Phenotypes of non-alcoholic fatty liver disease (NAFLD) and all-cause mortality: Unsupervised machine learning analysis of NHANES III

Objectives: Non-alcoholic fatty liver disease (NAFLD) is a non-communicable disease with a rising prevalence worldwide and with large burden for patients and health systems. To date, the presence of unique phenotypes in patients with NAFLD has not been studied, and their identification could inform precision medicine and public health with pragmatic implications in personalised management and care for patients with NAFLD. Design: Cross-sectional and prospective (up to 31 December 2019) analysis of National Health and Nutrition Examination Survey III (1988–1994). Primary and secondary outcomes measures: NAFLD diagnosis was based on liver ultrasound. The following predictors informed an unsupervised machine learning algorithm (k-means): body mass index, waist circumference, systolic blood pressure (SBP), plasma glucose, total cholesterol, triglycerides, liver enzymes alanine aminotransferase, aspartate aminotransferase and gamma glutamyl transferase. We summarised (means) and compared the predictors across clusters. We used Cox proportional hazard models to quantify the all-cause mortality risk associated with each cluster. Results: 1652 patients with NAFLD (mean age 47.2 years and 51.5% women) were grouped into 3 clusters: anthro-SBP-glucose (6.36%; highest levels of anthropometrics, SBP and glucose), lipid-liver (10.35%; highest levels of lipid and liver enzymes) and average (83.29%; predictors at average levels). Compared with the average phenotype, the anthro-SBP-glucose phenotype had higher all-cause mortality risk (aHR=2.88; 95% CI: 2.26 to 3.67); the lipid-liver phenotype was not associated with higher all-cause mortality risk (aHR=1.11; 95% CI: 0.86 to 1.42). Conclusions: There is heterogeneity in patients with NAFLD, whom can be divided into three phenotypes with different mortality risk. These phenotypes could guide specific interventions and management plans, thus advancing precision medicine and public health for patients with NAFLD

Estudos sôbre a fertilidade dos solos do cerrado: I. efeito da calagem na disponibilidade do fósforo (Nota prévia)

O método da diluição isotópica foi empregado com êxito para estudar a influência de doses crescentes de calcário na disponibilidade do fósforo do solo de cerrado. Os valores A foram determinados usando-se uma técnica simplificada; as amostras de solos de cerrado usadas no trabalho haviam sido submetidas prèviamente ao tratamento com diferentes dosagens de calcário em condições de campo. Tais amostras foram colhidas nas localidades de Orlandia, Pirassununga e Matão, todas elas no Estado de São Paulo. As seguintes conclusões puderam ser tiradas: (1) os três tipos de solos de cerrado apresentaram teores diferentes de fósforo assimilável; (2) nos casos das amostras de Pirassununga e Matão a calagem aumetou a disponibilidade do fósforo de modo linear; em Orlandia, entretanto, a dose mais alta de calcário diminuiu significativamente o teor de fósforo disponível.The method of isotopic dilution was successfully used to study the influence of limestone in the availability of native phosphorus. A values were determined by a simplified technique using samples of cerrado soils previously submitted in the field to the treatment with different amounts of limestone. It has been found out: (1) the three types of cerrado soils had different amounts of available phosphorus; (2) liming increased linearly the A values in the case of two of the soils under study; in the third one, howerer, the response was linear also up to a point wherefrom a further increase in the aumount of limestone applied caused a significant drop in available phosphorus

Synthesis:PLUTONS: Investigating the relationship between pluton growth and volcanism in the Central Andes

The Central Andes is a key global location to study the enigmatic relation between volcanism and plutonism because it has been the site of large ignimbrite-forming eruptions during the past several million years and currently hosts the world’s largest zone of silicic partial melt in the form of the Altiplano-Puna Magma (or Mush) Body (APMB) and the Southern Puna Magma Body (SPMB). In this themed issue, results from the recently completed PLUTONS project are synthesized. This project focused an interdisciplinary study on two regions of large-scale surface uplift that have been found to represent ongoing movement of magmatic fluids in the middle to upper crust. The locations are Uturuncu in Bolivia near the center of the APMB and Lazufre on the Chile-Argentina border, on the edge of the SPMB. These studies use a suite of geological, geochemical, geophysical (seismology, gravity, surface deformation, and electromagnetic methods), petrological, and geomorphological techniques with numerical modeling to infer the subsurface distribution, quantity, and movements of magmatic fluids, as well as the past history of eruptions. Both Uturuncu and Lazufre show separate geophysical anomalies in the upper, middle, and lower crust (e.g., low seismic velocity, low resistivity, etc.) indicating multiple distinct reservoirs of magma and/or hydrothermal fluids with different physical properties. The characteristics of the geophysical anomalies differ somewhat depending on the technique used—reflecting the different sensitivity of each method to subsurface melt (or fluid) of different compositions, connectivity, and volatile content and highlight the need for integrated, multidisciplinary studies. While the PLUTONS project has led to significant progress, many unresolved issues remain and new questions have been raised