Addressing the Evolution of Cardenolide Formation in Iridoid-Synthesizing Plants: Site-Directed Mutagenesis of PRISEs (Progesterone-5β-Reductase/Iridoid Synthase-like Enzymes) of Plantago Species.

Enzymes capable of processing a variety of compounds enable plants to adapt to diverse environmental conditions. PRISEs (progesterone-5β-reductase/iridoid synthase-like enzymes), examples of such substrate-promiscuous enzymes, are involved in iridoid and cardenolide pathways and demonstrate notable substrate promiscuity by reducing the activated C=C double bonds of plant-borne and exogenous 1,4-enones. In this study, we identified PRISE genes in () and (), and the corresponding enzymes were determined to share a sequence identity of 95%.

Visually navigated, ultrasound-guided, freehand percutaneous calyceal puncture - preclinical evaluation of a novel device to simplify a complex surgical task.

 Freehand sonographic percutaneous puncture techniques for the renal calyceal system are on the rise. Much time and practice are required to master this technique. Navigation-supported puncture aids could help make percutaneous access easier and faster.

Follow-up strategies after trimodal treatment for muscle-invasive bladder cancer: a systematic review.

Purpose: Optimal follow-up strategies following trimodal treatment for muscle invasive bladder cancer play a crucial role in detecting and managing relapse and side-effects. This article provides a comprehensive summary of the patterns and risk factors of relapse, functional outcomes, and follow-up protocols.

Methods: A systematic literature search on PubMed and review of current guidelines and institutional follow-up protocols after trimodal therapy were conducted.

Predicting the outcome of psychotherapy for chronic depression by person-specific symptom networks.

Psychotherapies are efficacious in the treatment of depression, albeit only with a moderate effect size. It is hoped that personalization of treatment can lead to better outcomes. The network theory of psychopathology offers a novel approach suggesting that symptom interactions as displayed in person-specific symptom networks could guide treatment planning for an individual patient.

Childhood maltreatment as predictor and moderator for treatment outcome in patients with major depressive disorders treated with metacognitive therapy or behavioral activation.

Background: Childhood maltreatment (CM) is a risk factor for developing and maintaining depression. It is unclear whether CM influences the effect of treatments for depression. This study examined CM's predictor and moderator effect in Behavioral Activation (BA) and Metacognitive Therapy (MCT).

Generative adversarial network-based reconstruction of healthy anatomy for anomaly detection in brain CT scans.

Purpose: To help radiologists examine the growing number of computed tomography (CT) scans, automatic anomaly detection is an ongoing focus of medical imaging research. Radiologists must analyze a CT scan by searching for any deviation from normal healthy anatomy. We propose an approach to detecting abnormalities in axial 2D CT slice images of the brain.

Adverse Events of Psychological Interventions: Definitions, Assessment, Current State of the Research and Implications for Research and Clinical Practice.

Background: The effectiveness of psychological interventions is undisputed. But while in other fields of health care the safety of interventions is studied alongside effectiveness, adverse events (AEs) have only recently been assessed in clinical studies of psychological interventions. This critical review summarizes the definition, assessment and current research status of AEs of psychological interventions.

The Effectiveness of Dialectical Behavior Therapy Compared to Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial.

Introduction: In the treatment of borderline personality disorder (BPD), there is empirical support for both dialectical behavior therapy (DBT) and schema therapy (ST); these treatments have never been compared directly. This study examines whether either of them is more effective than the other in treating patients with BPD.

Methods: In this randomized, parallel-group, rater-blind clinical trial, outpatients aged between 18 and 65 years with a primary diagnosis of BPD were recruited in a tertiary outpatient treatment center (Lübeck, Germany).

The long shadow of early-change patterns: a 3-year follow-up after the use of a web-based intervention for mild to moderate depressive symptoms.

Web-based interventions can be effective in treating depressive symptoms. Patients with risk not responding to treatment have been identified by early change patterns. This study aims to examine whether early changes are superior to baseline parameters in predicting long-term outcome.

Robotic Ureter Reimplantation After Urinary Diversion.

Introduction: Benign ureterointestinal anastomotic stricture (UIAS) is a recognized long-term complication following radical cystectomy with urinary diversion (UD). The incidence of UIAS following robotic-assisted radical cystectomy varies, with reported rates ranging from 6.5%-25.

Symptom-specific improvement across therapies and their putative mediators: A mediation network intervention analysis.

Objective: We evaluated differential treatment effects on specific symptoms and their mediators for Cognitive Behavioral Analysis System of Psychotherapy (CBASP) and Supportive Psychotherapy (SP) in persistently depressed patients.

Method: We conducted a Bayesian mediation network intervention analysis with data from a randomized controlled trial comparing CBASP and SP. Three networks were calculated to investigate (1) differential treatment effects on specific symptoms, (2) differential treatment effects on the potential mediators interpersonal problems and social functioning, and (3) associations between change in symptoms and change in the potential mediators.

[Efficacy of internet-based interventions for depression available in Germany-A systematic review and meta-analysis].

Background: Internet-based interventions (IBIs) for the treatment of depression have been found to have positive effects in international meta-analyses; however, it is unclear whether these effects also extend to IBIs specifically available in Germany. The aim of this meta-analysis was to estimate the immediate effects and the long-term effects of IBIs available in Germany free of charge or available on prescription and covered by the public health insurances as so-called digital health applications (DiGAs) and to compare the efficacy of DiGAs and freely available IBIs.

Method: A systematic literature search and random-effects meta-analysis were performed (preregistration: INPLASY202250070).

Progesterone Metabolism in Digitalis and Other Plants-60 Years of Research and Recent Results.

5β-Cardenolides are pharmaceutically important metabolites from the specialized metabolism of Digitalis lanata. They were used over decades to treat cardiac insufficiency and supraventricular tachycardia. Since the 1960s, plant scientists have known that progesterone is an essential precursor of cardenolide formation.

Automatic planning of MR-guided transcranial focused ultrasound treatment for essential tremor.

Introduction: Transcranial focused ultrasound therapy (tcFUS) offers precise thermal ablation for treating Parkinson's disease and essential tremor. However, the manual fine-tuning of fiber tracking and segmentation required for accurate treatment planning is time-consuming and demands expert knowledge of complex neuroimaging tools. This raises the question of whether a fully automated pipeline is feasible or if manual intervention remains necessary.

The Brainstem Cavernoma Case Series: A Formula for Surgery and Surgical Technique.

: Cavernous malformations (CM) are vascular malformations with low blood flow. The removal of brainstem CMs (BS) is associated with high surgical morbidity, and there is no general consensus on when to treat deep-seated BS CMs. The aim of this study is to compare the surgical outcomes of a series of deep-seated BS CMs with the surgical outcomes of a series of superficially located BS CMs operated on at the Department of Neurosurgery, College of Tuebingen, Germany.

Implications of the Network Theory for the Treatment of Mental Disorders: A Secondary Analysis of a Randomized Clinical Trial.

Importance: Conceptualizing mental disorders as latent entities has been challenged by the network theory of mental disorders, which states that psychological problems are constituted by a network of mutually interacting symptoms. While the implications of the network approach for planning and evaluating treatments have been intensively discussed, empirical support for the claims of the network theory regarding treatment effects is lacking.

Objective: To assess the extent to which specific hypotheses derived from the network theory regarding the (interindividual) changeability of symptom dynamics in response to treatment align with empirical data.

Occurrence and conversion of progestogens and androgens are conserved in land plants.

Progestogens and androgens have been found in many plants, but little is known about their biosynthesis and the evolution of steroidogenesis in these organisms. Here, we show that the occurrence and biosynthesis of progestogens and androgens are conserved across the viridiplantae lineage. An UHPLC-ESI-MS/MS method allowed high-throughput analysis of the occurrence and chemical conversion of progestogens and androgens in 41 species across the green plant lineage.

Deep learning-based segmentation of brain parenchyma and ventricular system in CT scans in the presence of anomalies.

Introduction: The automatic segmentation of brain parenchyma and cerebrospinal fluid-filled spaces such as the ventricular system is the first step for quantitative and qualitative analysis of brain CT data. For clinical practice and especially for diagnostics, it is crucial that such a method is robust to anatomical variability and pathological changes such as (hemorrhagic or neoplastic) lesions and chronic defects. This study investigates the increase in overall robustness of a deep learning algorithm that is gained by adding hemorrhage training data to an otherwise normal training cohort.

Overexpression and RNAi-mediated Knockdown of Two 3β-hydroxy-Δ5-steroid dehydrogenase Genes in Digitalis lanata Shoot Cultures Reveal Their Role in Cardenolide Biosynthesis.

3β-hydroxy-Δ5-steroid dehydrogenases (3βHSDs) are supposed to be involved in -cardenolide biosynthesis. Here, a novel () was isolated from shoot cultures and expressed in . Recombinant 3βHSD1 and 3βHSD2 shared 70% amino acid identity, reduced various 3-oxopregnanes and oxidised 3-hydroxypregnanes, but only 3βHSD2 converted small ketones and secondary alcohols efficiently.

The Effectiveness of Metacognitive Therapy Compared to Behavioral Activation for Severely Depressed Outpatients: A Single-Center Randomized Trial.

Introduction: Major depressive disorder (MDD) is a highly prevalent and disabling disorder. This study examines two psychotherapy methods for MDD, behavioral activation (BA), and metacognitive therapy (MCT), when applied as outpatient treatments to severely affected patients.

Methods: The study was conducted in a tertiary outpatient treatment center.