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The study of rum evolution is essential to determine the distinctive properties of each variety. The Industria Licorera de Caldas (ILC) promotes research focused on the identification of aging markers in rums and tafias-the latter not produced by the ILC but aged in its oak barrels. These tafias serve as raw material for the production of representative rums such as Ron Viejo de Caldas Tradicional, Ron Viejo de Caldas Juan de la Cruz, Ron Viejo de Caldas Carta de Oro, and Ron Viejo de Caldas Gran Reserva Especial. This research aimed to perform a volatilomic and olfactometric study to characterize and differentiate tafias and rums aged at the ILC from other rum varieties currently available on the market. The olfactometric profile was obtained using headspace solid-phase microextraction (HS-SPME), followed by olfactometry coupled to a gas chromatograph-mass spectrometer (GC-MS-O). The volatilomic profile was determined through liquid injections in GC-MS, while aging markers were exclusively analyzed by liquid injection GC-MS. Aging markers identified included ethyl propanoate, isobutyl acetate, ethyl butyrate, hexanal, butyric acid, ethyl isovalerate, isovaleric acid, ethyl hexanoate, ethyl heptanoate, guaiacol, ethyl octanoate, trans-whiskey lactone, ethyl decanoate, syringaldehyde, eugenol, cis-whiskey lactone, vanillin, and ethyl dodecanoate. These compounds enable differentiation between rums aged by the ILC and those from external producers. The correlation of these compounds with the rum aging process, through volatilomic and olfactometric analyses, highlighted key chemical markers and their olfactory descriptors as differentiating criteria for identifying high-quality rums within the volatile profile characteristic of ILC-produced rums.

The CURRENT registry is a prospective, multicenter, real-world investigation designed to evaluate the safety and effectiveness of the Renzan™ stent (Terumo MicroVention Inc., Aliso Viejo, CA, USA) in patients with femoro-popliteal peripheral artery disease (PAD), including complex lesions and chronic limb-threatening ischemia (CLTI). This study reports the interim outcomes at 6 and 12 months. A total of 89 patients with symptomatic PAD (Rutherford category IV-V 64.1%) were enrolled across three centers in Tuscany, Italy. All patients underwent endovascular treatment with the Renzan™ dual-layer interwoven nitinol stent. Baseline and follow-up assessments included clinical evaluation and duplex ultrasound imaging. The primary safety endpoint was the composite rate of all-cause death, target lesion revascularization (TLR), and major amputation at 30 days. The primary efficacy endpoint was primary patency at 6 months. Estimated patency and reintervention rates were reported at 12 months using Kaplan-Meier analysis. Technical and procedural success was achieved in 100% of cases. At 30 days, no deaths, TLRs, or major amputations occurred. At 6 months, the composite safety endpoint was met in 94.3% of patients. Primary patency was 100% at 1 and 3 months, 92.0% at 6 months, and declined to 78.7% (95% CI: 55.3-88.1%) at 12 months. Freedom from TLR was 97.2% at 6 months and 78.5% (95% CI: 63.7-88.7%) at 12 months. Exploratory multivariable analysis identified diabetes mellitus, previous peripheral endovascular intervention, and below-the-knee involvement as independent predictors of loss of patency, whereas dual antiplatelet therapy beyond 1 months was associated with a reduced risk of patency loss. The Renzan™ stent demonstrated excellent early safety and efficacy outcomes in a challenging PAD population, with sustained mid-term patency despite a high proportion of complex lesions. These preliminary results support the use of this new mimetic stent design in real-world clinical settings and warrant further confirmation with longer-term follow-up.

To describe the feasibility of Woven EndoBridge (WEB; Terumo Neuro, Aliso Viejo, CA, USA) treatment for an aneurysm at the distal anterior cerebral artery A4 bifurcation and to highlight technical considerations for achieving peripheral access. A 57-year-old woman was incidentally diagnosed with an unruptured distal anterior cerebral artery aneurysm during a brain MRI performed for evaluation of headache. DSA demonstrated a wide-neck aneurysm arising at the A4 bifurcation of a right-dominant bihemispheric distal anterior cerebral artery (neck width, 5.90 mm; dome, 6.53 × 7.76 mm [mean, 7.15 mm]; height, 6.82 mm). Given the broad neck configuration and the necessity of preserving both distal branches, intrasaccular flow disruption using a WEB device was considered appropriate. Advancement through the A1 segment was impeded by steep angulation at the internal carotid artery-A1 junction and a pronounced ledge effect. The buddy-wire technique was initially attempted to improve support and trackability, but was unsuccessful. Stable access to the A2 segment was achieved only after catheter reshaping without further use of the buddy wire. A WEB SL 8 × 3 mm device (Terumo Neuro) was deployed, achieving adequate neck coverage with a marked reduction in aneurysmal inflow while maintaining patency of both distal anterior cerebral artery branches. The procedure was completed without any procedure-related complications. Follow-up MRI/MRA at 1 month showed no evidence of residual aneurysm filling and no branch-related complications. In selected distal anterior cerebral artery aneurysms where branch preservation is essential and parent-artery protrusion can be avoided, WEB treatment may be a useful endovascular option. This case illustrates the feasibility of WEB treatment of aneurysms at the anterior cerebral artery A4 bifurcation.

This case report describes a rare mechanical etiology of postoperative refractive surprise - anterior displacement of an intraocular lens (IOL) secondary to localized posterior synechiae - in a patient with plateau iris syndrome (PIS) following combined clear lens extraction (CLE) and minimally invasive glaucoma surgery (MIGS). A 29-year-old man with PIS and medically refractory chronic angle-closure glaucoma underwent an uneventful left-eye CLE, goniosynechiolysis, implantation of a toric extended depth-of-focus (EDOF) IOL, and insertion of three iStent infinite® (Glaukos Corporation, Aliso Viejo, CA, USA) devices. Five weeks postoperatively, he presented with blurred vision, asthenopia, and binocular diplopia associated with a sudden -2.50 D myopic surprise. Dynamic slit-lamp examination revealed localized posterior synechiae extending from 1 to 5 o'clock. These adhesions exerted asymmetrical traction on the capsular bag, resulting in anterior displacement and temporal tilt of the IOL complex without pupillary block. The patient subsequently underwent targeted synechiolysis under local anesthesia. Postoperative biometry demonstrated an increase in anterior chamber depth (ACD) from 2.90 mm to 3.02 mm, confirming posterior repositioning of the IOL. Restoration of the effective lens position (ELP) reversed the myopic shift and resolved the patient's symptoms. This case highlights localized posterior synechiae as a rare but reversible cause of postoperative refractive surprise and underscores the importance of meticulous dynamic slit-lamp evaluation and ACD monitoring in patients with complex anterior segment conditions presenting with unexpected refractive outcomes. Timely synechiolysis may serve as a definitive and restorative intervention.

Protection and management of natural landscapes represent one of the most significant challenges of our time. Indigenous peoples own and manage a large proportion of the world's high biodiversity areas. Studying the landscape by integrating Indigenous knowledge into socioecological systems (SES) analysis requires practical and effective approaches. Here, we present an innovative methodology that characterizes the landscape through the co-production of knowledge between Indigenous and scientific communities. With its graphic language, the methodology maintains technical and cartographic rigour, ensuring the information is easily usable by members of both communities and technical and specialized audiences. We implemented this approach and examined its effectiveness at La Planada Nature Reserve, an area owned and managed by the Awá Pialapí Pueblo Viejo Indigenous Resguardo (Nariño, Colombia). We characterized the landscape and its spaces based on their spatial distribution, structure, temporality, local classification of the landscape and associated cultural aspects. Based on this participatory experience in this reserve, the landscape characterization was used to co-create a nature-based scientific tourism strategy for this protected area. These findings emphasize the value of integrating Indigenous and scientific knowledge to develop a deep understanding of landscape ecology and promote effective conservation strategies.

This Woven EndoBridge Database (W-EB DB) study was conducted using data from a nationwide, multicenter database to evaluate the safety and efficacy of the W-EB device (MicroVention, Aliso Viejo, CA, USA; distributed by Terumo, Tokyo, Japan) for the treatment of wide-neck intracranial bifurcation aneurysms in Japanese patients. In this paper, we confirm the clinical usefulness of the W-EB device in Japanese patients based on the comparable 1-year post-procedure outcomes to those reported from overseas. This W-EB DB study was a post-marketing, open-label, non-randomized cohort study conducted using the database of the Japanese Society of Neuroendovascular Therapy (JSNET). A total of 128 participants (including 103 patients with unruptured aneurysms and 25 patients with ruptured aneurysms) treated with the W-EB device between December 2020 and December 2025 at any of the 12 participating centers were included in this study. Clinical data collected from the database consisted of the patient demographics, comorbidities, aneurysm characteristics (location, size, and neck width), procedural details, and follow-up outcomes. The safety endpoints were the incidences of subarachnoid hemorrhage (SAH), rebleeding, cerebral infarction, and other adverse events occurring within 1 year after the procedure. The efficacy endpoints were the aneurysm occlusion rates and retreatment rates at 180 days and 1 year after the procedure; the aneurysm occlusion status was determined in accordance with the W-EB Occlusion Scale (WOS). We used descriptive statistics to analyze the results. The research within our submission was approved by the institutional ethics review board of Kyoto University (Approval No. R2088). In regard to the safety endpoints, SAH occurred in 1 patient (1.0%) with an unruptured aneurysm, and rebleeding occurred in 1 patient (4.0%) with a ruptured aneurysm. The incidence of cerebral infarction was 7.0%. Most other adverse events were mild, and no new device-related risks were identified. In regard to the efficacy of the device, at 1 year post-procedure, complete occlusion (WOS grade A or B) was achieved in 58 of 95 lesions (61.1%) and adequate occlusion (WOS grade A, B, or C) was achieved in 79 of 95 lesions (83.2%). Retreatment was needed for 5 of 126 lesions (4.0%). The safety and efficacy outcomes were comparable to those reported from multicenter studies conducted in Europe and the United States, with slightly higher complete occlusion rates and similar adequate occlusion and retreatment rates. Favorable safety and effectiveness of the W-EB device were observed at 1 year after device deployment in Japanese patients with wide-neck intracranial aneurysms. These findings are consistent with international reports and support the clinical utility of the W-EB device, given the low incidence of serious complications.

Corneal ectasias are progressive diseases that, if untreated, can cause severe vision loss. Among several causes, eye rubbing is increasingly recognized. Many reports link eye rubbing to ectasia development, but few describe the potential for reversal after cessation. A 68-year-old White man presented with subjective eye redness, itchiness, and progressively worsening vision for 5 months. Corneal tomography showed a superior corneal ectasia with central thinning and irregular astigmatism. The ectasia was attributed to repetitive mechanical trauma from frequent eye rubbing. Treatment included antihistamine drops, an eyelid scrub for suspected allergic conjunctivitis, and counseling on stopping eye rubbing. At 1 week, symptoms improved; at 1 month, corneal tomography showed significant improvement. Early identification of eye rubbing in patients developing corneal ectasia is critical. Stopping the behavior may halt progression and potentially reverse early corneal changes.

Marine macroalgae remain largely overlooked in global assessments of carbon budgets, despite being dominant and highly productive primary producers in coastal zones. Such assessments require studies at the level of whole assemblages as well as a better understanding of how human-induced shifts affect algal forest metabolism. This study aimed to quantify primary productivity and the carbon balance and stocks of different intertidal macroalgal assemblages in the Ría de Vigo (Galicia, NW Spain), in order to evaluate how structural shifts from canopy-forming to turf-forming species influence ecosystem functioning. We examined assemblages dominated by large canopy-forming brown algae (Fucus vesiculosus, Ascophyllum nodosum) and by opportunistic and/or turf-forming species. Using incubation chambers in an outdoor mesocosm system, we measured net primary productivity (NPP) and respiration of whole assemblages, quantifying the contribution of macroalgae and of the associated fauna to respiration rates. Estimates of gross primary productivity (GPP), total gross productivity (GP) and net (NP) productivity (i.e. trophic state) were made for each assemblage. Photosynthetic (PQ) and respiration (RQ) quotients were calculated from changes in dissolved inorganic carbon (DIC) and O2, and the values were used to calculate the diel carbon balance. The carbon and nitrogen contents of the dominant macroalgae were also quantified to assess the storage capacity. The study findings show positive diel carbon balances (autotrophic metabolism) during summer in both intertidal fucoid-dominated and turf-dominated assemblages, with a non-significant trend for greater values in the fucoid-dominated site. The observed inverse trends in the diel balances of net O2 fluxes may be linked to low PQ values of fucoid assemblages and higher RQ values of the turf-dominated community. Assemblages dominated by A. nodosum exhibited the highest biomass and specific carbon and nitrogen contents. Projected shifts from large canopy-forming species toward smaller, turf-forming macroalgae maintain a positive carbon balance but are likely to reduce the carbon gains and overall productivity in intertidal habitats.

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Accurate preoperative identification of patients with Fuchs endothelial corneal dystrophy (FECD) who are at risk of requiring endothelial keratoplasty (EK) after cataract surgery remains challenging. The SUbClinical Corneal Edema Scheimpflug Study (SUCCESS) score was previously developed to estimate this risk using Scheimpflug tomography. We aimed to prospectively and externally validate the SUCCESS score in an independent multicenter cohort and determine whether the incorporation of corneal densitometry improves predictive performance and clinical utility. In this prospective multicenter cohort study, 207 eyes from 177 patients with FECD grade&#x2009;&#x2265;&#x2009;2 and visually significant cataract were enrolled across six tertiary hospitals in Spain (June 2020 to October 2024), with follow-up through May 2025. After predefined exclusions, 178 eyes (149 patients) were analyzed. The original SUCCESS score was used without recalibration. An extended model incorporated peak mean corneal densitometry within the central 3-mm zone. Time-to-event analyses were performed using Cox proportional hazards models. Discrimination, calibration, reclassification, and clinical utility were assessed using Harrell's C-index, Brier score, net reclassification index (NRI), integrated discrimination improvement (IDI), and decision curve analysis. Over a median follow-up of 37.0&#xa0;months (interquartile range [IQR], 10.1-45.9), 38 eyes (21%) met the criteria for EK, with 82% of events occurring within 6&#xa0;months after phacoemulsification. The original SUCCESS score demonstrated good discrimination (C-index&#x2009;=&#x2009;0.80; 95% confidence interval [CI], 0.73-0.86) with slight underestimation of absolute risk (predicted 16.4% vs. observed 21.6%). Incorporation of corneal densitometry improved discrimination (C-index&#x2009;=&#x2009;0.85; 95% CI, 0.79-0.90; &#x394;C&#x2009;=&#x2009;+&#x2009;0.05; P&#x2009;=&#x2009;0.0047), reduced prediction error (&#x394;Brier&#x2009;= -&#x2009;0.019; P&#x2009;<&#x2009;0.001), and enhanced risk reclassification (NRI&#x2009;=&#x2009;0.39; 95% CI, 0.14-0.64; P&#x2009;=&#x2009;0.002), including correct upward reclassification of 26% of eyes requiring EK. The extended model provided greater net benefit at relevant decision thresholds (25%-50%). In this multicenter external validation study, the SUCCESS score demonstrated a robust performance in predicting postoperative EK in FECD. The addition of corneal densitometry provided incremental improvements in discrimination and clinically meaningful risk stratification, particularly in intermediate-risk cases. Standardized Scheimpflug-based risk assessment may support individualized surgical planning and referral decisions.

The concept of complexity of care is well established in scientific literature; however, in pediatric populations, research has primarily focused on medical aspects, lacking a comprehensive approach that includes additional influencing factors. This study aimed to identify the evidence on complexity of care among pediatric patients attending pediatric acute care settings. An integrative review was conducted the PRISMA guidelines (PROSPERO registration: CRD42023469426). The search included articles published up to July 2025 in PubMed, CINHAL, Scopus, and WOS. Both the quality and internal validity of the studies included were independently assessed by two reviewers. Twenty-two articles were analysed, identifying 48 complexity-related factors and 39 assessment scales. Findings were grouped into four thematic categories, within each of which the following key complexity factors were identified: A) Clinical aspects of pediatric patients, such as diagnosis, patient type, and clinical stability; B) Environmental factors, particularly family involvement; C) Care provider aspects, such as direct/indirect nursing activities and workload; D) Organisational elements, especially nursing staff experience. This review expands the understanding of complexity beyond patient pathology. It underscores the need for further research to explore healthcare professionals' perceptions of complexity and examine how the identified factors influence health outcomes. Developing integrated assessment tools may enhance care planning and resource allocation in pediatric settings.

Cancer is the leading cause of disease-related deaths among children in high-income countries. Tumor heterogeneity and lack of mechanism-of-action-based therapeutic options are key challenges to overcome to improve pediatric cancer patient survival. To address these challenges, we formed the EU-IMI-2 funded public-private partnership "ITCC-Pediatric Preclinical Proof-of-Concept Platform" (ITCC-P4), which built a large repertoire of patient-derived xenograft (PDX) models representing all major high-risk solid pediatric cancer types for in vivo drug testing. A total of 353 PDX models were established from diagnostic and relapsed pediatric cancers and molecularly characterized, together with matched germline/tumor samples. Serial PDX models were also established, spanning diagnostic/posttreatment, primary/relapse, and metastasis-derived pairs. Proof-of-concept in vivo drug screening data in neuroblastoma and rhabdomyosarcoma models identified potential predictive biomarkers for targeted therapy. Molecular data from the PDX models, accessible at https://r2platform.com/itcc-p4, allowed the selection of models for preclinical testing based on oncogenic drivers and/or potential biomarkers. Operated by a non-profit entity, this sustainable platform aids academic and industrial researchers in developing and prioritizing innovative therapies for pediatric cancer.

We present the first reported use of the EndoSound Vision System (EVS; EndoSound, Inc, Portland, OR) for rectal endoscopic ultrasound (EUS) in an ambulatory surgical center. Two patients with rectal subepithelial lesions underwent EVS-assisted EUS, followed by same day endoscopic mucosal resection. EVS provided high-resolution imaging while maintaining forward-viewing optics and full working channel access. Both procedures were completed safely and efficiently in the outpatient setting. These cases highlight the feasibility of using EVS for rectal EUS and same session intervention in a carefully selected outpatient setting. Further studies are needed to define its role alongside established diagnostic modalities.

Performing germline genetic testing of family members following the identification of an individual with a pathogenic variant in a cancer predisposition gene, a process known as cascade testing, is a critical step in maximizing the preventive benefit of genetic testing for hereditary cancer. To determine how often family members undergo cascade testing and to evaluate demographic, socioeconomic, and clinical factors associated with this process. This retrospective cross-sectional study analyzed demographics, cancer history, genetic test results, and cascade testing data from probands who underwent multigene panel testing between December 2016 and August 2020 at a single diagnostic laboratory. The study cohort included probands found to have a pathogenic or likely pathogenic variant (P/LPV) in Lynch syndrome (MLH1, MSH2, MSH6, PMS2, or EPCAM) or hereditary breast and ovarian cancer (ATM, BRCA1, BRCA2, CHEK2, or PALB2) genes. Statistical analyses were conducted between June 2023 and March 2025. Identification of a P/LPV in a cancer predisposition gene. Variables assessed included proband age, sex, race and ethnicity, socioeconomic status (SES), availability of free testing for family members, cancer history, type of test ordered, and clinician credentials. Differences in cascade testing rates were calculated via 2-sided &#x3c7;2 test. Of 22&#x202f;932 probands (18&#x202f;949 [81.38%] female; mean [SD] age at testing. 51.6 [14.5] years), 5559 (24.24%) had at least 1 family member who underwent cascade testing. Higher rates of cascade testing were seen in individuals aged 40 to 79 years compared with those aged 20 to 39 years (age 40-59 years: 2587 of 10&#x202f;420 probands [24.83%]; P&#x2009;<&#x2009;.001; age 60-79 years: 1960 of 6869 probands [28.53%]; P&#x2009;<&#x2009;.001; age &#x2265;80 years: 129 of 462 probands [27.92%]; P&#x2009;<&#x2009;.001), women (4740 of 18&#x202f;948 female probands [25.02%] vs 817 of 3963 male probands [20.62%]; P&#x2009;<&#x2009;.001), non-Hispanic White individuals (3762 of 13&#x202f;834 probands [27.19%]), those with a personal cancer history vs those without (4712 of 16&#x202f;674 probands [39.43%] vs 847 of 6261 probands [15.64%]; P&#x2009;<&#x2009;.001), and those whose care involved genetic counselors vs those whose did not (3614 of 13&#x202f;847 probands [26.10%] vs 1948 of 9088 probands [21.43%]; P&#x2009;<&#x2009;.001). People with BRCA1 or BRCA2 variants had higher cascade testing rates compared with those with ATM, CHEK2, or PALB2 variants (2614 of 9699 probands [26.95%] vs 2015 of 8973 probands [22.46%]; P&#x2009;<&#x2009;.001). Several disparities were identified, including lower rates of cascade testing among male probands and probands from racial or ethnic minority groups compared with non-Hispanic White probands (227 of 1406 African American or Black probands [16.15%]; P&#x2009;<&#x2009;.001; 175 of 875 Asian probands [20.00%]; P&#x2009;<&#x2009;.001; 319 of 1616 Hispanic probands [19.74%]; P&#x2009;<&#x2009;.001; 17 of 146 Middle Eastern probands [11.64%]; P&#x2009;<&#x2009;.001). SES had minimal associations with testing rates, and free family testing was not associated with boosting participation. In this retrospective cross-sectional study, cascade testing was underused, especially among specific demographic groups, with clinical and cultural factors appearing to play a larger role than financial barriers. These findings may guide efforts to address barriers preventing wider uptake of cascade testing and improve cancer prevention efforts, particularly among racial and ethnic minority groups.

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Obtaining a precise genetic tuberous sclerosis complex diagnosis is a challenge as many missense TSC2 variants are variants of uncertain significance. Variants of uncertain significance in TSC2 have been resolved by one-at-a-time functional assays, but these assays cannot scale to the 3634 TSC2 missense variants of uncertain significance observed so far. To address this challenge, we use massively parallel sequencing to measure the steady-state abundance of almost 9000 TSC2 missense variants and develop an mTOR pathway activity assay using genome editing and cell sorting to generate activity scores for 391 missense variants. We observe that 1256 of 8864 (14.17%) missense variants assayed have altered TSC2 abundance, and 69 of 391 (17.65%) missense variants assayed have altered mTOR pathway activity. Calibration and integration of these data into classification of variants identified in a clinical cohort putatively reclassifies 212 of 276 (76.8%) TSC2 missense variants of uncertain significance. These datasets will lead to improved genetic diagnosis of tuberous sclerosis complex with potential positive impacts on the clinical management of patients and their families.

Variants of uncertain significance (VUS) are a substantial barrier to clinical care in genetics, and VUS that are suspected to affect splicing can be particularly difficult to resolve. We used exome sequencing (ES) followed by variant-specific RNA testing to resolve VUS in four separate cases resulting in reclassification to Likely Pathogenic and a positive molecular diagnosis in all cases. The variants in these cases include a homozygous variant in ATP6V0A2 in a trio exome case, heterozygous variants in SLC20A2 and in CSF1R in adult proband-only cases, and a heterozygous variant in COL1A1 in a family. All variants were associated with aberrant splicing resulting in loss of function or a major alteration to the protein sequence. These findings demonstrate the power of targeted RNA testing for reclassifying VUS that have limited direct evidence across a broad range of indications for exome testing.

The introduction of coatings on flow diverter stents (FD) marks a significant evolution in neurovascular intervention for aneurysm embolization. FDs represent a major innovation in the treatment of intracranial aneurysms by promoting endothelial healing and reconstructing the parent artery. FRED Omega is a new generation FD featuring a poly(2-methoxyethyl acrylate) (PMEA)-based surface modification designed to reduce thrombogenicity while maintaining endothelialization. This preclinical study assessed the biocompatibility and aneurysm occlusion efficacy of FRED Omega in a rabbit elastase aneurysm model. Eight New Zealand white rabbits were implanted with FRED Omega across elastase-induced aneurysms and maintained on single antiplatelet therapy (SAPT). Angiography, cone-beam computed tomography, and optical coherence tomography (OCT) were used to evaluate device performance. Histology, environmental scanning electron microscopy (ESEM) and multiphoton microscopy analyses (MM) were conducted on explanted tissues. At day 28, 7 aneurysms (87.50%, 7/8) achieved complete or near-complete occlusion. All implants remained stable over the time study. All vessels were clear of thrombus with no flow abnormalities nor sign of intimal hyperplasia. OCT confirmed these data associated with good wall apposition for all stents (100.00%, 8/8). Histology and ESEM showed well-organized new tissue on each FD (100.00%, 8/8), compared to 75.00% for MM (6/8, 75.00%). Quantitative measurement of neointimal ratio was excellent with an average of 0.068. FRED Omega demonstrated promising preclinical performance with enhanced endothelialization and aneurysm occlusion in a validated animal model under SAPT.

Heart transplantation (HTx) offers life-saving treatment for advanced heart failure. While physical recovery is well-documented, psychological recovery and health-related quality of life (HRQOL) during early post-discharge remains less well understood. This mixed-methods study aims to describe changes in depression, anxiety, and HRQOL in HTx recipients from hospital discharge to three months, integrated with qualitative perspectives. The study enrolled 18 HTx recipients. Patient Health Questionnaire-8 (PHQ-8), Generalized Anxiety Disorder-7 (GAD-7), and the 36-Item Short Form Health Survey (SF-36) were administered at both time points. For scaled responses, change and associations were evaluated using paired t-tests and correlations; semi-structured interviews were examined using thematic analysis. Findings were integrated with a convergent matrix approach. Participants (mean age 49 &#xb1; 15.2) reported no significant changes in depression or anxiety at 3 months. HRQOL improved significantly in SF-36 physical functioning (p = 0.001), physical role limitations (p = 0.007), bodily pain (p < 0.001), and social functioning (p < 0.001). Qualitative findings characterized emotional recovery as early vulnerability and gradual adjustment. HRQOL improved significantly after discharge, while psychological recovery was unchanged. Integrated findings identified medication-induced mood changes and social isolation as barriers to the strengthening of emotional well-being during early recovery.