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Response to: Comment to “EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease”
No full textWe thank Jorge Fonseca et al. for their comments, which give us the opportunity to clarify the controversial issue of dietary approach to NAFLD, an issue that did not receive adequate attention in the Clinical Practice Guidelines (CPG) due to space constraints. They are concerned about the sentence suggesting ‘‘low-to-moderate fat and moderate-to-high carbohydrate intake” as a reasonable option for NAFLD cases. Indeed, no recommendation on nutrient composition of the diet was issued within the CPG, but a formal recommendation reads ‘‘Dietary recommendations should consider energy restriction and exclusion of NAFLD-promoting components (processed food, and food and beverages high in added fructose). The macronutrient composition should be adjusted according to the Mediterranean diet (B1)” [1]. This recommendation is based on a single experimental study [2] and a lot of indirect evidence, granting the B1 grade. On the contrary, the sentence in Table 5 is a mere suggestion derived from literature review, also considering the mandatory need for calorie restriction and weight loss
The complex link between NAFLD and type 2 diabetes mellitus - mechanisms and treatments
No full textNonalcoholic fatty liver disease (NAFLD) has reached epidemic proportions worldwide. NAFLD and type 2 diabetes mellitus (T2DM) are known to frequently coexist and act synergistically to increase the risk of adverse (hepatic and extra-hepatic) clinical outcomes. T2DM is also one of the strongest risk factors for the faster progression of NAFLD to nonalcoholic steatohepatitis, advanced fibrosis or cirrhosis. However, the link between NAFLD and T2DM is more complex than previously believed. Strong evidence indicates that NAFLD is associated with an approximate twofold higher risk of developing T2DM, irrespective of obesity and other common metabolic risk factors. This risk parallels the severity of NAFLD, such that patients with more advanced stages of liver fibrosis are at increased risk of incident T2DM. In addition, the improvement or resolution of NAFLD (on ultrasonography) is associated with a reduction of T2DM risk, adding weight to causality and suggesting that liver-focused treatments might reduce the risk of developing T2DM. This Review describes the evidence of an association and causal link between NAFLD and T2DM, discusses the putative pathophysiological mechanisms linking NAFLD to T2DM and summarizes the current pharmacological treatments for NAFLD or T2DM that might benefit or adversely affect the risk of T2DM or NAFLD progression.This Review describes the evidence of an association and causal link between nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM), discusses their pathophysiological mechanisms and summarizes the pharmacological treatments that might benefit or adversely affect the risk of T2DM or NAFLD progression
Is Nonalcoholic Fatty Liver Disease Not a Risk Factor for Cardiovascular Disease: Not Yet Time for a Change of Heart
No full textCardiovascular disease (CVD) is the leading cause of death among individuals with non-alcoholic fatty liver disease (NAFLD), and a growing body of evidence indicates that NAFLD is strongly associated with an increased risk of incident CVD events.(1) The independent contribution of NAFLD to CVD development, however, remains an area of debate. Recently, Alexander et al. performed a population-based, retrospective, case-control study using data from four large European electronic primary care databases (United Kingdom, Netherlands, Italy and Spain) to estimate the incidence of fatal and non-fatal acute myocardial infarction (AMI) and ischemic/unspecified stroke in patients with NAFLD compared to the general population after adjustment for traditional CVD risk factors.(2) Among nearly 17.7 million individuals, 120,795 adults had a recorded diagnosis of NAFLD or non-alcoholic steatohepatitis (NASH) without other known liver diseases, a diagnosis of excessive alcohol use, or prior AMI or stroke. Cases were matched with up to 100 controls by age, sex, practice site, and visit within six months of the case’s NAFLD/NASH diagnosis. Participants were followed until the occurrence of a primary outcome, end of the study period, or database exit, and the median follow-up time was 2.1-5.5 years (with a total of 205,046 recorded diagnoses of CVD events that occurred during follow-up). Cox proportional hazards models estimated the hazard ratios (HR) of AMI and stroke within each database and then pooled HR using a random effect meta-analysis
Nonalcoholic Fatty Liver Disease and Cardiovascular Disease
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Nonalcoholic steatohepatitis: the role of peroxisome proliferator-activated receptors
No full textThe increasing epidemic of obesity worldwide is linked to serious health effects, including increased prevalence of type 2 diabetes mellitus, cardiovascular disease and nonalcoholic fatty liver disease (NAFLD). NAFLD is the liver manifestation of the metabolic syndrome and includes the spectrum of liver steatosis (known as nonalcoholic fatty liver) and steatohepatitis (known as nonalcoholic steatohepatitis), which can evolve into progressive liver fibrosis and eventually cause cirrhosis. Although NAFLD is becoming the number one cause of chronic liver diseases, it is part of a systemic disease that affects many other parts of the body, including adipose tissue, pancreatic β-cells and the cardiovascular system. The pathomechanism of NAFLD is multifactorial across a spectrum of metabolic derangements and changes in the host microbiome that trigger low-grade inflammation in the liver and other organs. Peroxisome proliferator-activated receptors (PPARs) are a group of nuclear regulatory factors that provide fine tuning for key elements of glucose and fat metabolism and regulate inflammatory cell activation and fibrotic processes. This Review summarizes and discusses the current literature on NAFLD as the liver manifestation of the systemic metabolic syndrome and focuses on the role of PPARs in the pathomechanisms as well as in the potential targeting of disease.<br/
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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