https://www.selleckchem.com/Bcl-2.html In this study the authors hypothesized that "Lean management" within a dedicated ablation protocol could standardize the pulmonary vein isolation (PVI) procedure and improve quality. There is a large variability in safety, effectiveness, and efficiency of PVI. This was a single-center prospective study with inclusion of all consecutive PVI procedures from 2017 to2019. A 3-step intervention was introduced based on Lean management step 1) simplification (CLOSE protocol); step2) waste elimination (higher power shorter duration); and step 3) improved standardization (Lab Optimization Tool [LOT]). PVI was divided into steps that were tracked (in minutes) using LOT. Parameters were compared in 6-month intervals. Overall, 295 patients (146 patients with LOT) were analyzed. Step 1 reduced skin-to-skin procedure duration (2017 119 ± 21min vs. 2018 77 ± 15min; p<0.001) and variance (from 2018 to 2019p=0.024). Step 2 reduced the radiofrequency time (2017 38 ± 6min vs. 2018 20 ± 3min; p<0.001) and variance mprove health care utilization, increased efficiency should become an accepted goal in addition to procedural safety and effectiveness.Schizophrenia is a complex brain disorder with genetic and environmental factors contributing to its etiology. Complement C4 genes are schizophrenia susceptibility loci and are activated in response to infections and gut microbiome imbalances. We hypothesize that C4 genetic susceptibility predisposes individuals to neuropathological effects from pathogen exposures or a microbiome in dysbiosis. In 214 individuals with schizophrenia and 123 non-psychiatric controls, we examined C4 gene copy number and haplotype groups for associations with schizophrenia and microbial plasma biomarkers. C4A copy number and haplotypes containing HERV-K insertions (C4A-long; C4AL-C4AL) conferred elevated odds ratios for schizophrenia diagnoses (OR 1.58-2.56, p less then 0.0001), while C4B-short (C4BS) haplogroups conferred dec