Textbooks continue to serve as essential central repositories of knowledge for postgraduate education in paediatric cardiology, despite the widespread availability of digital learning tools. Recent studies confirm that trainees still value textbooks for their structure, depth, and accessibility, while also requesting improved pedagogy and organisation. In preparing the 5th edition of Anderson’s Pediatric Cardiology, our editorial team implemented several deliberate educational innovations. These included (1) re-focusing towards our target audience, the congenital cardiac trainee and practicing congenital cardiologist; (2) adoption of a consistent lesion-based framework, termed the “red line,” linking anatomy, physiology, and clinical features; (3) expansion of concise visual elements such as tables, figures, algorithms, and flowcharts; and (4) incorporation of clear learning objectives throughout. These modifications were informed by feedback from trainees, educators, and practicing providers, balancing the desires and needs of the modern learner, and firmly grounded in principles of cognitive and educational science. This paper outlines the rationale, design, and pedagogical implications of these innovations within the broader context of modern medical education.

To address challenges in the real-world implementation of digital health for mental healthcare in Nigeria, this study conducted a process evaluation of five World Health Organization-recommended digital tools within a state-wide primary health care program in Lagos. Employing a convergent mixed-methods design across five facilities, we measured implementation fidelity through observation and platform analytics, and assessed stakeholder perceptions via validated surveys and interviews. The findings revealed a sharp divergence in success. Administrative tools that streamlined workflows, such as drug stock notification and automated client reminders, achieved high fidelity (>90% adherence). In contrast, clinical tools that altered provider–patient interactions, including a decision support app and a client helpline, demonstrated low fidelity (<66% adherence). Qualitative analysis attributed this gap to the successful tools’ seamless workflow integration versus the clinical tools’ disruption of practice and introduction of perceived professional and liability risks. The study concludes that digital health adoption is determined less by technological sophistication than by its integration into human systems. Scaling these innovations effectively requires prioritizing tools that align with existing workflows and developing a supportive policy ecosystem to address the professional concerns of frontline health workers.

A kitten’s early experiences have lasting effects on adult behaviour and welfare. Domestic cat (Felis silvestris catus) breeders play an important role in shaping these outcomes through their knowledge and understanding of early environment and socialisation. This study aimed to investigate Swedish pedigree cat breeders’ knowledge, attitudes and current socialisation practices. An online survey was distributed via social media to active Swedish breeders of pedigree cats (n = 133). The data were analysed primarily using descriptive statistics with several areas for improvement being identified. More breeders stated the importance of multiple people handling the kittens than they applied in practice. Significantly more breeders reported that it was important for kittens to interact with other companion animals than they demonstrated in practice. Gaps in knowledge were identified regarding the optimal age for socialisation, handling quantity, and the heritability of traits relating to the approach to new experiences. Breeders generally expressed positive attitudes towards socialisation and wished they could have prioritised it more. These findings have important implications for animal welfare, as insufficient early socialisation can increase the risk of fear-related behaviours and reduced overall cat welfare later in life. In conclusion, this study, although based on a convenience sample, provides an important first step towards understanding and improving kitten socialisation practices in Sweden and elsewhere.

Microbial protein feed (MPF), produced through precision fermentation, offers a promising pathway toward a more sustainable agri-food sector by reducing reliance on conventional feed sources. This emerging cellular technology can help conserve natural resources, lower greenhouse gas emissions, and address the growing global demand for protein alternatives. Similar to other biotechnology innovations, the realization of MPF’s potential benefits dependents heavily on a supportive regulatory environment. This study examines the regulatory frameworks of the United States, the European Union, China, and Australia to assess how pre-market regulations shape the development of MPF and to identify specific legal challenges faced by manufacturers. Across these jurisdictions, there are no specific laws or regulations for MPF products. Their oversight falls under general feed and GMO-related legislation, creating regulatory gaps, ambiguity in product assessments, and procedural inefficiencies that are further exacerbated by overlapping regulatory authorities and generic labeling requirements. Such challenges not only slow the commercialization of MPF products but also impede broader efforts to develop more sustainable agri-food systems. Our analysis indicates that targeted regulatory reforms are needed to streamline pre-market approval pathways and improve risk assessment standards. By adopting dedicated regulatory approaches and strengthening pre-market consultation mechanisms with developers, these jurisdictions will be better positioned to advance environmentally responsible protein production and accelerate the transition to a more sustainable agri-food sector.

It is increasingly acknowledged that the transition from animal- to plant-based proteins confers substantial benefits for both human health and environmental sustainability. This review provides a critical examination of the necessity to consider not only the degree of processing applied to plant protein-based foods, particularly those derived from legume seeds, but also the nutritional quality of the resulting products. While it is well established that plant proteins exhibit a lower environmental footprint compared with their animal-derived counterparts, their digestibility is often reduced, primarily due to the matrix composition of raw ingredients. To improve protein digestibility and reduce the antinutrient content in these raw materials, a variety of processing methods are used, encompassing thermal and biological treatments (e.g. extrusion and fermentation, respectively). However, processing methods may also introduce unintended adverse effects, including protein oxidation and formation of undesirable compounds. Therefore, this review explores the paradox of sustainable processing, where process conditions may simultaneously confer environmental advantages while compromising nutritional quality. In this context, food classification systems such as NOVA are critically examined, highlighting the absence of an evidence-based system that integrates both processing conditions and product formulation in the classification of plant-based foods. Current approaches categorizing plant-based options as ultra-processed foods without accounting for the nutritional quality of their ingredients, and their ultimate digestibility, may mislead consumers and discourage the consumption of nutritionally adequate plant-based alternatives. Finally, the review emphasizes the need for the adoption of processing technologies that address the sustainability challenge and the nutritional quality of plant protein-based foods.