Accuracy of hyaluronic acid level for predicting liver fibrosis stages in patients with hepatitis C virus

BACKGROUND: In patients with chronic hepatitis C virus, liver biopsy is the gold standard for assessing liver disease stage; nevertheless, it is prone to complications, some of them serious. Non-invasive methods have been proposed as surrogate markers for liver fibrosis. It was shown that serum hyaluronic acid (HA) level increases with the development for liver fibrosis. The aim of this study was to evaluate the diagnostic value of HA as well as to determine the HA level cut-off for predicting the presence or absence of fibrosis, severe fibrosis, and cirrhosis. RESULTS: 405 patients with chronic hepatitis C were prospectively included with biomarker measurement and liver biopsy done the same day: 151 in the training set (only biopsy lengths of 25 mm or more) and 254 in the validation set. For the discrimination of significant fibrosis, severe fibrosis, and cirrhosis in the training set, the areas under curve (AUCs) were 0.75 ± 0.03, 0.82 ± 0.02, and 0.89 ± 0.03, respectively. Absence of significant fibrosis, severe fibrosis, and cirrhosis can be predicted by HA levels of 16, 25, and 50 μg/l, respectively (with negative predictive values of 82%, 89%, and 100%, in the same order). Presence of significant fibrosis, severe fibrosis, and cirrhosis can be predicted by HA levels of 121, 160, and 237 μg/l, respectively (with positive predictive values of 94%, 100%, and 57%, in the same order). CONCLUSION: In the validation set, HA was accurate in predicting significant fibrosis, severe fibrosis, and cirrhosis with AUCs of 0.73, 0.77, and 0.97, respectively. Moreover, accurate HA level cut-offs were defined for predicting significant fibrosis, severe fibrosis, and cirrhosis. Thus, the study supports that HA level may be clinically useful as a non-invasive marker for liver fibrosis and/or cirrhosis

EuReCa ONE—27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe

AbstractIntroductionThe aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe.MethodsThis was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries.ResultsData on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge.ConclusionThe results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe.EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events

Le Parc naturel régional Normandie-Maine et la reconnaissance des patrimoines géologique et géomorphologique

National audienc

Les pierriers du Parc naturel régional Normandie-Maine, Connaissance – Préservation – Valorisation

International audienc

Samanburður á samfélagsstefnum helstu viðskiptabanka Íslands

Samfélagsábyrgð hefur öðlast aukið mikilvægi síðustu ár vegna vitundarvakningar þeirra áhrifa sem fyrirtæki hafa á umhverfið og hefur því mikilvægi samfélagsábyrgðar farið að vega þyngra hjá fyrirtækjum. Heimsmarkmið Sameinuðu þjóðanna hafa nýst fyrirtækjum sem leiðarvísir við innleiðingu á samfélagsstefnu og hafa þrír stærstu viðskiptabankar Íslands tileinkað sér heimsmarkmið sem heyra best undir starfsemi þeirra. Sköpun og hámörkun sameiginlegra verðmæta samfélagsins eiga sér stað þegar bankar eru samfélagslega ábyrgir og er því ávinningur við innleiðingu samfélagsábyrgðar mikill. Markmið þessa verkefnis er að bera saman samfélagsstefnur þriggja stærstu viðskiptabanka Íslands og reyna að meta að hversu miklu leyti bankarnir styðjist við samfélagsstefnur sínar við úrvinnslu lánaumsókna þegar áföll verða. Notkun fyrirliggjandi heimilda og gagna bankanna, meðal annars árs- og sjálfbærniskýrslur, voru nýttar til frekari greiningar. Rannsókn þessi byggir á eigindlegri nálgun óstaðlaðra viðtala við fulltrúa helstu viðskiptabanka Íslands ásamt efnisgreiningu. Helstu niðurstöður rannsókarninnar er að nálgun áhersluþátta sem henta starfsemi hvers banka sé helsti munurinn á samfélagsstefnum þeirra. Notkun UFS mælikvarða er meðal helstu áhersluþátta bankanna og telja bankarnir að heimsmarkmið Sameinuðu þjóðanna séu ekki fullnægjandi til að byggja samfélagsskýrslu. Rannsóknin sýndi að samkeppnislög ættu ekki við á sviði samfélagsábyrgðar þar sem það ættu ekki að ríkja leyndarmál er varða málefnið. Efnisorð: Samfélagsábyrgð, sjálfbærni, heimsmarkmið Sameinuðu þjóðanna, viðskiptabankar, UF

Geoconservation in France: History, Key Policies and Current Tools

International audienc

Protection de la nature abiotique et géoconservation en France. Evolutions du droit et des pratiques du XIXe siècle à nos jours

National audienc

Protection de la nature abiotique et géoconservation en France. Evolutions du droit et des pratiques du XIXe siècle à nos jours

National audienc

Utilisation de la rhéologie pour la description de la morphologie de mélanges caoutchouc naturel/polybutadiène

International audienceL'objectif de cette étude est de présenter comment la rhéologie a pu être utilisée pour caractériser la morphologie de mélanges de deux élastomères incompatibles, le caoutchouc naturel (NR) et le polybutadiène (PB). Les mesures rhéologiques à l'état fondu en cisaillement oscillatoire dans le domaine linéaire ont été réalisées pour obtenir des informations sur la structure de ces coupages. A basse fréquence et pour de faibles taux de la phase minoritaire, le module de conservation présente un excès d'élasticité qui augmente avec la teneur en phase minoritaire. Pour de plus fortes concentrations en phase minoritaire, cette extra-élasticité diminue en relation avec la morphologie. Des mesures rhéologiques à l'état solide en torsion rectangulaire ont été conduites sur les coupages NR/PB. L'évolution du module de conservation à la température de cristallisation du PB est reliée à la morphologie de cet élastomère. Le phénomène de cristallisation fractionnée est évoqué pour expliquer la structure du PB dans les coupages NR/PB. Enfin, les mélanges NR/PB ont été ultra-cryo-microtomés et analysés par microscopie électronique en transmission, afin de confirmer les résultats des deux tests précédents. La superposition de ces différentes procédures permet une description de la morphologie des coupages NR/PB non chargés et non vulcanisés sur l'ensemble du domaine de composition