Search Results (999)

Background: Wilson’s disease (WD) is a genetic disorder of copper metabolism with over 600 disease-causing mutations, leading to variable hepatic and neurological symptoms. Early diagnosis and treatment are crucial. To evaluate hepatic involvement, serum scores and non-invasive imaging techniques complement histology. Methods: This pilot study assessed the utility of ultrasound-based tissue attenuation imaging (TAI), tissue scatter distribution imaging (TSI), and shear-wave elastography (SWE) for quantifying steatosis and fibrosis in WD. Results: Among 131 treated patients, 53 (mean age 40.5 ± 13.1 years, M/F = 35/18) underwent measurements. Based on literature-validated thresholds, 41 patients did not have significant liver fibrosis, 5 patients had moderate (F2) and 4 advanced (F3) fibrosis, while 3 patients had cirrhosis. The LS (liver stiffness) was in moderate correlation with FIB-4 (r = 0.306, p < 0.03), NAFLD fibrosis index (r = 0.336, p < 0.02), and APRI (r = 0.31, p = 0.0857). Among the WD patients, 37 had no steatosis (S0), 14 had mild steatosis (S1), and 2 had intermediate steatosis (S2); none of them had severe steatosis (S3) based on UEFF calculation. LS correlated positively with calculated free copper and negatively with serum ceruloplasmin. Normal-BMI patients exhibited no significant steatosis (R2 = 0. 0065, p = 0.966) by ultrasound-estimated fat fraction (UEFF), while those with BMI > 25 kg/m² had increased UEFF correlating with BMI (R2 = 0.288, p < 0.015). Over a five-year follow-up using liver elastography, the fibrosis score did not progress significantly in adequately treated patients. Conclusions: Ultrasound with artificial intelligence-derived parameters supports the non-invasive evaluation of hepatic steatosis and fibrosis in WD, complementing clinical and laboratory data. However, population-specific liver stiffness thresholds are still needed. Full article

Antimicrobial resistance (AMR) in Escherichia coli (E. coli) from food-producing animals constitutes a substantial public health concern. This study characterized antimicrobial resistance profiles, phylogenetic diversity, virulence-gene distribution, and plasmid-borne extended-spectrum β-lactamase (ESBL) determinants of E. coli isolates recovered from water buffaloes with subclinical mastitis. Among the 54 ESBL-producing E. coli isolates, all were resistant to ampicillin and cefotaxime. High resistance rates were also observed for cephalothin (75.9%), trimethoprim–sulfamethoxazole (74.0%), ceftiofur (70.4%), florfenicol (68.5%), and cefazolin (63.0%). Lower resistance was recorded for colistin sulfate (40.7%), enrofloxacin (33.3%), and gentamicin (25.9%). Phylogenetic analysis of ESBL producers identified phylogroup B1 (42.6%) as predominant, followed by groups A (29.6%) and D (25.9%). Multilocus sequence typing (MLST) revealed that ST50 (20.4%) was the most common sequence type, and serogroup O150 was dominant (70.4%). Virulence genes, such as iss (81.5%), astA (59.3%), and espP (38.9%), were frequently detected among ESBL isolates. ESBL genes were predominantly bla_CTX-M-1 (27.8%) in all isolates, while the narrow-spectrum β-lactamase genes bla_TEM-1 (55.6%) and bla_OXA-10 (14.8%) were also commonly co-detected. Bioinformatic analysis predicted that all ESBL genes were associated with plasmid-derived contigs, with the predicted plasmid size ranging from approximately 32 to 187 kb and belonging to IncFIB, IncFIA, IncI1, IncFIA + I1, and IncFII replicon types. Conjugation frequencies ranged from 4.8 × 10⁻⁷ to 4.1 × 10⁻², and plasmids were predicted to carry additional resistance genes mediating resistance to chloramphenicol (floR), sulfonamides (sul1, sul3), tetracyclines (tet(A) and tet(B)), and trimethoprim (dfrA1, dfrA12). The co-carriage of ESBL genes with additional antimicrobial resistance and virulence determinants suggests the potential role of water buffaloes as reservoirs of clinically relevant resistance traits that may disseminate through horizontal gene transfer. Full article

Since its introduction, focused ion beam (FIB) technology has expanded from micro/nanofabrication in the semiconductor industry to the field of multimodal characterization of metallic material microstructures. This article systematically reviews the latest research advances in FIB-SEM technology in the field of metallic materials science. The fundamental principles and system functions of FIB-SEM are introduced, with an emphasis on its key applications in two-dimensional and three-dimensional morphological characterization, as well as specimen preparation for transmission electron microscopy (TEM) and atom probe tomography (APT). The combined strategies of FIB-SEM with electron backscatter diffraction (EBSD), time-of-flight secondary ion mass spectrometry (TOF-SIMS), and other characterization techniques are also discussed. Current developments indicate that FIB-SEM technology is advancing toward multi-ion-source synergy and multimodal integration. In the future, combined with artificial intelligence and big data analysis, it is expected to enable high-throughput, correlative measurements of multidimensional properties at the micro scale, providing important technical support for “materials genome” research in metallic materials. Full article

To elucidate the role of environmentally friendly oxide additives in a molybdenum disulfide (MoS₂)-based solid lubricant, this study investigates the tribological behavior of a MoS₂–TiO₂ coating deposited via a spray-bonding process and compares it with a commercial Sb₂O₃-containing formulation (Everlube 620C). Interfacial characteristics and wear-related mechanisms were systematically analyzed using scanning electron microscopy (SEM), focused ion beam (FIB), Raman spectroscopy, and X-ray diffraction (XRD). The MoS₂–TiO₂ coating exhibited a higher steady-state coefficient of friction (0.35–0.45) and wear compared to the baseline. Its wear behavior was governed by fracture-induced three-body abrasion, driven by the hard and brittle nature of TiO₂, which promotes stress concentration at particle–matrix interfaces, crack initiation, particle pull-out, and debris generation. These processes suppress the formation of a desirable MoS₂-rich tribo/transfer film, leading to deformation-dominated friction. Overall, the findings indicate that the intrinsic mechanical properties and interfacial behavior of TiO₂ limit its effectiveness as an additive in MoS₂-based coatings, highlighting the importance of additive selection and compatibility in achieving optimal tribological performance. Notably, this study was performed at an additive volume fraction equivalent to that of Sb₂O₃ in Everlube 620C, serving as a foundation and indicating that further optimization of TiO₂ particle size and concentration is required to achieve comparable performance. Full article

Background/Objectives: Chronic liver diseases, including metabolic dysfunction-associated steatohepatitis (MASH) and chronic viral hepatitis (CVH), are major global health concerns due to their potential progression to cirrhosis, liver failure, and hepatocellular carcinoma. Because liver biopsy, despite meeting the diagnostic gold standard, is invasive and associated with complications, non-invasive fibrosis assessment tools have been increasingly recommended in clinical practice. This study aimed to compare the diagnostic performance of several non-invasive fibrosis markers (ARR, APRI, FI, FIB-4, API, NFS, BARD) and transient elastography in detecting advanced liver fibrosis (F4) in patients with MASH and CVH. Methods: This retrospective study included 237 adult patients (77 MASH, 160 CVH) who underwent liver biopsy between 2017 and 2025 at the University Clinical Center of Serbia. CVH included chronic hepatitis B (CHB) and C (CHC). Patients were evaluated using serum fibrosis indices and TE, and results were compared to histological staging (F0–F4). ROC analysis assessed diagnostic performance. Results: Cirrhosis (F4) was more common in CVH than MASH (p < 0.001). In MASH, NFS (AUROC 0.931), FIB-4 (0.915), BARD (0.872), and APRI (0.878) showed high diagnostic accuracy for F4. In CHC, APRI (0.931), FIB-4 (0.863), and TE (0.938) had strong performance, while in CHB, TE (0.987) outperformed FIB-4 (0.821). Sensitivity and specificity varied by test and cohort, with TE consistently yielding the best results where available. Conclusions: Non-invasive methods, particularly NFS and FIB-4 for MASH and TE for CVH, effectively identify advanced fibrosis. Their application could significantly reduce the need for biopsy, especially in high-risk groups. TE demonstrated superior accuracy, but access limitations highlight the continued relevance of serum-based scores. Full article

The reservoir quality and gas-bearing properties of the Wufeng Formation–Longmaxi Formation shale vary significantly across different structural units in the Luzhou area of the Sichuan Basin. The mechanisms of shale gas enrichment, tectonic controls, and accumulation models are critical determinants of the potential for three-dimensional (3D) development. Integrating data from core analyses, logging interpretation, focused ion beam scanning electron microscopy (FIB-SEM), and high-resolution core scanning, this study investigates the control exerted by fracture development and tectonic activity on shale gas enrichment and preservation. A conceptual model for shale gas enrichment and accumulation is established, and the potential for 3D development of deep shale gas in the Luzhou block is evaluated. The results indicate that: (1) Reservoir heterogeneity in deep shale gas plays is jointly governed by reservoir space characteristics, diagenesis, structural position, tectonic evolution, and fracture-fluid activity. Organic-rich siliceous shales retain favorable reservoir properties, characterized by an organic matter (OM) pore-dominated pore structure, relatively high porosity and permeability, and good gas-bearing potential due to overpressure preservation. (2) Structural style exerts dominant control over the gas-bearing variability. Synclines are significantly more favorable than anticlines, with free gas migration governing the enrichment pattern. The cores and flanks of synclines form zones of high gas content due to structural integrity, whereas the gas content decreases in anticlinal areas near faults. (3) Shale gas enrichment relies on the synergistic configuration of “high organic carbon content + high-quality pore reservoir space + robust structural preservation conditions.” Well L213 in the syncline core, distant from faults, exhibits good structural integrity and preservation conditions. Free gas from structurally lower positions migrates laterally toward the flanking anticlines, with a portion preserved in the syncline flanks. Concurrently, microfractures enhance reservoir storage and permeability, rendering syncline structures more conducive to shale gas preservation. (4) The high-quality shale succession in the study area is thick and laterally continuous, characterized by “vertical stacked pay zones.” This provides an excellent geological foundation for 3D development. By optimizing the well trajectory design and employing efficient fracturing technologies, such as “intensive fracturing” combined with temporary plugging and diversion, full and balanced utilization of vertically stacked sweet spot reservoirs can be achieved, significantly enhancing the single-well productivity and estimated ultimate recovery (EUR). Full article

Background: Direct-acting antivirals (DAAs) achieve high sustained virologic response (SVR) in hepatitis C virus (HCV) patients with cirrhosis, yet the risk of hepatic decompensation or hepatocellular carcinoma (HCC) persists. Fibrosis-4 (FIB-4), a pre-treatment index that predicts advanced fibrosis, is linked to HCC risk post SVR. We compared post-SVR outcomes and care engagement, and determined the optimal pre-treatment FIB-4 index to predict the risk of HCC or decompensation in HCV patients with cirrhosis treated at the Department of Corrections (DOC) and non-DOC clinics. Methods: HCV patients with cirrhosis treated with DAAs since 2014 in the HCV Treatment Registry were included. Cirrhosis was defined by elastography, imaging, or clinical criteria. Patients with prior decompensation or HCC were excluded. Outcomes (HCC, decompensation) were collected from records. The FIB-4 index was compared between DOC and non-DOC groups. Results: Among 2104 cirrhotic patients (mean age 54; 76% male), 53% were treated in DOC via telemedicine and 47% in non-DOC clinics. HCC developed in 4.8% and decompensation in 8.1%. DOC patients had lower FIB-4 scores and SVR, partly from higher loss to follow-up (9% vs. 1%). Of 1581 with follow-up, surveillance was more common in non-DOC, which also had higher HCC and decompensation. A higher baseline FIB-4 index independently predicted HCC and decompensation (cutoffs: 3.24, 3.7; AUROC 0.79, 0.75, respectively). Conclusions: Despite SVR, cirrhotic patients—especially with a high FIB-4 index—remain at risk for HCC and decompensation. Outcomes differ by care setting, highlighting the need for continued AASLD-recommended surveillance post-SVR. Full article

Municipal solid waste (MSW) landfills are seldom regarded as potential sources of airborne mineral fibres, notwithstanding the possible presence of legacy asbestos-containing materials within mixed waste streams. Prolonged exposure to asbestos fibres is well established as causally associated with severe adverse health outcomes, prompting stringent regulatory measures across the European Union, most recently reinforced by Directive (EU) 2023/2668 amending Directive 2009/148/EC on the protection of workers from the risks related to asbestos exposure. This study presents systematic annual monitoring of airborne mineral fibres (MinFib), including asbestos fibres (AsbFib), conducted between 2019 and 2025 at an MSW landfill in the Czech Republic. Personal air sampling targeted heavy equipment operators as the most exposed occupational group and was conducted in accordance with established occupational hygiene principles. Fibre identification and quantification were carried out using Scanning Electron Microscopy coupled with Energy-Dispersive X-ray analysis (SEM/EDX) according to accredited laboratory internal standard operating procedures (SOPs). Across all monitoring campaigns, asbestos fibre concentrations remained below the analytical detection limits, including during handling of asbestos-containing materials. However, the analytical sensitivity appears to be within the range relevant to the current EU occupational exposure limit (0.01 fibres/cm³), potentially limiting the ability to identify very low-level exposures. These findings indicate that occupational exposure under routine operational conditions was below analytical detection limits, suggesting a low exposure potential. However, non-detectable results should be interpreted as method-limited rather than as indicating that exposure did not occur. Continued monitoring using more sensitive analytical approaches is therefore warranted. Full article

Background: Antimicrobial resistance is a One Health problem driven by the intricate interactions across human, animal, and environmental interfaces that enable microbial exchange and movement of mobile genetic elements encoding resistance and virulence. This study investigated the genomic epidemiology of ESBL and non-ESBL Escherichia coli across One Health interfaces in Oman. Methods: This prospective cross-sectional study analyzed 295 non-duplicate Escherichia coli isolates derived from 104 clinical, 173 animal [diseased (123) and healthy (50)], 14 sewage and four water sources. Antimicrobial susceptibility testing was performed phenotypically, and a representative subset of 50 ESBL and non-ESBL Escherichia coli from the three interfaces underwent whole genome sequencing to determine MLST, phylogroups, resistance genes, virulence determinants and plasmid replicons. Results: ESBL prevalence was highest in human isolates (73%), followed by sewage (28.6%) and animals (16.3% diseased; 8% healthy). blaCTX-M-15 predominated in humans, whereas blaCTX-M-55 dominated in animals and sewage, suggesting ecological partitioning with partial overlap. Quinolone resistance was lowest in the animal interface. Sewage isolates harbored the most complex resistome, including rmtB and plasmid-mediated quinolone resistance genes. MLST analysis revealed high diversity in human isolates, including globally recognized ExPEC lineages (ST10, ST38, ST73, ST127, ST131), while ST224 dominated in animals with evidence of possible spillover to humans. ST167 was confined to sewage, consistent with environmental maintenance of high-risk clones. Phylogroup structuring showed predominance of A, B2 and D among human isolates and A, B1, and E among animal and sewage isolates. Virulence profiling demonstrated broader virulome diversity in humans, but shared core determinants (fimH, sitA, traT) across all domains. IncFIB(AP001918) was the dominant plasmid replicon, particularly among ESBL isolates, underscoring its role in horizontal gene dissemination. Alarmingly, mutation in pmrB (V161G) was identified in a healthy animal isolate, pointing to a need for greater colistin restriction in animal husbandry. Conclusions: This study highlights plasmid-mediated resistance and shared virulence determinants linking reservoirs; although AMR profile was quite distinct across the three interfaces, human isolates demonstrated greater resistance than animal isolates, suggesting healthcare-driven AMR in Oman. Continued integrated genomic surveillance is essential to monitor gene flow and inform coordinated antimicrobial stewardship strategies. Full article

Background/Objectives: Left atrial thrombus (LAT) is a clinically important finding in nonvalvular atrial fibrillation (AF). The Fibrosis-4 (FIB-4) index reflects systemic fibrotic burden. We investigated the association between FIB-4 and LAT. Methods: This retrospective study included 859 patients with nonvalvular paroxysmal AF undergoing transesophageal echocardiography (TEE). ROC analysis and multivariable logistic regression were performed. Results: Left atrial thrombus (LAT) was detected in 10.2% of patients. Patients with thrombus exhibited significantly higher admission FIB-4 scores compared to those without (1.5 vs. 1.1, p < 0.001). ROC analysis yielded an optimal FIB-4 cut-off of 1.47 (AUC: 0.65, 95% CI: 0.57–0.70, p < 0.001), providing 71.6% sensitivity and 72.0% specificity. After adjusting for CHA₂DS₂-VASc score, renal function, and left atrial diameter, a FIB-4 > 1.47 remained a strong independent predictor of LAT (OR: 5.200; 95% CI: 3.105–8.708, p < 0.001). However, the addition of FIB-4 to the CHA₂DS₂-VASc score did not significantly improve discriminatory performance (p = 0.314, DeLong’s test). Spearman’s correlation showed a modest relationship between FIB-4 and CHA₂DS₂-VASc (r = 0.321). Conclusions: Elevated FIB-4 index values are independently associated with LAT in patients with paroxysmal AF. This simple, noninvasive marker may reflect a systemic fibro-inflammatory milieu that promotes an atrial thrombogenic substrate beyond traditional clinical risk scores. Full article

Background: Discrepancies are frequently observed between liver steatosis grading assessed by conventional B-mode ultrasonography and vibration-controlled transient elastography (VCTE) with controlled attenuation parameter (CAP). This study aimed to identify factors associated with these differences and to evaluate whether the two imaging methods provide comparable steatosis classifications. Methods: We conducted a retrospective cross-sectional observational study including 130 hospitalized patients evaluated over a two-year period who underwent laboratory testing, abdominal ultrasonography, and transient elastography. The analyzed variables included demographic characteristics, nutritional status, comorbidities, and biochemical parameters such as alanine aminotransferase (ALAT), total cholesterol, triglycerides, gamma-glutamyl transferase (GGT), and the fibrosis-4 index (FIB-4). Patients were classified into two groups: concordant steatosis grading between the two methods (n = 61) and discordant results (n = 69). Results: Concordant steatosis grading was more frequently observed in patients with serum total cholesterol > 200 mg/dL (45.9%) and FIB-4 values between 1.45–3.25 (44.2%). A trend toward higher concordance was also observed in patients with elevated triglycerides. In contrast, viral liver disease was significantly associated with discordant results (26.2%). Higher fibrosis stages assessed by VCTE (F ≥ 2) and FIB-4 values > 3.25 showed a non-significant trend toward discordance. Conclusions: Several clinical and biochemical factors influence the agreement between ultrasound and VCTE-based CAP in the assessment of hepatic steatosis. Elevated cholesterol and intermediate FIB-4 values were associated with concordant results, whereas viral liver disease was associated with discordance between the two imaging modalities. Full article

Background: Chronic liver disease (CLD) in children requires long-term monitoring. Liver biopsy and transient elastography (TE) are resource-intensive methods that require specialized equipment and trained personnel. Simple indirect fibrosis scores based on routine laboratory parameters offer a potentially cost-effective alternative but have not been systematically evaluated in pediatric populations with diverse CLD etiologies. Objectives: This study aimed to assess the performance of several indirect fibrosis and cirrhosis scores in predicting significant (≥F2) and advanced (≥F3) fibrosis and cirrhosis (F4) in children with CLD using TE as a comparator. Methods: We retrospectively reviewed medical records of children with CLD evaluated at a tertiary center between January 2023 and June 2025. TE results and routine laboratory data were used to calculate fibrosis scores, including APRI, FIB-4, FibroIndex, FORNS, GPR, GUCI, King’s score, and Lok’s index. ROC analyses were performed to assess each score’s ability to discriminate significant fibrosis, advanced fibrosis and cirrhosis. Optimal cut-offs were established using the Youden index. Results: GPR showed the strongest concordance with TE-based fibrosis classification across both fibrosis thresholds, achieving an AUROC of 0.835 for significant fibrosis and a superior 0.917 for advanced fibrosis. FibroIndex and APRI also demonstrated good discriminatory power for advanced disease. Utilizing mathematically optimized cut-offs, GPR (0.45) and APRI (0.84) achieved good negative predictive values (100% and 95%) and sensitivities (100% and 85%) for advanced fibrosis, establishing them as potentially valuable screening tools. For cirrhosis detection (F4), Lok’s Index performed best (AUROC 0.854). Conclusions: In this diverse pediatric cohort, simple indirect scores—particularly GPR, APRI, and FibroIndex—demonstrated the highest concordance relative to TE findings, with negative predictive values up to 100% for GPR. This indicates that they can serve as reliable first-line screening tools when TE is unavailable. While their good negative predictive values allow for the confident exclusion of severe disease—potentially sparing many children from invasive testing—their low positive predictive values limit their role in definitive diagnosis. The systematic failure of adult-derived, age-dependent formulas in this cohort underscores the critical need for specialized pediatric biomarkers. Full article

Klebsiella pneumoniae has been associated with reproductive infections in equines. The detection of β-lactam resistance determinants, especially extended-spectrum β-lactamase (ESBL) genes, within genomic regions linked to horizontal gene transfer (HGT), is of a particular concern. In this study, we characterize the whole-genome sequences (WGS) of three K. pneumoniae equine isolates harboring multiple antimicrobial resistance genes. Two isolates were recovered from uterine washes of mares: one with endometritis (YAH-KPEM1) and one clinically normal (YAH-KPSE1), and a third from the feces of a diarrheic foal (YAH-KPF132). WGS was performed using the Illumina MiSeq platform, and the reads were subsequently processed through hybrid assembly in Unicycler v0.5.1. Genome annotation was completed using PROKKA v1.14.5. Strain YAH-KPEM1 was classified as ST127, whereas YAH-KPSE1 and YAH-KPF132 belonged to ST1630 and ST224, respectively. Notably, K. pneumoniae ST1630 and ST224 have not been reported before in equines. All three genomes encoded multiple antimicrobial resistance (AMR) determinants, including two encoding ESBL genes (CTX-M-15), as well as virulence factors and regions associated with HGT. Additionally, two (YAH-KPEM1 and YAH-KPSE1) isolates were found to be multidrug resistant (MDR), harboring an IncFIB(K) plasmid replicon, and another isolate, YAH-KPF132, carried an IncFII replicon. The detection of AMR and virulence genes in equine Klebsiella isolates has important clinical implications for guiding antimicrobial selection and improving treatment success. Full article

Background: Non-invasive scoring systems for predicting the hepatic venous pressure gradient (HVPG) and, thus, clinically significant portal hypertension (CSPH) have been proposed; the aim of this study was to evaluate the accuracy of these scores in a cohort of patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) placement and to further analyze patients without a markedly elevated portosystemic gradient (PSG) at the time of the procedure. Methods: We retrospectively analyzed 314 patients who underwent TIPS implantation at our tertiary care center between 2010 and 2022. The diagnostic performance of CT-based scoring systems by Iranmanesh (Score 1) and Kihira (Score 2), as well as laboratory-based scores including MELD (Score 3), FIB-4 (Score 4), and APRI (Score 5), was assessed for detecting a markedly elevated PSG (PSG > 10 mmHg). Additionally, we evaluated whether incorporating the inferior vena cava (IVC) diameter as a surrogate marker of central venous pressure (CVP) improves the accuracy of CT-based scores. Results: Both Scores 1 and 2 showed high sensitivity (89–87%) but low specificity (33–27%). ROC analysis revealed AUC values between 0.65 and 0.62. Laboratory-based scores (Score 3–5) performed poorly with AUCs of 0.57–0.54. Adding IVC diameter as an estimator for CVP to Scores 1 and 2 significantly increased the AUC to 0.74 and 0.76. In Lasso regression, IVC diameter was selected as a significant variable for PSG estimation. Conclusions: CT-based scoring systems showed promise in assessing markedly elevated PSG, but their specificity was low. Including the IVC diameter improved accuracy in detecting elevated PSG in TIPS patients. Future scoring systems should incorporate CVP estimators like the IVC diameter. Full article

Background and Objectives: Accurate assessment of liver fibrosis is essential for treatment decisions in patients with chronic hepatitis B (CHB). Although liver biopsy is considered the reference standard, its invasive nature limits routine use. Serum-based non-invasive fibrosis scores have been proposed as alternatives; however, their diagnostic performance in CHB remains variable. This study aimed to compare multiple serum-based non-invasive fibrosis scores with liver biopsy findings and to evaluate their association with histological activity. Materials and Methods: This retrospective cross-sectional study included 219 adult patients with CHB who underwent liver biopsy with simultaneous laboratory evaluation. Patients with viral co-infections (HIV, HCV, or HDV), metabolic syndrome, diabetes mellitus, hepatic steatosis, or incomplete data were excluded. Non-invasive fibrosis scores—including APRI, FIB-4, AST/ALT ratio (AAR), age–platelet index (API), GGT-to-platelet ratio (GPR), Lok index, modified Forns index, Albumin–Bilirubin (ALBI) score, and red cell distribution width (RDW)-based indices—were calculated using routine laboratory parameters. Histopathological fibrosis staging served as the reference standard. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis, and areas under the curve (AUC) were compared using the DeLong test. Associations with histological activity index (HAI) were assessed using Spearman correlation. Results: For the prediction of significant fibrosis (≥F2), FIB-4 demonstrated the highest AUC, followed by ALBI and APRI. For advanced fibrosis (≥F3), FIB-4 again showed the highest AUC, followed by APRI and GPR. For significant fibrosis (≥F2), DeLong analysis revealed no statistically significant differences between FIB-4 and the other serum-based scores (p > 0.05). APRI (r = 0.556, p < 0.001) and FIB-4 (r = 0.463, p < 0.001) showed the strongest correlations with HAI. In ROC analysis for moderate-to-severe histological activity (HAI ≥ 4), APRI demonstrated the highest diagnostic accuracy (AUC = 0.677). Conclusions: Serum-based non-invasive fibrosis scores demonstrate comparable but overall modest diagnostic performance for biopsy-confirmed fibrosis in patients with chronic hepatitis B. Indices such as FIB-4 and APRI demonstrated relatively better discrimination and may be considered as screening or rule-out tools in selected clinical contexts. APRI and FIB-4 also show associations with histological activity; however, their clinical application should be interpreted with caution, given their moderate discriminatory capacity. Full article