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Obesity Insulin Resistance And Cardiovascular Disease

Abdominal Obesity, Insulin Resistance, And Cardiovascular Risk In Pre-diabetes And Type 2 Diabetes

Abdominal Obesity, Insulin Resistance, And Cardiovascular Risk In Pre-diabetes And Type 2 Diabetes

Abdominal obesity, insulin resistance, and cardiovascular risk in pre-diabetes and type 2 diabetes Article in European Heart Journal Supplements 8(Suppl B)May 2006 with 5 Reads Cardiovascular (CV) disease remains the leading source of premature mortality in western populations. There is an increasing prevalence of obesity, particularly abdominal obesity. Nine states in the USA now report a prevalence of obesity [body mass index (BMI) >30 kg/m2] of 25% or more, and the prevalence of abdominal obesity (waist circumference >102 cm for men and 88 cm for women) has increased by 20% in men and 14% in women in a single decade. The intra-abdominal adiposity associated with abdominal obesity increases cardiometabolic risk directly, via altered secretion of adipokines, and indirectly, via promotion insulin resistance, diabetes and the cluster of cardiometabolic risk factors associated with the metabolic syndrome. Patients with type 2 diabetes, or subjects with pre-diabetic dysglycaemia are at greater risk of CV events, compared with normoglycaemic subjects. A large and growing body of evidence indicates that abdominal obesity is a more powerful predictor of adverse CV outcomes than BMI. Measurement of waist circumference as an index of intra-abdominal adiposity should be included in routine evaluations of overall cardiometabolic risk. The European Society of Cardiology 2006. All rights reserved. Do you want to read the rest of this article? ... Abdominal obesity specifically refers to increased accumulation of adipose tissue in the visceral intra-abdominal region. Mounting evidence suggests that abdominal obesity is a more powerful contributor to the pathogenesis of cardiovascular disease than body mass index (BMI)[2]. Abdominal obesity is associated with an increased risk of in Continue reading >>

Insulin Resistance And Cardiovascular Disease

Insulin Resistance And Cardiovascular Disease

INSULIN RESISTANCE describes an impaired biological response to insulin ( 1 4 ). In the early states of insulin resistance there is a compensatory increase in insulin concentrations. Although hyperinsulinemia may compensate for resistance to some biological actions of insulin, it may result in overexpression of actions in tissues that retain normal or minimally impaired sensitivity to insulin. Also, high concentrations of insulin can act through receptors for insulin-like growth factor I (IGF-I) ( 5 8 ). Thus, accentuation of some actions of insulin with concurrent resistance to other actions gives rise to diverse clinical manifestations and sequelae of the insulin resistance syndrome. In general, insulin resistance can be due to a prereceptor, receptor, or postreceptor abnormality ( 1 ). One signaling pathway for insulin and IGF-I is the phosphatidylinositide 3-kinase (PI3 -kinase) system. Upon binding to their receptors, there is autophosphorylation of the -subunit, which mediates noncovalent but stable interactions between the receptor and cellular proteins ( 1 ). Several proteins are then rapidly phosphorylated on tyrosine residues by ligand-bound insulin receptors, including insulin receptor substrate-1 (IRS-1) ( 1 ). IRS docking proteins bind strongly to the enzyme PI3 -kinase ( 1 ), a heterodimer consisting of a p85 regulatory subunit and a p110 catalytic subunit, via SH-2 domain interaction with the p85 subunit ( 1 ). Insulin and IGF-I stimulation increases the amount of PI3 -kinase associated with IRS, and the binding process is associated with increased activity of the enzyme. Activation of the enzyme is crucial for transducing the actions of these peptides in cardiovascular (CV) tissue ( 9 14 ) as well as conventional insulin-sensitive tissues ( 1 ). The int Continue reading >>

Adrenal Cortisol Hyper-responsiveness As A Possible Cause Of Obesity, Insulin Resistance And Cardiovascular Risk

Adrenal Cortisol Hyper-responsiveness As A Possible Cause Of Obesity, Insulin Resistance And Cardiovascular Risk

concentrations due to endogenous over-secretion or exogenous administration result in obesity, insulin resistance, and increased risk of cardiovascular disease (CVD). We wanted to assess whether non pathological adrenal hyper responsiveness to ACTH could reproduce these changes and thus explain how stress, via the pituitary-adrenal axis, can also cause such abnormalities. Methods: ACTH stimulation test was performed on 1072 non diabetic healthy participants in the St. Francis Heart Study and multiple blood tests, anthropometric measurements and coronary calcium scores were also obtained. Results: Post stimulation cortisol concentrations were correlated with obesity, insulin resistance, lipid abnormalities, Framingham scores (all p 0.01), but not with blood pressure and not with coronary calcium scores. In multivariate models, increased cortisol secretion was significantly predictive of even after controlling for insulin resistance, and of insulin resistance even after controlling for abdominal fat. Conclusions: Adrenal hyper responsiveness may explain some of the observation of the relationship between stress and the metabolic abnormalities which can lead to CVD. Increased cortisol secretion predicts insulin resistance and Cortisol ; Glucose; Insulin; Obesity; Lipids; ACTH; Adrenal glands ; HOMA Insulin resistance, central adiposity, hypertension and lipid abnormalities, sometimes combined in the term the metabolic syndrome [ 1 - 3 ], predispose to future risk of diabetes mellitus type II and are independent risk factors for cardiovascular diseas e [ 4 ]. The cause(s) of the metabolic syndrome and its components is unknown. Many of the metabolic abnormalities resemble a milder form of the metabolic derangements seen in Cushings syndrome. However, almost none of these p Continue reading >>

Obesity, Insulin Resistance And The Metabolic Syndrome

Obesity, Insulin Resistance And The Metabolic Syndrome

MD, Professor, Department of Pediatrics, University of Minnesota, Twin Cities, MN, USA There has been a remarkable increase in interest during the past two decades in the relation between cardiovascular risk factors in children and the development of arteriosclerotic cardiovascular disease (ASCVD) and type 2 diabetes in adulthood. Initial studies concentrated on individual factors such as lipids and blood pressure. However, as research in this area has evolved and pediatricians have followed the lead of their colleagues in internal medicine, attention has turned to broader considerations of risk and, in particular, to obesity, insulin resistance and the metabolic syndrome. It is not surprising that these studies are affirming the concept that the roots of ASCVD and type 2 diabetes extend back into childhood. The relation of obesity to ASCVD in adults is well known. Although children and adolescents do not have overt ASCVD, obese children have a cardiovascular risk profile consistent with its early development, i.e., significantly higher blood pressure, triglycerides and fasting insulin and significantly lower HDL-C.1 Moreover, the degree of risk increases with increasing obesity.2 The result is early deposition of fatty streaks and plaque in adolescent coronary arteries,3 and the outcome in adulthood is an increased incidence of premature cardiovascular and all-cause mortality in individuals who were obese adolescents.4 Despite a perception in the general population that overweight children tend to become thinner as they go through adolescence and maintain the thinness as they become young adults, longitudinal growth studies have shown a highly significant (r = 0.61) correlation in body mass index (BMI) between ages 7 and 24, and have further shown that BMI at age 7 pr Continue reading >>

Adipocyte Biology, Insulin Resistance And Cardiovascular Disease

Adipocyte Biology, Insulin Resistance And Cardiovascular Disease

Adipocyte Biology, Insulin Resistance and Cardiovascular Disease Adipocyte Biology, Insulin Resistance and Cardiovascular Disease Academic site: Medicine, St Vincent's Hospital, Eastern Hill Campus This project is in the field of metabolism focused on the interaction of obesity, insulin resistance, diabetes and cardiovascular disease (CVD). There is extensive animal and epidemiological evidence to support links between obesity and CVD, however there is relatively limited data about the exact nature of this relationship particularly related to the specific role of the adipocyte. One area that is not well understood is adipocyte function in vivo and how it relates to measures of whole body insulin sensitivity, particularly in those with CVD. There is also hypothesized to be a difference in adipocyte biology between central and peripheral adipocytes although this has not been well shown in humans. Thus, we aim to measure whole body insulin sensitivity in patients with CVD and to relate these findings to adipocyte function in human subjects. Hypotheses: That whole body insulin sensitivity will relate to adipocyte structure and AMP-activated protein kinase expression in patients with CVD. That central and peripheral adipocytes will have distinct phenotypes in patients with and without IR. That vascular function in vessels from insulin resistant animals and humans will be abnormal. The aims are to compare insulin sensitivity in patients with CVD and markers of adipocyte structure and function in adipose tissue from a range of sites including central and peripheral fat as well as muscle, a key site of insulin and glucose metabolism and to assess vascular function in vitro in tissues from insulin resistant animals and humans. Techniques: Immunohistochemistry, molecular biology Continue reading >>

The Relative Effects Of Obesity And Insulin Resistance On Cardiovascular Risk Factors In Nondiabetic And Normotensive Men

The Relative Effects Of Obesity And Insulin Resistance On Cardiovascular Risk Factors In Nondiabetic And Normotensive Men

DOI: The Relative Effects of Obesity and Insulin Resistance on Cardiovascular Risk Factors in Nondiabetic and Normotensive Men Seung Ha Park , Won Young Lee , Yong Su Lee , Eun Jung Rhee , Sun Woo Kim Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea Correspondence to: Won Young Lee, M.D., Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine 108, Pyung-Dong, Jongno-ku, Seoul, Korea, Tel: 82-2-2001-2075, Fax: 82-2-2001-2049, E-mail: [email protected] Copyright 2004 The Korean Association of Internal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( ) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Several reports have documented that Asians have a strong tendency to develop insulin resistance. The aims of this study were to evaluate the relative effects of insulin resistance and obesity on the risk factors for coronary heart disease (CHD) and to clarify whether insulin resistance accentuates these effects in apparently healthy men. We conducted a cross sectional survey on 4,067 apparently healthy Korean men, aged between 20 and 83 years, with body mass indices (BMI) ranging from 15.19 to 40.29 kg/m2. The presence of insulin resistance was defined as a homeostasis model assessment (HOMA-IR) value >2.23, which is the cutoff for the highest decile in the normal BMI group (BMI <23 kg/m2; 1,438 subjects). The prevalence of insulin resistance was 24.7% in the overweight subjects (23BMI<25 kg/m2; 1,259 subjects) and 43.9% in the obese subjects (BMI25 kg/m2; 1,370 subjects). The BMI was identified a Continue reading >>

Obesity, Insulin Resistance, And Cardiovascular Disease.

Obesity, Insulin Resistance, And Cardiovascular Disease.

Obesity, insulin resistance, and cardiovascular disease. School of Medicine, Stanford University, Stanford, California 94305, USA. The ability of insulin to stimulate glucose disposal varies more than six-fold in apparently healthy individuals. The one third of the population that is most insulin resistant is at greatly increased risk to develop cardiovascular disease (CVD), type 2 diabetes, hypertension, stroke, nonalcoholic fatty liver disease, polycystic ovary disease, and certain forms of cancer. Between 25-35% of the variability in insulin action is related to being overweight. The importance of the adverse effects of excess adiposity is apparent in light of the evidence that more than half of the adult population in the United States is classified as being overweight/obese, as defined by a body mass index greater than 25.0 kg/m(2). The current epidemic of overweight/obesity is most-likely related to a combination of increased caloric intake and decreased energy expenditure. In either instance, the fact that CVD risk is increased as individuals gain weight emphasizes the gravity of the health care dilemma posed by the explosive increase in the prevalence of overweight/obesity in the population at large. Given the enormity of the problem, it is necessary to differentiate between the CVD risk related to obesity per se, as distinct from the fact that the prevalence of insulin resistance and compensatory hyperinsulinemia are increased in overweight/obese individuals. Although the majority of individuals in the general population that can be considered insulin resistant are also overweight/obese, not all overweight/obese persons are insulin resistant. Furthermore, the cluster of abnormalities associated with insulin resistance - namely, glucose intolerance, hyperinsuli Continue reading >>

Nutrients | Free Full-text | Lysophosphatidic Acid Signaling In Obesity And Insulin Resistance

Nutrients | Free Full-text | Lysophosphatidic Acid Signaling In Obesity And Insulin Resistance

Nutrients 2018, 10(4), 399; doi: 10.3390/nu10040399 Lysophosphatidic Acid Signaling in Obesity and Insulin Resistance Department of Biochemistry and Molecular Biology, Faculty of Medicine, Dalhousie University, Dalhousie Medicine New Brunswick, Saint John, NB, E2L 4L5 Canada Author to whom correspondence should be addressed. Received: 31 January 2018 / Revised: 13 March 2018 / Accepted: 20 March 2018 / Published: 23 March 2018 Although simple in structure, lysophosphatidic acid (LPA) is a potent bioactive lipid that profoundly influences cellular signaling and function upon binding to G protein-coupled receptors (LPA1-6). The majority of circulating LPA is produced by the secreted enzyme autotaxin (ATX). Alterations in LPA signaling, in conjunction with changes in autotaxin (ATX) expression and activity, have been implicated in metabolic and inflammatory disorders including obesity, insulin resistance, and cardiovascular disease. This review summarizes our current understanding of the sources and metabolism of LPA with focus on the influence of diet on circulating LPA. Furthermore, we explore how the ATX-LPA pathway impacts obesity and obesity-associated disorders, including impaired glucose homeostasis, insulin resistance, and cardiovascular disease. View Full-Text Continue reading >>

Insulin Resistance And Cardiovascular Disease

Insulin Resistance And Cardiovascular Disease

Insulin resistance and cardiovascular disease Department of Medicine, Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, New York 10032, USA. Phone: (212) 305-9562 ext. 69562; Fax: (212) 305-3213; E-mail: [email protected] . Copyright 2000, American Society for Clinical Investigation This article has been cited by other articles in PMC. Insulin resistance means different things to different people. As other Perspectives in this series make clear, insulin resistance can be seen as a molecular and genetic mystery involving defective insulin signaling and glucose transport into cells. To me, on the other hand, insulin resistance represents a major underlying abnormality driving cardiovascular disease, the major cause of morbidity and mortality in much of the world. Because most of the work on insulin resistance has focused on its role in the pathophysiology of type 2 diabetes mellitus, a brief review of the history of the link between cardiovascular disease and insulin resistance is in order. Margaret Albrink was probably the first investigator to identify a cluster of factors, including obesity and hypertriglyceridemia, that was associated with increased risk for coronary artery disease (CAD) ( 1 ). The groundbreaking development of the insulin radioimmunoassay by Berson and Yalow, and the subsequent observation that many diabetics were actually hyperinsulinemic, enabled Albrink and others, including Reaven and Farquhar and their colleagues ( 2 ), to begin to define the insulin resistance syndrome and its links to both hypertriglyceridemia and CAD. The next decades brought several prospective cohort studies in which hyperinsulinemia was often associated with CAD, at first in univariate and more recently in multivariate analyses. Thes Continue reading >>

Obesity, Insulin Resistance, Diabetes, And Cardiovascular Risk In Children

Obesity, Insulin Resistance, Diabetes, And Cardiovascular Risk In Children

This statement was reviewed by the American Diabetes Association. The recommendations contained herein are consistent with the American Diabetes Association’s Clinical Practice Recommendations. Atherosclerotic cardiovascular disease is the No. 1 killer in the adult population of Western societies,1 but the pathological processes and risk factors associated with its development have been shown to begin during childhood.2 Obesity plays a central role in the insulin resistance syndrome, which includes hyperinsulinemia, hypertension, hyperlipidemia, type 2 diabetes mellitus, and an increased risk of atherosclerotic cardiovascular disease. The incidence of type 2 diabetes reported in children has increased alarmingly.3,4 Resistance of the body to the actions of insulin results in increased production of this hormone by the pancreas and ensuing hyperinsulinemia. Obesity beginning in childhood often precedes the hyperinsulinemic state. Other components of the insulin resistance syndrome are also present in children and adolescents.5,6 An association between obesity and insulin resistance has been reported in the young, as has the link between insulin resistance, hypertension, and abnormal lipid profile. There is an increasing amount of data showing that being overweight during childhood and adolescence is significantly associated with insulin resistance, dyslipidemia, and elevated blood pressure in young adulthood. Weight loss by obese youngsters results in a decrease in insulin concentration and improvement in insulin sensitivity. Moreover, it has been determined that increased left ventricular mass, which is an independent risk factor for cardiovascular disease in adults, is present in childhood. Recent research has found that left ventricular hypertrophy is related to oth Continue reading >>

Roles Of The Chemokine System In Development Of Obesity, Insulin Resistance, And Cardiovascular Disease

Roles Of The Chemokine System In Development Of Obesity, Insulin Resistance, And Cardiovascular Disease

Roles of the Chemokine System in Development of Obesity, Insulin Resistance, and Cardiovascular Disease Cardiovascular Biology Program, Oklahoma Medical Research Foundation, 825 NE 13th Street, Oklahoma City, OK 73104, USA Received 14 December 2013; Accepted 4 February 2014; Published 16 March 2014 Copyright 2014 Longbiao Yao et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The escalating epidemic of obesity has increased the incidence of obesity-induced complications to historically high levels. Adipose tissue is a dynamic energy depot, which stores energy and mobilizes it during nutrient deficiency. Excess nutrient intake resulting in adipose tissue expansion triggers lipid release and aberrant adipokine, cytokine and chemokine production, and signaling that ultimately lead to adipose tissue inflammation, a hallmark of obesity. This low-grade chronic inflammation is thought to link obesity to insulin resistance and the associated comorbidities of metabolic syndrome such as dyslipidemia and hypertension, which increase risk of type 2 diabetes and cardiovascular disease. In this review, we focus on and discuss members of the chemokine system for which there is clear evidence of participation in the development of obesity and obesity-induced pathologies. More than 35% of adults and almost 17% of youth in the United States were reported to be obese in 2012 ( ). Obesity is an independent risk factor for metabolic disorders including insulin resistance, type 2 diabetes, hypertension, adverse plasma lipid concentrations, and cardiovascular disease (Figure 1 ) [ 1 ]. Given the high prevalence of obesity Continue reading >>

Insulin Resistance: Risk Factor For Heart Disease And Diabetes

Insulin Resistance: Risk Factor For Heart Disease And Diabetes

MORE Insulin resistance is a metabolic disorder that occurs when the body's cells cannot properly intake insulin. Insulin, which is produced in the pancreas, is a hormone that helps the body use energy from blood glucose, or blood sugar from digested food, according to the National Institute of Diabetes and Digestive and Kidney Diseases. "Think of insulin as the key that unlocks the door to their cells. That door needs to be opened in order for glucose to exit the blood into the cell," said Kimber Stanhope, a nutrition research scientist at the University of California at Davis. When people are insulin resistant, their pancreas, which acts as the locksmith of sorts, is still making those "keys," but the locks — the receptors on cells that take in blood sugar — aren't working as well as they should, Stanhope said. That’s a problem because insulin doesn't just play a role in helping the body use blood sugar as fuel; it's critical for many other bodily processes as well. Being insulin resistant can put people on the path towards developing Type 2 diabetes, and is the single best predictor of who will develop diabetes 10 or 20 years down the line. Once someone is pre-diabetic or diabetic, the pancreas simply can't produce enough insulin to make the cells sufficiently take up glucose and blood sugar levels rise. Insulin resistance also raises the risk of other disorders, such as heart disease. More than 50 million Americans have metabolic disorders that include insulin resistance, according to the American Heart Association. The condition occurs in more than 50 percent of obese children, according to a 2006 study published in the journal Diabetes Care. Causes One of the primary causes of insulin resistance is excess body fat, Stanhope said. "Nearly everybody that is ov Continue reading >>

Abdominal Obesity, Insulin Resistance, And Cardiovascular Risk In Pre-diabetes And Type 2 Diabetes

Abdominal Obesity, Insulin Resistance, And Cardiovascular Risk In Pre-diabetes And Type 2 Diabetes

Abdominal obesity, insulin resistance, and cardiovascular risk in pre-diabetes and type 2 diabetes Department of Medicine, Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284-7873, USA Corresponding author. Tel: +1 210 567 4722; fax: +1 210 567 6955. E-mail address: [email protected] Search for other works by this author on: European Heart Journal Supplements, Volume 8, Issue suppl_B, 1 May 2006, Pages B20B25, Steven M. Haffner; Abdominal obesity, insulin resistance, and cardiovascular risk in pre-diabetes and type 2 diabetes, European Heart Journal Supplements, Volume 8, Issue suppl_B, 1 May 2006, Pages B20B25, Cardiovascular (CV) disease remains the leading source of premature mortality in western populations. There is an increasing prevalence of obesity, particularly abdominal obesity. Nine states in the USA now report a prevalence of obesity [body mass index (BMI) >30 kg/m2] of 25% or more, and the prevalence of abdominal obesity (waist circumference >102 cm for men and 88 cm for women) has increased by 20% in men and 14% in women in a single decade. The intra-abdominal adiposity associated with abdominal obesity increases cardiometabolic risk directly, via altered secretion of adipokines, and indirectly, via promotion insulin resistance, diabetes and the cluster of cardiometabolic risk factors associated with the metabolic syndrome. Patients with type 2 diabetes, or subjects with pre-diabetic dysglycaemia are at greater risk of CV events, compared with normoglycaemic subjects. A large and growing body of evidence indicates that abdominal obesity is a more powerful predictor of adverse CV outcomes than BMI. Measurement of waist circumference as an index of intra-abdominal adipos Continue reading >>

Cardiovascular Disease & Diabetes

Cardiovascular Disease & Diabetes

The following statistics speak loud and clear that there is a strong correlation between cardiovascular disease (CVD) and diabetes. At least 68 percent of people age 65 or olderwith diabetes die from some form of heart disease; and 16% die of stroke. Adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes. The American Heart Association considers diabetes to be one of theseven major controllable risk factors for cardiovascular disease. Why are people with diabetes at increased risk for CVD? Diabetes is treatable, but even when glucose levels are under control it greatly increases the risk of heart disease and stroke. That's because people with diabetes, particularly type 2 diabetes,may have the following conditions that contribute to their risk for developing cardiovascular disease. High blood pressure has long been recognized as a major risk factor for cardiovascular disease. Studies report a positive association between hypertension and insulin resistance. When patients have both hypertension and diabetes, which is a common combination, their risk for cardiovascular disease doubles. Abnormal cholesterol and high triglycerides Patients with diabetes often have unhealthy cholesterol levels including high LDL ("bad") cholesterol, low HDL ("good") cholesterol, and high triglycerides. This triad of poor lipid counts often occurs in patients with premature coronary heart disease. It is also characteristic of a lipid disorder associated with insulin resistance called atherogenic dyslipidemia, or diabetic dyslipidemia in those patients with diabetes. Learn more about cholesterol abnormalities as they relate to diabetes. Obesity is a major risk factor for cardiovascular disease and has been strongly associated with insulin Continue reading >>

Evolutionary Aspects Of Obesity, Insulin Resistance, And Cardiovascular Risk

Evolutionary Aspects Of Obesity, Insulin Resistance, And Cardiovascular Risk

Evolutionary Aspects of Obesity, Insulin Resistance, and Cardiovascular Risk Cardiovascular disease (CVD) is still virtually absent in those rare populations with minimal Western dietary influence. To date, exercise, altered fats, fibre, anti-oxidants or Mediterranean diet do not appear to overcome the discrepancy in CVD between hunter-gatherer and Western populations. The CVD risk factors of obesity and diabetes are driven by increased caloric intake, with carbohydrates potentially implicated. Paradoxically, non-Westernized diets vary widely in macronutrients, glycemic and insulinemic indices, yet apparently produce no obesity or CVD regardless, even with abundant food. 'Ancestral' grain-free whole-food diet may represent the best lifestyle intervention for obesity and CVD. Such diets are composed of the cells of living organisms, while Western grains, flour and sugar are dense, acellular powders. Bacterial inflammation of the small intestine and vagal afferents appears a crucial step in leptin-resistance and obesity. Therefore it may be important that the Western diet resembles a bacterial growth medium. 2018 Digital Science & Research Solutions, Inc. All Rights Reserved | About us Privacy policy Legal terms VPAT Citation Count is the number of times that this paper has been cited by other published papers in the database. The Altmetric Attention Score is a weighted count of all of the online attention Altmetric have found for an individual research output. This includes mentions in public policy documents and references in Wikipedia, the mainstream news, social networks, blogs and more. More detail on the weightings of each source and how they contribute to the attention score is available here . The Relative Citation Ratio (RCR) indicates the relative citation perf Continue reading >>

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