SUMMARY. Significant liver disease has been reported in chronic hepatitis B patients with normal alanine aminotransferase (ALT). Liver biopsy (LB) is the current gold standard for assessing hepatic inflammation and fibrosis in patients with chronic HBV. However, associated risks have led to the development of noninvasive models. Their utility in patients with normal ALT is unknown. FIB-4 and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) were calculated for patients with chronic HBV infection undergoing biopsy. The performance of each model and AUROC for predicting significant fibrosis (Scheuer's score ! S2) were determined for the entire cohort and stratified by elevated ( ! 50 U/L) and normal ALT. Twohundred and thirty-one liver biopsies were included. The number of patient with normal ALT was 140, and 22.1% had significant fibrosis. The AUROC curve for patients with normal ALT was 0.81 for FIB-4 and 0.80 for APRI, compared with 0.71 for FIB-4 and 0.72 for APRI for those with mildly elevated ALT level. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FIB-4 were 0.63, 0.88, 0.61 and 0.93, for patients with normal ALT; the values for APRI were 0.40, 0.88, 0.33 and 0.93. Both FIB-4 and APRI are useful for identification of those without significant fibrosis. However, because they have poor PPV, LB will continue to be used for assessment of HBV-infected patients with normal ALT and mildly elevated ALT.

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A simple prismatic Timoshenko beam model with soil-structure interaction (SSI) is developed to approximate the dynamic linear elastic behavior of buildings. A closed-form solution with complete vibration modes is derived. It is demonstrated that building properties, including mode shapes, can be derived from knowledge of the natural frequencies of the first two translational modes in a particular direction and from the building dimensions. In many cases, the natural frequencies of a building's first two vibrational modes can be determined from data recorded by a single seismometer. The total building's vibration response can then be simulated by the appropriate modal summation. Preliminary analysis is performed on the Caltech Millikan Library, which has significant bending deformation because it is much stiffer in shear.

Among patients presenting with low HBV DNA levels and normal ALT levels, about 38.2% had significant liver disease. Neither serum HBsAg nor HBV DNA levels correlate with liver histology. However, APRI≥0.24 might be considered an indicator of liver biopsy.

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