A global action agenda for turning the tide on fatty liver disease

Background and Aims: Fatty liver disease is a major public health threat due to its very high prevalence and related morbidity and mortality. Focused and dedicated interventions are urgently needed to target disease prevention, treatment, and care. Approach and Results: We developed an aligned, prioritized action agenda for the global fatty liver disease community of practice. Following a Delphi methodology over 2 rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the action priorities using Qualtrics XM, indicating agreement using a 4-point Likert-scale and providing written feedback. Priorities were revised between rounds, and in R2, panelists also ranked the priorities within 6 domains: epidemiology, treatment and care, models of care, education and awareness, patient and community perspectives, and leadership and public health policy. The consensus fatty liver disease action agenda encompasses 29 priorities. In R2, the mean percentage of “agree” responses was 82.4%, with all individual priorities having at least a super-majority of agreement (> 66.7% “agree”). The highest-ranked action priorities included collaboration between liver specialists and primary care doctors on early diagnosis, action to address the needs of people living with multiple morbidities, and the incorporation of fatty liver disease into relevant non-communicable disease strategies and guidance. Conclusions: This consensus-driven multidisciplinary fatty liver disease action agenda developed by care providers, clinical researchers, and public health and policy experts provides a path to reduce the prevalence of fatty liver disease and improve health outcomes. To implement this agenda, concerted efforts will be needed at the global, regional, and national levels.publishedVersio

A global research priority agenda to advance public health responses to fatty liver disease

Background & aims An estimated 38% of adults worldwide have non-alcoholic fatty liver disease (NAFLD). From individual impacts to widespread public health and economic consequences, the implications of this disease are profound. This study aimed to develop an aligned, prioritised fatty liver disease research agenda for the global health community. Methods Nine co-chairs drafted initial research priorities, subsequently reviewed by 40 core authors and debated during a three-day in-person meeting. Following a Delphi methodology, over two rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the priorities, via Qualtrics XM, indicating agreement using a four-point Likert-scale and providing written feedback. The core group revised the draft priorities between rounds. In R2, panellists also ranked the priorities within six domains: epidemiology, models of care, treatment and care, education and awareness, patient and community perspectives, and leadership and public health policy. Results The consensus-built fatty liver disease research agenda encompasses 28 priorities. The mean percentage of ‘agree’ responses increased from 78.3 in R1 to 81.1 in R2. Five priorities received unanimous combined agreement (‘agree’ + ‘somewhat agree’); the remaining 23 priorities had >90% combined agreement. While all but one of the priorities exhibited at least a super-majority of agreement (>66.7% ‘agree’), 13 priorities had 90% combined agreement. Conclusions Adopting this multidisciplinary consensus-built research priorities agenda can deliver a step-change in addressing fatty liver disease, mitigating against its individual and societal harms and proactively altering its natural history through prevention, identification, treatment, and care. This agenda should catalyse the global health community’s efforts to advance and accelerate responses to this widespread and fast-growing public health threat. Impact and implications An estimated 38% of adults and 13% of children and adolescents worldwide have fatty liver disease, making it the most prevalent liver disease in history. Despite substantial scientific progress in the past three decades, the burden continues to grow, with an urgent need to advance understanding of how to prevent, manage, and treat the disease. Through a global consensus process, a multidisciplinary group agreed on 28 research priorities covering a broad range of themes, from disease burden, treatment, and health system responses to awareness and policy. The findings have relevance for clinical and non-clinical researchers as well as funders working on fatty liver disease and non-communicable diseases more broadly, setting out a prioritised, ranked research agenda for turning the tide on this fast-growing public health threat

SEMICLASSICAL THEORY OF MAGNETIZATION FOR A 2-DIMENSIONAL NONINTERACTING ELECTRON-GAS

We compute the semiclassical magnetization and susceptibility of non-interacting electrons, confined by a smooth two-dimensional potential and subjected to a uniform perpendicular magnetic field, in the general case when their classical motion is chaotic. It is demonstrated that the magnetization per particle m(B) is directly related to the staircase function N(E), which counts the single-particle levels up to energy E. Using Gutzwiller's trace formula for N, we derive a semiclassical expression for m. Our results show that the magnetization has a non-zero average, which arises from quantum corrections to the leading-order Weyl approximation to the mean staircase and which is independent of whether the classical motion is chaotic or not. Fluctuations about the average are due to classical periodic orbits and do represent a signature of chaos. This behaviour is confirmed by numerical computations for a specific system

Optimization of the isocratic separation of dithranol and related compounds by reversed-phase liquid chromatography

An optimum mobile-phase composition is proposed for resolution of the impurities in dithranol and compounds related to dithranol by isocratic reversed-phase HPLC in a single run. A combination of Snyder's solvent selectivity triangle concept with mixture design was used to achieve this goal. The quantification of the five substances involved was tested and the ruggedness of the method verified for small changes in the mobile phase composition

PHYSICAL-PROPERTIES OF METAL CLUSTER COMPOUNDS .5. MAGNETIC MEASUREMENTS ON LOW-NUCLEARITY RUTHENIUM CARBONYL CLUSTERS

We present magnetic susceptibility and magnetization measurements on a series of low-nuclearity (n = 3 - 6) ruthenium carbonyl clusters. It is shown that even these very small metal cluster have a fraction of unpaired spin density leading to a low-temperature divergent susceptibility and a magnetization that is far from saturated in fields up to 5 tesla. The effect of CO adsorption on the magnetic properties of a bare cluster is discussed. © 1988

Tropical forests structure and diversity: A comparison of methodological choices

Abstract Large‐scale data compilation is increasing steadily in tropical forest research, but the lack of standardized methods for data collection limits drawing inference from large datasets and cross‐biome analyses. Different inclusion methods and minimum tree diameter threshold are among these varying factors. To tackle this issue, we evaluated how different approaches for tree sampling affects our understanding of diversity and functioning in different tropical vegetation types. We used a unique dataset of 44 inventory plots (43.54 ha) encompassing an aridity gradient: evergreen moist forests, semideciduous and deciduous tropical forests. Data were collected using the by‐tree inclusion method, in which, all stems are measured if the equivalent diameter of the tree reaches the minimum threshold. We simulated the impact of adopting different inclusion methods (by‐stem and by‐tree) and different minimum diameter thresholds on the estimation of number of trees and stems, biomass and species richness. We used linear and nonlinear mixed models to investigate the effect of minimum diameter threshold and inclusion method on our different response variables. We also evaluated species chance to be sampled under different minimum inclusion criteria. Inclusion method and minimum diameter threshold mainly affect the estimation of number of trees and stems and species richness, especially in deciduous and semideciduous forests, where resprouting is a prevalent strategy. In these forests, many trees that have several stems do not reach the minimum size individually when adopting the by‐stem method, yet they do reach the minimum size threshold when all stems are considered together. For these environments under water stress, our analysis showed that using large minimum sizes, such as the 10 cm typically used in rainforests, implies large sampling losses, especially when used jointly with the by‐stem inclusion method. The by‐tree inclusion method represents an alternative approach that offers a more reliable sampling in different vegetation types, particularly in those habitats where resprouting is a widely encountered strategy along all age classes. We demonstrate the infeasibility of adopting broad and standard minimum thresholds for different tropical vegetation types, particularly considering their widely different ecological strategies

Tropical forests structure and diversity: A comparison of methodological choices

Abstract Large‐scale data compilation is increasing steadily in tropical forest research, but the lack of standardized methods for data collection limits drawing inference from large datasets and cross‐biome analyses. Different inclusion methods and minimum tree diameter threshold are among these varying factors. To tackle this issue, we evaluated how different approaches for tree sampling affects our understanding of diversity and functioning in different tropical vegetation types. We used a unique dataset of 44 inventory plots (43.54 ha) encompassing an aridity gradient: evergreen moist forests, semideciduous and deciduous tropical forests. Data were collected using the by‐tree inclusion method, in which, all stems are measured if the equivalent diameter of the tree reaches the minimum threshold. We simulated the impact of adopting different inclusion methods (by‐stem and by‐tree) and different minimum diameter thresholds on the estimation of number of trees and stems, biomass and species richness. We used linear and nonlinear mixed models to investigate the effect of minimum diameter threshold and inclusion method on our different response variables. We also evaluated species chance to be sampled under different minimum inclusion criteria. Inclusion method and minimum diameter threshold mainly affect the estimation of number of trees and stems and species richness, especially in deciduous and semideciduous forests, where resprouting is a prevalent strategy. In these forests, many trees that have several stems do not reach the minimum size individually when adopting the by‐stem method, yet they do reach the minimum size threshold when all stems are considered together. For these environments under water stress, our analysis showed that using large minimum sizes, such as the 10 cm typically used in rainforests, implies large sampling losses, especially when used jointly with the by‐stem inclusion method. The by‐tree inclusion method represents an alternative approach that offers a more reliable sampling in different vegetation types, particularly in those habitats where resprouting is a widely encountered strategy along all age classes. We demonstrate the infeasibility of adopting broad and standard minimum thresholds for different tropical vegetation types, particularly considering their widely different ecological strategies