Cantrell’s pentalogy is a rare congenital disorder with high mortality. This report presents an infant with type 1 Cantrell’s pentalogy and complex CHD, managed through staged surgeries and hybrid interventions. Genetic studies ruled out hereditary causes. The case highlights the importance of multidisciplinary approaches and further documentation to improve management and outcomes.

Existing studies suggest that foods rich in phytoestrogens could reduce mortality and protect against the shortening of telomere length (TL). However, the specific phytoestrogens responsible for this effect remain unidentified. We conducted a cross-sectional study using data from the 1999–2002 US National Health and Nutrition Examination Survey. Four metabolites of soya isoflavones (daidzein, equol, genistein, O-demethylangolensin) and two metabolites of lignans (enterodiol and enterolactone) were detected. Leukocyte TL was measured. After ln-transformed, the association of phytoestrogen metabolites and leukocyte TL was assessed using multivariable linear regression. Percentage change was calculated as (eβ–1) × 100 %. Of the 2607 participants, 48·52 % were male. A 1-sd increase in urinary equol was associated with a 1·50 % (95 % CI 0·51, 2·50) increase in TL, and TL was 4·26 % (95 % CI 1·07, 7·56) longer in the highest quintile of equol compared with the lowest. Similarly, a 1-sd increase in the equol:daidzein ratio was linked to a 1·87 % (95 % CI 0·91, 2·84) rise in TL, and TL was 4·83 % (95 % CI 1·71, 8·05) longer in the highest quintile of the equol:daidzein ratio compared with the lowest. No significant association of urinary daidzein, genistein, O-demethylangolensin, enterodiol and enterolactone with TL was observed. Our findings suggested that higher levels of urinary equol and its ratio with daidzein were associated with longer leukocyte TL, highlighting the need for further research into their relationship with ageing.

Schizophrenia (SCZ) and alcohol use disorder (AUD) are associated with physical decline and motor dysfunction, but objective wearable-based motor assessments remain underutilized in psychiatric research. This study compared handgrip strength (HGS) and gait features between healthy controls (HCs) and individuals with SCZ or AUD using wearable sensors. A total of 434 participants (HCs: n = 210; AUD: n = 80; SCZ: n = 144) completed instrumented Timed Up and Go, walking, and HGS tests. Fifteen motor features were extracted and analyzed using multivariable linear regression adjusted for age, sex, and BMI. Five features—HGS, relative HGS (rHGS), walk quality index, symmetry index, and mid-turning phase duration—significantly differentiated one or both diagnostic groups from HCs. In AUD, rHGS showed moderate associations with multiple gait parameters, consistent with more widespread motor dysfunction. In SCZ, these associations were weaker, suggesting reduced coupling between upper- and lower-limb motor function. Both groups showed reduced HGS and gait alterations, but with distinct coordination patterns. These findings support wearable-based grip and gait metrics as scalable and objective motor functional markers in SCZ and AUD.

Rural communities face unique challenges after a disaster as a result of overlapping vulnerabilities related to limited housing and transportation infrastructure, employment or income loss, and fewer emergency response and recovery resources. Hurricane Helene (Southeast Coast, USA; 2024) made landfall in Florida as a Category-4 hurricane, later impacting Western North Carolina with severe flooding, landslides, and hurricane-force winds. Communications and transportation were interrupted for months, leading to disinformation, recovery disruptions, and a loss of trust. To assess household impacts and recovery from Hurricane Helene in two rural Western North Carolina counties, a 29-question survey was adapted from a Community Assessment for Public Health Emergency Response (CASPER) conducted in Buncombe County, a nearby urban county. Thirty clusters were selected with probability proportionate to population across the two counties. Survey teams completed 183 interviews (completion rate = 87.1%). More than 35% of households evacuated because of Hurricane Helene, with nearly 18% evacuating in the week after due to on-going communication and utility outages. Less than 10% of households experienced new or worsening environmental health or chronic diseases. However, 40% reported anxiety, 30% reported trouble sleeping and depression, and 60% reported worrying about another disaster affecting their home. Nearly one year after the direct impact of the hurricane, much work remained as part of continued long-term recovery and resilience building. Because of their small populations and limited infrastructure, restoration of services necessary for response and recovery can be hindered in rural areas which often lack options such as public transportation, affordable short-term housing, and broadband or Wi-Fi.

On April 14 and October 1, 2024, and then for 10 days from June 13, 2025, Israel was under ballistic missile attacks, causing casualties and destruction. This report describes the response of an emergency department (ED) in Jerusalem to maintain quality care and safety during these attacks. It was vital to minimize the number of ED patients in unprotected zones. Patients in the unprotected area of the ED were relocated to protected zones, and a mechanism was implemented to close blast doors that had been blocked by a technical issue. Lessons learned included: adapting protected areas in the ED for continued patient care, properly closing blast doors, and maintaining flexible emergency protocols to address evolving hazards.

Successful completion of industry-sponsored clinical trials requires effective collaboration between sponsors and clinical research sites recruiting patients. As pharmaceutical companies specialize in more therapy areas, complexity and volume of clinical trials increases, with study sites facing growing operational and logistical challenges. These may be administrative, financial, technological, or workforce-related and can prevent sites from meeting trial obligations, inhibiting long-term site sustainability. Here we outline a suggested framework (with metrics) designed to address three key pillars: site infrastructure, workforce, and the establishment of a ‘trial funnel’ to maintain sufficient trial volume. We review key site-level challenges and barriers to success in clinical trial conduct and argue that issues could be mitigated by sponsors investing programmatically in their site partnerships, including investing in research-naïve sites. Long-term programmatic planning and investment has the potential to deliver greater efficiency and sustainability in trial delivery; site investment upfront would increase working capital for the site, maximizing commitment and security on both sides. This, however, requires safeguarding through the implementation of targets and metrics of success. Many of the challenges faced in modern clinical research can be mitigated by new and longer-term thinking, concerning the working relationship and methods adopted between sponsors and research sites.

This article highlights the critical need for additional security measures in health care facilities during armed conflicts, emphasizing the importance of securing vital resources such as water, electricity, medical care, infrastructure, and essential medical equipment, medications, etc., to ensure proper care for the sick and vulnerable persons. We examine the impact of conflicts in Ukraine and Palestine. This article aims to draw lessons from historical experiences and propose strategies to enhance health care resilience, focusing on key topics such as essential infrastructure, protection of health care facilities, the physical preparedness of hospitals, and the availability of alternative sources for water and electricity. Enhancing the resilience of health services requires comprehensive disaster preparedness plans for hospitals that will ensure reliable power supplies in challenging situations and provide resilient physical protection for health facilities during times of conflict. Medical facilities must prepare for emergencies involving chemical, biological, radiological, or nuclear events, implementing water supply plans, and maintaining sufficient stocks of food and materials.

The COVID-19 pandemic overwhelmed New York City’s healthcare infrastructure, prompting rapid adaptations to expand critical care capacity. Montefiore Medical Center’s Hutchinson Metro Center (the Hutch), a standalone ambulatory surgical center (ASC), was converted into an ICU within 5 days to address the surge in COVID-19 cases. This was done by repurposing 16 operating rooms and 60 post-anesthesia care unit beds into 14 ICU and 60 floor beds. A 5-step framework guided the conversion process, including: (1) feasibility of conversion, (2) critical structural logistics, (3) essential supplies and technology, (4) Clinical criteria, and (5) staffing. Key challenges were oxygen supply limitations, staffing shortages, and logistical hurdles such as medication and equipment procurement. This report highlights the potential of ASCs as adaptable overflow facilities during public health crises and provides a blueprint for future pandemic preparedness.