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Abstract Metabolic dysfunction-associated steatotic liver disease (MASLD) is common in individuals with obesity. Sexual dimorphism is present in MASLD. A noninvasive test to diagnose the severity of the disease, in particular the presence of Metabolic dysfunction-associated steatohepatitis (MASH), is lacking. This European multicenter prospective study uses a blood test based on mid-infrared (MIR) metabolic fingerprinting of individuals with severe or morbid obesity to diagnose MASH. Three hundred eighty-two individuals with severe or morbid obesity undergoing bariatric surgery were enrolled prospectively. Liver biopsies were obtained during surgery and assessed centrally. An algorithm was defined to calculate a score from the recorded MIR spectrum and to establish a diagnostic threshold to classify patients with MASH. Among the women (n = 217), MASH was diagnosed in 14.3% of cases. For women, the performance in terms of AUC were 0.83 and 0.82 in the calibration and validation groups, respectively. For a threshold of 0.1817, sensitivities were 86% and 70%, specificities were 81% and 75%, PPV were 43% and 32%, NPV were 97% and 94% and ACC were 82% and 74% for the calibration and validation groups, respectively. For men (n = 78; MASH: 33.3%), the performance of the spectral model was poor. The metabolic fingerprint obtained by MIR spectroscopy can rule out MASH in women with severe or morbid obesity. Its value in men needs new studies. Trial registration: ClinicalTrials.gov identifier: ClinicalTrials.gov identifier: NCT03978247 (04/06/2019)

BackgroundSymptom checker apps (SCA) aim to enable individuals without medical training to classify perceived symptoms and receive guidance on appropriate actions, such as self-care or seeking professional medical attention. However, there is a lack of detailed understanding regarding the contexts in which individuals use SCA and their opinions on these tools. ObjectiveThis mixed methods study aims to explore the circumstances under which medical laypeople use SCA and to identify which aspects users find noteworthy after using SCA. MethodsA total of 48 SCA users documented their medical symptoms, provided open-ended responses, and recorded their SCA use along with other variables over 6 weeks in a longitudinal study. Generalized linear mixed models with and those without regularization were applied to consider the hierarchical structure of the data, and the models’ outcomes were evaluated for comparison. Qualitative data were analyzed through Kuckartz qualitative content analysis. ResultsSignificant predictors of SCA use included the initial occurrence of symptoms, day of measurement (odds ratio [OR] 0.97), self-rated health (OR 0.80, P

Abstract Background Transforaminal epidural injections with steroids (TESI) are increasingly being used in patients sciatica. The STAR (steroids against radiculopathy)-trial aimed to evaluate the (cost-) effectiveness of TESI in patients with acute sciatica (

Abstract Oxide-derived copper (OD-Cu) materials exhibit extraordinary catalytic activities in the electrochemical carbon dioxide reduction reaction (CO2RR), which likely relates to non-metallic material constituents formed in transitions between the oxidized and the reduced material. In time-resolved operando experiment, we track the structural dynamics of copper oxide reduction and its re-formation separately in the bulk of the catalyst material and at its surface using X-ray absorption spectroscopy and surface-enhanced Raman spectroscopy. Surface-species transformations progress within seconds whereas the subsurface (bulk) processes unfold within minutes. Evidence is presented that electroreduction of OD-Cu foams results in kinetic trapping of subsurface (bulk) oxide species, especially for cycling between strongly oxidizing and reducing potentials. Specific reduction-oxidation protocols may optimize formation of bulk-oxide species and thereby catalytic properties. Together with the Raman-detected surface-adsorbed *OH and C-containing species, the oxide species could collectively facilitate *CO adsorption, resulting an enhanced selectivity towards valuable C2+ products during CO2RR.

Abstract Dietary polyunsaturated fatty acids (PUFA) are increasingly recognized for their health benefits, whereas a high production of endogenous fatty acids – a process called de novo lipogenesis (DNL) - is closely linked to metabolic diseases. Determinants of PUFA incorporation into complex lipids are insufficiently understood and may influence the onset and progression of metabolic diseases. Here we show that fatty acid synthase (FASN), the key enzyme of DNL, critically determines the use of dietary PUFA in mice and humans. Moreover, the combination of FASN inhibition and PUFA-supplementation decreases liver triacylglycerols (TAG) in mice fed with high-fat diet. Mechanistically, FASN inhibition causes higher PUFA uptake via the lysophosphatidylcholine transporter MFSD2A, and a diacylglycerol O-acyltransferase 2 (DGAT2)-dependent incorporation of PUFA into TAG. Overall, the outcome of PUFA supplementation may depend on the degree of endogenous DNL and combining PUFA supplementation and FASN inhibition might be a promising approach to target metabolic disease.

The deep ocean releases large amounts of old, pre-industrial carbon dioxide (CO2) to the atmosphere through upwelling in the Southern Ocean, which counters the marine carbon uptake occurring elsewhere. This Southern Ocean CO2 release is relevant to the global climate because its changes could alter atmospheric CO2 levels on long time scales, and also affects the present-day potential of the Southern Ocean to take up anthropogenic CO2. Here, year-round profiling float measurements show that this CO2 release arises from a zonal band of upwelling waters between the Subantarctic Front and wintertime sea-ice edge. This band of high CO2 subsurface water coincides with the outcropping of the 27.8 kg m-3 isoneutral density surface that characterizes Indo-Pacific Deep Water (IPDW). It has a potential partial pressure of CO2 exceeding current atmospheric CO2 levels (∆PCO2) by 175 ± 32 μatm. Ship-based measurements reveal that IPDW exhibits a distinct ∆PCO2 maximum in the ocean, which is set by remineralization of organic carbon and originates from the northern Pacific and Indian Ocean basins. Below this IPDW layer, the carbon content increases downwards, whereas ∆PCO2 decreases. Most of this vertical ∆PCO2 decline results from decreasing temperatures and increasing alkalinity due to an increased fraction of calcium carbonate dissolution. These two factors limit the CO2 outgassing from the high-carbon content deep waters on more southerly surface outcrops. Our results imply that the response of Southern Ocean CO2 fluxes to possible future changes in upwelling are sensitive to the subsurface carbon chemistry set by the vertical remineralization and dissolution profiles.

Summary: Insect physiology and reproduction depend on several terpenoid compounds, whose biosynthesis is mainly unknown. One enigmatic group of insect monoterpenoids are mealybug sex pheromones, presumably resulting from the irregular coupling activity of unidentified isoprenyl diphosphate synthases (IDSs). Here, we performed a comprehensive search for IDS coding sequences of the pest mealybug Planococcus citri. We queried the available genomic and newly generated short- and long-read P. citri transcriptomic data and identified 18 putative IDS genes, whose phylogenetic analysis indicates several gene family expansion events. In vitro testing confirmed regular short-chain coupling activity with five gene products. With the candidate with highest IDS activity, we also detected low amounts of irregular coupling products, and determined amino acid residues important for chain-length preference and irregular coupling activity. This work therefore provides an important foundation for deciphering terpenoid biosynthesis in mealybugs, including the sex pheromone biosynthesis in P. citri.

Despite the proliferation of coproduction concepts in various B2C contexts, knowledge on how coproduction shapes customer relationships is still surprisingly limited, as prior studies find mixed results and are bound to a short-term perspective. The present study addresses these limitations by providing first insights into the underlying psychological processes that explain differences in the short- and long-term relationship consequences of positive and negative coproduction perceptions. Drawing from the multiple inference model, this research shows how customers' ambivalent attributions of a firm's coproduction motives (i.e., firm-serving and customer-serving) affect customer satisfaction, willingness to pay, and spending behavior over time. The results of a latent growth analysis based on a longitudinal field study (n.sub.1 = 12,662; six waves) show that coproduction can harm customer relationships in the long-run, as the detrimental effects of firm-serving motive attributions are temporally more persistent than the favorable but ephemeral effects of customer-serving motive attributions. An additional experiment (n.sub.2 = 931) and field study (n.sub.3 = 360) confirm the generalizability of the key findings and provide new managerial insights into how firm-specific characteristics of a coproduction concept (i.e., coproduction intensity, design freedom, monetary savings) influence customer attributions different coproduction motives and thereby shape customer relationships over time., Author(s): Pascal Güntürkün [sup.1] , Till Haumann [sup.2] , Laura Marie Edinger-Schons [sup.3] , Jan Wieseke [sup.4] Author Affiliations: (1) grid.15788.33, 0000 0001 1177 4763, Department of Marketing, Vienna University [...]

As the climate warms, the grounded ice sheet and floating ice shelves surrounding Antarctica are melting and releasing additional freshwater into the Southern Ocean. Nonetheless, almost all existing coupled climate models have fixed ice sheets and lack the physics required to represent the dominant sources of Antarctic melt. These missing ice dynamics represent a key uncertainty that is typically unaccounted for in current global climate change projections. Previous modelling studies that have imposed additional Antarctic meltwater have demonstrated regional impacts on Southern Ocean stratification, circulation, and sea ice, as well as remote changes in atmospheric circulation, tropical precipitation, and global temperature. However, these previous studies have used widely varying rates of freshwater forcing, have been conducted using different climate models and configurations, and have reached differing conclusions on the magnitude of meltwater–climate feedbacks. The Southern Ocean Freshwater Input from Antarctica (SOFIA) initiative brings together a team of scientists to quantify the climate system response to Antarctic meltwater input along with key aspects of the uncertainty. In this paper, we summarize the state of knowledge on meltwater discharge from the Antarctic ice sheet and ice shelves to the Southern Ocean and explain the scientific objectives of our initiative. We propose a series of coupled and ocean–sea ice model experiments, including idealized meltwater experiments, historical experiments with observationally consistent meltwater input, and future scenarios driven by meltwater inputs derived from stand-alone ice sheet models. Through coordinating a multi-model ensemble of simulations using a common experimental design, open data archiving, and facilitating scientific collaboration, SOFIA aims to move the community toward better constraining our understanding of the climate system response to Antarctic melt.

Abstract Gallium-rich supported catalytically active liquid metal solutions (SCALMS) were recently introduced as a new way towards heterogeneous single atom catalysis. SCALMS were demonstrated to exhibit a certain resistance against coking during the dehydrogenation of alkanes using Ga-rich alloys of noble metals. Here, the conceptual catalytic application of SCALMS in dry reforming of methane (DRM) is tested with non-noble metal (Co, Cu, Fe, Ni) atoms in the gallium-rich liquid alloy. This study introduces SCALMS to high-temperature applications and an oxidative reaction environment. Most catalysts were shown to undergo severe oxidation during DRM, while Ga-Ni SCALMS retained a certain level of activity. This observation is explained by a kinetically controlled redox process, namely oxidation to gallium oxide species and re-reduction via H2 activation over Ni. Consequentially, this redox process can be shifted to the metallic side when using increasing concentrations of Ni in Ga, which strongly suppresses coke formation. Density-functional theory (DFT) based ab initio molecular dynamics (AIMD) simulations were performed to confirm the increased availability of Ni at the liquid alloy-gas interface. However, leaching of gallium via the formation of volatile oxidic species during the hypothesised redox cycles was identified indicating a critical instability of Ga-Ni SCALMS for prolonged test durations.

BackgroundDisorders of consciousness (DOC), i.e., unresponsive wakefulness syndrome (UWS) or vegetative state (VS) and minimally conscious state (MCS), are conditions that can arise from severe brain injury, inducing widespread functional changes. Given the damaging implications resulting from these conditions, there is an increasing need for rehabilitation treatments aimed at enhancing the level of consciousness, the quality of life, and creating new recovery perspectives for the patients. Music may represent an additional rehabilitative tool in contexts where cognition and language are severely compromised, such as among DOC patients. A further type of rehabilitation strategies for DOC patients consists of Non-Invasive Brain Stimulation techniques (NIBS), including transcranial electrical stimulation (tES), affecting neural excitability and promoting brain plasticity.ObjectiveWe here propose a novel rehabilitation protocol for DOC patients that combines music-based intervention and NIBS in neurological patients. The main objectives are (i) to assess the residual neuroplastic processes in DOC patients exposed to music, (ii) to determine the putative neural modulation and the clinical outcome in DOC patients of non-pharmacological strategies, i.e., tES(control condition), and music stimulation, and (iii) to evaluate the putative positive impact of this intervention on caregiver's burden and psychological distress.MethodsThis is a randomised cross-over trial in which a total of 30 participants will be randomly allocated to one of three different combinations of conditions: (i) Music only, (ii) tES only (control condition), (iii) Music + tES. The music intervention will consist of listening to an individually tailored playlist including familiar and self-relevant music together with fixed songs; concerning NIBS, tES will be applied for 20 minutes every day, 5 times a week, for two weeks. After these stimulations two weeks of placebo treatments will follow, with sham stimulation combined with noise for other two weeks. The primary outcomes will be clinical, i.e., based on the differences in the scores obtained on the neuropsychological tests, such as Coma Recovery Scale-Revised, and neurophysiological measures as EEG, collected pre-intervention, post-intervention and post-placebo.DiscussionThis study proposes a novel rehabilitation protocol for patients with DOC including a combined intervention of music and NIBS. Considering the need for rigorous longitudinal randomised controlled trials for people with severe brain injury disease, the results of this study will be highly informative for highlighting and implementing the putative beneficial role of music and NIBS in rehabilitation treatments.Trial registrationClinicalTrials.gov identifier: NCT05706831, registered on January 30, 2023.

Abstract The hydrological cycle is expected to intensify in a warming climate. However, observational evidence of such changes in the Southern Ocean is difficult to obtain due to sparse measurements and a complex superposition of changes in precipitation, sea ice, and glacial meltwater. Here we disentangle these signals using a dataset of salinity and seawater oxygen isotope observations collected in the Indian sector of the Southern Ocean. Our results show that the atmospheric water cycle has intensified in this region between 1993 and 2021, increasing the salinity in subtropical surface waters by 0.06 ± 0.07 g kg−1 per decade, and decreasing the salinity in subpolar surface waters by -0.02 ± 0.01 g kg−1 per decade. The oxygen isotope data allow to discriminate the different freshwater processes showing that in the subpolar region, the freshening is largely driven by the increase in net precipitation (by a factor two) while the decrease in sea ice melt is largely balanced by the contribution of glacial meltwater at these latitudes. These changes extend the growing evidence for an acceleration of the hydrological cycle and a melting cryosphere that can be expected from global warming.