AIM: To study factors associated with nonalcoholic steatohepatitis (NASH) and advanced fibrosis, and medical treatment of biopsy-proven nonalcoholic fatty liver disease (NAFLD) patients.
METHODS: Retrospective study of biopsy-proven NAFLD patients from centres in the GO ASIA Workgroup. Independent factors associated with NASH and with advanced fibrosis on binary logistic regression analyses in a training cohort were used for the development of their corresponding risk score, which were validated in a validation cohort.
RESULTS: We included 1008 patients from nine centres across eight countries (NASH 62.9%, advanced fibrosis 17.2%). Independent predictors of NASH were body mass index ≥30 kg/m2 , diabetes mellitus, dyslipidaemia, alanine aminotransferase ≥88 U/L and aspartate aminotransferase ≥38 U/L, constituting the Asia Pacific NASH risk score. A high score has a positive predictive value of 80%-83% for NASH. Independent predictors of advanced fibrosis were age ≥55 years, diabetes mellitus and platelet count <150 × 109 /L, constituting the Asia-Pacific NAFLD advanced fibrosis risk score. A low score has a negative predictive value of 95%-96% for advanced fibrosis. Only 1.7% of patients were referred for structured lifestyle program, 4.2% were on vitamin E, and 2.4% were on pioglitazone.
CONCLUSIONS: More severe liver disease can be suspected or ruled out based on factors identified in this study. Utilisation of structured lifestyle program, vitamin E and pioglitazone was limited despite this being a cohort of biopsy-proven NAFLD patients with majority of patients having NASH.
RESULTS: A molecular phylogenetic analysis of the mitochondrial ORF and putative control region concurs with a haploweb analysis of nuclear ITS2 sequences in delimiting three species among our dataset: species A and B are found in Madagascar whereas species C occurs in Okinawa, the Philippines and New Caledonia. Comparison of ITS1 sequences from these three species with data available online suggests that species C is also found on the Great Barrier Reef, in Malaysia, in the South China Sea and in Taiwan, and that a distinct species D occurs in the Red Sea. Shallow-water morphs of species A correspond to the morphological description of Stylophora madagascarensis, species B presents the morphology of Stylophora mordax, whereas species C comprises various morphotypes including Stylophora pistillata and Stylophora mordax.
CONCLUSIONS: Genetic analysis of the coral genus Stylophora reveals species boundaries that are not congruent with morphological traits. Of the four hypotheses that may explain such discrepancy (phenotypic plasticity, morphological stasis, morphological convergence, and interspecific hybridization), the first two appear likely to play a role but the fourth one is rejected since mitochondrial and nuclear markers yield congruent species delimitations. The position of the root in our molecular phylogenies suggests that the center of origin of Stylophora is located in the western Indian Ocean, which probably explains why this genus presents a higher biodiversity in the westernmost part of its area of distribution than in the "Coral Triangle".
PURPOSE: The purpose is to describe the new species morphologically and molecularly and provide new information of its evolutionally relationships with other species of the subgenus.
METHODS: Standard methods of collection and examination of marine hosts, processing and illustrating of specimens, and taxonomic identification of parasites using the extensive collection of the lead author were used. Specimens were further studied using energy-dispersive X-ray analysis and ion sectioning of hooks, SEM analysis, and molecular sequencing. Type specimens were deposited at the Harold W. Manter Lab. collection, Lincoln, Nebraska.
RESULTS: Acanthogyrus (Acanthosentis) fusiformis n. sp. is described from the catfish, Arius sp. (Ariidae: Siluriformes) off the Pacific Coast of Vietnam at Bac Lieu in the Gulf of Thailand. The three other marine Indian species include A. (A.) arii Bilqees, 1971 which is also described from a similar catfish, Arius serratus Day off the Karachi coast in the Arabian Sea, Indian Ocean. Our new species from Vietnam is distinguished from the other 46 species by a combination of characters including a small fusiform trunk, complete circles of small hollow spines covering the entire trunk, prominent double apical organs often extending posteriorly past posterior hooks, middle and posterior hooks of equal size slightly smaller than anterior hooks, large neck continuous with the outline of the proboscis without distinct separation, big drop-shaped cephalic ganglion, extension of the proboscis receptacle anteriorly past the base of the proboscis up to the insertion point of the posterior hooks, presence of two para-receptacle structures (PRSs), free unattached thick lemnisci, short female reproductive system with filamentous attachment of the distal end of the uterine bell to the ventral body wall, and small narrowly ellipsoid eggs with thickened polar ends. Partial sequences of the 18S and internal transcribed spacers (ITS1-5.8S-ITS2) of ribosomal RNA were generated and used for phylogenetic analyses to confirm the taxonomic identity of Acanthogyrus (Acanthosentis) fusiformis n. sp.
CONCLUSIONS: We describe unique morphological features of A. fusiformis never before known in the subgenus Acanthosentis. The uniqueness of A. fusiformis is further demonstrated by its EDXA fingerprint characterized by high levels of calcium and phosphorous in hooks. The zoogeography of species of Acanthosentis is elucidated in the Indian subcontinent, the Caribbean, China, and Africa. Molecular data have been available only in few species of Acanthogyrus (Acanthosentis) to date on GenBank database. For 18S, only two sequences from unknown Acanthosentis sp. from India are available, while for the ITS1-5.8S-ITS2 region, only sequences of A. cheni from China and of two unidentified species from Malaysia are available. Additional studies of species of Acanthosentis based on morphological and molecular genetic data will be needed to reconstruct the evolutionary history and phylogenetic affinities of this group of acanthocephalans.
RESULTS: Phylogenetic analyses of the nuclear ribosomal internal transcribed spacer region based on materials collected from 17 populations in the Western Pacific and the Eastern Indian Ocean showed that some specimens identified as H. ovalis belonged to the H. major clade, also supported by morphological data. Evolutionary divergence between the two clades is between 0.033 and 0.038, much higher than the evolutionary divergence among H. ovalis populations. Eight haplotypes were found; none of the haplotypes from the Western Pacific is found in India and vice versa. Analysis of genetic diversity based on microsatellite analysis revealed that the genetic diversity in the Western Pacific is higher than in the Eastern Indian Ocean. The unrooted neighbor-joining tree among 14 populations from the Western Pacific and the Eastern Indian Ocean showed six groups. The Mantel test results revealed a significant correlation between genetic and geographic distances among populations. Results from band-based and allele frequency-based approaches from Amplified Fragment Length Polymorphism showed that all samples collected from both sides of the Thai-Malay peninsula were clustered into two clades: Gulf of Thailand and Andaman Sea.
CONCLUSIONS: Our study documented the new records of H. major for Malaysia and Myanmar. The study also revealed that the Thai-Malay peninsula is a geographic barrier between H. ovalis populations in the Western Pacific and the Eastern Indian Ocean.
METHODS: A structured questionnaire was mailed in 2008, 2011 and 2014 to senior medical physicists representing 23 countries. The questionnaire covers 7 themes: education and training including certification; staffing; typical tasks; professional organisations; resources; research and teaching; job satisfaction.
RESULTS: Across all surveys the response rate was >85% with the replies representing practice affecting more than half of the world's population. The expectation of ROMP qualifications (MSc and between 1 and 3years of clinical experience) has not changed much over the years. However, compared to 2008, the number of medical physicists in many countries has doubled. Formal professional certification is only available in a small number of countries. The number of experienced ROMPs is small in particular in low and middle income countries. The increase in staff numbers from 2008 to 2014 is matched by a similar increase in the number of treatment units which is accompanied by an increase in treatment complexity. Many ROMPs are required to work overtime and not many find time for research. Resource availability has only improved marginally and ROMPs still feel generally overworked, but professional recognition, while varying widely, appears to be improving slowly.
CONCLUSION: While number of physicists and complexity of treatment techniques and technologies have increased significantly, ROMP practice remains essentially unchanged over the last 6years in the Asia Pacific Region.