Predictive Factors for HBsAg Loss in Chronic HBeAg-Negative Hepatitis B Virus Infection: Insights From a 5-Year French Cohort.

Prognostic factors for the long-term evolution of chronic hepatitis B e antigen (HBeAg)-negative hepatitis B virus (HBV) infection may vary depending on local epidemiology. We aimed to identify these factors in France, where the epidemiology is influenced by diverse immigration. Hepatitis B surface antigen (HBsAg)-positive, HBeAg-negative adults with normal transaminase levels and viral loads < 20,000 IU/mL for 1 year, without viral co-infection or advanced liver disease, were enrolled for a 5-year follow-up.

External Validation of the Oakland Score for Acute Lower Gastrointestinal Bleeding.

Introduction Acute lower gastrointestinal bleeding (LGIB) presents challenges in emergency settings, with incidence influenced by demographic shifts and anticoagulant usage. The Oakland score aids in risk stratification for safe discharge based on clinical and laboratory parameters. However, external validation remains limited.

Non-invasive diagnosis and follow-up of primary sclerosing cholangitis.

Primary sclerosing cholangitis (PSC) is a rare and chronic cholestatic liver disease of unknown cause commonly associated with inflammatory bowel disease (IBD) and characterized by progressive obliterative fibro-inflammation of the biliary tree. Although the natural course is highly variable, PSC is often progressive, leading to biliary cirrhosis and its complications. In addition, PSC is a condition harbouring broad neoplastic potential with increased susceptibility for the development of both biliary and colon cancer.

Non-invasive diagnosis and follow-up of primary biliary cholangitis.

Primary biliary cholangitis (PBC) is a chronic inflammatory disease of the intra-hepatic bile ducts [1]. It is characterised biologically by chronic cholestasis associated with the presence of specific autoantibodies, and histologically by lesions of nonsuppurative destructive cholangitis. If left untreated it can progress to cirrhosis, portal hypertension and liver failure.

Evolution and phenotypic characterization of whole HBV genome in compliant patients experiencing unexplained entecavir treatment failure.

Entecavir treatment failure can be observed in compliant patients despite an absence of detectable resistance mutations by Pol/RT Sanger sequencing. We hypothesized that these unexplained treatment failures could rely on other mechanisms of viral resistance, especially on mutations selected outside of the Pol/RT domain. Partial virological response to entecavir was observed in three patients treated with immunosuppressive drugs, without selection of Pol/RT resistance mutations.

Combination of fibrates with obeticholic acid is able to normalise biochemical liver tests in patients with difficult-to-treat primary biliary cholangitis.

Background: Obeticholic acid (OCA) and fibrates are second-line therapies for patients with primary biliary cholangitis (PBC) with an inadequate response to ursodeoxycholic acid (UDCA).

Aim: To know whether OCA and fibrates, administered together in combination with UDCA, have additive beneficial effects in patients with difficult-to-treat PBC.

Methods: PBC patients treated for ≥3 months with UDCA, OCA and fibrates (bezafibrate or fenofibrate) due to failure of either second-line therapy were included in a multicentre, uncontrolled retrospective cohort study.

Low-phospholipid-associated cholelithiasis syndrome: Prevalence, clinical features, and comorbidities.

Background & Aims: Low-phospholipid-associated cholelithiasis (LPAC) syndrome, a rare genetic form of intrahepatic cholelithiasis in adults, is still poorly understood. We report the results of the largest-ever case-control study of patients with LPAC syndrome aiming to assess the prevalence, clinical features, and comorbidities of the disease.

Methods: We included all LPAC cases diagnosed between 2001 and 2016 in 11 French centres.

Early liver transplantation for corticosteroid non-responders with acute severe autoimmune hepatitis: The SURFASA score.

Background & Aims: In acute severe autoimmune hepatitis (AS-AIH), the optimal timing for liver transplantation (LT) remains controversial. The objectives of this study were to determine early predictive factors for a non-response to corticosteroids and to propose a score to identify patients in whom LT is urgently indicated.

Methods: This was a retrospective, multicenter study (2009-2016).

Assessment of Several THOR Thoracic Injury Criteria based on a New Post Mortem Human Subject Test Series and Recommendations.

Several studies, available in the literature, were conducted to establish the most relevant criterion for predicting the thoracic injury risk on the THOR dummy. The criteria, such as the maximum deflection or a combination of parameters including the difference between the chest right and left deflections, were all developed based on given samples of Post Mortem Human Subject (PMHS). However, they were not validated against independent data and they are not always consistent with the observations from field data analysis.

Far Side Impact Injury Threshold Recommendations Based on 6 Paired WorldSID / Post-Mortem Human Subjects Tests.

Far side has been identified in the literature as a potential cause of numerous injuries and fatalities. Euro NCAP developed a far side test protocol to be performed to assess adult protection. A monitoring phase was undertaken between January 2018 and December 2019, and the far side assessment will become part of the rating for all vehicles launched in 2020 onward.

Human Shoulder Response to Lateral Impact in Intermediate Loading Conditions Between High-Velocity, Short-Duration and Low-Velocity, Long-Duration.

The EuroSID-2re (ES-2re) Anthropomorphic Test Device (ATD) commonly known as the crash test dummy is also used in the military domain to assess the risk of injury of armored vehicles occupants from lateral impact. The loading conditions range from low velocity - long duration impacts (4 m/s - 50 ms) similar to the automotive domain, to high velocity - short duration impacts (28 m/s - 3 ms) corresponding to cases where the panel deforms under an explosion. The human shoulder response to lateral impact was investigated at bounds of the loading condition spectrum previously mentioned, and also at intermediate conditions (14 m/s - 9 ms) in previous studies.

Reference PMHS Sled Tests to Assess Submarining of the Small Female.

In the last decade, extensive efforts have been made to understand the physics of submarining and its consequences in terms of abdominal injuries. For that purpose, 27 Post Mortem Human Subject (PMHS) tests were performed in well controlled conditions on a sled and response corridors were provided to assess the biofidelity of dummies or human body models. All these efforts were based on the 50th percentile male.

A Placebo-Controlled Trial of Bezafibrate in Primary Biliary Cholangitis.

Background: Patients with primary biliary cholangitis who have an inadequate response to therapy with ursodeoxycholic acid are at high risk for disease progression. Fibrates, which are agonists of peroxisome proliferator-activated receptors, in combination with ursodeoxycholic acid, have shown potential benefit in patients with this condition.

Methods: In this 24-month, double-blind, placebo-controlled, phase 3 trial, we randomly assigned 100 patients who had had an inadequate response to ursodeoxycholic acid according to the Paris 2 criteria to receive bezafibrate at a daily dose of 400 mg (50 patients), or placebo (50 patients), in addition to continued treatment with ursodeoxycholic acid.

New Reference PMHS Tests to Assess Whole-Body Pedestrian Impact Using a Simplified Generic Vehicle Front-End.

This study aims to provide a set of reference post-mortem human subject tests which can be used, with easily reproducible test conditions, for developing and/or validating pedestrian dummies and computational human body models against a road vehicle. An adjustable generic buck was first developed to represent vehicle front-ends. It was composed of four components: two steel cylindrical tubes screwed on rigid supports in V-form represent the bumper and spoiler respectively, a quarter of a steel cylindrical tube represents the bonnet leading edge, and a steel plate represents the bonnet.

Investigation of Pelvic Injuries on Eighteen Post Mortem Human Subjects Submitted to Oblique Lateral Impacts.

The aim of this study was to investigate the sacroiliac joint injury mechanism. Two test configurations were selected from full scale car crashes conducted with the WorldSID 50 dummy resulting in high sacroiliac joint loads and low pubic symphysis force, i.e.

Reference PMHS Sled Tests to Assess Submarining.

Sled tests focused on pelvis behavior and submarining can be found in the literature. However, they were performed either with rigid seats or with commercial seats. The objective of this study was to get reference tests to assess the submarining ability of dummies in more realistic conditions than on rigid seat, but still in a repeatable and reproducible setup.

A Comparison of Sacroiliac and Pubic Rami Fracture Occurrences in Oblique Side Impact Tests on Nine Post Mortem Human Subjects.

Unlabelled: The WorldSID dummy can be equipped with both a pubic and a sacroiliac joint (S-I joint) loadcell. Although a pubic force criterion and the associated injury risk curve are currently available and used in regulation (ECE95, FMVSS214), as of today injury mechanisms, injury criteria, and injury assessment reference values are not available for the sacroiliac joint itself. The aim of this study was to investigate the sacroiliac joint injury mechanism.

The Effect of Upper Body Mass and Initial Knee Flexion on the Injury Outcome of Post Mortem Human Subject Pedestrian Isolated Legs.

In the ECE 127 Regulation on pedestrian leg protection, as well as in the Euro NCAP test protocol, a legform impactor hits the vehicle at the speed of 40 kph. In these tests, the knee is fully extended and the leg is not coupled to the upper body. However, the typical configuration of a pedestrian impact differs since the knee is flexed during most of the gait cycle and the hip joint applies an unknown force to the femur.

Comparison of the Thorax Dynamic Responses of Small Female and Midsize Male Post Mortem Human Subjects in Side and Forward Oblique Impact Tests.

Despite the increasing knowledge of the thorax mechanics in impact loadings, the effects of inter-individual differences on the mechanical response are difficult to take into account. For example, the biofidelity corridors for the small female or large male are extrapolated from the midsize male corridors. The present study reports on the results of new tests performed on small female Post Mortem Human Subjects (PMHS), and compares them with test results on midsize male PMHS.

Hepatogastroenterologists' knowledge of inactive carriers and immunotolerant hepatitis B virus patients in France: results of a practice survey.

Background: Before the 2012 revision of the EASL guidelines for the management of hepatitis B virus infection, we conducted a survey to determine how French nonacademic hepatogastroenterologists defined inactive hepatitis B virus carriers and immunotolerant patients.

Methods: We asked 680 hepatogastroenterologists to complete a simple survey consisting of 11 multiple-choice questions.

Results: The participation rate was 32%.

Kinematics and dynamics of the pelvis in the process of submarining using PMHS sled tests.

This study focused on a better understanding and characterization of the submarining phenomenon that occurs in frontal crashes when the lap belt slides over the anterior superi or iliac spine. Submarining is the consequence of the pelvis kinematics relative to the lap belt, driven by the equilibrium of forces and moments applied to the pelvis. The study had two primary purposes; the first was to provide new PMHS data in submarining test configurations, the second was to investigate the Hybrid II and Hybrid III dummies biofidelity regarding submarining.

Study of rib fracture mechanisms based on the rib strain profiles in side and forward oblique impact.

Rib fractures constitute a good indication of severity as there are the most frequent type of AIS3+ chest injuries. In 2008, Trosseille et al. showed a promising methodology to exhibit the rib fracture mechanisms, using strain gauges glued on the ribs of Post-Mortem Human Subjects (PMHS) and developing a specific signal analysis.

Investigation on occupant ejection in high severity rear impact based on post mortem human subject sled tests.

Occupant protection in rear impact involves two competing challenges. On one hand, allowing a deformation of the seat would act as an energy absorber in low severity impacts and would consequently decrease the risk of neck injuries. However, on the other hand, large deformations of the seat may increase the likelihood of occupant ejection in high severity cases.