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Environmental sustainability is characterized by a conflict between short-term self-interest and longer-term collective interests. Self-control capacity has been proposed to be a crucial determinant of people’s ability to overcome this conflict. Yet, causal evidence is lacking, and previous research is dominated by the use of self-report measures. Here, we modulated self-control capacity by applying inhibitory high-definition transcranial current stimulation (HD-tDCS) above the left dorsolateral prefrontal cortex (dlPFC) while participants engaged in an environmentally consequential decision-making task. The task includes conflicting and low conflicting trade-offs between short-term personal interests and long-term environmental benefits. Contrary to our preregistered expectation, inhibitory HD-tDCS above the left dlPFC, presumably by reducing self-control capacity, led to more, and not less, pro-environmental behavior in conflicting decisions. We speculate that in our exceptionally environmentally friendly sample, deviating from an environmentally sustainable default required self-control capacity, and that inhibiting the left dlPFC might have reduced participants’ ability to do so.

Abstract Intergenerational sustainability is a pressing challenge, which is exacerbated by the fact that the current generation must make sacrifices today to ensure the well-being of future generations. There are large interindividual differences in intergenerational sustainable behavior. However, the neural mechanisms underlying these interindividual differences have remained unexplored. Here, we combined fMRI with a consequential intergenerational sustainability paradigm in a sample of 72 healthy students. Specifically, we analyzed task-dependent functional activity and connectivity during intergenerational sustainable decision-making, focusing on the state-like neurophysiological processes giving rise to behavioral heterogeneity in sustainability. We found that differences in neural communication within and between the mentalizing (TPJ/DMPFC) and cognitive control (ACC/DLPFC) network are related to interindividual differences in intergenerational sustainable behavior. Specifically, the stronger the functional connectivity within and between these networks during decision-making, the more individuals behaved intergenerationally sustainably. Corroborated by mediation analyses, these findings suggest that differences in the engagement of perspective-taking and self-control processes underly interindividual differences in intergenerational sustainable behavior. By answering recent calls for leveraging behavioral and neuroscience for sustainability research, we hope to contribute to interdisciplinary efforts to advance the understanding of interindividual differences in intergenerational sustainability.

We describe here the first case of exposure to patisiran treatment, a small interfering RNA molecule, during early pregnancy of a 36-year-old woman with symptomatic hereditary transthyretin-related amyloidosis. There were no major complications during pregnancy and delivery, except for a postpartum hemorrhage due to uterine atony. Vitamin A levels had to be closely monitored during pregnancy, and vitamin A substitution adapted accordingly. There was no sign of minor or major congenital abnormalities of the baby. One month after delivery, the patient showed slight clinical and electrophysiological signs of neuropathy progression due to patisiran treatment withdrawal. Patisiran infusions were resumed 3 months after delivery. Due to the unknown teratogenic potential of patisiran, the risk of neuropathy worsening associated with withholding treatment must of course be weighed against a potential teratogenic risk of treatment during pregnancy. Vitamin A levels need to be closely assessed, and substitution must be adapted accordingly, to avoid embryofetal adverse outcome due to vitamin A deficiency or toxicity.

Various methods have been developed to measure the strength of a Lewis acid. A major challenge for these measurements lies in the complexity that arises from variable solvent interactions and perturbations of Lewis acids as their reaction environment changes. Herein, we investigate the impact of solvent effects on Lewis acids for the first time as measured by the fluorescent Lewis adduct (FLA) method. The binding of a Lewis acid in various solvents reveals a measurable dichotomy between both polarity and donor ability of the solvent. While not strictly separable, we observe that the influence of solvent polarity on Lewis acid unit (LAU) values is distinctly opposite to the influence of donor ability. This dichotomy was confirmed by titration data, illustrating that solvation effects can be appropriately and precisely gauged by the FLA method.

Right-sided infective endocarditis (IE) accounts for 5% to 10% of all IE cases. Compared with left-sided IE, it is more often associated with intravenous drug abuse and intracardiac devices, whereas the latter has become more prevalent in recent decades. The authors report the first case of IE in a heterotopic caval valved stent used for treating torrential tricuspid regurgitation. (Level of Difficulty: Advanced.)

Intergenerational sustainability requires people of the present generation to make sacrifices today to benefit others of future generations (e.g. mitigating climate change, reducing public debt). Individuals vary greatly in their intergenerational sustainability, and the cognitive and neural sources of these interindividual differences are not yet well understood. We here combined neuroscientific and behavioral methods by assessing interindividual differences in cortical thickness and by using a common-pool resource paradigm with intergenerational contingencies. This enabled us to look for objective, stable, and trait-like neural markers of interindividual differences in consequential intergenerational behavior. We found that individuals behaving sustainably (vs. unsustainably) were marked by greater cortical thickness of the dorsomedial and dorsolateral prefrontal cortex. Given that these brain areas are involved in perspective-taking and self-control and supported by mediation analyses, we speculate that greater cortical thickness of these brain areas better enable individuals to take the perspective of future generations and to resist temptations to maximize personal benefits that incur costs for future generations. By meeting recent calls for the contribution of neuroscience to sustainability research, it is our hope that the present study advances the transdisciplinary understanding of interindividual differences in intergenerational sustainability.

Summary: Background: Patients with type 2 diabetes and obesity have chronic activation of the innate immune system possibly contributing to the higher risk of hyperinflammatory response to SARS-CoV2 and severe COVID-19 observed in this population. We tested whether interleukin-1β (IL-1β) blockade using canakinumab improves clinical outcome. Methods: CanCovDia was a multicenter, randomised, double-blind, placebo-controlled trial to assess the efficacy of canakinumab plus standard-of-care compared with placebo plus standard-of-care in patients with type 2 diabetes and a BMI > 25 kg/m2 hospitalised with SARS-CoV2 infection in seven tertiary-hospitals in Switzerland. Patients were randomly assigned 1:1 to a single intravenous dose of canakinumab (body weight adapted dose of 450-750 mg) or placebo. Canakinumab and placebo were compared based on an unmatched win-ratio approach based on length of survival, ventilation, ICU stay and hospitalization at day 29. This study is registered with ClinicalTrials.gov, NCT04510493. Findings: Between October 17, 2020, and May 12, 2021, 116 patients were randomly assigned with 58 in each group. One participant dropped out in each group for the primary analysis. At the time of randomization, 85 patients (74·6 %) were treated with dexamethasone. The win-ratio of canakinumab vs placebo was 1·08 (95 % CI 0·69-1·69; p = 0·72). During four weeks, in the canakinumab vs placebo group 4 (7·0%) vs 7 (12·3%) participants died, 11 (20·0 %) vs 16 (28·1%) patients were on ICU, 12 (23·5 %) vs 11 (21·6%) were hospitalised for more than 3 weeks, respectively. Median ventilation time at four weeks in the canakinumab vs placebo group was 10 [IQR 6.0, 16.5] and 16 days [IQR 14.0, 23.0], respectively. There was no statistically significant difference in HbA1c after four weeks despite a lower number of anti-diabetes drug administered in patients treated with canakinumab. Finally, high-sensitive CRP and IL-6 was lowered by canakinumab. Serious adverse events were reported in 13 patients (11·4%) in each group. Interpretation: In patients with type 2 diabetes who were hospitalised with COVID-19, treatment with canakinumab in addition to standard-of-care did not result in a statistically significant improvement of the primary composite outcome. Patients treated with canakinumab required significantly less anti-diabetes drugs to achieve similar glycaemic control. Canakinumab was associated with a prolonged reduction of systemic inflammation. Funding: Swiss National Science Foundation grant #198415 and University of Basel. Novartis supplied study medication.