Interatrial stenting has become an essential intervention for children with CHD requiring sustained interatrial communication to optimise systemic and pulmonary haemodynamics. This study aimed to evaluate procedural success, clinical outcomes, and factors influencing haemodynamic improvement in a single-centre paediatric cohort.

A retrospective study was conducted on 16 patients who underwent interatrial stenting between 2018 and 2024. Patients were categorised by age as Group 1 (≤12 months, n = 10) and Group 2 (>12 months, n = 6). Demographic, procedural parameters, and follow-up data were analysed.

Sixteen patients (median age 10.5 months, median weight 5.0 kg) underwent interatrial stenting. The most frequent diagnosis was borderline left ventricle (37.5%), followed by hypoplastic left heart syndrome (25%) and myocarditis (12.5%). Procedural success was achieved in 15 of 16 patients (93.8%), with one acute failure due to stent embolisation. The median radiation exposure was 244.5 mGy (interquartile range 123.8–447.0). Radiation exposure correlated positively with patient weight (rs = 0.596, p = 0.015). During a median follow-up of 17.5 months, six patients (37.5%) died, and two required redilation. No stent thrombosis occurred.

Interatrial stenting is a safe and effective palliative intervention for paediatric CHD, providing significant haemodynamic improvement and bridging to definitive surgical management.

This study aimed to investigate the mediating role of perceived stigma in the relationship between cancer-related symptoms and social relationships among cancer patients.

This cross-sectional descriptive study was conducted with 250 cancer patients undergoing chemotherapy in an oncology hospital in Ankara, Türkiye. Data were collected using a sociodemographic form, the Nightingale Symptom Assessment Scale, the Cataldo Lung Cancer Stigma Scale, and the Social Relationship Scale. Descriptive analyses, group comparisons, Pearson correlation, and mediation analysis were performed with SPSS v27.0 and DataTab web-based analysis platform.

The findings revealed significant positive correlations between cancer-related symptoms and perceived stigma (r = 0.51, p < .001), and negative correlations between both cancer-related symptoms and social relationships (r = −0.24, p < .001) and stigma and social relationships (r = −0.54, p < .001). The mediation analysis suggested that perceived stigma may play a mediating role in the relationship between cancer–related symptoms and social relationships, as indicated by a non–significant direct effect and a significant indirect effect. Cancer-related symptoms significantly predicted perceived stigma (B = 0.58, p < .001), and stigma was a significant predictor of decreased social relationship quality (B = −0.72, p < .001). The indirect effect of cancer-related symptoms on social relationships via stigma was statistically significant (B = −0.42, p < .001), while the direct effect was not (B = −0.27, p = .182).

Perceived stigma is a critical psychosocial factor that may mediate the adverse impact of cancer-related symptoms on social relationships in this study. Therefore, addressing stigma may play a crucial role in maintaining social functioning in cancer care.

The KONAR-MF™ occluder, with its flexible medium-profile design, has broadened the feasibility of transcatheter closure of muscular ventricular septal defects, particularly in infants.

To assess feasibility, safety, techniques, and outcomes of muscular ventricular septal defect closure using the KONAR-MF™ occluder in a multicentre paediatric cohort.

A retrospective review was conducted at three tertiary paediatric cardiac centres (2018–2024). Patient demographics, ventricular septal defect characteristics, procedural approaches, and follow-up outcomes were analysed. Device implantation was performed via retrograde, antegrade, transseptal, or hybrid approaches under fluoroscopic and echocardiographic guidance.

Fifty patients (54 devices) were included (median age: 48 months [interquartile range 12–96]; weight: 12 kg [interquartile range 7.5–23]), including 14 infants (9 < 7 kg). Indications were failure to thrive (46%), heart failure (28%), recurrent infections (12%), and postoperative residual ventricular septal defect (14%). The mean ventricular septal defect size was 5.8 ± 2 mm. Median fluoroscopy time was 18 minutes (range: 3–71). Residual shunts were present in 18% immediately, reducing to 9% at one week and resolving by three months. Mild, transient tricuspid regurgitation occurred in 14%. Over a median 9-month follow-up (range 1–60), no cases of heart block or haemolysis occurred. One embolisation required surgical retrieval. Pulmonary artery pressure decreased significantly (37 ± 13.4 to 19 ± 3.8 mmHg, p < 0.001).

Transcatheter closure of muscular ventricular septal defects with the KONAR-MF™ occluder is safe, effective, and versatile across paediatric age groups, including infants and postoperative cases. High success rates, minimal complications, and favourable short- to mid-term outcomes support its use in routine practice.

Electronic consent (eConsent) and procedure-specific consent forms have been highlighted as methods of improving the consent process. In this two-cycle audit, we assessed the quality of consent documentation pre- and post-implementation of eConsent.

We reviewed paper (first cycle) and eConsent (second cycle) forms for discussion of benefits, risks and alternatives for septorhinoplasty and functional endoscopic sinus surgery. A survey which included the System Usability Scale was distributed to clinicians.

Post-implementation of eConsent, there was a statistically significant increase in the number of risks documented in septorhinoplasty (p-value < 0.001) though this was not the same for functional endoscopic sinus surgery. Feedback was generally positive with a System Usability Scale score of 85.3 indicating high usability.

The implementation of eConsent with procedure-specific consent forms in our centre was well received with significant improvements in septorhinoplasty documentation and more modest improvements in FESS.

Mass gathering events represent complex operational environments that challenge emergency preparedness and prehospital medical response systems. Milano Pride, Italy’s largest LGBTQIA+ event, attracts over 300,000 attendees annually and combines a dynamic parade with a high-density static concert. This study reports a 3-year experience (2022-2024) of prehospital organization, operational deployment, and patient presentation patterns during the event.

A retrospective observational study was conducted using data from medical action plans, mission reports, and patient records collected during the final day of Milano Pride from 2022 to 2024. The integrated response system included 6 Basic Life Support ambulances, one Advanced Life Support unit, foot and bicycle rescue teams, a field hospital, and a centralized command center.

A total of 165 missions were recorded across the 3 editions. Most cases were minor and managed on site; 8-20% required field hospital care and ≤7% hospital transport. Substance- and alcohol-related presentations accounted for approximately one quarter of cases annually. Trauma-related cases decreased over time. The mean patient age was 32 years, and the medical incident rate (0.17-0.20 per 1,000 participants) was lower than rates reported for comparable international events.

A structured, multidisciplinary prehospital system ensured effective on-site care while minimizing hospital impact, highlighting the importance of proactive planning and coordinated response in large urban mass gatherings.

Manual submission of clinical trial data to the ClinicalTrials.gov registry is labor-intensive and error-prone, contributing to variability in the completeness and consistency of registry entries. To explore whether recent advances in large language models could support this process, we developed ChatCT, a pilot retrieval-augmented system that drafts ClinicalTrials.gov registry elements.

We evaluated ChatCT-generated registry elements across three dimensions: 1. semantic similarity to the public ClinicalTrials.gov record, 2. formatting compliance with ClinicalTrials.gov requirements, and 3. coverage of key trial biomedical concepts.

ChatCT-generated registry elements were highly semantically similar to human-authored ClinicalTrials.gov records (median BERTScore F1 ≈ 0.82). Formatting compliance was high for structured elements, including Study Design (91% of required fields present; mean completeness 0.897) and Arms/Interventions (75%; 0.772), while narrative sections showed greater variability, including Outcome Measures (79%; 0.929) and Study Description (57%; 0.784). Ontology-based concept extraction and matching demonstrated consistently high precision, with scores ranging from 90% to 100%.

A retrieval-augmented large language model can generate ClinicalTrials.gov registry drafts that preserve essential protocol details and adhere to most formatting requirements. However, light post-processing (e.g., automated schema validation) remains necessary for full submission readiness. This proof-of-concept evaluation suggests that ChatCT-assisted drafting could support registry reporting by improving consistency between protocol documents and publicly reported trial information.

The choice between transcatheter and surgical pulmonary valve replacement for young adults with repaired tetralogy of Fallot who develop significant pulmonary valve insufficiency is challenging. Decision analytic modelling may be used to simulate long-term outcomes and suggest influential clinical thresholds for decision-making. A Markov model was constructed to compare the 5-year outcomes for a hypothetical cohort of 18-year-old patients.

A Markov model was constructed to simulate 10,000 hypothetical patients undergoing either transcatheter pulmonary valve replacement or surgical pulmonary valve replacement. Model inputs were abstracted from contemporary literature on the 5-year horizon. Outputs were used to derive an incremental cost-effectiveness ratio. Sensitivity and threshold analyses were performed to identify factors that would hypothetically change management.

From modelling, surgical pulmonary valve replacement had superior survival, lower incidence of endocarditis, and lower reintervention rate compared to transcatheter pulmonary valve replacement at 5 years. Surgical pulmonary valve replacement yielded lower cumulative postprocedural costs ($10,767 versus $14,528) and greater quality-adjusted life years (3.16 versus 3.12 QALYs) than transcatheter pulmonary valve replacement. The calculated incremental cost-effectiveness ratio (−88,743$/QALY) identified surgical pulmonary valve replacement as the preferred strategy at baseline. Sensitivity analysis demonstrated that transcatheter pulmonary valve replacement would be the preferred strategy if either the post-transcatheter pulmonary valve replacement endocarditis rate or the post-transcatheter pulmonary valve replacement surgical reintervention rate were reduced to 0%/month.

Comprehensive modelling of diverse outcomes showed that surgical pulmonary valve replacement had superior mid-term cost-effectiveness outcomes compared to transcatheter pulmonary valve replacement for young adults with repaired tetralogy of Fallot and pulmonary valve regurgitation. Sensitivity analysis found that the prevalence of post-transcatheter pulmonary valve replacement endocarditis and post-transcatheter pulmonary valve replacement surgical reintervention were influential outcomes for centres to consider when choosing between these strategies.

Participatory action research (PAR) methods effectively engage communities in identifying health priorities in low-resource settings. This study applied PAR methods during the establishment of a Health and Demographic Surveillance System (HDSS) in Gorakhpur, Uttar Pradesh, India.

We implemented seven PAR methods across rural and urban populations: transect walks, resource mapping, social mapping, seasonal mapping, focus group discussions, semi-structured interviews, and community ranking exercises. Data were collected in September 2023 following facilitator training. Visual materials and field notes were thematically categorized, while audio-recorded interviews were transcribed, translated, and analysed with combined inductive-deductive thematic analysis. Community health priorities were quantitatively analysed through free listing, pile sorting, and ranking.

Five major themes emerged: (1) Community context revealed diverse caste compositions and essential infrastructure; (2) Health priorities included acute conditions (fever, joint pain), chronic diseases (hypertension, diabetes), healthcare access limitations, and WASH issues; (3) Key contributors to poor health encompassed inadequate WASH facilities, limited health awareness, and discrimination; (4) Healthcare access barriers included absent primary care facilities, financial constraints, limited transportation, and poor service quality; (5) Community suggestions addressed both social determinants and healthcare services, emphasizing governance participation, WASH interventions, and improved healthcare infrastructure.

PAR methods successfully identified community-defined health needs and barriers, demonstrating consistency across urban and rural settings. Community members provided concrete recommendations for health system improvements, validating the importance of incorporating local voices in HDSS design. The alignment between community priorities and documented regional health challenges underscores how participatory methods can shape surveillance activities to foster sustainable health improvements and enhance governance capacities. These insights directly informed HDSS operational plans, creating a foundation for responsive and equitable health surveillance systems.

The general objective was to explore the nutritional condition of schoolchildren, based on certain body measurements published in various reports (from 1934 to 1965). More specifically, we intended to analyse, first, the secular trend of growth by comparing historical anthropometric data with current national and international figures and, second, to study the possible variability of body measurements at that time among different Spanish regions and of different socioeconomical levels.

Based on these reports, a sample of individuals of both sexes, between 6 and 16 years of age, was selected. Average weight and height were calculated for each age and sex, and the BMI was determined for all series. The data of these series were compared first with each other and then, using the z-score method, with reference tables published by the WHO and by a current Spanish reference.

Seven Spanish historical series, from 1934 to 1965.

114 880 individuals aged 6 to 16 years (59 786 boys and 55 094 girls).

Almost all the historical populations assessed show chronic undernutrition and underweight, strongly influenced by socioeconomic status. On the other hand, nutritional status appears almost independent of rural or urban environment.

In the series analysed, various states of chronic undernutrition and underweight were present, mainly in schoolchildren from the most disadvantaged social groups. The secular trend in height and weight occurred in times after the beginning of Franco’s developmentalism.

Disaster risk assessment is essential in territories increasingly affected by climate-related hazards. This study applies a sequential methodology for quantifying and assessing disaster risk using open-source information, focusing on Coquimbo, Chile, a coastal city with high exposure.

A 7-step model was developed, integrating sectorization by Neighborhood Units, hazard identification, recurrence analysis (2000-2024), and the evaluation of vulnerabilities, capacities, and exposure. Hazards included earthquakes, tsunamis, droughts, wildfires, and landslides. Resilience was calculated through weighted vulnerability and capacity variables, while exposure was estimated using infrastructure values. Disaster risk was computed as the product of hazard, resilience, and exposure.

Coquimbo shows heterogeneity. UV06 Sindempart, UV10 El Llano, and UV15 La Herradura demonstrated capacities, while UV12 El Culebrón and UV17–UV18 Tierras Blancas showed the highest vulnerabilities. Coastal UVs such as UV05 Baquedano and UV13 Guayacán concentrate exposure due to infrastructure and population density. Earthquakes and tsunamis were identified as the most recurrent hazards. The methodology generated 150 risk estimates across 30 Neighborhood Units.

The methodology enables a structured, replicable evaluation of disaster risk, even with limited data. Its application in Coquimbo highlights territorial disparities that can guide prioritization of resilience strategies, early-warning systems, and evidence-based planning.