomicidal effect was evaluated through the assessment of motility and mortality, cellular viability of the worms and ultrastructural analysis through scanning electron microscopy. To evaluate the cytotoxicity of barbatic acid, a cell viability assay was performed with human peripheral blood mononuclear cells. Barbatic acid showed a schistosomicidal effect after 3 h of exposure. At the end of 24 h the concentrations of 50-200 µM presented lethality on the worms. Motility changes were observed at sublethal concentrations. The IC50 obtained by the cell viability assay for S. mansoni was 99.43 µM. Extensive damage to the worm's tegument was observed from 25 µM. No cytotoxicity was observed on human peripheral blood mononuclear cells. This report provides data showing the schistosomicidal effect of barbatic acid on S. mansoni, causing death, motility changes and ultrastructural damage to worms. In addition, barbatic acid was shown to be non-toxic to human peripheral blood mononuclear cells at concentrations that are effective against S. mansoni.

Myocardial peak systolic velocity-a tool for cardiac screening of HIV-exposed uninfected children.

HIV-uninfected children exposed prenatally to the virus and to prophylactic antiretroviral therapy are at an uncertain risk of long-term myocardial dysfunction. This study aimed to analyse the structure and function of their ventricles and to identify potential screening tools for this at-risk population. One hundred and fifteen children (77 exposed vs 38 controls) aged between 2.7 and 16.2 years were included. An echocardiographic study was performed where both ventricles' dimensions and systolic functions were evaluated. In the left ventricle, parameters related to diastolic function were also analysed. Tissue Doppler values were determined in the basal state and after passive leg raising. Serologic analysis of amino-terminal pro-B-type natriuretic peptide (NT-proBNP) was carried out. The two groups had identical ventricular sizes and left ventricular diastolic functions. However, contractility assessed by myocardial peak systolic velocity was significantly inferior in the exposed group. These systolic echocardiographic differences were present despite similar values of NT-proBNP in both groups.Conclusion: HIV-exposed uninfected children may be vulnerable to ventricular systolic dysfunction at long term. Cardiovascular surveillance and periodic monitoring of biventricular function are therefore recommended. Myocardial peak systolic velocity may be a useful screening tool for this purpose.What is Known:• Previous studies on HIV-exposed uninfected children subjected prenatally to antiretroviral therapy have alerted to potential long-term cardiovascular toxicity effects on the left ventricle.What is New:• The study gives new insights on ventricular function and morphology in HIV-exposed uninfected children.• Myocardial peak systolic velocities are significantly inferior in this paediatric sub-group, therefore long-term cardiac surveillance is recommended.

Assessment of metal and metalloid contamination in soils trough compositional data: the old Mortórios uranium mine area, central Portugal.

Soils from the old Mortórios uranium mine area were studied to look for contamination, as they are close to two villages, up to 3 km away, and used for agriculture. They are mainly contaminated in U and As and constitute an ecological threat. This study attempts to outline the degree to which soils have been affected by the old mining activities through the computation of significant hot clusters, Traditional geostatistical approaches commonly use raw data (concentrations) accepting that the analyzed elements represent the soil's entirety. However, in geochemical studies these elements are just a fraction of the total soil composition. Thus, considering compositional data is pivotal. The spatial characterization, considering raw and compositional data together, allowed a broad discussion about not only the concentrations' spatial distribution, but also a better understanding on the possibility of trends of "relative enrichment" and, furthermore an insight in U and As fate. The highest proportions (compositional data) on U (up to 33%), As (up to 35%) and Th (up to 13%) are reached in the south-southeast segment. However, the highest concentrations (raw data) occur in north and northwest of the studied area, pointing out to a "relative enrichment" toward the south-southeast zone. The Mondego Sul area is mainly contaminated in U and As, but also in Co, Cu, Pb and Sb. The Mortórios area is less contaminated than the Mondego Sul area.

Serum proteinogram of the Campeiro horse / Proteinograma sérico de equinos da raça Campeiro

The aim of this study to measure the fractions of the total serum proteins of the Campeiro horse and identify the influences of biological variants. Blood samples were taken in 138 horses of the breed Campeiro for measuring the concentration of total serum protein by the biuret method. Serum concentrations of protein fractions were measured by electrophoresis using agarose gel. Groups were formed according to age, sex and reproductive condition. The average values of serum fractions: albumin (2.85±0.36g/dl), alpha 1 (0.28±0.11g/dl), alpha 2 (0.26±0.08g/dL) beta 1 (0.57±0.15g/dl), beta 2 (0.89±0.28g/dL), gamaglobulinas (1.86±0.34g/dL), albumin/globulin ratio (0.75±0.18) and 2.5% percentile and 97.5% had slight differences in relation to the reference interval proposed for the species. They observed higher values of alpha 1 and 2 globulins in the group from that had six to eight years old and gammaglobulins in group above 13 years old. Serum protein concentrations were similar in horses and mares and between non-pregnant and pregnant. Sex and pregnancy status did not affect serum proteinogram. Alpha and gammaglobulins have higher values as the age increases. Serum proteinogram of Campeiro horses shows variations that have to be considered in the interpretation of laboratory tests.(AU)

Este trabalho tem por objetivo mensurar as frações das proteínas totais séricas de equinos Campeiros e identificar as influências de variantes biológicas. Foram colhidas amostras de sangue de 138 equinos, machos e fêmeas da raça Campeiro. A determinação da concentração de proteínas totais séricas foi realizada pelo método de biureto. As concentrações séricas das frações proteicas foram determinadas por eletroforese, utilizando-se gel de agarose. Formaram-se grupos em relação à idade, ao sexo e à condição reprodutiva. Os valores médios das frações séricas albumina (2,85±0,36g/dL), alfa 1 (0,28±0,11g/dL), alfa 2 (0,26±0,08g/dL), beta 1 (0,57±0,15g/dL), beta 2 (0,89±0,28g/dL), gamaglobulinas (1,86±0,34g/dL), relação albumina/globulina (0,75±0,18) e os percentis 2,5% e 97,5% apresentaram diferenças pontuais em relação aos intervalos propostos para a espécie. Observaram-se maiores valores de alfa 1, alfa 2 globulinas, no grupo de seis a oito anos, e de gamaglobulinas, no grupo acima de 13 anos de idade. O proteinograma sérico foi similar entre machos e fêmeas e entre fêmeas vazias e gestantes. Sexo e estado gestacional não afetaram o proteinograma sérico. Alfa e gamaglobulinas têm incrementos em função de idades crescentes. O proteinograma sérico de equinos Campeiros tem variações que devem ser consideradas em exames laboratoriais.(AU)

Fracture Resistance of Endodontically Treated Maxillary Premolars Restored With Different Methods.

PURPOSE:: The purpose of this in vitro study was to evaluate the resistance and patterns of fracture of endodontically treated maxillary premolars (ETPs) restored with different methods. METHODS AND MATERIALS:: Mesio-occluso-distal cavities were prepared in 50 extracted caries-free human maxillary premolars after endodontic treatment. The teeth were divided into five groups (n=10), according to the restorative method. G1: intact teeth (control group); G2: conventional composite resin; G3: conventional composite resin with a horizontal glass fiber post inserted between buccal and palatal walls; G4: bulk-fill flowable and bulk-fill restorative composites; and G5: ceramic inlay. For direct restorations, Filtek Z350 XT, Filtek Bulk Fill Flowable Restorative, and Filtek Bulk Fill Posterior Restorative were used. Indirect restorations were fabricated from a pressable lithium disilicate glass-ceramic (IPS e-max Press) and adhesively cemented (RelyX Ultimate). All specimens were subjected to thermocycling (5°C to 55°C/5000 cycles) and additionally submitted to cyclic loading 50,000 times in an Electro-Mechanical Fatigue Machine. Next, the specimens were subjected to a compressive load at a crosshead speed of 1 mm/min until fracture. The fractured specimens were analyzed to determine the fracture pattern using a stereomicroscope, and then representative specimens were carbon coated to allow for the studying of the fracture surface under scanning electron microscopy. One-way analysis of variance (ANOVA) was used to compare fracture resistance of the groups. The results of fracture patterns were submitted to the Fisher exact test (α=0.05). RESULTS:: All specimens survived fatigue. Mean (standard deviation) failure loads (N) for groups were as follows: G1: 949.6 (331.5); G2: 999.6 (352.5); G3: 934.5 (233.6); G4: 771.0 (147.4); and G5: 856.7 (237.5). The lowest fracture resistance was recorded for G4, and the highest ones were recorded for G2, followed by that of G1 and G3. One-way ANOVA did not reveal significant differences between groups ( p>0.05). The highest repairable fracture rates were observed in G1 (100%) and G3 (80%). CONCLUSIONS:: ETPs restored with conventional composite resin with or without horizontal fiber post, bulk-fill composite, and ceramic inlay showed fracture resistance similar to that of sound teeth. Conventional composite resin restorations exhibited the highest prevalence of unrepairable fractures, and the insertion of a horizontal fiber post decreased this prevalence. Intact teeth showed 100% of repairable fractures. It is difficult to extrapolate the results directly to a clinical situation due to the limitations of this study.

A coupled multivariate statistics, geostatistical and machine-learning approach to address soil pollution in a prototypical Hg-mining site in a natural reserve.

The impact of mining activities on the environment is vast. In this regard, many mines were operating well before the introduction of environmental law. This is particularly true of cinnabar mines, whose activity has declined for decades due to growing public concern regarding Hg high toxicity. Here we present the exemplary case study of an abandoned Hg mine located in the Somiedo Natural Reserve (Spain). Until its closure in the 1970s, this mine operated under no environmental regulations, its tailings dumped in two spoil heaps, one of them located uphill and the other in the surroundings of the village of Caunedo. This study attempts to outline the degree to which soil and other environmental compartments have been affected by the two heaps. To this end, we used a novel combination of multivariate statistical, geostatistical and machine-learning methodologies. The techniques used included principal component and clustering analysis, Bayesian networks, indicator kriging, and sequential Gaussian simulations. Our results revealed high concentrations of Hg and, secondarily, As in soil but not in water or sediments. The innovative methodology abovementioned allowed us to identify natural and anthropogenic associations between 25 elements and to conclude that soil pollution was attributable mainly to natural weathering of the uphill heap. Moreover, the probability of surpassing the threshold limits and the local backgrounds was found to be high in a large extension of the area. The methodology used herein demonstrated to be effective for addressing complex pollution scenarios and therefore they are applicable to similar cases.

Data set of the toxic effects of divaricatic acid depside on Biomphalaria glabrata and Schistosoma mansoni cercariae.

In this study, the molluscicidal and antiparasitic activities of divaricatic acid was evaluated, targeting the mollusc Biomphalaria glabrata and cercariae of the helminth Schistosoma mansoni. Divaricatic acid showed high toxicity against both adult snails (5.5 µg/mL) and embryos (20 µg/mL after 6 h of exposure). Similar activity was observed in S. mansoni cercariae after only a short exposure time. The divaricatic acid proved to be a promising substance for the control of the snail B. glabrata, an intermediate host of schistosomiasis, as well as the cercariae of the pathogen.

Spatial environmental risk evaluation of potential toxic elements in stream sediments.

Potential toxic elements (PTE), in stream sediments, were used as contamination indicators for the definition of high-/low-grade spatial clusters in the Monfortinho area (Central Portugal). A set of 271 stream sediment samples was used for spatial modelling and further definition of rings of enrichment-high and low rings. A three-step multivariate statistical and geostatistical approach was used: (1) principal components analysis for PTE's association evaluation and dimensionality reduction; (2) ordinary kriging as an unbiased interpolator for content inference and construction of a continuous representation of the considered attributes, at any arbitrary spatial location; (3) G clustering algorithm for the definition of high and low significance clusters. A moderate contamination in stream sediments is observed for almost all the considered PTE and a very high contamination for Ba, Cr and B. High contamination clusters are observed for Fe, Ni, Ba, Cu, B, Zn, V-northwest and southeast clusters-and for Cr-north and southwest clusters. The contamination degree index varies from moderate to high, which is mainly associated with the old mineralizations. The high computed rings often overlap the areas of abandoned Ba-Zn mineralization, as well as the sedimentary gold concentrations, along the Erges River banks. Tin and Cd spatial distribution may be related to former cassiterite exploitations in the survey area. Chromium is possibly connected with the schists. The definition of clusters with a PTE spatial enrichment will allow for the identification of contamination activities and therefore, the definition of adequate monitoring and mitigation actions.

Combining raw and compositional data to determine the spatial patterns of Potentially Toxic Elements in soils.

When considering complex scenarios involving several attributes, such as in environmental characterization, a clearer picture of reality can be achieved through the dimensional reduction of data. In this context, maps facilitate the visualization of spatial patterns of contaminant distribution and the identification of enriched areas. A set, of 15 Potentially Toxic Elements (PTEs) - (As, Ba, Cd, Co, Cr, Cu, Hg, Mo, Ni, Pb, Sb, Se, Tl, V, and Zn), was measured in soil, collected in Langreo's municipality (80km2), Spain. Relative enrichment (RE) is introduced here to refer to the proportion of elements present in a given context. Indeed, a novel approach is provided for research into PTE fate. This method involves studying the variability of PTE proportions throughout the study area, thereby allowing the identification of dissemination trends. Traditional geostatistical approaches commonly use raw data (concentrations) accepting that the elements analyzed make up the entirety of the soil. However, in geochemical studies the analyzed elements are just a fraction of the total soil composition. Therefore, considering compositional data is pivotal. The spatial characterization of PTEs considering raw and compositional data together allowed a broad discussion about, not only the PTEs concentration's distribution but also to reckon possible trends of relative enrichment (RE). Transformations to open closed data are widely used for this purpose. Spatial patterns have an indubitable interest. In this study, the Centered Log-ratio transformation (clr) was used, followed by its back-transformation, to build a set of compositional data that, combined with raw data, allowed to establish the sources of the PTEs and trends of spatial dissemination. Based on the obtained findings it was possible to conclude that the Langreo area is deeply affected by its industrial and mining legacy. City center is highly enriched in Pb and Hg and As shows enrichment in a northwesterly direction.

The economic burden of tuberculosis and latent tuberculosis in people living with HIV in Brazil: a cost study from the patient perspective.

OBJECTIVE: The objective of this study was to evaluate the direct and indirect costs of tuberculosis (TB) (active and latent TB [LTB]) and HIV co-infection from the patient perspective. STUDY DESIGN: Costing study conducted alongside a pragmatic clinical trial. METHODS: The study was conducted in Brazil in a referral service for HIV/AIDS. We applied a standardised questionnaire to collect data about out-of-pocket expenses and indirect cost. The questionnaire was applied at every patient's appointment in the referral service after TB or LTB diagnosis. We followed all patients' pathways during the prediagnosis period and treatment period. For patients on sickness benefit due to TB/HIV, income loss was calculated as the difference between an employee's wages forgone and the sickness benefit received. The monetary value of the time loss was calculated based on the Brazilian minimum wage/2015. RESULTS: Among 239 people living with HIV recruited in the first year of the trial, 31 patients were included into the costing study, 26 patients who were diagnosed and treated for TB/HIV and five patients who were diagnosed and treated for LTB/HIV. TB/HIV patients incurred higher total costs than LTB/HIV (US$ 1,429 vs US$ 166). The main cost component for TB/HIV was indirect costs, especially income loss (US$ 749). CONCLUSIONS: Public health policies may address ways to prevent high patients' costs through the introduction of more accurate algorithms for TB diagnosis to prevent delays in the diagnosis and treatment.