Diet and lifestyle changes have led to worldwide increases in the prevalences of obesity and metabolic syndrome, resulting in substantially greater incidence of nonalcoholic fatty liver disease (NAFLD). NAFLD is considered a hepatic manifestation of metabolic syndrome and is related to diabetes, insulin resistance, central obesity, hyperlipidemia, and hypertension. Nonalcoholic steatohepatitis (NASH) is an entity that describes liver inflammation due to NAFLD. Growing evidence suggests that NAFLD is a multisystem disease with a clinical burden that is not only confined to liver-related morbidity and mortality, but that also affects several extra-hepatic organs and regulatory pathways. Thus, NAFLD is considered an important public health issue, but there is currently no effective therapy for all NAFLD patients in the general population. Studies seeking optimal therapy for NAFLD and NASH have not yet led to development of a universal protocol for treating this growing problem. Several pharmacological agents have been studied in an effort to improve insulin resistance and the proinflammatory mediators that may be responsible for NASH progression. Cardiovascular risk factors are highly prevalent among NASH patients, and the backbone of treatment regimens for these patients still comprises general lifestyle interventions, including dietary changes and increased physical activity. Vitamin E and thiazolidinedione derivatives are currently the most evidence-based therapeutic options, but only limited clinical evidence is available regarding their long-term efficacy and safety. Vitamin D and renin–angiotensin–aldosterone system blockers are promising drugs that are currently being intensively investigated for use in NAFLD/NASH patients.
In order to solve mathematical problems, students often need to make the transition from one representation of mathematical concepts in those problem formulations to another representation. In this paper we explore the influence of the representations used in the problem formulation (problems with the same mathematical background with regards to solving easier or more complex equations and determining the unknown value of the proportion) on students' success in solving those problems. On a representative sample of 584 8th grade students, we tested whether there were differences in students' success in solving mathematical problems while using symbolic, graphic, or verbal representations in the formulations of problems belonging to different level of complexity. Results of this research indicate that there is significant impact of the representations of mathematical concepts used in problem formulation on students' success. Furthermore, the level of impact of using different representations in problem formulations depends on the level of the problem complexity when it comes to students' success in solving those problems.
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