Attenuation Parameter Research Articles

Effect of Vessel Attenuation, VMI Level, and Reconstruction Kernel on Pericoronary Adipose Tissue Attenuation for EID CT and PCD CT: An Ex Vivo Porcine Heart Study.

Background: Pericoronary adipose tissue (PCAT) attenuation and fat attenuation index (FAI) may serve as markers of inflammation and risk of adverse cardiac events. However, standardization of relevant CT acquisition and reconstruction parameters is lacking. Objective: To investigate the influence of vessel attenuation, virtual monoenergetic image (VMI) level, and reconstruction kernel on PCAT attenuation and FAI using energy-integrating detector (EID) and photon-counting detector (PCD) CT systems in an ex-vivo porcine heart model. Methods: A porcine heart's right coronary artery (RCA) was injected with saline or varying contrast media dilutions to achieve vessel attenuations ranging from 0 to 1000 HU. After each injection, the heart was scanned with EID CT at 120 kVp and PCD CT at 140 kVp, at constant CTDIvol (10 mGy). For EID CT, polychromatic images were reconstructed with Qr40 kernel. For PCD CT, VMI (40-80 keV at 10-keV increments) were reconstructed with Qr40, Bv40, and Bv56 kernels. ROIs were placed to measure RCA and PCAT attenuation. FAI was determined using software; histogram analysis was performed of voxel attenuations in the volumes of interest for FAI calculation. Results: Correlations were observed between attenuation in the RCA and adjacent PCAT (r=0.3-1.0), and between vessel attenuation and FAI (r=-0.9-1.0). For PCAT attenuation and FAI, these associations became progressively weaker for progressively sharper kernels. For increasing vessel attenuation for EID CT and for increasing VMI level for PCD CT, FAI histograms showed right shifts of the peak attenuation; the percentage of histogram voxels meeting the threshold range for inclusion in FAI calculation for EID CT was 8-29% and for PCD CT at VMI levels of 70-80 keV was 5-42%. For PCD CT, sharper kernels were associated with left shifts in peak attenuations and greater percentages of voxels within the threshold range for inclusion in FAI calculations. Conclusion: PCAT attenuation and FAI are influenced by vessel lumen attenuation, VMI level, and reconstruction kernel. A minority of pericoronary voxels contribute to FAI measurements for polychromatic EID CT and for PCD CT at high VMI levels. Clinical Impact: These findings may help standardize acquisition and reconstruction parameters for PCAT attenuation and FAI measurements.

Use of a Micronutrient Cocktail to Improve Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in Adults with Obesity: A Randomized, Double-Blinded Pilot Clinical Trial.

Background and Objectives: The goal of this study was to assess the impact of supplementation with a combination of nutrients on metabolic-dysfunction-associated steatotic liver disease (MASLD)-related liver parameters, and other parameters related to metabolic syndrome in adults with obesity. These measurements included anthropometric and lipid profiling, and FibroScan technology (controlled attenuation parameter (CAP) and transient elastography (TE) values). Materials and Methods: A double-blind, placebo-controlled pilot clinical trial was conducted over a three-month treatment period. Adults with metabolic syndrome and obesity were allocated to receive either a cocktail of nutrients with defined daily dosages (5-MTHF, betaine, alpha-linolenic acid, eicosapentaenoic acid, choline bitartrate, docosahexaenoic acid, and vitamin B12) or a placebo. The participants were evaluated at the start and the end of the three-month treatment period. Results: A total of 155 participants entered the study, comprising 84 in the treatment group and 71 in the placebo group. The administration of the nutritional supplement resulted in a notable reduction in both CAP and TE scores when compared to the placebo group. The treatment group exhibited a mean reduction in CAP of 4% (p < 0.05) and a mean reduction in TE of 7.8% (p < 0.05), indicative of a decline in liver fat content and fibrosis. Conclusions: The supplementation over a period of three months led to a significant amelioration of liver fibrosis and steatosis parameters in adults with metabolic syndrome and obesity. These findings suggest that this supplementation regimen could be a beneficial adjunct therapy for improving liver health in adults with obesity-induced MASLD.

Effect of 5:2 intermittent fasting diet versus daily calorie restriction eating on metabolic-associated fatty liver disease-a randomized controlled trial.

Both 5:2 IF diet (intermittent fasting) and daily caloric restriction eating had been suggested for management of MAFLD (Metabolic-Associated Fatty Liver Disease), this study aimed to evaluate the effects of 5:2 IF diet on body weight and metabolic parameters in adults with MAFLD, in comparison to daily caloric restriction eating. This single-center, double-blind, prospective, randomized controlled trial included 60 patients with MAFLD, who were administered either a 5:2 IF diet limited calories consumed for 2 days each week with no restrictions on the remaining 5 (Group 5:2 IF diet) or a daily calorie restriction eating (Group daily calorie restriction). Fibrotouch-B instrument assessment, ultrasound assessment of hepatic steatosis, anthropometric indices and body composition analysis, blood sample measurements were conducted during two distinct visits: initially on the day of study commencement (T1), and subsequently at the conclusion of the 12-week intervention period (T2). In comparison to daily calorie restriction eating, the 5:2 IF diet significantly decreased the proportion of hepatic steatosis ≥moderate (29.6% vs. 59.3%, p = 0.028) and the degree of hepatic fibrosis F ≥ 2 (3.7% vs. 25.9%, p = 0.05), and fewer percentage of patients were diagnosed with fatty liver via upper abdominal ultrasound in the 5:2 intermittent fasting diet group (33.3% vs. 63.0%, p = 0.029). Additionally, the CAP (controlled attenuation parameter) and LSM (liver stiffness measurements) value were significantly lower in the 5:2 IF diet group (p < 0.05). No statistically significant differences were observed between the two groups in terms of weight, BMI (body mass index), WC (waist circumference), HC (hip circumference), and WHR (waist to hip ratio). Similarly, there were no significant differences in lipid profile, glycemic indices and adverse events (p > 0.05). In summary, although both 5:2 IF diet and daily caloric restriction eating achieved similar effect on body weight, liver enzymes, lipid profile and glycemic indices after 12 weeks treatment, 5:2 IF diet demonstrates better improvement in fibrosis and steatosis scores independently from weight regulation. Consequently, it is anticipated to emerge as a viable dietary modality for lifestyle intervention among patients diagnosed with MAFLD. https://www.crd.york.ac.uk/PROSPERO, identifier ChiCTR2400080292.

Experimental study of gamma-ray attenuation capability of B2O3-ZnO-Na2O-Fe2O3 glass system

In the present work, a glass system with developed composition consisting of B2O3, ZnO, Na2O and Fe2O3 samples has been investigated. Glass samples were prepared using the melt quenching method and the density of the system was measured using Archimedes’ principle. Spectroscopic analysis using a gamma source and a high-purity germanium detector at four energies of 0.0595, 0.6617, 1.173, and 1.333 MeV emitted from Am-241, Cs-137, and Co-60 were used to determine the attenuation parameters of present glass composites. The sample containing 45 B2O3 + 10 Na2O + 40 ZnO + 5 Fe2O3 (coded BNZF-4) had the highest mass attenuation coefficient (MAC) value at all the energies discussed compared to the other composites. Whoever, the BNZF-1 sample had the lowest value at all ranges of energies. The transmission factors (TF, %) of the manufactured samples were calculated, at 0.0595 MeV (TF, %) values are 32.6429 and 6.4612 for samples BNZF-1 and BNZF-4, respectively. The statistical results demonstrated significantly better to increase the ZnO concentration in the sample, where the percentage of zinc oxide inside the prepared glass samples has the following direction BNZF -4 > BNZF -3 > BNZF -2 > BNZF -1. The significance of this study is that transparent, environmentally harmless glass composites with relatively high density have been prepared that can be used as shielding materials against gamma rays, especially at low energies.

Enhancing the radiation shielding performance of polyepoxide composites based on cement bypass dust

In this study, radiation shielding composite materials were created by combining epoxy with cement bypass dust (CBPD) at different weight percentages (0%, 10%, 20%, and 30%). The solution casting technique was employed to construct these materials. The FTIR spectra confirmed the formation of the composites and the production of complexes. The morphology and elemental content of the produced composite samples were illustrated using SEM pictures and EDX spectra. In addition, the research findings demonstrated that the composites exhibited improved resistance to changes in temperature as the loading of CBPD increased. The gamma-ray attenuation coefficients of composites consisting of Epoxy + x% CBPD exhibited an increase, along with an increase in the neutron removal cross-section. However, there was a gradual increase in both the mean free path (MFP) as well as the half value layer (HVL) with increasing energy. Additionally, the experimental and theoretical data for attenuation parameters were compared using the Phy-X/PSD software. The relationship between the effective atomic and electron numbers of the Epoxy + x% CBPD composites has been studied. The values of fast and thermal neutron attenuation were analyzed using the NGCal software. In general, these composites are appropriate for use in radiation shielding applications.

Therapeutic Effects of Semaglutide on Nonalcoholic Fatty Liver Disease with Type 2 Diabetes Mellitus and Obesity: An Open-Label Controlled Trial.

GLP-1 receptor agonists (GLP-1 RAs) have been shown to improve glycemic control and insulin sensitivity and reduce body weight in obese patients with type 2 diabetes mellitus (T2D). This trial sought to evaluate the therapeutic effect of oral and subcutaneous semaglutide in NAFLD and its sequelae in obesity and/or T2D. In an open-labelled intervention study, the sample was 180 patients classified into three parallel groups (1:1:1): group I received oral semaglutide, group II patients received injectable semaglutide, and group III received pioglitazone and/or vitamin E. Patients were evaluated at 6 and 12 months. There was a substantial improvement in lipid profile, liver enzymes, and body mass index, especially in group II. As for HDL, only group II showed a consistent increase at both 6 months (51 ± 4.62 mg/dL) and 12 months (50.08 ± 2.45 mg/dL) compared with baseline (45.6 ± 6.37 mg/dL) (p-value < 0.001). Despite the non-significant difference in NAFLD fibrosis score (NFS) (p-value = 0.45 and 0.63), group II had significantly lower scores of the fibrosis-4 score (FIB-4), liver stiffness measurement (LSM), and controlled attenuation parameter (CAP) at 6 and 12 months (p-value < 0.001). Conclusions: Semaglutide improves lipid profile, liver steatosis, and fibrosis parameters and reduces the BMI in T2D and obese patients with NAFLD.

Effect of metabolic dysfunction-associated steatotic liver disease on BNT162b2 immunogenicity against the severe acute respiratory syndrome coronavirus 2 omicron variant.

We aimed to investigate the effect of metabolic dysfunction-associated steatotic liver disease (MASLD) on three-dose BNT162b2 immunogenicity to the omicron variant. Adult recipients of three doses of BNT162b2 were prospectively recruited between May and December 2021. The serology of the neutralizing antibody by live virus microneutralization (vMN) to the omicron variant was measured at baseline, day 180, and day 360 after the first dose. The primary outcome was seroconversion (vMN titer≥10) at day 360. Exposure of interest was MASLD, defined as hepatic steatosis (controlled attenuation parameter≥248dB/m on transient elastography) plus at least one of five cardiometabolic risk factors. Subjects with prior COVID-19 were excluded. A multivariable logistic regression model was used to derive the adjusted odds ratio of seroconversion with MASLD by adjusting for age, sex, antibiotic use, and proton pump inhibitor use. One hundred forty-eight BNT162b2 recipients (male: 48 [32.4%]; median age: 51.0years [interquartile range, IQR: 44.5-57.3]) were recruited. The median time from the first dose to the third dose was 8.5months (IQR: 7.9-8.9). MASLD subjects had a lower seroconversion rate than non-MASLD ones (89.6% vs 99.0%; P=0.007). MASLD was the only independent risk factor for seroconversion (adjusted odds ratio: 0.051, 95% confidence interval: 0.002-0.440). Subgroup analysis of immunogenicity at 4months after the third dose shows significantly lower vMN titer (13.06 [IQR: 7.69-22.20] vs 33.49 [IQR: 24.05-46.53]; P=0.004) and seroconversion rate (76.9% vs 97.4%; P=0.016) in MASLD than non-MASLD subjects, but not within 4months from the third dose (vMN titer: 46.87 [IQR: 33.12-66.02] vs 41.86 [IQR: 34.47-50.91], P=0.240; seroconversion rate: 94.3% vs 100%, P=0.131). Metabolic dysfunction-associated steatotic liver disease was a risk factor for poorer immunogenicity to the omicron variant, with a more pronounced waning effect compared among three-dose BNT162b2 recipients.

Associations between per- and polyfluoroalkyl substance exposures and metabolic dysfunction associated steatotic liver disease (MASLD) in adult National Health and Nutrition Examination Survey 2017 to 2018.

Per- and polyfluoroalkyl substances (PFAS) are persistent organic pollutants previously associated with elevated liver enzymes in human cohorts and steatotic liver disease in animal models. We aimed to evaluate the associations between PFAS exposures, and liver enzymes and vibration controlled transient elastography (VCTE) biomarkers of metabolic dysfunction associated steatotic liver disease (MASLD) in adult National Health and Nutrition Examination Survey (NHANES) 2017 to 2018. VCTE was determined by FibroScan. Serum PFAS (n = 14), measured by mass spectrometry, were analyzed individually and by principal component (PC). Univariate and multivariable associations were determined between PFAS exposures and liver disease outcome variables: alanine aminotransferase (ALT), controlled attenuation parameter (CAP), liver stiffness measurement (LSM), FibroScan-based Score (FAST), using R. About 1,400 participants including 50% women with a mean age of 48 ± 19 years and a mean BMI of 29 ± 7 kg/m2 were analyzed. Four PFAS clustered to PC1, whereas 3 PFAS clustered to PC2. PC1 was significantly associated with ALT (β = 0.028), CAP (β = 0.041), LSM (β = 0.025), and FAST (β = 0.198) in univariate analysis. Individual PFAS exposures were oftentimes inversely associated with these measurements in multivariate analysis. In adult NHANES 2017-2018, PFAS may not be a significant burden for MASLD, because of the inconsistent associations between the environmental PFAS exposures and biomarkers of liver steatosis, inflammation, and fibrosis. More data are required to better understand the relationships between PFAS exposures and liver disease.

Prevalence of Metabolic Dysfunction-associated Steatotic Liver Disease and Cardiometabolic Risk Factor in US Adolescents.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is widespread worldwide, and a strong link between MASLD and cardiometabolic risk factors (CMRFs) was emphasized. This study characterized the prevalence of MASLD in adolescent population and overlapping CMRFs conditions in MASLD. This is a cross-sectional study of US adolescents aged 12--19 years in the 2017-2020 cycles of the National Health and Nutrition Examination Survey. The relationship between CMRFs and liver steatosis, evaluated by the median controlled attenuation parameter (CAP), was assessed. The prevalence of MASLD in adolescents was 23.77%. Isolated overweight/obesity (35%) was the top CMRF. Non-Hispanic Black patients had the highest proportion of overweight/obesity plus elevated glucose (24%), while non-Hispanic Asian had the highest burden of dyslipidemia (2%, 14%, and 19%). Except hypertension, overweight/obesity (β=48.7; 95% CI, 43.4-54.0), hypertriglyceridemia (β=15.5; 95% CI, 7.2-28.3), low HDL-C (β=10.0; 95% CI, 3.1-16.9), elevated glucose (β=6.9; 95% CI, 0.6-13.2) were all significantly associated with increased CAP values. Increased CAP was linked to the synergistic interactions between overweight/obesity and dyslipidemia or elevated glucose (overweight/obesity and elevated glucose: RERI=8.21, AP=0.45, SI=1.91; overweight/obesity and hypertriglyceridemia: RERI=19.00, AP=0.69, SI=3.53; overweight/obesity and low HDL-C: RERI=10.83, AP=0.58, SI=2.61). Adolescents with combination of overweight/obesity, dyslipidemia (β=15.1; 95% CI, 0.1-30.2) and combination of overweight/obesity, dyslipidemia and elevated glucose (β=48.0; 95% CI, 23.3-72.6) had a significantly higher CAP values. The prevalence of MASLD was alarmingly high in adolescents, and overweight/obesity was the most important CMRF. Overweight/obesity and dyslipidemia or elevated glucose had positive additive interaction effects on liver steatosis.

Monte Carlo simulation analysis of radiation attenuation properties induced by arsenic accumulation in femur and tibia bones of rats exposed to sodium arsenite diet

PurposeThe study aims to investigate the effect of sodium arsenite (NaAsO2) on radiation permeability in biological tissues of rats, challenging existing literature claims about NaAsO2's influence on the density of bones. The motivation is determining whether exposure alters radiation permeability within a defined range of radiological energy. Should any changes be observed, radiation protection guidelines may necessitate the use of lower energy levels in imaging procedures involving such exposure. This consideration is vital for ensuring adherence to radiation safety standards, particularly in medical imaging, where minimizing patient and operator exposure to radiation is paramount. Materials and methodsIn this study, rats were divided into two groups: a control group and a NaAsO2-treated group. After the treatment period, these animals were euthanized to collect their femurs and tibias for further analysis. The elemental composition of these bones was then meticulously examined using Scanning Electron Microscopy (SEM), enhanced by Energy-dispersive X-ray Spectrometry (EDX). Monte Carlo Simulation codes of MCNP6 and PHITS 3.22 were used for investigate photon induced interactions. These powerful tools allowed us to assess the gamma-ray attenuation properties of the collected samples. For an accurate comparison and analysis, we referred to the NIST database using the WinXCom program. Furthermore, the study explored the effects of charged particles on the bone samples, employing the SRIM code for this purpose. This part of the research was crucial to understanding the interactions at a more detailed level. We calculated the photon attenuation parameters for radiological energies up to 0.5 MeV and also investigated the interactions of charged particles with energies as high as 15 MeV. ResultsIn groups treated with NaAsO2, while there is less reduction in mass attenuation coefficients, larger differences have been observed in linear attenuation coefficients. Notably, a decrease in the linear attenuation coefficient has been observed in the NaAs Tibia group. ConclusionThe application of sodium arsenite (NaAsO2) results in a reduction in the Linear Attenuation Coefficient, necessitating a detailed investigation to determine whether this decrease also affects the Hounsfield unit, in accordance with the ALARA (As Low As Reasonably Achievable) principle that guides radiation safety protocols.

Central Obesity is an Independent Determinant of Advanced Fibrosis in Lean Patients With Nonalcoholic Fatty Liver Disease

BackgroundThe current definition of lean is based on BMI. However, BMI is an imperfect surrogate for adiposity and provides no information on central obesity (CO). Hence, we explored the differences in clinical profile and liver disease severity in lean patients with NAFLD with and without CO. Methods170 lean patients with NAFLD (BMI <23 kg/m2) were divided into two groups depending upon the presence or absence of CO (waist circumference ≥80 cm in females and ≥90 cm in males). Non-invasive assessment of steatosis was done by ultrasound and controlled attenuation parameter (CAP) while fibrosis was assessed with FIB-4 and liver stiffness measurement (LSM). FibroScan-AST (FAST) score was used for non-invasive prediction of NASH with significant fibrosis. ResultsOf 170 patients with lean NAFLD, 96 (56.5%) had CO. Female gender (40.6% vs 17.6%, p=0.001), hypertriglyceridemia (58.3% vs 39.2%, p=0.01) and metabolic syndrome (23.9% vs 4.1%, p<0.001) were more common in CO group. There was a poor correlation between BMI and waist circumference (r=0.24, 95% CI: 0.09-0.38). Grade 2-3 steatosis on ultrasound was significantly more common in CO patients (30% vs 12.3%, p=0.007). CAP [312.5 (289.8-341) dB/m vs 275 (248-305.1) dB/m, p=0.002], FAST score [0.42 (0.15-0.66) vs 0.26 (0.11-0.39), p=0.04], FIB-4 and LSM were higher in those with CO. Advanced fibrosis was more prevalent among CO patients using FIB-4 (19.8% vs 8.1%, p=0.03) and LSM (9.5% vs 0, p=0.04). CO was independently associated with advanced fibrosis after adjusting for BMI and metabolic risk factors (aOR: 3.11 (1.10-8.96), p=0.03). Among these 170 patients, 142 fulfilled MASLD criteria. CO was also an independent risk factor for advanced fibrosis in MASLD (3.32 (1.23-8.5), p=0.02). ConclusionLean patients with NAFLD or MASLD and CO have more severe liver disease compared to those without CO.

Understanding confounding factors allows for accurate interpretation of liver stiffness measurements by ElastQ, a novel 2D shear wave elastography technique.

Liver stiffness measurement (LSM) using vibration-controlled transient elastography (VCTE) or two-dimensional shear wave elastography (2D-SWE) is recommended to assess the risk of liver fibrosis and advanced chronic liver disease. Even though both techniques measure liver stiffness, their numerical results often diverge. Confounders and reliability criteria for 2D-SWE have not been systematically investigated. We prospectively recruited participants with paired LSM by VCTE and the novel 2D-SWE technique ElastQ (Philips) in three European tertiary centers. The following parameters were recorded: sex, age, body mass index (BMI), etiology, laboratory markers of liver damage and function, as well as cholestasis, LSM by VCTE and controlled attenuation parameter (CAP), interquartile range (IQR)/median for VCTE-LSM and ElastQ-LSM, and the skin-to-liver capsule distance. We included 840 participants: 447 (53.2%) males; median age 57.0 [IQR:19.0] years; median BMI 25.4 [6.0] kg/m2; median VCTE-LSM 7.25 [9.2] kPa; median ElastQ-LSM 6.7 [5.4] kPa. On uni- and multivariable modeling (adjusted for LSM), we found that the discrepancy increased with liver stiffness and markers of disease severity. Skin-to-liver capsule distance and BMI affected VCTE-LSM more compared to ElastQ-LSM and significantly increased the discordance between the two measurements. The discrepancy of ElastQ-LSM to VCTE-LSM increases with liver stiffness and disease severity. BMI and skin-to-liver capsule distance increase the discrepancy between VCTE- and ElastQ-LSM but affect ElastQ-LSM less. The quality criterion IQR/median ≤ 30% indicates reliable ElastQ-LSM.

Correlation of the grade of hepatic steatosis between Ultrasound attenuation parameter and ultrasound in patients with Metabolic dysfunction associated steatotic liver disease

Correlation of the grade of hepatic steatosis between Ultrasound attenuation parameter and ultrasound in patients with Metabolic dysfunction associated steatotic liver disease

Intra-observer variability in liver stiffness and ultrasound attenuation parameter measurement using vibration-controlled transient elastography in patients with metabolic dysfunction-associated steatotic liver disease

Intra-observer variability in liver stiffness and ultrasound attenuation parameter measurement using vibration-controlled transient elastography in patients with metabolic dysfunction-associated steatotic liver disease

Assessment of HBV variants and novel viral and immune biomarkers in chronic hepatitis B patients with metabolic dysfunction associated steatotic liver disease.

Co-existing chronic hepatitis B virus (CHB) infection and metabolic dysfunction associated steatotic liver disease (MASLD) can exert complex effects on hepatic metabolism, requiring mechanistic study. CHB participants were assessed for MASLD and the impact of hepatic steatosis/metabolic syndrome (MetS) on novel viral and immunological markers. In this prospective, cohort study, untreated CHB subjects were assessed for liver disease by non-invasive tests (i.e. FibroScan, controlled attenuation parameter, CAP). Subjects were tested for cytokines and IFN-γ ELISPOT assay to HBV Surface (S) and Core (C) proteins. Standard HBV serological, exploratory biomarkers and deep sequencing of HBV S and C genes were performed. In 53 subjects (median age 45 years [SD = 10.6], 35% F, 56% Asian, 20% Black, 3% White), 94% (50) HBeAg negative, 63% genotype B/C, mean HBV DNA 3.2 log10 IU/mL (SD = 1.8), quantitative HBsAg 2.9 log10 IU/mL (SD = 1.2) and HBV pgRNA 2.1 log10 copies/mL (SD = 1.3). In enrolled subjects, the mean ALT was 41.9 U/L (SD = 24.0), FibroScan was 5.7 kPa (SD = 1.9) and CAP was 306.4 dB/m (SD = 49.0). The mean BMI was 28.2 kg/m2 (SD = 4.2), 20% (11/53) had diabetes, 35% (19/53) dyslipidaemia and 24% (13/53) hypertension. Subjects with MetS and steatosis showed lower HBV markers (p < .01), higher HBV S diversity (p = .02) and greater frequency of HBV variants associated with host-anti-viral immune escape. Pro-inflammatory cytokine levels and HBV-specific cellular responses were higher in participants with hepatic steatosis. In CHB, MASLD/hepatic steatosis was associated with HBV variants and systemic immune responses potentially impacting liver disease progression despite low-level viraemia.

Associations of the EAT-Lancet reference diet with metabolic dysfunction-associated steatotic liver disease and its severity: A multicohort study.

The EAT-Lancet Commission devised a globally sustainable dietary pattern to jointly promote human health and sustainability. However, the extent to which this diet supports metabolic dysfunction-associated steatotic liver disease (MASLD) has not yet been assessed. This study aimed to investigate the association between the EAT-Lancet diet and the risk of MASLD and its severity. This prospective multicohort study included 15,263 adults from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort, 1137 adults from the Guangzhou Nutrition and Health Study (GNHS) cohort, and 175,078 adults from the UK Biobank. In addition, 228 Chinese adults from the Prospective Epidemic Research Specifically of Non-alcoholic Steatohepatitis (PERSONS) with biopsy-proven MASLD were included. An EAT-Lancet diet index was created to reflect adherence to the EAT-Lancet reference diet. The TCLSIH cohort recorded 3010 MASLD cases during 53,575 person-years of follow-up, the GNHS cohort documented 624 MASLD cases during 6454 person-years of follow-up, and the UK Biobank developed 1350 MASLD cases during 1,745,432 person-years of follow-up. In multivariable models, participants in the highest tertiles of the EAT-Lancet diet index had a lower risk of MASLD compared with those in the lowest tertiles (TCLSIH: HR = 0.87, 95% CI: 0.78, 0.96; GNHS: HR = 0.79, 95% CI: 0.64, 0.98; UK Biobank: HR = 0.73, 95% CI: 0.63, 0.85). Moreover, liver-controlled attenuation parameter decreased with increasing the diet index in individuals with biopsy-proven MASLD (β = -5.895; 95% CI: -10.014, -1.775). Adherence to the EAT-Lancet reference diet was inversely associated with the risk of MASLD as well as its severity.

When metabolic comorbidities and risk of malnutrition coexist: The new era of inflammatory bowel disease

BackgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) and risk of malnutrition can coexist in patients with inflammatory bowel disease (IBD). We performed a malnutrition risk assessment as part of the standard follow-up of IBD patients and studied the potential risk factors for being at risk of malnutrition based on the presence or absence of MASLD. MethodsThe Malnutrition Universal Screening Tool (MUST) was used to screen malnutrition risk (MUST ≥1) and controlled attenuation parameter (CAP ≥248 dB/min) to assess MASLD. Adherence to a Mediterranean diet, physical activity, and quality of life were also assessed. ResultsOf 686 evaluated IBD patients, 130 (18.9 %) were identified as being at risk of malnutrition. Patients without MASLD (n = 89 [68.5 %]) were more likely to be at risk than those with MASLD (n = 41 [31.5 %], p = 0.005). However, among patients at risk of malnutrition, those with MASLD were more likely to have active IBD (82.9 %) than patients without MASLD (39.3 %, p < 0.001). Female sex (OR 1.984, p = 0.027) and young age (OR 1.014, p = 0.006) were associated with malnutrition risk only in patients with IBD without MASLD. Being at risk of malnutrition was associated with worse quality of life (p < 0.001), especially in IBD patients with MASLD. ConclusionsMalnutrition risk and quality of life are modified by the presence of MASLD in IBD patients.

Heavy metals are liver fibrosis risk factors in people without traditional liver disease etiologies

Liver fibrosis is an important predictor of mortality. Liver disease case definitions changed in 2023. These definitions include an easily over-looked group with no traditional etiology (NTE) of liver disease and no steatosis. We analyzed heavy metals and cardiometabolic risk factors (CMRFs) as fibrosis risk factors in the NTE group and in people with another newly-defined condition, metabolic dysfunction-associated steatotic liver disease (MASLD). Two National Health and Nutrition Examination Survey (NHANES) datasets were analyzed. In NHANES III (1988–1994), fibrosis and steatosis were defined by Fibrosis-4 scores and ultrasound, respectively, in 12,208 adults. In NHANES 2017–2020, fibrosis and steatosis were defined by transient elastography and the controlled attenuation parameter (CAP) in 5525 adults. Fibrosis risk factors varied over time and by race/ethnicity. In the earlier dataset, NTE-fibrosis had a positive, non-significant, association with high blood levels of lead (Pb). MASLD-fibrosis was associated with Pb (OR = 2.5, 95 % CI, 1.4–4.4) and not with CMRFs in non-Hispanic Blacks but was associated with CMRFs in non-Hispanic Whites. Heavy metal exposures fell between the two time periods. In the later dataset, NTE-fibrosis was associated with Pb (OR = 4.2, 95 % CI, 2.6–6.8) and cadmium (OR = 1.8, 95 % CI, 1.1–3.0) in the total population, but not with CMRFs. MASLD-fibrosis was strongly-significantly associated with CMRFs in every racial/ethnic group except non-Hispanic Blacks in whom CMRFs were only weakly associated with MASLD-fibrosis. Heavy metal pollution, which disproportionately impacts minoritized populations, decreased over time, but remained strongly associated with liver fibrosis in people lacking traditional etiological factors for liver disease.

Tailoring the Magnetic, Structural and Shielding Characteristics of Nano Er2O3 via Ni Doping

We investigated the effects of Ni-doping amount on the structural, magnetic, and shielding properties of nano Er2O3. Nano Er2−xNixO3 (x = 0, 0.05, 0.1, 0.15) samples were fabricated by a pechini scheme and characterized via X-ray diffraction. Rietveld refinement was used to discover the distribution of cations on the two crystallographic sites. Cation ordering in the two nonequivalent sites of the structure and the variation of the oxygen bond lengths of octahedra with the composition x were also investigated. A consistent reduction in the average bond lengths of (Er/Ni)O6 octahedra around 8b and 24d as x progresses was observed. Average crystallite size reduced while average lattice micro-strain increased with increasing Ni doping. The correlation between magnetization and temperature for all samples under a magnetic field of 200 Oe was studied. Curie-Weiss law was applied to find the magnetic moments and the types of magnetic structure. The μ eff in the Er2−xNixO3 samples dropped from 9.7 to 9.36 μB as the nickel doping level rose from 0 to 0.15. Calculated magnetic moments, μ cal, were found to drop from 9.4 to 9.02 μB as the nickel doping level changed from x = 0 to x = 0.15 in Er2−xNixO3 samples. Curie paramagnetic temperature (θ) for all samples has been observed to rise from −10.6 to −19.34. The theoretical gamma-ray attenuation parameters for nano Er2−xNixO3 samples were acquired through the Phy-X/PSD software. The nano Er2−xNixO3 samples have been proven to possess remarkable magnetic and neutron shielding applications.

Two-station Lg wave attenuation tomography in Eastern Asia

SUMMARY Utilizing over 31 000 Lg waveforms from 136 crustal earthquakes recorded at 346 regional stations, we conduct detailed tomographic mappings of the Lg Q structure across Eastern Asia in a frequency range from 0.5 to 4.0 Hz. By improving the standard two-station (TS) method, we effectively correct non-unity site response ratios using site responses estimated at individual stations. This innovative approach combines the flexible recording geometry of the TS method with the precision of reversed two-station (RTS) and reversed two-event (RTE) methods, producing a comprehensive data set devoid of source and site effects for Q tomography. To address unsolvable 3-D structural effects in the Lg spectral amplitude modelling, we justify these as modelling errors with a Gaussian distribution. This approach supports our SVD-based tomographic method, allowing for effective inversion of attenuation parameters and quantitative assessment of model resolution and errors. Our results reveal a complex relationship between Lg Q and the tectonic characteristics of Eastern Asia. In well-resolved regions, low Qo (1-Hz Q) values correspond to areas with high heat flow, partial melt, thick sediment and recent tectonic-thermal activities, in contrast to high Qo values in stable, ancient crusts lacking recent tectonic activity. Rift basins are characterized by low Lg Qo, whereas flexural basins generally have high Qo basements. We also note that post-formation factors, such as sedimentation and crustal flow intrusion, significantly impact Qo values. Furthermore, Lg Q shows a complex frequency relationship, though the power-law approximation with positive power η remains useful. The frequency dependence power η is inversely related to Qo: the regions with low Qo typically have high η and vice versa. This study provides reliable attenuation tomographic and relative site response models for Lg waves in Eastern Asia, pertinent for relative geophysical studies.