Aim: Hepatic fibrosis is associated with various factors, including metabolic dysfunction-associated fatty liver disease (MAFLD), insulin resistance, and alcohol intake in patients with morbid obesity. We investigated factors directly associated with hepatic fibrosis in patients with morbid obesity using a graphical model. Methods:We enrolled 134 consecutive patients with morbid obesity who underwent liver biopsy during sleeve gastrectomy (median age 43.5 years; MAFLD 78.4%; homeostasis model assessment of insulin resistance [HOMA-IR] 5.97; >20 g/day alcohol intake 14.2%). Patients were classified into none/mild (F0/1; n = 77) or significant/advanced fibrosis (F2/3; n = 57) groups, based on histology. Factors associated with F2/3 were analyzed using logistic regression analysis and a graphical model.Results: F2/3 was observed in 42.5% of the enrolled patients. The prevalence of MAFLD and HOMA-IR values were significantly higher in the F2/3 group than in the F0/1 group; however, no significant difference in alcohol intake was observed between the two groups. On logistic regression analysis, MAFLD, but not HOMA-IR or alcohol intake, was the only independent factor associated with F2/3 (odds ratio

Fatty liver is known to be associated with extra-hepatic diseases including atherosclerotic cardiovascular disease and extra-hepatic cancers, which affect the prognosis and quality of life of the patients. The inter-organ crosstalk is mediated by metabolic abnormalities such as insulin resistance and visceral adiposity. Recently, metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed as a new definition for fatty liver. MAFLD is characterized by the inclusion criteria of metabolic abnormality. Therefore, MAFLD is expected to identify patients at high risk of extra-hepatic complications. In this review, we focus on the relationships between MAFLD and multi-organ diseases. We also describe the pathogenic mechanisms of the inter-organ crosstalk.

We tested treatement with UV irradiation for controlling the growth of bread mold. First, we analyzed the sterilizing effect of a dose of approximately 25 mJ/cm 2 radiation on nine Penicillium and two Talaromyces strains that were isolated from a bread-manufacturing plant. The P. chermesinum and P. paneum strains were sterilized completely at that dose, while it was only partially effective against P. corylophilum. P. chrysogenum and P. decumbens were sterilized at a dose of approximately 120 mJ/cm 2 , while T. amestolkiae was sterilized at approximately 150 mJ/cm 2. Sterilization of T. cecidicola and P. hispanicum required more than 200 mJ/cm 2 of radiation. These results suggest that UV resistance varies depending on the species and the strains. We also carried out UV irradiation of bread at 70 mJ/cm 2 : a dose at which the taste of bread is not affected; we observed that mold growth was delayed visibly compared to the non-irradiated bread. These results suggest that UV irradiation at 70 mJ/cm 2 is effective at delaying mold growth, though it does not cause complete sterilization. This method should prove useful for extending the shelf-life of bread.

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