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In traditional Chinese medicine, acupuncture is understood to be a treatment that is adapted to each individual patient. However, to date, during the scientific evaluation of acupuncture treatments, an individual patient’s point of view has rarely been considered. As an example of one of several possible mechanisms of acupuncture, the fascial component, or the role of connective tissue as a possible important mediator of the acupuncture effect is considered from different perspectives. Including the subjective experience of the patient, as well as embryological, fascial, and psychological perspectives, a spectrum opens up to also include the veterinary dimension. This article’s focus is from the perspective of an individual patient and is based on the individualized application of acupuncture. As the second part of a trilogy, this article aims to provide an interdisciplinary view on acupuncture by several authors.

Acupuncture, derived from traditional Chinese medicine, is used in modern Western medicine. In China, acupuncture is widely practiced and considered to be a healing art that has been scientifically studied since the 1950s. In modern Western medicine, acupuncture is included in guidelines and the service catalogs of health insurance companies for indications where its effectiveness has been scientifically proven. However, the transformation of this ancient healing art into evidence-based medicine has not been smooth. For example, a need exists for developing criteria related to the responsiveness of each individual patient and the critical examination of sham acupuncture as a placebo in study design. This article focuses on acupuncture as a traditional healing art and the scientific investigation of its effects, mechanisms, and evidence-based effectiveness. As the first part of a trilogy, this article aims to provide an interdisciplinary view of acupuncture by several authors.

Acupuncture is characterized by its different mechanisms and has a wide range of possible uses. It is classified as complementary medicine and has been partially incorporated into the guidelines of modern Western medicine. The practice and research in the field of acupuncture meets conditions that reflect its acceptance in current society. The initiation of acupuncture treatment varies in different countries due to, for example, medical, historical, cultural, technical, legal, and economic differences. This article focuses on the conditions that influence the integration of acupuncture in Western medicine as well as the interdisciplinary cooperation between several practitioners of different specialties. In the long term, these factors can support the acceptance of acupuncture in Western medicine and promote its adoption at the same time. This article is the last of a trilogy that aims to provide an interdisciplinary view of acupuncture by several authors.

Transcatheter left atrial appendage occlusion (LAAO) is non-inferior to vitamin K antagonists (VKAs) in preventing thromboembolic events in atrial fibrillation (AF). Non-vitamin K antagonists (NOACs) have an improved safety profile over VKAs; however, evidence regarding their effect on cardiovascular and neurological outcomes relative to LAAO is limited. Up-to-date randomized trials or propensity-score-matched data comparing LAAO vs. NOACs in high-risk patients with AF were pooled in our study. A total of 2849 AF patients (LAAO: 1368, NOACs: 1481, mean age: 75 ± 7.5 yrs, 63.5% male) were enrolled. The mean CHA2DS2-VASc score was 4.3 ± 1.7, and the mean HAS-BLED score was 3.4 ± 1.2. The baseline characteristics were comparable between the two groups. In the LAAO group, the success rate of device implantation was 98.8%. During a mean follow-up of 2 years, as compared with NOACs, LAAO was associated with a significant reduction of ISTH major bleeding (p = 0.0002). There were no significant differences in terms of ischemic stroke (p = 0.61), ischemic stroke/thromboembolism (p = 0.63), ISTH major and clinically relevant minor bleeding (p = 0.73), cardiovascular death (p = 0.63), and all-cause mortality (p = 0.71). There was a trend toward reduction of combined major cardiovascular and neurological endpoints in the LAAO group (OR: 0.84, 95% CI: 0.64–1.11, p = 0.12). In conclusion, for high-risk AF patients, LAAO is associated with a significant reduction of ISTH major bleeding without increased ischemic events, as compared to “contemporary NOACs”. The present data show the superior role of LAAO over NOACs among high-risk AF patients in terms of reduction of major bleeding; however, more randomized controlled trials are warranted.

The electrochemical N2 fixation, which is far from practical application in aqueous solution under ambient conditions, is extremely challenging and requires a rational design of electrocatalytic centers. We observed that bismuth (Bi) might be a promising candidate for this task because of its weak binding with H adatoms, which increases the selectivity and production rate. Furthermore, we successfully synthesized defect-rich Bi nanoplates as an efficient noble-metal-free N2 reduction electrocatalyst via a low-temperature plasma bombardment approach. When exclusively using 1H NMR measurements with N2 gas as a quantitative testing method, the defect-rich Bi(110) nanoplates achieved a 15NH3 production rate of 5.453 μg mgBi−1 h−1 and a Faradaic efficiency of 11.68 % at −0.6 V vs. RHE in aqueous solution at ambient conditions. © 2019 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim