Dysplasia of the tricuspid valve leading to recurrent atrial flutter and fibrillation: a case report.

Background: Atrial flutter (AFL) is usually effectively treated by cavotricuspid isthmus (CTI) ablation. If AFL recurs despite ablation, there is risk of progression to atrial fibrillation (AF) and clinicians should consider underlying structural heart diseases. This consideration becomes especially critical when right-heart-chambers are dilated.

Magnetic Resonance Imaging Prior Authorizations for Orthopaedic Care Are Negatively Affected by Medicaid Insurance Status.

Background: Magnetic resonance imaging (MRI) has revolutionized musculoskeletal care. However, its high costs and high utilization has prompted many insurance payors to require a prior authorization. This process remains burdensome and results in delays to patient care.

Cerebrospinal Fluid Cytology in Lyme Neuroborreliosis Revisited-Role of Neutrophilic Granulocytes: A Retrospective Single-Center Study.

: diagnosis of Lyme neuroborreliosis (LNB) relies on medical history, clinical findings, and detection of pathogen-specific antibodies in the blood and cerebrospinal fluid (CSF). The chemoattractant CXCL13 serves as an additional marker for LNB acuity. During the diagnostic workup, cytomorphological examination of immune cells in CSF provides early insights.

Early resistance rehabilitation improves functional regeneration following segmental bone defect injury.

Many studies have explored different loading and rehabilitation strategies, yet rehabilitation intensity and its impact on the local strain environment and bone healing have largely not been investigated. This study combined implantable strain sensors and subject-specific finite element models in a 2 mm rodent segmental bone defect model. After injury animals were underwent high or low intensity rehabilitation.

Iron regulatory protein 1-deficient mice exhibit hypospermatogenesis.

Imbalances in testicular iron levels are linked to compromised sperm production and male infertility. Iron regulatory proteins (IRP) 1 and 2 play crucial roles in cellular iron regulation. We investigated the role of IRP1 on spermatogenesis using Irp1-deficient mice (Irp1).

Asymmetric Migratory Tsuji-Wacker Oxidation Enables the Enantioselective Synthesis of Hetero- and Isosteric Diarylmethanes.

Diarylmethanes play, in part, a pivotal role in the design of highly potent, chiral, nonracemic drugs whose bioactivity is typically affected by the substitution pattern of their arene units. In this context, certain arenes such as -substituted benzenes or unsubstituted heteroarenes cause particular synthetic challenges, since such isosteric residues at the central methane carbon atom are typically indistinguishable for a chiral catalyst. Hence, the stereoselective incorporation of isosteric (hetero)arenes into chiral methane scaffolds requires the use of stoichiometrically differentiated building blocks, which is typically realized through preceding redox-modifying operations such as metalation or halogenation and thus associated with disadvantageous step- and redox-economic traits.

Integrating binding affinity and tonic signaling enables a rational CAR design for augmented T cell function.

Background: The success of chimeric antigen receptor (CAR) T cell therapy for hematological malignancies has not yet translated into long-term elimination of solid tumors indicating the need for adequately tuning CAR T cell functionality.

Methods: We leveraged a translational pipeline including biophysical characterization and structural prediction of the CAR binding moiety, evaluation of cellular avidity, synapse formation, T cell motility, and functional capacities under repetitive target challenge and in sustained tumor control.

Results: As an example of clinical relevance, we derived a panel of anti-Her2 CARs covering a 4-log affinity range, all expected to target the same Her2 epitope.

Psychological interventions to prevent the onset of major depression in adults: a systematic review and individual participant data meta-analysis.

Background: Psychological interventions are increasingly discussed as a method to prevent major depressive disorder (MDD) in adults who already experience subthreshold depressive symptoms. In this individual participant data meta-analysis, we quantify the effect of preventive interventions against control on MDD onset in this population, and explore effect modifiers.

Methods: In this systematic review and individual participant data meta-analysis, we screened full-texts of eligible studies within the Metapsy research domain for articles on psychological interventions for depression, from database inception to May 1, 2023, published in English, German, Spanish, and Dutch.

A single-chain variable fragment-based bispecific T-cell activating antibody against CD117 enables T-cell mediated lysis of acute myeloid leukemia and hematopoietic stem and progenitor cells.

Acute myeloid leukemia (AML) derives from hematopoietic stem and progenitor cells (HSPCs). To date, no AML-exclusive, non-HSPC-expressed cell-surface target molecules for AML selective immunotherapy have been identified. Therefore, to still apply surface-directed immunotherapy in this disease setting, time-limited combined immune-targeting of AML cells and healthy HSPCs, followed by hematopoietic stem cell transplantation (HSCT), might be a viable therapeutic approach.

CD19-targeting CAR T-cell therapy in patients with diffuse systemic sclerosis: a case series.

Background: CD19-targeting chimeric antigen receptor (CAR) T-cell therapy has shown remarkable outcomes in patients with systemic lupus erythematosus. The effects of CD19-targeting CAR T cells on organ manifestations in patients with systemic sclerosis have yet to be characterised. B cells have a central role in the pathogenesis of systemic sclerosis.

The overestimation of the effect sizes of psychotherapies for depression in waitlist controlled trials: a meta-analytic comparison with usual care controlled trials.

Aims: There is considerable evidence that waiting list (WL) control groups overestimate the effect sizes of psychotherapies for depression. It is not clear, however, what are the exact causes for this overestimation. We decided to conduct a meta-analytic study to compare trials on psychotherapy for depression with a WL control group against trials with a care-as-usual (CAU) control group.

An Efficiency Model for Decreasing Operative Room Turnover Time for Total Joint Arthroplasties.

Objectives: Despite an increased demand for total joint arthroplasty (TJA), rising health-care costs and bundling of payments by payers have shifted the focus to improving operating room (OR) efficiency. This study aimed to assess the efficacy of an efficiency model that optimized instrument trays on decreasing OR turnover time (TOT) and the benefits made possible by this improved efficiency.

Methods: All primary TJA procedures performed by a single fellowship-trained surgeon from January 2022 to August 2023 were reviewed.

Efficacy of Liposomal Bupivacaine Versus a Traditional Local Anesthetic in Periarticular Injections during Total Hip Arthroplasty: A Systematic Review and Meta-analysis.

Periarticular injections (PAI) are a common component to multimodal regimens in total hip arthroplasty (THA), although the efficacy of adding liposomal bupivacaine (LB) remains unclear. A meta-analysis of total knee arthroplasty did not find LB superior, but a similar study has not been performed in THA. The purpose of this study was to compare opioid consumption, pain scores, and length of stay between PAIs with LB and traditional PAIs in THA.

Improving Functional Muscle Regeneration in Volumetric Muscle Loss Injuries by Shifting the Balance of Inflammatory and Pro-Resolving Lipid Mediators.

Severe tissue loss resulting from extremity trauma, such as volumetric muscle loss (VML), poses significant clinical challenges for both general and military populations. VML disrupts the endogenous tissue repair mechanisms, resulting in acute and unresolved chronic inflammation and immune cell presence, impaired muscle healing, scar tissue formation, persistent pain, and permanent functional deficits. The aberrant healing response is preceded by acute inflammation and immune cell infiltration which does not resolve.

Minimally-invasive tracheostomy (MIT): A care bundle for safety improvement in high-risk critically ill patients.

Background: Detailed reports are scarce on minimally-invasive tracheostomy (MIT) techniques for critically ill patients with challenging anatomy or complex coagulopathies. In such high-risk patients, conventional percutaneous dilatational tracheostomy (PDT) may lead to severe complications.

Methods: Aiming to broaden the scope of MIT for patients previously excluded due to high risks, we developed a new care bundle (MIT technique), specifically designed for intensive care specialists.

Psychological interventions for early-phase schizophrenia: protocol for a systematic review and network meta-analysis.

Introduction: Treating the early phase of schizophrenia is crucial for preventing further episodes and improving quality of life, functioning, and social inclusion. Pharmacotherapies are first-line treatments, but have limitations. There is consensus on the need for non-pharmacological interventions for individuals in the early phase of schizophrenia.

Unimolecular net heterolysis of symmetric and homopolar σ-bonds.

The unimolecular heterolysis of covalent σ-bonds is integral to many chemical transformations, including S1-, E1- and 1,2-migration reactions. To a first approximation, the unequal redistribution of electron density during bond heterolysis is governed by the difference in polarity of the two departing bonding partners. This means that if a σ-bond consists of two identical groups (that is, symmetric σ-bonds), its unimolecular fission from the S, S, or T states only occurs homolytically after thermal or photochemical activation.