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Background: The market for plant-based yogurt alternatives has rapidly expanded, reflecting the growing popularity of plant-based diets. However, their nutritional profiles and micronutrient fortification often differ substantially from those of traditional dairy yogurt. Methods: This study conducted a cross-sectional audit of retail labels on fermented plant-based yogurt alternatives available in major Polish retail chains. Data were collected in 2024 from eight stores across four nationwide supermarket chains. Nutritional composition, primary plant ingredient, micronutrient fortification, and processing level (NOVA classification) were recorded from product labels, while nutrient values were summarized using descriptive statistics and compared across product categories. Results: A total of 62 plant-based yogurt alternatives were identified, including 49 fruit-flavored and 13 natural products. Coconut was the predominant plant ingredient (54.8%), followed by soy (24.2%) and oat (11.3%). Fruit-flavored products contained significantly higher carbohydrate and sugar levels than natural ones. Soy-based products exhibited the highest protein content, often approaching that of conventional dairy yogurt, whereas coconut-based products were characterized by the lowest protein and higher saturated fat content. Overall, 37.1% of products were fortified with at least one micronutrient, primarily calcium, vitamin D, and vitamin B12. Most products were classified as ultra-processed (NOVA 4). Conclusions: Plant-based yogurt alternatives available on the Polish market are nutritionally diverse. Their composition is heavily influenced by the primary plant ingredient and fortification practices. Many of these products cannot be considered direct nutritional equivalents to dairy yogurt, underscoring the need for careful formulation, effective micronutrient fortification, and transparent labeling.

Ultra-processed foods (UPF) have become a central topic in nutrition science, with extensive observational research linking higher intake to adverse health outcomes. More recent randomized controlled trials have been presented as strengthening causal claims, yet closer examination reveals a pattern of interpretation that extends beyond what the data support. This perspective reviews four trials that directly compared ultra-processed diets with minimally processed diets, examining both their findings and how those findings have been represented in scientific commentary. Across all studies, the comparison group limited the ability to isolate processing as the causal factor, as multiple dietary features differed simultaneously. Reporting consistently emphasized findings aligning with expectations of harm while downplaying neutral or contradictory evidence, including favorable clinical markers and higher adherence in some ultra-processed conditions. Methodological limitations were also underrepresented in secondary interpretations. The current experimental evidence therefore require cautious interpretation. Specifically, four actionable recommendations follow from this analysis: (1) future trials should match intervention arms on nutrient composition so that processing effects can be disaggregated from nutritional quality effects; (2) adherence and dropout rates should be reported as primary, not secondary, outcomes; (3) terms such as "excess consumption" and "overeating" should be reserved for conditions of positive energy balance and weight gain; and (4) the heterogeneity within Nova Group 4 warrants sub-category analyses rather than class-wide causal claims. Without these changes, the evidentiary basis for UPF policy risks overstating certainty and misdirecting intervention targets.

Modern healthcare demands warrant the reconceptualization of pharmaceutical practitioners as primary caregivers capable of addressing contemporary medical challenges. Their specialized knowledge in molecular therapeutics, computational medicine tools, and physiological surveillance technologies uniquely qualifies them to oversee complicated treatment protocols for cutting-edge interventions, including genomic modifications and targeted biological agents. Historical success in managing long-term metabolic and cardiovascular conditions establishes credibility for supervising precision medicine applications. Digital innovations (e.g., remote consultation systems, algorithmic forecasting, and distributed ledger prescription tracking) enhance their capacity to coordinate fragmented services while responding to infectious outbreaks and polypharmacy challenges in elderly populations. This evolution promises decreased emergency admissions, improved therapeutic compliance, and more cost-effective care delivery. Regulatory reform must eliminate practice limitations, enabling these accessible professionals to address population health requirements fully.

The pharmacy profession stands at a pivotal moment, as emerging scientific advancements and evolving healthcare demands require adept pharmacy practitioners and scientists. The integration of precision medicine, cellular and acellular regeneration, nano and bioengineering (e.g., 3D/4D bioprinting), digital therapeutics, artificial intelligence (AI)-point-of-care testing, and treating is starting to reshape pharmacy education, practice, and patient care. Pharmacy education needs to embrace these innovations to prepare graduates for the future of practice, to optimize therapeutic outcomes, and contribute meaningfully to translational medicine. This review elaborates on the historical evolution toward the incoming wave of the pharmacy profession and considers the necessary educational models that might be associated with its practice. Expanded patient care roles are essential in this new era, with clinical pharmacists increasingly working alongside physicians under collaborative practice agreements. Additionally, prescriptive authority for pharmacists is gaining traction, enhancing healthcare accessibility and medication management. The integration of digital health technologies (e.g., telepharmacy, automation, wearable medical devices, and AI-driven decision support systems) further empowers pharmacists to deliver efficient, patient-centered care. Certain prospective concentrations (e.g., precision/personalized medicine, industrial pharmacy, drug discovery and development, drug compounding and formulation, and advanced drug delivery systems and devices) can further empower pharmacy education towards healthcare needs. By embracing technological and scientific advancements, pharmacists can solidify their roles as integral healthcare providers, ensuring that the profession remains dynamic, relevant, and impactful in an evolving healthcare landscape.

The pathological assessment of breast cancer resection specimens with neoadjuvant therapy (NAT) offers invaluable information for prognosis and further management. At times, these cases are difficult to pathologically evaluate, at least partly due to tumour bed obscuration after NAT. This study aimed to compare time and resource utilization by surgical pathology laboratories when handling breast specimens treated with NAT against those without NAT. We secondarily aimed to identify features associated with tumour bed identifiability at gross assessment. In this retrospective, single-institution study, we identified 241 breast resection specimens with systemic NAT between 2019 and 2025. A 1:1 non-NAT control group was randomly selected. The NAT cohort had a higher median number of tissue blocks (20.0 versus 13.0, P&#x2009;<&#x2009;0.001), as well as larger proportions requiring gross resampling (23.7% versus 7.1%, P&#x2009;<&#x2009;0.001) and pathologist review (16.2% versus 4.6%, P&#x2009;<&#x2009;0.001) compared with the control. The NAT cohort had a longer median pathology report turnaround time (17.0&#x2009;days versus 15.0&#x2009;days, P&#x2009;<&#x2009;0.001). In NAT cases, pretreatment clinical stage was associated with macroscopic identifiability of the tumour bed. Breast cancer resection specimens with NAT required significantly more time and laboratory resources than similar specimens without NAT. As NAT becomes more frequent across breast and other cancer types, pathological assessment of the excisional specimens from these patients is expected to become more challenging and time-consuming. By recognizing these trends early, healthcare systems can plan and allocate resources accordingly.

Introduction/Objectives: Although contemporary cardiovascular guidelines endorse intensive low-density lipoprotein cholesterol (LDL-C) lowering and advanced lipid biomarkers for refined risk stratification, important gaps in knowledge and implementation persist. This study evaluated clinician familiarity with novel lipid-lowering therapies, approaches to residual cardiovascular risk, confidence in identifying familial hypercholesterolemia (FH), and perceived usefulness of digital decision-support tools. Methods: A multispecialty, cross-sectional online survey (October 2025) of physicians involved in dyslipidemia care was conducted. The questionnaire assessed familiarity, accessibility, and barriers regarding proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, inclisiran, and bempedoic acid; confidence and practice in managing complex populations and residual risk; confidence in detecting FH and expectations for lipoprotein(a) [Lp(a)]; and perceived value of digital decision-support and automated risk alerts. Descriptive statistics and chi-square tests were performed. Results: Ninety-five clinicians completed the survey, with the largest group (41.1%) being general practitioners. Of them, 20.0% reported familiarity with all three novel therapies, and 49.5% reported restricted access due to cost and reimbursement constraints. Overall confidence in managing dyslipidemia in complex populations was moderate. Of note, 31.6% did not routinely assess residual risk after achieving LDL-C targets. Among those who did, imaging-based evaluation of subclinical atherosclerosis was the most frequently selected approach, followed by Lp(a) and triglycerides, hs-CRP, and apoB. Confidence in recognizing FH was modest, and expectations regarding future Lp(a) testing differed across specialties. Most respondents endorsed integrated decision-support tools and automated risk-alert prompts. Conclusions: Implementation gaps persist in dyslipidemia care, while strong receptiveness to digital decision-support highlights an opportunity to align practice more closely with evidence-based recommendations.

C2 pedicle screws (C2PS) are extensively used in the treatment of upper cervical spine disorders owing to their superior mechanical properties. However, incorrect screw insertion in the C2 pedicle can lead to catastrophic consequences due to the proximity to critical structures such as the vertebral artery groove and spinal cord. There is currently no universally accepted method for precise C2PS placement. In this study, we evaluated a novel free-hand C2PS insertion technique that uses the superior margin of the C2 lamina and the medial margin of the C2 pedicle as landmarks, thereby avoiding routine exposure of the C2/C3 facet joint capsule. Compared with the traditional Harms technique, the novel method reduced the transverse screw angle and sagittal screw angle, which may facilitate screw insertion in a limited operative field. The overall rate of pedicle breach was not significantly increased. Finite element analysis further showed comparable fixation strength between the two techniques in the modeled normal C2 anatomy. In summary, for anatomically suitable C2 pedicles, the novel C2PS insertion technique provided comparable radiographic accuracy and similar biomechanical stability to the Harms technique, while requiring smaller insertion angles and less lateral exposure.

The increasing popularity of macroalgae products highlights their potential as a safe source of essential macro and microelements for consumers. This study characterized wild and farmed macroalgae elemental composition and assessed the presence of biotoxins to identify potential health risks. Wild and farmed macroalgae samples were collected throughout 2024-2025, from three aquaculture production sites along the Portuguese coast (Ria de Aveiro, Matosinhos, and Olh&#xe3;o). Samples were freeze-dried, compressed and using a micro-XRF spectrometer, elemental composition was assessed. Macroalgae species factor was the strongest driver of elemental composition, explaining over 80% variation in macro and trace elements. Origin did not showcase statistical significance for elemental composition. Seasonal differences, though relatively small in extent, significantly impacted redox-sensitive elements in macroalgae, namely copper and manganese. All elements stayed below 30% of the recommended dietary recommendations, except iron (ranging from 0.5% to 111.8% of UL%) and Mn (ranging from 0.1% to 101% of UL%). All samples revealed the absence of regulated marine toxins. Only traces of the non-regulated cyclic-imine toxin SPX1 were detected in samples of Fucus vesiculosus. All quantified elements do not represent any risk for human health, strengthening the safety of macroalgae from the Portuguese coast.

Reconstruction of large segmental bone defects remains challenging because current grafting strategies often fail to coordinate angiogenesis, neurogenesis, and osteogenesis. Here we developed a functional scaffold (peptide/Talin1 plasmid/PLA-HA/GelMA, PTPG) capable of simultaneously delivering peptides and Talin1 plasmids. We hypothesized that this scaffold enables neurovascularized bone regeneration through bidirectional activation of integrin &#x3b2;1 (ITGB1). The REDV-IKVAV (Arg-Glu-Asp-Val-Gly-Gly-Gly-Ile-Lys-Val-Ala-Val) peptide triggers "outside-in" ITGB1 signaling in endothelial and Schwann cells, while Talin1 plasmid-mediated "inside-out" activation. This PTPG scaffold synergistically enhances cell proliferation, migration and secretion, which are eliminated by ITGB1 silencing. In vivo, PTPG scaffold promotes aligned neurovascular networks guiding bone deposition. Single-cell RNA sequencing demonstrates enrichment of endothelial H-type signatures and repair-associated Schwann cell phenotypes, with activation of ITGB1-focal adhesion kinase-paxillin signaling. Collectively, this scaffold integrates structural support with peptide and genetic cues to promote coordinated angiogenesis, neurogenesis, and osteogenesis, offering a promising strategy for functional bone regeneration.

This study aimed to evaluate effects of replacing whole soybean grain with micronized defatted soybean meal (MDSM) in diets of lactating dairy cows on performance, digestion, metabolism, and milk yield and composition. Ten primiparous Jersey cows with an initial body weight (BW) of 410 &#xb1; 9 kg and 105 &#xb1; 5 days in milk were used. Five replacement levels (0, 25, 50, 75, and 100% of dietary DM) of whole soybean grain with MDSM were evaluated. The experiment was conducted as two simultaneous 5&#xd7;5 Latin squares, each composed of five animals, five treatments, and five experimental periods, totaling 80 days. Each period lasted 16 days, including 12 days for adaptation and 4 days for data collection. No differences were observed among experimental diets for dry matter intake (mean = 14.58 kg day-1; p = 0.08) or organic matter intake (mean = 13.60 kg day-1; p = 0.08). Increasing dietary inclusion of MDSM resulted in greater crude protein intake, with the highest intake observed at 14% MDSM inclusion. A linear increase (P < 0.05) was observed in digestibility of dry matter, organic matter, crude protein, ether extract, and starch as MDSM inclusion increased. The inclusion level that maximized short-chain fatty acid production was 9.22%. Milk yield corrected to 3.5% fat increased linearly with increasing MDSM inclusion. Inclusion of MDSM did not affect milk fat (p = 0.41), protein (p = 0.86), or lactose (p = 0.88) concentrations. Complete replacement of whole soybean grain with MDSM in diets of Jersey cows increased milk yield, improved feed efficiency, and did not alter milk composition. Additionally, it enhanced digestibility of dry matter, organic matter, crude protein, and starch.

Many biological processes, including cellular senescence, manifest as diverse phenotypes across cell types and conditions. Lacking definitive markers, researchers often rely on the expression of sets of genes to identify these complex states. However, multiple approaches exist to summarize gene set expression into quantitative metrics (i.e. signatures), each with distinct strengths and limitations, and we know of no consensual framework to systematically evaluate their performance across datasets. We therefore developed markeR, an open-source, modular R package that evaluates gene sets as phenotypic markers using scoring and enrichment-based approaches. markeR generates interpretable metrics and intuitive visualizations for benchmarking gene signatures and exploring their associations with study variables. As a case study, we applied markeR to 9 published senescence-related gene sets across 25 RNA-seq datasets, 6 human cell types and 12 senescence-inducing conditions. Gene set performance varied widely: some signatures (e.g. SenMayo) were robust senescence markers across contexts, while others (e.g. MSigDB sets) performed poorly. We further applied markeR to 49 GTEx tissues, revealing tissue- and age-related differences in senescence-associated signals. Together, these findings emphasize the difficulty of characterizing molecular phenotypes and demonstrate markeR's potential for the systematic evaluation of gene sets in various biological contexts.

We examined treatment outcomes of firework-related hand injuries through a case series and literature review by evaluating various surgical results and long-term psychosocial recovery. The objective of this study was to evaluate common injury patterns, surgical decision-making, restoration of hand function, and the multidisciplinary approach to physical and psychological recovery following firework-related hand injuries. This study employed a mixed descriptive design, integrating six clinical case reports with a targeted literature review. All six cases were analyzed collectively; however, three representative cases were selected for inclusion in the final manuscript to avoid redundancy while demonstrating the common patterns and treatment approaches associated with blast injuries to the hand. This approach allowed for the presentation of firsthand clinical experiences while contextualizing them within the broader body of published evidence on surgical decision-making for restoring hand function and psychological recovery following firework-related hand injuries, as well as proposing a decision-making framework and providing an educational narrative on multidisciplinary care. The reviewed cases demonstrated recurrent patterns of soft tissue destruction, fractures, tendon injuries, neurovascular compromise, and digit amputations requiring individualized surgical management strategies. The findings additionally emphasized the importance of prioritizing functional preservation when considering digit salvage, as well as the role of multidisciplinary rehabilitation, including occupational therapy and psychosocial support, in optimizing long-term functional and psychological recovery following firework-related hand injuries.

Over the years, numerous high-intensity hurricanes have struck Florida, United States of America, resulting in catastrophic damage. This is expected to surge, as climate change causes storms of greater intensity. Damage associated with hurricanes is typically based on destruction of property and loss of life; however, the impact on the mental health of those affected is more challenging to assess. The following case demonstrates a patient who survived a hurricane but emerged from the storm with an exacerbation of previously diagnosed mental health conditions. In the days following a major hurricane strike, a young male in his 20s required inpatient psychiatric hospitalization after reporting a suicide attempt by consuming large amounts of alcohol and cocaine. The patient, who lived on a boat, experienced total loss of housing and personal belongings following the hurricane, a stressor that contributed to significant psychosocial distress and a subsequent suicide attempt. The patient reported previous diagnoses of bipolar disorder and anxiety, for which he was currently being treated with psychotropic medications. At the initial presentation, his affect was flat, and he appeared guarded towards the staff. Adjustments to his psychotropic medication regimen were made throughout his admission. After the third day of admission, he was deemed stable for discharge. This case demonstrates the fragility of mental health in the setting of natural disasters and the complexity of maintaining mental health care in the aftermath. Most studies have focused on the incidence of mental health conditions after storms have caused areas of devastation, rather than on how storms precipitate decompensation in patients with pre-existing mental health illnesses, including substance use. This report explores management options and highlights the need for new policies and resources.

Background: With a half-life of 18-20 days, rapid declines in plasma albumin (PA) levels may reflect increased vascular loss of PA, e.g., as seen with inflammatory insults. Methods: Our study included 11,562 adult patients with first-time bloodstream infection (BSI) in a geographically well-defined Danish region between 2007 and 2016, all with &#x2265;2 PA specimens during BSI admission and discharged alive from the hospital. We assessed mortality 1-30, 31-90, 91-365, and >365 days after discharge. Predictors were the BSI admission's first or last PA specimen's level, grouped into <25, 25-34, and &#x2265;35 g/L as well as combinations of these (reflecting changes [none, increase, or decrease]). We applied Cox's regression analyses for a baseline model with age, sex, comorbidity, and BSI microorganisms as well as the baseline model with amendments of the first, last, or change in the PA levels. We further computed areas under the ROC curves (AUROCs) to assess how much the PA covariates changed AUROCs for the baseline model. Results: The last PA group and the changes between the first and the last PA group were the strongest predictors, with little differences between these. Lower PA level groups predicted higher mortality, especially up to 90 days. For 1-30 day mortality, the hazard ratio was 3.69 for the last PA group of <25 g/L and 0.31 for &#x2265;35 g/L (reference: 25-34 g/L). AUROCs for the baseline model were 0.72 for the 1-30 and 0.73 for the 31-90-day mortality whereas the amendment of the PA changes increased these areas to 0.79 and 0.76, respectively. Higher AUROCs (range 0.83-0.90) were seen in non-comorbid patients, in patients aged <65 years, and in the lower quartile of days between the first and the last PA specimen. Conclusions: The BSI admission's last PA specimen was a strong mortality predictor, especially up to 90 days. Higher AUROCs were found in younger, non-comorbid patients, and in patients with higher velocity of the PA changes. These results corroborate that hypoalbuminemia is mainly a marker of acute events.

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Access to musculoskeletal healthcare services in Sub-Saharan Africa is inadequate. As osteoarthritis is the most prevalent chronic osteoarticular disease globally, it's essential to understand its social and economic impact, as well as the determinants of inequities in access to healthcare services in Sub-Saharan Africa. The absence of systematised knowledge on this topic makes this review pertinent. However, due to data scarcity, assessing this burden is challenging. The objective of this scoping review is to map and summarise the available literature up to 2025 on the socioeconomic burden and health inequity determinants among the Sub-Saharan African population with osteoarthritis. A predefined search strategy will be applied to MEDLINE (via PubMed), Embase, African Journals Online and African Index Medicus to incorporate articles relevant to adults diagnosed with osteoarthritis who are residents of sub-Saharan Africa. We will also include grey literature sources such as Google Scholar, Research Square, manuals, books, medical society websites, secondary databases, theses and dissertation repositories and conference proceedings. Study selection will be conducted in two stages by a pair of reviewers who will independently screen titles and abstracts according to the eligibility criteria, followed by a full-text review of the selected studies. The search period was from October 2025 to January 2026. Data extraction will be performed using a standardised charting form developed by the review team. This scoping review maps evidence on OA-related socioeconomic impacts and healthcare inequities in Sub-Saharan Africa. As a secondary data analysis, ethical approval is not required. Findings will be disseminated via peer-reviewed journals and academic conferences to clinicians and policymakers.

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