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In this report from the Swedish Obese Subjects study, the rate of incident type 2 diabetes in usual-care and bariatric-surgery groups was 28.4 and 6.8 cases per 1000 person-years, respectively. These findings suggest that surgery is much more efficient than usual care. Multiple studies have shown associations between obesity and type 2 diabetes 1 – 6 and between changes in body weight and incident type 2 diabetes. 7 , 8 It is also well established that the worldwide increase in obesity is associated with an increase in the prevalence of type 2 diabetes. 9 Currently, 285 million people have type 2 diabetes, and this number is predicted to increase to 439 million by 2030. 10 Among persons in a prediabetic state, the incidence of type 2 diabetes is reduced by approximately 40 to 45% with effective lifestyle changes or drug treatment, 11 – 15 and the effects persist, in part, . . .

Alzheimer’s disease (AD) is the most common form of dementia. However, the etiopathogenesis of this devastating disease is not fully understood. Recent studies in rodents suggest that alterations in the gut microbiome may contribute to amyloid deposition, yet the microbial communities associated with AD have not been characterized in humans. Towards this end, we characterized the bacterial taxonomic composition of fecal samples from participants with and without a diagnosis of dementia due to AD. Our analyses revealed that the gut microbiome of AD participants has decreased microbial diversity and is compositionally distinct from control age- and sex-matched individuals. We identified phylum- through genus-wide differences in bacterial abundance including decreased Firmicutes, increased Bacteroidetes, and decreased Bifidobacterium in the microbiome of AD participants. Furthermore, we observed correlations between levels of differentially abundant genera and cerebrospinal fluid (CSF) biomarkers of AD. These findings add AD to the growing list of diseases associated with gut microbial alterations, as well as suggest that gut bacterial communities may be a target for therapeutic intervention.

Billingham UK, where Mike Spencer spent his entire industrial career, has long been associated with the use of steam reforming for the production of synthesis gas required for the manufacture of some important chemicals, particularly ammonia and methanol. This paper describes the steam reforming process and presents some of the history of the development of tubular reforming. The catalysts, technology and industrial operation of plants are briefly reviewed. Newer technologies, such as adiabatic reforming, autothermal reforming (ATR) and gas heated reforming (GHR) that aim to increase efficiency of and reduce the environmental impact of conventional steam reforming processes are presented.

Brain changes associated with Alzheimer's disease (AD) begin decades before disease diagnosis. While β-amyloid plaques and neurofibrillary tangles are defining features of AD, neuronal loss and synaptic pathology are closely related to the cognitive dysfunction. Brain imaging methods that are tuned to assess degeneration of myelinated nerve fibers in the brain (collectively called white matter) include diffusion tensor imaging (DTI) and related techniques, and are expected to shed light on disease-related loss of structural connectivity. Participants (N = 70, ages 47-76 years) from the Wisconsin Registry for Alzheimer's Prevention study underwent DTI and hybrid diffusion imaging to determine a free-water elimination (FWE-DTI) model. The study assessed the extent to which preclinical AD pathology affects brain white matter. Preclinical AD pathology was determined using cerebrospinal fluid (CSF) biomarkers. The sample was enriched for AD risk (APOE ε4 and parental history of AD). AD pathology assessed by CSF analyses was significantly associated with altered microstructure on both DTI and FWE-DTI. Affected regions included frontal, parietal, and especially temporal white matter. The f-value derived from the FWE-DTI model appeared to be the most sensitive to the relationship between the CSF AD biomarkers and microstructural alterations in white matter. These findings suggest that white matter degeneration is an early pathological feature of AD that may have utility both for early disease detection and as outcome measures for clinical trials. More complex models of microstructural diffusion properties including FWE-DTI may provide increased sensitivity to early brain changes associated with AD over standard DTI.

The prospective, controlled Swedish Obese Subjects study enrolled 4047 subjects who either underwent bariatric surgery or received conventional treatment. The results of follow-up for up to 15 years suggest that bariatric surgery for severe obesity is associated with long-term weight loss and decreased overall mortality. The results suggest that bariatric surgery for severe obesity is associated with long-term weight loss and decreased overall mortality. In the United States from 1980 through 2004, the prevalence of obesity — defined as a body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) of 30 or more — doubled, rising to include more than 30% of the population. 1 , 2 The majority of large and long-term epidemiologic studies have indicated that obesity is associated with increased mortality. 3 – 9 The life expectancy of severely obese persons is reduced by an estimated 5 to 20 years. 10 Weight loss is known to be associated with improvement of intermediate risk factors for disease, 11 suggesting that weight . . .

In the lower solar atmosphere, the chromosphere is permeated by jets known as spicules, in which plasma is propelled at speeds of 50 to 150 kilometers per second into the corona. The origin of the spicules is poorly understood, although they are expected to play a role in heating the million-degree corona and are associated with Alfvénic waves that help drive the solar wind. We compare magnetohydrodynamic simulations of spicules with observations from the Interface Region Imaging Spectrograph and the Swedish 1-m Solar Telescope. Spicules are shown to occur when magnetic tension is amplified and transported upward through interactions between ions and neutrals or ambipolar diffusion. The tension is impulsively released to drive flows, heat plasma (through ambipolar diffusion), and generate Alfvénic waves.

Obesity increases cancer risk, whereas surgery-induced weight loss is associated with reduced risk. Risk-based patient stratification may be needed to better understand and maximize benefits of weight loss interventions in individuals with obesity. To this end, comprehensive data from high-quality studies with extended follow-up are imperative. This study examines the link between bariatric surgery and long-term cancer outcomes, focusing on patient subgroups defined by previously suggested predictors of treatment benefit, such as sex and baseline insulin levels. This post-hoc analysis used data from the Swedish Obese Subjects (SOS) study, a prospective, controlled intervention trial, designed to investigate the long-term effects of bariatric surgery-induced weight loss (ClinicalTrials.gov, NCT01479452). The study was conducted at 25 public surgical departments and 480 primary healthcare centers across Sweden. Between Sept 1, 1987, and Jan 31, 2001, 2,007 per-protocol patients with obesity who underwent bariatric surgery (gastric bypass, n = 266; gastric banding, n = 376; vertical banded gastroplasty, n = 1,365) and 2,040 matched controls, receiving standard nonsurgical obesity-related care, were recruited. Inclusion criteria were age 37-60 years and a body mass index (BMI) ≥34 kg/m2 for men and ≥38 kg/m2 for women. The primary outcome measures were cancer events and cancer-related deaths, captured through nearly complete data sourced from national Swedish health registries. Female-specific cancers were defined as gynecologic and breast cancers. Analyses were adjusted (adj) for baseline age, sagittal diameter, alcohol consumption, smoking, and serum insulin levels. The study was closed on December 31, 2022. Median follow-up was 26.8 years (interquartile range (IQR) [22.9, 29.6]) in the surgery group and 24.9 years (IQR [18.7, 28.8]) in the control group. Bariatric surgery was associated with a lower overall cancer incidence rate in women (adjusted hazard ratio (HRadj) = 0.78; 95% confidence interval (CI) [0.67, 0.90]; p = 0.001), but not in men (sex-treatment interaction p = 0.013). The HRadj for overall cancer mortality rate in women was 0.78 (95% CI [0.61, 1.00]; p = 0.050). In women, surgery was associated with a lower incidence rate of both obesity-related cancers (HRadj = 0.70; 95% CI [0.58, 0.85]; p < 0.001) and female-specific cancers (HRadj = 0.60; 95% CI [0.47, 0.75]; p < 0.001). Importantly, subgroup analyses showed that the associations between surgery and female-specific cancer incidence, as well as female-specific cancer-related mortality, were stronger in women with high baseline insulin levels (insulin-treatment interaction p = 0.021 and 0.039, respectively). The main limitation is that cancer was not a predefined study outcome. Bariatric surgery is associated with a lower risk of cancer and cancer-related mortality in women with obesity, with the strongest association observed for female-specific cancers in women with elevated baseline insulin levels. In men, bariatric surgery was not associated with overall cancer incidence or mortality. These findings support incorporating risk-based stratification to better tailor cancer prevention strategies in obesity care.

Obesity is a risk factor for cancer. Intentional weight loss in the obese might protect against malignancy, but evidence is limited. To our knowledge, the Swedish Obese Subjects (SOS) study is the first intervention trial in the obese population to provide prospective, controlled cancer-incidence data. The SOS study started in 1987 and involved 2010 obese patients (body-mass index [BMI] ≥34 kg/m 2 in men, and ≥38 kg/m 2 in women) who underwent bariatric surgery and 2037 contemporaneously matched obese controls, who received conventional treatment. While the main endpoint of SOS was overall mortality, the main outcome of this exploratory report was cancer incidence until Dec 31, 2005. Cancer follow-up rate was 99·9% and the median follow-up time was 10·9 years (range 0–18·1 years). Bariatric surgery resulted in a sustained mean weight reduction of 19·9 kg (SD 15·6 kg) over 10 years, whereas the mean weight change in controls was a gain of 1·3 kg (SD 13·7 kg). The number of first-time cancers after inclusion was lower in the surgery group (n=117) than in the control group (n=169; HR 0·67, 95% CI 0·53–0·85, p=0·0009). The sex–treatment interaction p value was 0·054. In women, the number of first-time cancers after inclusion was lower in the surgery group (n=79) than in the control group (n=130; HR 0·58, 0·44–0·77; p=0·0001), whereas there was no effect of surgery in men (38 in the surgery group vs 39 in the control group; HR 0·97, 0·62–1·52; p=0·90). Similar results were obtained after exclusion of all cancer cases during the first 3 years of the intervention. Bariatric surgery was associated with reduced cancer incidence in obese women but not in obese men. Swedish Research Council, Swedish Foundation for Strategic Research, Swedish Federal Government under the LUA/ALF agreement, Hoffmann La Roche, Cederoths, AstraZeneca, Sanofi-Aventis, Ethicon Endosurgery.

The development of reliable computational methods for novel battery materials has become essential due to the recently intensified research efforts on more sustainable energy storage materials. Here, we use a recently developed framework allowing to consistently incorporate quantum-mechanical activation barriers to classical molecular dynamics simulations to study the reductive solvent decomposition and formation of the solid electrolyte interphase for a graphite/carbonate electrolyte interface. We focus on deriving condensed-phase effective rates based on the elementary gas-phase reduction and decomposition energy barriers. After a short initial transient limited by the elementary barriers, we observe that the effective rate shows a transition to a kinetically slow regime influenced by the changing coordination environment and the ionic fluxes between the bulk electrolyte and the interface. We also discuss the impact of the decomposition on the ionic mobility. Thus, our work shows how elementary first-principles properties can be mechanistically leveraged to provide fundamental insights into electrochemical stability of battery electrolytes.

This study compared long-term mortality and life expectancy among patients who underwent bariatric surgery or received usual obesity care in the Swedish Obese Subjects study and in persons in the SOS reference study. The adjusted median life expectancy with surgery was 3.0 years longer than in control patients but 5.5 years shorter than in the general population.