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Third- and concerned-party positions in moral dilemmas: Effect of empathy on ethical judgment
The present study proposes a categorization of moral dilemmas into third-party dilemmas in which a judge’s choice affects only the life or death of others, and concerned-party dilemmas in which not only others’ but also the judge’s life or death is altered. While the former requires the judge to make only moral judgments to save others, another rational decision-making process that considers the judge’s life and death may also impact the latter. We examined ethical judgments based on these two types of dilemmas with a focus on empathic concern. Participants in Experiment 1 were more ethically permissive to save the many including him/herself at the expense of one person in the concerned-party dilemma than in the third-party dilemma, but empathic concern in both types of dilemmas consistently suppressed such utilitarian choices derived from “instrumental harm” (IH), which permits sacrificing a few necessary when it saves many. In Experiment 2, we also confirmed the suppressive effect of empathic concern for utilitarian choices derived from IH in the Pareto concerned-party dilemma in which the death of one person remains fixed regardless of the judge’s choice. We discuss the importance of categorizing these two types of dilemmas in moral dilemmas and demonstrates the public goods dilemma as a Pareto concerned-party dilemma in everyday life.
Socioeconomic equity in maternal health services use in Bangladesh: The role of service readiness in health facilities during the period 2001–2016
Background Equity in health service utilization refers to equal treatment for equal health needs, regardless of socioeconomic status. In low- and middle-income countries, inequity in maternal health service use remains a pressing issue in the pursuit of universal health coverage by 2030. This study examines whether socioeconomic equity in the use of key maternal health services—antenatal care (ANC) from a medically trained provider, facility delivery, and management of complications—improved faster in districts with high facility readiness than elsewhere in Bangladesh between 2001 and 2016. Methods and findings We analyzed data from three rounds of the Bangladesh Maternal Mortality and Health Care Survey and corresponding Bangladesh Health Facility Survey rounds. These datasets were linked at the district level and pooled for the years 2001, 2010, and 2016. Using an adaptation of the Difference-in-Differences (DID) model based on linear probability models, we estimated whether poor-nonpoor gaps in maternal health service utilization changed differently over time in districts with high facility readiness than in districts with lower readiness. Bangladesh achieved substantial improvements in overall maternal health service use during the study period. However, these gains were not equitably distributed. Socioeconomic equity improved modestly for ANC and complication management but worsened significantly for facility deliveries. The gap between nonpoor and poor women widened more in high facility readiness districts than in low readiness districts (p < 0.05). Additionally, equity in ANC use improved among women living within one hour of a private facility (p < 0.05). Conclusions This is the first systematic investigation of the role of facility readiness in maternal health equity in Bangladesh using nationally representative data. Despite overall progress, persistent and, in some cases, widening socioeconomic inequities were observed—especially in facility-based delivery. These findings highlight the need for targeted policy action to ensure that improvements in service readiness translate into more equitable maternal healthcare access and outcomes.
Longitudinal omics study of transcriptional dynamics in Lactobacillus crispatus
Background The vaginal microbiome is an important component of female reproductive health. Community State Type I (CST-I), which is dominated by Lactobacillus crispatus , is generally considered to be closely associated with a healthy vaginal microecological state. Although the taxonomic composition of CST-I communities remains relatively stable, the transcriptional dynamics of Lactobacillus crispatus across different phases of the menstrual cycle remain unclear. Methods A healthy reproductive-age woman with a stable CST-I vaginal microbiome was enrolled in this longitudinal study. Vaginal secretion samples were collected at six non-menstrual time points throughout a menstrual cycle. Third-generation full-length 16S rRNA gene sequencing and metatranscriptomic sequencing were performed. Differential transcript expression analysis, KEGG pathway enrichment analysis, and Mfuzz time-series clustering were applied to systematically characterize the transcriptional dynamics of the vaginal microbiome across different phases. Results Full-length 16S rRNA gene sequencing confirmed that Lactobacillus crispatus remained the dominant species at all six sampling time points, with no substantial changes in overall community composition. However, metatranscriptomic analysis revealed pronounced phase-specific transcriptional reprogramming. During the pre-ovulatory phase, pathways involved in DNA replication, biosynthesis, and central carbon metabolism were upregulated. On the first day after ovulation, pathways associated with carbohydrate utilization, quorum sensing, and redox homeostasis were selectively upregulated. During the mid-to-late luteal phase, pathways related to cell proliferation and growth were generally downregulated, whereas pathways involved in cofactor biosynthesis, the pentose phosphate pathway, and D-amino acid metabolism showed increased expression. Mfuzz clustering further revealed distinct phase-specific functional transitions in L. crispatus that were absent in non- L. crispatus lactobacilli. Conclusion The ecological dominance of Lactobacillus crispatus is maintained not solely through numerical abundance, but also through rhythmic and phase-specific transcriptional regulation. Dynamic functional remodeling and metabolic plasticity may represent important mechanisms underlying its long-term persistence and ecological dominance within healthy CST-I vaginal communities.
Assessing the investment risk: An empirical analysis of Altman’s Z-score model
Investors can play a significant role in reviving the economy and addressing the national agenda of poverty elimination through job creation. Though foreign and local investment are the backbone of any economy, especially in developing economies like Pakistan, investors face the challenge of assessing investment risk to protect the capital employed and achieve an appropriate return on investment. The aim of this research is to assess investment risk faced by firms in Pakistan using the most suitable approach, and then to develop an economic model for a comprehensive assessment of the factors influencing investors’ risk, focusing on firm-specific characteristics, economic conditions, and political stability. The introduction of the Investment Risk Index based on Altman Z-scores provides a structured diagnostic approach to assessing investment risk in Pakistan. Earlier studies have mainly used financial ratios to explain risk. The estimation results using an analytical approach (the Investment Risk Framework) confirm that firm-specific characteristics and economic, political, and financial stability indicators significantly impact investment risk. The findings, based on 443 firms over the period 2014–2023, reveal that the proportion of firms in the distress zone increased from 4.8% to 8.5% (a doubling) during the study period. Retained earnings relative to total assets emerged as a strongly correlated factor with investment risk, while the market value of equity relative to total liabilities played a significant role in keeping firms (around 88% of the sample) in the safe zone. For the determinants, the GMM results indicate that past values of investment risk strongly predict future risk. A 1% increase in past risk is associated with a 0.395% higher future risk. Additionally, political stability, GDP growth, inflation, current account balance, broad money, dividend premium paid, and growth opportunities are found to have a significant impact on the investment risk. Furthermore, internal factors such as fixed asset accumulation, firm size, and tax expenses also influence risk, with larger firms facing higher risk. This study underscores the importance of understanding investment risk factors for informed decision-making. The findings offer valuable insights for investors and policymakers, with potential applicability to other developing economies.
Mechanistic evaluation of NSC 57774 as a SHP2 inhibitor in gastric cancer: Multi-pathway signaling modulation in vitro
Gastric cancer (GC) remains a leading cause of cancer-related mortality worldwide, driven by late-stage diagnosis, metastatic progression, and therapeutic resistance. Src homology region 2 domain-containing phosphatase 2 (SHP2) has emerged as a critical regulator of oncogenic signaling in gastric tumorigenesis, yet its therapeutic targeting remains underexplored. In this study, we evaluated the anti-cancer efficacy of NSC 57774, a novel SHP2 inhibitor, using integrated bioinformatics and functional assays in AGS gastric cancer cells. Analysis of The Cancer Genome Atlas (TCGA) and UALCAN datasets revealed marked upregulation of SHP2 and multiple receptor tyrosine kinases in gastric cancer tissues. NSC 57774 potently inhibited cell proliferation and migration, demonstrating selective cytotoxicity towards cancer cells over non-cancerous fibroblasts. Mechanistically, NSC 57774 disrupted key oncogenic pathways including MAPK/ERK, AKT and STAT3 in a concentration- and time-dependent manner, with higher doses achieving more sustained pathway suppression. NSC 57774 suppressed NF-κB inflammatory signaling at early timepoints and induced cleaved caspase-3 across all treatment groups at 72 hours, indicative of pro-apoptotic activity. A paradoxical late-phase increase in phospho-p38 was observed at 72 hours, consistent with a compensatory pro-apoptotic stress response. Comparative analysis revealed that NSC 57774 outperformed the commercial SHP2 inhibitor NSC 87877 and doxorubicin in reducing viability and migration of gastric cancer cells. Collectively, these findings position NSC 57774 as a promising candidate for targeted gastric cancer therapy, capable of disrupting multiple signaling pathways involved in tumor progression, metastasis, and inflammation, warranting further preclinical and clinical investigation.
Field evaluation of 3-(N-acetyl-n-butyl) aminopropionic acid ethyl ester - IR3535 as a spatial repellent to control malaria: A Randomised, Before-After-Control-Intervention trial
Background Malaria remains a major public health challenge in sub-Saharan Africa. Increasing mosquito resistance to insecticides can significantly limit current vector control strategies. Spatial repellents represent a promising complementary tool by disrupting mosquito human-seeking behaviour. This trial aimed to evaluate the efficacy of IR3535 as a spatial repellent in Tambai, a high-transmission rural area in central Mozambique. Methods This was a randomised, Before-After-Control-Intervention trial. Four Tambai blocks were randomly selected, with 40 households randomly assigned to receive IR3535 spraying and 40 assigned to as a no-repellent control group. Plasmodium falciparum malaria prevalence was estimated in children under 5 years of age using polymerase chain reaction, before, at year one and at year two. Data were first analysed using frequentist methods and subsequently using spatiotemporal Bayesian models, incorporating INLA-based models to assess the impact of repellent intervention on mosquito density and diversity, sporozoite rates, and malaria prevalence in the repellent and control groups. Results A total of 5716 mosquitoes were collected, 57.2% were Anopheles and 42.7% were Culex sp. . An. funestus s.l. females, were the most prevalent mosquito both indoor (92.7%) and outdoor (82.5%), followed by An. gambiae and An. tenebrosus . The total number of An. funestus s.l. females was lower in the repellent group compared with the control group [indoors: 765 vs 1,432; outdoors: 175 vs 293], as was the average number of mosquitoes collected per household [indoors: 18.6 vs 35.0; outdoors: 4.3 vs 7.1]. Spatiotemporal analysis revealed evidence of repellent-associated reduction in mosquito densities, with species-specific and indoor-outdoor differences, highlighting An. funestus s.l. dominance and spatial-temporal clustering patterns. P. falciparum prevalence among children under five declined from 72.6% (95% CI = 64.1–80.2) at baseline to 51.3% (95% CI = 43.5–59.1) at year one and 43.3% (95% CI = 35.7–51.1) at the end of the study, with similar reductions in both repellent and control groups. Sporozoite rates were slightly lower in the repellent group, particularly outdoors, however, these differences could not be directedly attributed to the repellent. Conclusion Our findings indicate that the use of IR3535 as a spatial repellent reduces indoor and outdoor malaria vector densities, which may contribute to reduced malaria transmission. Trial registration ClinicalTrials.gov NCT04419766
Leveraging expression quantitative trait loci information in single-cell resolution to identify cell-specific genes for gestational diabetes
Background Gestational diabetes mellitus (GDM) is a common pregnancy complication with long-term metabolic consequences for both mother and offspring. While genome-wide association studies (GWAS) have identified risk loci, the cell-type-specific genetic architecture remains poorly characterized due to the limitations of bulk-tissue analyses. Methods We integrated GWAS summary statistics from FinnGen (12,332 cases, 131,109 controls) with single-cell expression quantitative trait loci (sc-eQTL) data from 12 immune cell types in the OneK1K cohort. Using the OTTERS framework and ACAT-O omnibus testing, we performed single-cell transcriptome-wide association studies (scTWAS) to identify GDM-associated genes. We performed bulk-level TWAS as a sensitivity analysis. To investigate the function of significant genes, we performed functional enrichment. Results We detected 14 unique genes significantly associated with GDM across immune cell types (FDR < 0.05), with the strongest signals in CD4 + T cells and monocytes. Notably, ERAP1 and ERAP2 showed associations in 10 of 12 cell types (ACAT. P = 2.17 × 10 −5 ), and RIOK2 emerged as a shared regulator. Gene Ontology analysis consistently highlighted “antigen processing and presentation via MHC class I” as the top enriched pathway (FDR < 10 −5 ). In contrast, traditional bulk TWAS using GTEx whole blood identified only two genes with nominal associations. Conclusion Our sc-TWAS identifies cell-type-specific GDM-associated genes that are not detected in bulk tissue, highlighting dysregulated antigen presentation in peripheral immune cells. Colocalization prioritizes monocytic LNPEP as the primary causal candidate, while associations for ERAP1 , ERAP2 , and RIOK2 likely reflect complex LD or tissue-specific effects.
Predicting medication non-adherence using machine learning: Incorporating Complementary and Alternative Medicine (CAM) beliefs in Malaysian chronic disease patients
Medication non-adherence among chronic disease patients remains a major contributor to poor health outcomes and medication wastage, particularly in multi-ethnic populations such as Malaysia where cultural and religious beliefs strongly influence health behaviours. This study aimed to develop and evaluate machine learning models that integrate demographic, clinical, and complementary and alternative medicine (CAM) belief factors to predict medication non-adherence among patients with type 2 diabetes mellitus, hypertension, and dyslipidaemia. A cross-sectional survey was conducted using a structured questionnaire comprising demographic and clinical data, history of CAM use, the 17-item Complementary and Alternative Medicine Beliefs Inventory (CAMBI), and the Malaysian Medication Adherence Scale (MALMAS). Twelve conventional machine learning algorithms and three stacked ensemble models were utilised using both balanced and unbalanced datasets with all variables as well as feature-selected variables. The best-performing model was a stacked ensemble using logistic regression-selected variables with the unbalanced dataset, achieving the highest AUC of 0.816. Feature selection identified significant variables including CAM beliefs (natural and holistic), race, number of daily doses, number of medications prescribed, religion, educational level, treatment duration, and hypertension status which were later interpreted using SHapley Additive exPlanations (SHAP) analysis. Model performance was further evaluated using the Youden Index and Decision Curve Analysis (DCA) to stratify patients into lower- and higher-risk groups, with a suitable cutoff identified at 0.4. These findings show that incorporating cultural and belief-related factors into machine learning models provides a novel, population-specific approach to predict better non-adherence and guide targeted interventions to reduce medication wastage in chronic disease management.
Methicillin-resistant Staphylococcus aureus (MRSA) infection in hospitalized patients is dominated by community-acquired strains: genomic epidemiological evidence
Objective This study aimed to systematically investigate the molecular epidemiological characteristics of methicillin-resistant Staphylococcus aureus (MRSA) in Ningxia hospitals, to elucidate their genetic evolutionary relationships, and to delineate the genomic and phenotypic profiles of the dominant lineages. Methods Clinical isolates of MRSA strains collected between 01/01/2024 and 30/06/2024 were analyzed, employing second-generation gene sequencing technology, combined with MLST and SCC mec typing, along with evaluation of drug resistance and virulence genes. A phylogenetic tree was constructed to analyze strain homology. Results A total of 74 non-duplicate Staphylococcus aureus strains (67 MRSA and 7 MSSA) were collected. The most common clonal strain was ST59-IVa, accounting for 46.27%. This strain exhibited a high prevalence of resistance genes mecA and blaZ , at 91.04%. All five ST22-IVa strains were found to lack mecA and erm genes but showed β-lactam resistance, while possessing both lukS/F-PV ( PVL ) and tsst-1 virulence genes, indicating a significant toxicity risk. Genetic evolution analysis revealed that ST3355, ST4513, and ST59 were closely related, all belonging to SCC mec types IVa; the other ST types exhibited mutations at various loci, with ST5 as the central node, resulting in a wider array of ST and SCC mec typing. Conclusion The ST59-IVa clone is the predominant MRSA strain in Ningxia hospitals, exhibiting multidrug resistance and virulence gene profiles consistent with national trends. However, the emergence of hypervirulent ST22-IVa strains with atypical resistance mechanisms warrants increased vigilance. We recommend enhancing the rational use of antibiotics in hospitals and implementing molecular surveillance for these highly virulent strains.
High-accuracy pseudospectral scheme for fractional diffusion-wave problems based on cardinal functions
Fractional diffusion-wave equations (FDWEs) are essential for modeling complex physical phenomena with memory and hereditary properties, such as anomalous diffusion and viscoelasticity, which classical integer-order models fail to capture accurately. In this paper, we introduce an efficient and high-accuracy pseudospectral scheme utilizing Legendre cardinal functions (LCFs) as basis functions to solve both second- and fourth-order FDWEs. By reformulating the governing equations into equivalent integral forms and developing direct matrix representations for the Caputo fractional derivative and fractional integral operators, we systematically transform the original problem into a solvable system of algebraic equations. Detailed convergence analysis and numerical experiments confirm that this method consistently achieves spectral convergence. A key novelty of this technique, and what significantly advances it beyond previous efforts in the literature, is its exploitation of the cardinal properties of LCFs to avoid numerical integral evaluations when computing basis coefficients entirely. Consequently, this approach dramatically reduces computational overhead while delivering superior accuracy and efficiency compared to existing finite difference and collocation methods.
Association between anthropometric measures and abdominal wall thickness in patients with obesity: A cross-sectional CT study
Background Abdominal wall thickness (AWT) is a critical determinant of safe abdominal access in patients with obesity, yet it is not routinely assessed preoperatively. Simple, bedside methods for evaluating factors associated with AWT are lacking. This study aimed to evaluate the association between readily available anthropometric measurements and AWT across multiple surgically relevant abdominal regions. Methods In this prospective cross-sectional study, 105 patients with obesity (body mass index [BMI] ≥30 kg/m 2 ) who underwent computed tomography (CT) imaging were included. AWT was measured at nine predefined anatomical points corresponding to commonly used surgical landmarks. Anthropometric parameters, including BMI, neck circumference, mid-upper arm circumference, and waist circumference, were recorded. Correlation analyses were performed to assess the associations between anthropometric measurements and CT-measured AWT. Results BMI demonstrated a moderate and consistent positive association with AWT across all anatomical regions (rs = 0.34–0.55, all p < 0.001). Waist circumference and mid-upper arm circumference showed moderate associations, whereas neck circumference demonstrated weak and inconsistent associations. AWT varied across anatomical regions, with greater thickness observed in the lower abdomen. Female patients had significantly greater AWT at several sites. These findings highlight regional variability in AWT and its association with anthropometric measurements. Conclusions Anthropometric measurements, particularly BMI, were significantly associated with AWT across multiple abdominal regions in patients with obesity. These findings provide additional insight into regional abdominal wall variability and may support future development of bedside assessment tools for abdominal access planning. Further studies are needed to develop and validate predictive models for clinical application.
Evaluation of a tele-refraction model to address the lack of human resources in Kenya
Background Uncorrected Refractive Errors (URE) constitute a significant public health concern in Kenya, where limited availability of qualified eye care professionals continues to impede equitable access to refractive services. This shortage is particularly acute in rural and underserved regions, resulting in significant unmet visual health needs. The implementation of telemedicine; specifically, a tele-refraction model utilizing low-cost, portable devices, has emerged as a viable and cost-effective approach to decentralize service delivery, enhance accessibility, and mitigate the burden of URE at the primary healthcare level. Methods This non-inferiority diagnostic accuracy study was conducted in Machakos. County, Kenya, to evaluate the performance of the OneSight EssilorLuxottica Foundation’s ClickCheck™ tele-refraction model in comparison with conventional face-to-face retinoscopy, which served as the reference (gold) standard. A total of 92 patients (184 eyes) were examined. The tele-refraction procedure entailed a trained technician performing objective refraction using the ClickCheck™ device, followed by subjective refinement under the real-time supervision of a remote optometrist via telecommunication. Statistical analyses assessed the agreement between the final subjective prescriptions obtained from both methods, focusing on the clinical conformity rate for spherical equivalent (SE), cylindrical power, and power vector components within a strict clinical tolerance limit of ±0.50 diopters (D). Results The study demonstrated a high level of clinical concordance between the telerefraction model and the conventional gold-standard refraction method. The mean difference in spherical equivalent (SE) for objective refraction was minimal (+0.08 D), indicating negligible bias between the two techniques. Importantly, the final subjective prescriptions exhibited excellent clinical interchangeability, with 93.01% of cases falling within the ± 0.50D tolerance for SE and 94.41% within the same tolerance for cylindrical power magnitude. Furthermore, for clinically significant astigmatism, axis alignment showed complete conformity within the 10 degrees tolerance range across all cases. Conclusion The tele-refraction model using the ClickCheck™ device, combined with remotely guided subjective refraction, demonstrated accuracy, reliability, and non-inferiority when compared with conventional in-person refraction. These findings substantiate the clinical validity of tele-refraction, which holds the potential to mitigate the acute shortage of eye care professionals and to enhance equitable access to refractive error correction services among underserved populations in Kenya.
EEG spectral biomarkers of postoperative delirium in spinal surgery: A high-resolution analysis
Background Postoperative delirium is common in older adults following spinal surgery, yet current EEG-based detection methods rely on broad conventional frequency bands that may obscure clinically meaningful oscillatory changes. More granular spectral approaches may reveal candidate frequency-specific features that could improve diagnostic performance. Methods We recorded single-electrode frontal EEG (Fp1) from 47 patients at four perioperative timepoints and compared traditional band-level power with high-resolution 1-Hz spectral analysis (1–45 Hz). Group differences were evaluated using non-parametric statistics with FDR correction, and diagnostic accuracy was assessed using AUROC and threshold-optimized metrics. All diagnostics thresholds were derived and evaluated in the same dataset. Results Seven patients (14.9%) developed delirium. Conventional band analysis detected only reduced theta power during active delirium (|r| = 0.31; AUROC = 0.53). In contrast, 1-Hz analysis revealed a richer pattern: elevated 1-Hz power (|r| = 0.27), reduced 3–7 Hz power (|r| = 0.25–0.27), and increased 14–15 Hz power (|r| = 0.22–0.26). The 23-Hz narrow-band feature achieved the best discrimination (AUROC = 0.74), despite showing no significant effect within the traditional beta band (12–30 Hz). Several frequencies remained altered even after clinical resolution of delirium. Conclusions In this exploratory analysis, high-resolution spectral analysis identified candidate frequency-specific EEG features that distinguished delirium cases more accurately than conventional frequency bands in this cohort. Broadband averaging may not detect frequency-specific oscillatory patterns; adopting finer spectral resolution could enhance the utility of single-channel EEG for routine clinical monitoring.
A comparative study of Korean and Chinese learners’ strategy use in request-refusal continuous dialogue speech acts
In daily communications, the use of speech acts that may threaten others’ faces, such as request and refusal, is inevitable. By methods of DCT with 24 coherent request-refusal scenarios as well as optimized classification of request and refusal strategies, differences in request-refusal continuous dialogue speech acts between Native Korean (NK) and Chinese Korean language learners of intermediate level (CKLI) and advanced level (CKLA) were examined. There were statistically significant differences in frequencies of NK, CKLA, and CKLI using request and refusal strategies in different scenarios. Overall, NK used more categories and numbers of strategies than CKLI. The gap between NK and CKLI might narrow as language proficiency increases. Furthermore, not only the single influence factor that affected strategy choice but also the interactions between these factors, suggesting that people might behave differently when faced with complex scenarios consisting of multiple factors. This study also proposes a new research methodology that inserts factors affecting strategy choice into individual scenarios, designs multiple independent scenarios with the same factors, and analyses the effects of these factors and their interactions on strategy choice. The results of the associated analysis could be used to assist in the development of a detailed instructional plan.
Bioassay-guided isolation of antioxidant, antibacterial, and antidiabetic compounds from Aleuritopteris bicolor of Nepal: In vitro/in silico study
Aleuritopteris bicolor , a fern species known locally as “Raani Sinkaa” in Nepal, has traditionally been used to treat wounds, diarrhea, dysentery, and gastritis. Despite its widespread use, scientific data on its bioactive compounds and bioactivities remain limited. To address this gap, this study aimed to isolate bioactive compounds from A. bicolor and evaluate their antioxidant, antibacterial, and antidiabetic properties using both in vitro and in silico methods. The 70% methanol extract of A. bicolor afforded three compounds: 20-hydroxyecdysone ( 1 ), and a mixture of quercetin 3- O - β -D-glucopyranoside ( 2 ) and quercetin 3- O - β -D-galactopyranoside ( 3 ), isolated via column chromatography. The structures of the isolated compounds were elucidated based on spectroscopic (NMR) and spectrometric (LC-MS) analyses. Compound 1 exhibited weak antioxidant activity, with an IC 50 of 38.38 ± 3.41 µg/mL in the DPPH free radical scavenging assay. In contrast, the mixture of compounds 2 and 3 demonstrated significant antioxidant activity, with an IC 50 of 1.56 ± 0.3 µg/mL, surpassing the standard ascorbic acid (IC 50 : 4.15 ± 0.3 µg/mL). Compounds 2 and 3 also showed moderate antibacterial activity against Staphylococcus aureus and Klebsiella pneumoniae . Furthermore, these compounds exhibited notable inhibition of α -amylase and α -glucosidase enzymes in in vitro assays, with EC 50 values of 99.48 ± 3.2 µg/mL and 68.53 ± 1.7 µg/mL, respectively. In silico molecular docking analyses supported these enzyme inhibitions by revealing favorable interactions between compound 2 and key catalytic residues of the target enzymes, with binding energies of −7.2 kcal/mol for α -amylase and −7.1 kcal/mol for α -glucosidase. Additionally, ADMET analysis suggests further lead optimization of compounds 2 and 3 . This study successfully isolated three bioactive compounds from A. bicolor and recommends further medicinal chemistry and in vivo investigations to establish their therapeutic potential as antidiabetic phytomedicine.
Psychometric properties of the Arabic Perceived Digital Well-Being Scale (PDWS) in Saudi young adults
Rapid digital transformation in Saudi Arabia has intensified young adults’ day-to-day reliance on smartphones, increasing the need for balanced, culturally appropriate measures of perceived digital well-being. This study aimed to psychometrically validate the Arabic version of the Perceived Digital Well-Being Scale (PDWS) among Saudi young adults aged (18–25). A cross-sectional instrument-validation study was conducted with (N = 450) participants. The full sample was randomly split into two independent analytic subsamples: Sample (1) for exploratory factor analysis (EFA) (n = 225) and Sample (2) for confirmatory factor analysis (CFA) (n = 225); convergent validity was examined in both subsamples. EFA supported a clear three-factor structure (Emotional, Social, Cognitive). CFA confirmed a second-order model with excellent fit: χ²(116)=133.275, p = .130, χ²/df=(1.149), CFI=(.986), TLI=(.983), RMSEA=(.026), and SRMR=(.055). Convergent validity was supported by positive associations with life satisfaction (SWLS) and negative associations with fear of missing out (FoMO), with the same pattern observed across both subsamples (Sample (2): SWLS r=(.416–.550), p < .01; FoMO r=(−.321–-.254), p < .01). Internal consistency was acceptable across subsamples (Cronbach’s α=(.759–.886); McDonald’s ω=(.761–.889)). Overall, the Arabic PDWS demonstrates strong initial evidence of structural validity, theoretically consistent convergent validity, and adequate reliability, supporting its use as a multidimensional measure of perceived smartphone-related digital well-being among Saudi emerging adults.
Diagnostic yield and complication rate of transbronchial lung cryobiopsy using 1.1 mm probe in patients with interstitial lung disease
Background Widespread adoption of transbronchial lung cryobiopsy (TBLC) using a 1.9 or 2.4 mm touch cryoprobe in interstitial lung disease (ILD) has been limited by high bleeding risk. Recent studies have demonstrated that the 1.1 mm cryoprobe via conventional bronchoscope may achieve diagnostic yields comparable to larger probes while maintaining a favorable safety profile. Studies of the 1.1 mm touch cryoprobe in the diagnosis of ILD have been flawed and conflicting. Aim The aim of this study is to describe the complication rate, diagnostic yield, and factors that increase diagnostic yield of TBLC using a 1.1 mm touch cryoprobe in patients with ILD. Methods The retrospective cohort study included patients that were prospectively identified in the ILD clinic registry at University of Texas Southwestern Medical Center (UTSW) who underwent TBLC from 2022–2026. Procedural characteristics were recorded. Patients were assigned a pre-TBLC, post-TBLC, and final diagnosis. Results This study demonstrates that TBLC using a 1.1 mm probe added to BAL significantly increases diagnostic yield with an 11% risk of pneumothorax and a 6.5% risk of bleeding. The combination of BAL and TBLC was diagnostic in 27 (43.5%) of patients and led to a change in diagnosis in 27 (43.5%) of patients. The number of TBLC samples taken is associated with a higher diagnostic yield. Conclusion The diagnostic yield and complication rates of the 1.1 mm touch probe in our study are higher than previously reported studies with TBBx but lower than 1.9 and 2.4 mm touch probes, though there was no direct comparison group in our study. To increase yield of the procedure, multiple lobes should be biopsied and more samples taken.
Integrating smoking cessation into HIV care settings: A systematic review and meta-analysis of effectiveness and the evidence gap in cost-effectiveness
The prevalence of smoking among people living with HIV (PLWH) is higher than in the general population, and PLWH who smoke are at increased risk of both smoking- and HIV-related comorbidities. As most PLWH reside in low- and middle-income countries (LMICs), there is a need for effective and cost-effective smoking cessation interventions in resource-constrained settings. We systematically reviewed and meta-analyzed the effectiveness of smoking cessation interventions for PLWH and looked for economic evaluations. Four databases (PubMed, Cochrane, Scopus, Web of Science) were searched up to March 23 rd , 2026. Interventional and quasi-experimental studies evaluating smoking cessation interventions for PLWH were included. Risk of bias was assessed using Cochrane’s risk-of-bias tool for randomized studies and the Effective Public Healthcare Panacea Project tool for non-randomized studies. Thirty-two articles met the inclusion criteria. Most evidence originated from high-income countries, with three randomized controlled trials conducted in LMICs (Kenya, South Africa and Vietnam). No economic evaluations were identified. Smoking cessation interventions varied in type, duration, intensity, and mode of delivery. Overall, studies had low to moderate risk of bias. GRADE assessments indicated moderate-certainty evidence that pharmacological interventions (RR 1.86, 95% CI 1.42–2.45) and tailored, intensive behavioral support (RR 1.34, 95% CI 1.05–1.71) increase smoking abstinence compared with standard care. This review indicates that pharmacological and tailored, intensive behavioral support interventions can support smoking cessation among PLWH, including emerging evidence from LMICs, but the absence of economic evaluations limits guidance for resource-constrained settings. Future research should prioritise implementation strategies and economic evaluations to support scalable integration into routine HIV care. (PROSPERO Registration no: CRD42022313630).
Influence of a complex mycotoxin detoxifier on growth performance, liver health, inflammation, and redox status of broilers fed a diet contaminated with multiple mycotoxins
This study investigated the effects of a complex mycotoxin detoxifier (CMD) on growth performance, liver health, inflammation, and redox status of broilers fed a diet contaminated with multiple mycotoxins. A total of 432 one-day-old male Ross 308 broiler chicks were randomly allocated to one of three treatments, with eight replicates per dietary group for 37 d. The treatment included: a basal diet without mycotoxin, positive control, PC; a basal diet contaminated with 80 ppb Aflatoxin + 900 ppb fumonisins + 30 ppb deoxynivalenol + 80 ppb Zearalenone, negative control, NC or NC supplemented with CMD (sodium bentonite, sepiolite, yeast cell wall, and β-glucans) at 1 and 0.5 kg/ton in the starter and finisher diet respectively. Compared with the PC and CMD groups, NC birds showed higher feed intake and poorer feed efficiency during days 1–10 (p < 0.05), although these differences were not observed thereafter. Newcastle disease antibody titer was reduced in NC birds but restored by CMD supplementation (p < 0.05). Birds receiving CMD also exhibited higher IL-10 concentrations than both PC and NC birds (p < 0.05). Furthermore, CMD supplementation reduced macroscopic fatty liver scores and liver inflammation (histopathological lesions) compared with the NC group (p < 0.05). In conclusion, dietary exposure to multiple mycotoxins caused only transient impairment of growth performance but adversely affected immune response and liver health. Supplementation with CMD at 1.0 and 0.5 kg/ton during the starter and finisher phases, respectively, alleviated several of these adverse effects in broiler chickens.
Efficient hybrid algorithm for nonnegative matrix factorization based on modified nonmonotone linear search
In this paper, we present a modified nonmonotone line search algorithm that employs a variable parameter to control the degree of nonmonotonicity. This modification enhances both the probability of identifying the global minimum and the rate of convergence. Within the framework of alternating nonnegative least squares (ANLS), we propose a hybrid algorithm that employs either the modified nonmonotone projected Barzilai–Borwein method and the block coordinate descent method to address the subproblems in each iteration. To further accelerate convergence, we integrate a technique that allows for a larger step size. Under mild assumptions, we establish the global convergence of the algorithm. Numerical experiments conducted on both synthetic and real datasets demonstrate that the proposed algorithm is efficient for nonnegative matrix factorization (NMF) and outperforms other state-of-the-art methods.