Low health literacy is common and can affect brain health behaviors, yet clinical neuropsychologists do not commonly assess this important construct. The Newest Vital Sign (NVS) is a performance-based health literacy screening instrument that might be of value to clinical neuropsychologists. The current study examined the possible effects of age on the NVS and its association with cognition and applied health literacy. Participants included 50 younger (18-32 years) and 41 middle-aged/older (51-82 years) healthy adults. All participants completed the NVS, a neuropsychological battery, and measures of applied health literacy, including web-based health search tasks and the Modified UCSD Brief Assessment for Capacity to Consent. Hypotheses were tested with multiple regression analyses covarying for oral word reading. Results showed that the middle-aged/older adults obtained mildly lower scores on the NVS as compared to younger adults. Lower NVS scores were moderately associated with cognition, particularly in the domain of executive functions (e.g. abstraction, flexibility, and generativity). Higher scores on the NVS were also moderately associated with better performance on measures of web-based health information searching and treatment appraisal. The NVS is associated with older age, executive functions, and applied health literacy. Clinical neuropsychologists might consider integrating the NVS into their batteries given its brevity and relevance to health factors that affect many people with central nervous system conditions.
Low health literacy is prevalent in both healthy and clinical populations, and plays a critical role in health behaviors and outcomes. The Newest Vital Sign (NVS) is a performance-based screening measure of health literacy that assesses numeracy, prose literacy, and document literacy. However, the underlying factor structure of the NVS is not well established and questions persist regarding optimal scoring methods, which limits our understanding of this widely-used measure. The current study therefore aimed to confirm the factor structure of the NVS in separate samples of healthy, English-speaking adults and people with HIV (PWH). The study samples consisted of English-speaking adults without HIV (n = 270) and PWH (n = 310) who completed the 6-item NVS. Confirmatory factor analysis was used to test one-, two-, and three-factor models for the items on the NVS. A five-item, single factor solution for the NVS provided the best fit to the data and showed configural invariance between the samples of healthy adults and PWH. Findings provide evidence for the construct validity of a revised, five-item scoring of the NVS in a clinical and non-clinical sample of English-speaking adults. Future research is needed to examine the psychometrics and construct validity of this revised NVS in other clinical populations. Results of this factor analytic study suggest that researchers and clinicians are well supported in using a single, five-item score from the NVS to assess health literacy in people with chronic medical conditions.
In 2026, the U.S. Food and Drug Administration introduced a new Risk Evaluation and Management Strategy (REMS) for the etonogestrel contraceptive implant. Although the intent was to maintain safe practices for device insertion and removal, the large body of long-standing safety data should raise questions about the need for these new requirements. In the absence of safety concerns regarding device insertion and removal, a REMS requirement on the etonogestrel contraceptive implant may lead to decreased reproductive health care access and provision.
Patients with psoriasis treated with biologic therapy are considered to have increased risk of developing skin neoplasms. The impact of novel therapies on the development and biology of melanocytic lesions is not completely known. The aim of the study was assess if the treatment with biologics exerts effects on the melanocytic nevi. Dermoscopy and videodermoscopic imaging of 276 melanocytic lesions were performed at the initial visit and after one year in 13 patients with psoriasis treated with IL-12/23 inhibitors, IL-23 inhibitors or IL-17 inhibitors. The nevi size significantly increased at the one-year follow-up in the whole study group and in patients treated either with IL-23 inhibitors or IL-12/23 inhibitor. 2% of melanocytic nevi showed an increase in any of the scores (ABCD score, 7-Point Checklist score, CASH score) or at least 1-mm change in the diameter at the one-year follow-up; however, these changes were not statistically significant between the different therapy groups. Although treatment with novel groups of biologics leads to an increase in nevi size, it does not contribute to significant structural or color changes in melanocytic nevi or to the development of dysplastic nevi or melanoma at the one-year follow-up.
Canine atopic dermatitis is a hereditary chronic inflammatory and pruritic skin disease, which is mediated by T cells and requires long-term, individualized management. In recent years, numerous studies have described a wide range of therapeutic approaches for canine atopic dermatitis, including fast-acting symptomatic treatments, long-term immune-modulating interventions, and strategies to support skin barrier function and microbial balance. This review summarizes the principal treatment modalities currently available, including glucocorticoids, cyclosporine A, mycophenolate, Janus kinase inhibitors, lokivetmab, and allergen-specific immunotherapy, as well as complementary strategies aimed at restoring skin barrier integrity. Emphasis is placed on the importance of a multimodal and personalized approach to optimize long-term disease control and improve quality of life in affected dogs. Providing an integrated overview of current evidence, this article aims to guide clinicians in making informed, evidence-based decisions and to support the safe and effective management of canine atopic dermatitis.
Studies on drought stress physiology have primarily focused on the newest fully expanded leaves, in which drought reduces cytokinin (CTK) content, thereby disrupting water balance and photosynthesis. Mature (old) leaves usually exhibit greater sensitivity to drought than the newest fully expanded ones. However, the impact of higher endogenous CTK levels on photosynthetic rate (AN) and water use efficiency (WUE) in drought-stressed mature leaves remains underexplored. To address this, a drought experiment was performed using wild-type (WT) cotton and two CYTOKININ DEHYDROGENASE (GhCKX) suppression lines with elevated CTK levels. Here, suppressing GhCKX optimized the trade-off between AN and intrinsic WUE (iWUE) in mature leaves during drought, since not only higher AN but also higher iWUE were observed in transgenic lines than the WT under drought. This optimization was driven by shifts in the relationships of mesophyll conductance (gm) and maximum carboxylation rate (Vcmax) to stomatal conductance (gs), specifically higher gm/gs and Vcmax/gs ratios, resulting from larger enhancements in gm and Vcmax than in gs, caused by up-regulated CTK. Moreover, higher gm in drought-stressed transgenic lines than drought-stressed WT resulted from thinner cell wall, shorter distance between adjacent chloroplasts, and larger ratio of chloroplast area to mesophyll area facing the intercellular airspace; and their superior Vcmax was attributed to increased Rubisco content and initial Rubisco activity. This study reveals that promoting endogenous CTK simultaneously enhances AN and iWUE in mature leaves under drought via the coordination of photosynthetic constraints, offering a sustainable strategy to improve the drought resistance of crops.
Baffle leaks are a known complication of the atrial switch for D-looped transposition of the great arteries. A 46-year-old woman with D-looped transposition of the great arteries who underwent an atrial switch (Mustard) presented with a hemodynamically significant baffle leak in close proximity to the systemic tricuspid valve. This report details the first-in-human percutaneous closure of a large baffle leak using a newest generation closure device, the GORE CARDIOFORM ASD Occluder (GCA). Baffle leaks are traditionally managed with either surgery or percutaneously with catheter-based devices. The location of the leak in this case was close to the tricuspid valve, and so the newer, softer GCA device was used. This is the first-in-human percutaneous closure of a baffle leak after an atrial switch using the GCA device. The GCA is the newest generation of closure devices that may convey an advantage over previous technology when closing leaks adjacent to important cardiac structures.
The helpful gut microbes create bioactive micro- and macromolecules known as postbiotics, which have substantial medical potential. These small-molecular-weight biomolecules, which provide the host with a number of physiological health advantages, are the subject of a revolutionary therapeutic strategy. Because of their varied delivery mechanisms and customizable dosage, several postbiotics are promising medical agents that may be used for both prophylactic and therapeutic purposes. Nonetheless, there are still a lot of obstacles to overcome when giving postbiotics in vivo. The current body of scientific literature supports utilizing targeted delivery systems based on nanoparticles as a novel and secure method for the delivery or/and release of postbiotics in a variety of (oral, intradermal, and intravenous) in vivo models due to their attractive characteristics in regards to low toxicity, high biodegradability, biocompatibility, and considerable capacity for carrying both hydrophobic and hydrophilic postbiotics. If postbiotics are to be widely used as therapeutic approaches, they must undergo considerable research and randomized double-blind clinical studies because they are still in the early stages of development. This article gives a thorough summary of the newest developments in drug delivery, with a focus on the main in vivo routes for the tailored delivery of postbiotics. However, the findings summarized in this review are primarily based on preclinical and early-stage studies, and limitations related to heterogeneous study designs, incomplete pharmacokinetic characterization, and limited clinical validation should be considered when interpreting the translational potential of postbiotic delivery systems.
Health literacy (HL) is the degree to which individuals comprehend information and services to inform health-related decisions and is a strong predictor of health outcomes. This study investigates whether increased exposure to the healthcare system equips caregivers of children with a chronic disease - cerebral palsy (CP) - with higher baseline HL compared to caregivers of otherwise healthy pediatric patients seeking acute surgical treatment. This prospective study utilized a single pediatric referral healthcare system over a 15-month period to recruit caregivers of pediatric patients with CP undergoing planned orthopaedic surgery (CP group) and caregivers of otherwise healthy pediatric patients undergoing planned surgical treatment for acute fractures (fracture group). Baseline HL was assessed pre-operatively with the Newest Vital Sign survey; charts were reviewed for no-shows, cancellations, and advice-only calls. Mann-Whitney U tests and pair-wise post hoc tests were utilized to compare cohorts. Ninety patients were included for analysis, of which 37 (41.1%) were in the CP group and 53 (58.9%) were in the fracture group. There was no difference in baseline caregiver HL between cohorts (CP: 3.76 ± 1.62; fracture: 3.55 ± 2.09, P = .790). However, the fracture cohort had significantly higher no-show (CP: 0.03 ± 0.16; fracture: 0.49 ± 1.17, P = .008) and canceled appointments (CP: 1.16 ± 1.69; fracture: 1.94 ± 2.43, P = .032). Conversely, the CP group had significantly higher advice-only calls (CP: 2.51 ± 3.42; fracture: 0.06 ± 0.31, P < .001). Despite more interaction with the healthcare system, caregivers of children with CP do not have measurably higher HL compared to caregivers of children seeking acute, episodic fracture care. While these two cohorts demonstrate comparable baseline HL levels, their needs and utilization of healthcare differ considerably. These findings emphasize the importance of tailoring education to individual caregivers, providing counseling and resources at each visit, and ensuring caregiver comprehension regardless of patient status, system familiarity, or healthcare utilization. (1)Caregivers of children with CP do not demonstrate higher baseline HL compared to caregivers of children with acute fractures.(2)Despite similar HL scores, caregivers in the CP group made significantly more advice-only calls, suggesting greater post-operative care needs.(3)Tailored educational support is essential, as healthcare system exposure alone does not equate to improved caregiver health literacy. II; Lesser-quality prospective study.
The proton's Gibbs solvation energy in various organic solvents was determined by experimental and theoretical means to serve as anchor points for the solvent-independent Unified Acidity Scale (UAS) and the Protoelectric Potential Map (PPM). Experimentally, potential differences between two half-cells connected by an "ideal" ionic liquid salt bridge (ILSB) were measured. Here, our established setup with the "ideal" Ionic Liquid [N2225][NTf2] in the ILSB ([N2225] = [N(C2H5)3(C5H11)]; Tf = SO2CF3) was refined to enable measurements of the Gibbs energies of proton transfer ΔtrG°(H+, S1→ S2) between different solvents S1 and S2, such as water, methanol, ethanol, acetonitrile and methyl formate. These results were further evaluated by extensive theoretical studies using the double-hybrid functional DSD-BLYP for structure optimization and highly accurate coupled cluster DLPNO-CCSD(T) calculations that were extrapolated to the basis set limit (CBS) for the gas phase contributions. Solvation effects were added implicitly with the Conductor-like Polarizable continuum Model (CPCM) in a Cluster Continuum approach, including a scheme to use the CPCM with coupled cluster calculations in ORCA's newest version. A monomer and a cluster thermodynamic cycle were used to calculate the proton's solvation energy from the calculated solvent clusters. The cluster cycle performed well with consistent improvement at higher levels of theory, while the monomer cycle suffered from inadequate error compensation. Yet, the monomer cycle results can be significantly improved by the inclusion of experimental data, such as Gibbs energies of evaporation. However, it remains clear that even when using the most sophisticated of all currently available methods, the error bars of the calculations may at best reach about 10-15 kJ mol-1 and, given low polarity solvents like methyl formate with εr = 8.838, may even substantially exceed this error bar. Analysis shows that one of the largest problems arising for the calculations is the lack of reliable experimental structural data in solution to know how the dissolved particles governing the protochemical potential exactly prevail in solution. The delicate balance of subtle and relatively weak hydrogen bonds or dispersive interactions may lead to large structural differences between the structures known in the solid state (e.g., from single crystal structure determinations) and those actually being thermodynamically relevant in (dynamic) equilibrium in solution. We present some problems encountered during our work on this subject. At least for the more polar "classical" solvents, experimental ILSB- as well as computationally obtained results are in good agreement with the known values from the TATB assumption, which is currently one of the most widely used assumptions for determining single-ion transfer energies. However, with none of the described in part rather sophisticated calculations, it is possible to achieve "chemical accuracy" in solution, as one can with the used "gold standard" coupled cluster methods in the gas phase (i.e., ±4 kJ mol-1).
Globally, the Cryptococcus species, particularly Cryptococcus neoformans and Cryptococcus gattii, have a significant impact on human health. Concurrent with the evolving epidemiology of cryptococcosis, it has now become evident how host immunity contributes to the pathophysiology of severe disease. The only pharmacological antifungal therapeutic agents available are 5-flucytosine, fluconazole, and amphotericin B. Echinocandins, the newest fungicidal class for invasive mycoses, are ineffective against cryptococcosis caused by C. neoformans. Antifungal treatment is hampered by the high toxicity, elevated resistance rate, and difficulty of currently known antifungal compounds crossing the blood-brain barrier, in addition to the limited pharmaceutical choices. Therefore, it is imperative to find novel therapeutic options for cryptococcal infections. This article will summarize what is now understood about the immunopathology linked to cryptococcal infections that produce a tolerant phenotype. We also outline the current possible antifungal therapeutic approaches to control cryptococcal illness. We go into further detail on the most recent developments in our knowledge of the adaptive and intrinsic resistance mechanisms used by Cryptococcus species to avoid medical interventions. Together with developments in genomics technology and high-throughput screening techniques, knowledge of the processes governing anti-cryptococcal drug resistance will, in general, spur innovation and quicken the discovery of antifungal drugs.
NHS Talking Therapies for anxiety and depression is a service that provides people in England with psychological support. There are several referral routes into the service, digital front door technologies being the most recent addition. The aim of this National Institute for Health and Care Excellence early value assessment was to map available evidence, assess potential benefits and costs of NHS Talking Therapies referral pathways with and without digital front door technologies, and identify evidence gaps to help direct future data collection and further research. The External Assessment Group carried out a systematic literature review (December 2024) to gather evidence relating to Limbic Access (Limbic), Wysa Digital Referral Assistant (Wysa), Censeo Digital (Psyomics) and AskFirst (Sensely). Information was collected across four broad outcome categories: accuracy and acceptability, resource and system impact, patient-reported outcomes, and costs. All study types were eligible for inclusion in the systematic literature review, along with evidence provided by the manufacturers of digital front door technologies (via requests for information). In addition, the External Assessment Group interviewed and sent questionnaires to stakeholders, including National Institute for Health and Care Excellence Specialist Committee Members, and carried out exploratory analyses of costs and benefits. Evidence was only available for two digital front door technologies: Limbic Access and Wysa Digital Referral Assistant. Literature meeting the systematic literature review eligibility criteria comprised two published peer-reviewed studies, six unpublished studies and five requests for information responses. The strongest evidence related to accessibility and overall satisfaction with Limbic Access. Results from one peer-reviewed study showed that Limbic Access increased the number of referrals to NHS Talking Therapies versus services that did not implement the technology (odds ratio = 1.10, 95% confidence interval 1.075 to 1.131); this included an increase in access for some minority groups [Asian (odds ratio = 1.29; confidence interval 1.163 to 1.422), Black (odds ratio = 1.35, confidence interval 1.183 to 1.551) and non-binary (odds ratio = 2.95; confidence interval 2.065 to 4.206)]. Overall satisfaction reported by users who completed the Limbic Access referral process was high (≥ 89%). Resource impact evidence was provided by one peer-reviewed study; results showed that Limbic Access reduced clinical assessment duration by 12.7 minutes. No relevant information on quality and accuracy was identified. Respondents were positive about digital front door technologies, suggesting that these tools could lead to better quality and more accurate (1) pre-referral practices and (2) initial clinical assessments; however, experts were unable to clearly define quality or accuracy. The External Assessment Group's exploratory economic analysis results suggested that the amount of clinical assessment time required to notionally offset the Limbic Access or Wysa Digital Referral Assistant licence cost was small (< 3 minutes). Most published evidence was non-comparative. The strength of the evidence provided by the technology companies was difficult to assess due to limited detail. Further evidence is required to better understand the benefits and costs of digital front door technologies for NHS Talking Therapies. Evidence generation should focus on whether digital front door technologies improve the accuracy and quality of clinical assessments and their impact on resources throughout the referral pathway. This study is registered as PROSPERO CRD42025634844. This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis Programme (NIHR award ref: NIHR171847) and is published in full in Health Technology Assessment; Vol. 30, No. 52. See the NIHR Funding and Awards website for further award information. NHS Talking Therapies provide psychological support to people in England who have anxiety and depression. There are different ways to access these services, and one of the newest methods is by using digital front door technologies. Digital front door technologies are digital tools that gather relevant information (with or without the use of artificial intelligence); they are intended to make the NHS referral process quicker and more efficient. This research explored the potential benefits and costs of using digital front door technologies. An independent research team reviewed published and unpublished evidence, collected information from the companies that created the technologies, and interviewed experts. Robust evidence was lacking for the impact of digital front door technologies on four key outcomes: quality and accuracy of the data collected using digital front door technologies, accuracy of the clinical assessment, impact on administrative burden and time taken to review data collected by digital front door technologies. There was some evidence about the effectiveness of two digital front door technologies (Limbic Access and Wysa Digital Referral Assistant). The Limbic Access evidence was more robust than the Wysa Digital Referral Assistant evidence, particularly in terms of accessibility outcomes; Talking Therapies services that used Limbic Access experienced a larger increase in the number of referrals than services that did not implement Limbic Access. Digital front door technologies were associated with high levels of user satisfaction and may help save time during the initial clinical assessment. None of the evidence reported any harms associated with the adoption of the Limbic Access and the Wysa Digital Referral Assistant digital front door technologies. The adoption of digital front door technologies may provide value for money for the NHS. For the technologies to be considered to provide value for money, < 3 minutes of clinical assessment time need to be saved or the technologies need to provide a very small gain in patient quality of life. Experts were generally positive about using digital front door technologies and felt the technologies could improve the quality and accuracy of referrals to NHS Talking Therapies. However, the experts could not clearly define what ‘quality’ and ‘accuracy’ meant in clinical practice. Overall, while findings are positive, more research is needed to fully understand the benefits, costs and impact of using digital front door technologies to access NHS Talking Therapies.
Gynaecological robotic surgery is one of the latest transformations in minimally invasive operative techniques. Gynaecological surgeons treat several conditions that affect a woman's reproductive organs using miniature instruments guided through a robotic system. Currently, benign gynaecological surgeries do not have many remarkable advantages over conventional laparoscopic surgeries. EndoWrist manoeuvres of robotic instruments resemble the open surgical technique, which allows better and precise suturing than conventional laparoscopy in procedures like myomectomy and sacrocolpopexies. Our study showcases our adaptation to the newest innovation and its outcome. Our prospective study includes 30 benign gynaecological cases operated by single surgeon in Da Vinci Xi system from June 2023 to July 2024. This included 28 hysterectomies and 2 myomectomies. Baseline demographic data, docking time, console time, blood loss, post-operative pain and dosage of analgesia taken, post-op ambulation, length of hospital stay, and post-op complications have been assessed. The BMI of 30-34.9 kg/m2 contributed to 24%, and 35-39.9 kg/m2 contributed to 21%. Docking time reduced from around 45 ± 15 min to 15 ± 5 min. An average console time was 132 min, which stepped down from 216 min. The average blood loss in 50% of them is 50-100 ml. A 95% of patients were discharged between 3 and 5 days. Post-operatively, 35% had mild pain and 50% moderate pain, assessed by the VAS scale. A minimally invasive technique with outcomes similar to laparoscopy but with an EndoWrist movement aiding to a less steeper learning curve to the surgeons and patient friendly outcomes which enhance with expertise.
Background/Objectives: In several contexts, Dried Sample Spot Devices (DSSDs) offer a convenient and safe alternative for sampling, storage, and shipment, allowing the transport and storage of biological samples at room temperature, reducing shipment costs and improving access to diagnostics in faraway sites. This can be pivotal for the use of the therapeutic drug monitoring of anti-HIV treatment: therefore, this study aimed to develop and validate a UHPLC-MS/MS method for the simultaneous quantification of 12 antiretroviral drugs, including the recently introduced long-acting agents, in Dry Plasma Spots (DPSs). Methods: First, 100 µL of plasma sample and 100 µL of internal standard solution were spotted on each DSSD. After complete drying, DPSs were added with an acidifying solution (ammonium acetate buffer pH 4), and then, each sample underwent extraction with hexane-dichloromethane 50:50 (v/v). After tumbling, the organic phase was evaporated and reconstituted for injection. An Acquity UPLC HSS T3 1.8 µm, 2.1 × 150 mm column at 50 °C enabled separation, performed using H2O + F.A. 0.05% (phase A) and ACN + F.A. 0.05% (phase B) as the mobile phase in gradient elution mode, for a total run time of 15 min. Results: The method was validated over the clinically relevant concentration ranges. For all quality control levels, accuracies ranged from 98.2% to 114.1%, and intra-day and inter-day RSD values ranged from 2.7% to 9.7% and 5.2% to 13.9%, respectively. All analytes demonstrated satisfactory short- and long-term stability in DPSs, confirming the suitability of shipment and storage at room temperature. Conclusions: The method demonstrated robustness and reproducibility in accordance with FDA and EMA guidelines. It ensures satisfactory accuracy and rapid analysis, supporting its application in clinical practice, including for monitoring the newest long-acting drugs.
Claudin 18.2 (CLDN18.2) represents one of the newest biomarkers expected to enter routine testing in the near future and expanding the spectrum of available predictive markers. It is currently a clinically relevant predictor for adenocarcinomas of the stomach and the gastroesophageal junction, although its use will likely extend also to other diagnoses. The aim of this report is to provide an overview of selected aspects of CLDN18.2 expression testing, including the choice of appropriate tissue, the issue of tumor heterogeneity, antibodies suitable for testing and their evaluation, where such testing can be performed, and the prospects for the future.
The accuracy of implant scans varies depending on the scanning technique used. Newest developments include the capability to capture implant positions by using tablet-based photogrammetry (PG). However, the accuracy of this scanning technique remains unknown. The purpose of this in vitro study was to analyze the accuracy of complete arch implant scans captured using a tablet-based PG and a noncalibrated implant scan body (ISB) system. A stone cast with 6 implant abutment analogs (MultiUnit Abutment Plus Replica) was digitized by using a laboratory scanner (T710) (control scan). Two groups were created depending on the scanning technique used to capture the experimental complete arch implant scans: tablet-based PG (T-Marker) (Tablet-PG group) and noncalibrated ISB system (IOConnect) (NC-ISB group) (n=30). In the Tablet-PG group, an optical marker was hand tightened into each implant abutment of the reference stone cast. Then, consecutive scans were captured by using a tablet (iPad Pro) and following the scanning distance and pattern recommended by the manufacturer. In the NC-ISB group, a noncalibrated ISB was hand tightened into each implant abutment toward the center of the arch, as instructed by the manufacturer. Consecutive scans involving the distal geometry of the noncalibrated ISBs were recorded using an IOS (Trios5). Euclidean linear and angular measurements were obtained on the control scan and used to compare the discrepancies with the same measurements obtained on each experimental scan. The independent samples t test was used to analyze the trueness data. The Levene test was used to analyze the precision values (α=.05). Significant differences were found among the overall linear (P<.001) and angular (P=.019) trueness discrepancies between the groups. The NC-ISB group had significantly better linear trueness but lower angular trueness than the Tablet-PG group. Additionally, significant angular (P<.001) precision discrepancies were found between the groups. The Tablet-PG group had significantly better angular precision than the NC-ISB group. Accuracy discrepancies were found among the scanning techniques tested. Nonetheless, the tablet-based PG and noncalibrated ISB system obtained accuracy values that may meet the clinical requirements for capturing implant positions.
Various cervical disc prosthesis and implant designs for motion preservation are routinely used in cervical disc arthroplasty (CDA). One of the newest implant designs combines features of an articulating gliding surface with those of a viscoelastic flexible core. This should allow for absorption of compressive loads in the axial direction, whereas the gliding surface at the inner surface is intended to allow a physiological range of motion with a progressive increase of resistance in six degrees of freedom (DOF). The aim of this study was to evaluate the safety and efficacy of a new cervical disc prosthesis in a mono-centric clinical setting. This observational study analyzes the first clinical and radiological results over a period of up to 24 months and evaluates the safety and efficacy of the novel CDA design. Subjects with one- or two-level degenerative cervical disc disease were enrolled. Radiographic assessments were performed pre-operatively, as well as at the 12- and 24-month follow-ups. Clinical data including pain scores [visual analog scale (VAS), Denis Pain Scale, pharmacological treatment], function scores [Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA)], outcome scores (mMacnab) and complication rates were monitored. Forty-five subjects (21 male/24 female) with a mean age of 43.4 years (30-62 years) were operated on the levels C4/5 (7.0), C5/6 (22.0) and C6/7 (23.0) between 01/2021 and 01/2025. A total of 52 implants with sizes between 5 mm ×16 mm and 8 mm ×18 mm were used. Clinically, all subjects reported significant improvements in pain and functional outcomes; however, VAS arm improved better than VAS neck, whereas NDI and mJOA improved at all time points over baseline. No serious adverse events were monitored. Heterotopic ossification (McAfee grades 3 and 4) was observed in 17.3% after 2 years, subsidence with migration into the endplates >2 mm in 11.5%. There were no re-operations due to mechanical problems or implant malfunction. The clinically tested articulating and viscoelastic design concept demonstrated both safety and effectiveness for the treatment of degenerative cervical disc disease. Compared to baseline, all subjects demonstrated significantly improved quality of life and reduced pain, as well as a decreased need for analgesics.
Over the past century, human food ration changed more vehemently than over millennium. The article presents reviewing analytical data concerning evolutionary characteristics of development of ancient humans and diversity of food set in close relationship with their lifestyle, migration re-settlements, discovery of new food sources, application of thermal food processing. The analysis was carried out concerning alteration of patterns of food ration associated with transition to sedentary life-style, globalization processes and technological advancement in agriculture. The most important stages of saltatory development of plant cultivation that play immense role in solving problems of hunger and diversity of food, shaping of food market under development of agronomy, selection and soil science, animal husbandry, emergence of agricultural technologies and newest bio-technologies. За последнее столетие рацион питания человека изменился стремительнее, чем за тысячелетия. В статье приведены обзорно-аналитические данные эволюционных особенностей развития древнейших людей и разнообразия продуктового набора в тесной связи с их образом жизни, миграционными переселениями, открытием новых пищевых источников, применением тепловой обработки пищи. Проведен анализ смены рациона питания с переходом к оседлому образу жизни, процессов глобализации и технологического совершенства в сельском хозяйстве. Показаны важнейшие этапы скачкообразного развития растениеводства, которые играют огромную роль в решении проблем голода и пищевого разнообразия, формирования продуктового рынка при развитии агрономии, селекции и почвоведения, животноводства, появлении агротехнологических и новейших биотехнологий.
Type III interferons (IFNλs) represent the newest interferon family, comprising four human subtypes (IFNλ1-4) that signal through the tissue-restricted IFNLR1 receptor. While traditionally characterized as antiviral cytokines protecting mucosal barriers, accumulating evidence suggests that IFNλs possess broader physiological roles that remain incompletely understood. A critical gap in our knowledge concerns whether the four IFNλ subtypes function redundantly, or serve distinct biological purposes. Recent discoveries challenge the assumption of functional redundancy among IFNλ subtypes. Emerging data indicate that different subtypes exhibit distinct signaling kinetics, potencies, and downstream effects on epithelial biology. Beyond their established antiviral functions, IFNλs appear to regulate fundamental aspects of epithelial homeostasis, including barrier integrity, cellular differentiation, and tissue architecture. The discovery of constitutive basal IFNλ expression in healthy epithelia-driven by microbiota and endogenous danger signals-suggests that these cytokines continuously shape tissue physiology rather than functioning solely as inducible defense molecules. Understanding subtype-specific IFNλ functions has become increasingly urgent as these cytokines enter clinical development. The tissue-restricted expression of IFNLR1 offers therapeutic advantages over broadly-acting type I interferons, but optimal clinical application requires comprehensive knowledge of how individual subtypes influence both pathogen control and tissue homeostasis. Critical questions remain: Do specific subtypes preferentially regulate barrier function versus antiviral immunity? Can imbalanced subtype expression contribute to epithelial pathology? How do pathogens differentially induce IFNλ subtypes to evade immunity or promote tissue damage? Addressing these questions will illuminate fundamental principles of mucosal immunity and guide rational design of IFNλ-based therapeutics that maximize protection while preserving epithelial health.