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Integrative group psychotherapy reduces daily cortisol output and hair cortisol: A randomized active‑controlled trial with multi‑day profiling

Background Chronic psychosocial stress can disrupt hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system function, yet randomized trials rarely combine multi-day diurnal salivary profiling with hair glucocorticoid assessment. Methods We conducted a parallel-group, superiority randomized controlled trial with 1:1 allocation to compare an 8-week integrative group program with a dose-matched active control. The intervention combined social-affective skills training, slow breathing with heart-rate-variability biofeedback, and cognitive reappraisal. The primary outcome was the change from baseline (T0) to end of treatment (T1) in daily salivary cortisol output, measured as the area under the curve with respect to ground (AUCg) from 3-day profiles. Key secondary outcomes were the cortisol awakening response, diurnal cortisol slope, salivary cortisone AUCg, salivary alpha-amylase AUCg, and hair cortisol concentration assessed from proximal 1-cm hair segments collected at the end of treatment and at the 6-month follow-up visit, with each segment indexing approximately the month immediately preceding collection. Outcomes were analyzed using intention-to-treat mixed-effects models with false-discovery-rate correction for secondary outcome families. Results Sixty participants were randomized to the intervention group (n = 30) or the control group (n = 30). The intervention reduced daily cortisol AUCg more than control from T0 to T1 (between-group difference in change, −21.91 nmol/L·h; 95% CI, −25.87 to −17.95), and this reduction was maintained at T2. Salivary cortisone AUCg and salivary alpha-amylase AUCg also decreased more in the intervention group. Hair cortisol concentration was lower in the proximal 1-cm segments collected at the end of treatment and at the 6-month follow-up visit. Trier Social Stress Test peak cortisol and baseline-corrected AUCi reactivity within the collected −1 to +30 min window did not differ significantly between groups. Adverse events were infrequent and similar between groups. Limitations The trial was conducted at a single site, and the Trier Social Stress Test subsample was modest. Conclusions An 8-week multicomponent group program reduced daily HPA-axis output and proximal-segment hair cortisol under active-control conditions. Trial registration ClinicalTrials.gov NCT06863948 (registered 07 Mar 2025).

An interviewer–evaluator–judger LLM framework for text-based personality inference

Seven ways endurance sports have taught me to be a better researcher

HF-OCAQ: Oral comfort assessment in heart failure patients

Oral discomfort is common among patients with heart failure (HF), with the potential to compromise nutritional intake, communication, and health-related quality of life. Existing oral assessment tools are predominantly clinician-administered and focused on objective pathology, thus failing to adequately capture patients’ subjective experiences of oral comfort. A patient-reported instrument specifically designed for HF populations is lacking. To develop and preliminarily validate a novel PROM, the HF Patients’ Oral Comfort Assessment Questionnaire (HF-OCAQ), designed to multidimensionally assess perceived oral comfort in hospitalized patients with HF. An initial item pool was generated through literature review, qualitative patient interviews, and expert consultation, guided by Kolcaba’s Comfort Theory. Content validity was evaluated using a two-round Delphi process. A pretest was conducted to assess feasibility and clarity. The questionnaire was then administered to hospitalized patients with HF from three general hospitals between June and September 2020. Psychometric comprised assessments of content validity indices, internal consistency reliability, criterion-related validity against the Beck Oral Assessment Scale (BOAS) using Pearson’s correlation, and structural validity via exploratory factor analysis (EFA) using a common-factor model. A total of 190 valid questionnaires were included in the final analysis. The final HF-OCAQ consisted of 24 items. Content validity indices were high (I-CVI range: 0.833–1.000; S-CVI/UA: 0.875; S-CVI/Ave: 0.979). Internal consistency was acceptable (Cronbach’s α = 0.810). Criterion-related validity showed a weak but statistically significant correlation with BOAS scores (r = 0.233, p  < 0.05), consistent with the conceptual distinction between subjective comfort and objective oral status. Exploratory factor analysis supported a four-factor structure that was theoretically coherent and aligned with the proposed multidimensional construct of oral comfort. The HF-OCAQ was developed and preliminarily validated as a patient-reported instrument for assessing perceived oral comfort in hospitalized patients with HF. The findings provide initial evidence supporting its content validity, internal consistency, and structural validity. Further studies, including confirmatory factor analysis, test–retest reliability, and assessment of responsiveness to clinical change, are warranted before broader clinical and research application.

Association of the sulfur microbial diet with metabolic profile, gut-related biomarkers, and adiposity indicators in adults with overweight and obesity

Are boldness and belligerence related?

Teosinte alleles enhance nitrogen assimilation and seed protein in maize

An energy- aware algorithm for optimizing dynamic zone monitoring and multiple cluster head selection with routing in border surveillance WSNs

Border surveillance plays a vital role in national security, necessitating the deployment of efficient and strong Wireless Sensor Networks (WSNs) to reveal and protect sensitive areas. This research describes a unique approach for optimizing border surveillance that combines a hybrid energy efficient zone-based dynamic clustering method with routing utilizing Geometric Modified Ant colony Harris Hawk Optimization Algorithm (EECR-GeMACHHOA). Our proposed method aims to enhance energy efficiency and prolong the network lifespan. This technique starts with the identification of zone monitors using geometric translational symmetry capabilities, which enables the formation of zones. These zones are then optimized by making use of modified ant colony based on dynamic pheromone evaporation for multiple cluster head selection. The EECR-GeMACHHOA improves routing pathways by integrating geometric, nature-inspired Ant colony and Harris Hawk optimization methodologies in order to decrease energy utilization and maximize the packet transmission rate. The proposed approach reduces network latency by 6.66%, consumes 15.03% less energy, and sends 9.86% increase in packets sent to the base station relative to alternative methods. The outcomes demonstrate a very good increase in network lifetime, robust energy efficient system, and data packet transmission dependability when compared to contemporary strategies.

Fe-doped BiVO4/g-C3N4 heterojunction for efficient tetracycline degradation under low-intensity UV irradiation

New hope in the fight against cachexia — cancer’s deadly co-conspirator

Expression of Concern: First molecular report of Moniezia expansa in small ruminants of Pakistan with epidemiological insight

DFT insights into indole detection and removal using aluminum and zinc doped coronene

Abstract The detection of Indole (IND) is crucial due to its biological and environmental significance. This study employs density functional theory (DFT) and time-dependent DFT (TD-DFT) calculations to investigate the adsorption behavior, electronic structure modifications, and sensing performance of pristine coronene (CRN) versus aluminum-doped (Al-CRN) and zinc-doped (Zn-CRN) coronene toward IND. All calculations were performed using ωB97XD and M06-2X functionals with the 6-311G(d) basis set, incorporating CPCM solvation (water) and gas-phase models for comparative analysis. Metal doping significantly reduced the HOMO-LUMO gap from 7.34 eV (CRN) to 6.00 eV (Al–CRN) and 4.95 eV (Zn-CRN), enhanced electron-accepting capability, and increased chemical softness. The adsorption energies followed the following order: CRN@IND (– 11.47 kcal/mol) < Al-CRN@IND (– 42.10 kcal/mol) < Zn-CRN@IND (– 82.51 kcal/mol), where Zn-CRN showed a stronger interaction. QTAIM analysis revealed increased electron density at metal-N bond critical points (ρ = 0.049 a.u. for Al-N; ρ = 0.080 a.u. for Zn-N) compared to weak CRN-IND interactions (ρ ≈ 0.006–0.007 a.u.). NCI/RDG, ELF, and LOL analyses confirmed the transition from weak van der Waals forces in CRN@IND to strong dative coordination interactions in doped systems. TD-DFT analysis showed that Al-CRN, after absorbing IND, produces a significant color change from the UV region (307 nm) to the visible region (415 nm), which can allow detection with the naked eye. Electrical conductivity analysis showed that Zn-CRN exhibits significant electronic disorder after IND binding, which can be considered for further investigation as an electrochemical sensor in the future. The calculated recovery times indicate effectively irreversible adsorption on doped surfaces, positioning these materials as promising candidates for single-use sensing, irreversible capture, and analyte removal applications rather than reusable sensors. These findings provide a theoretical basis for the synthesis of CRN-based nanomaterials for IND detection and environmental remediation.

A comparative analysis of ACE Inhibitors and ARBs as cancer risk factors

Importance Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are widely prescribed antihypertensive agents. Although their cardiovascular and renal benefits are well established, uncertainty remains regarding their long-term associations with cancer risk. Objective To compare cancer incidence among patients treated exclusively with ACEIs or ARBs in a large population-based cohort with long-term follow-up. Design, setting, and participants Retrospective cohort study using electronic health records from Clalit Health Services, Israel’s largest healthcare organization. The source population included hypertensive adults aged 40 years or older who were free of cancer on January 1, 2000 (n = 1,048,575). After applying eligibility criteria and excluding patients who switched between treatment groups or were non-compliant with therapy, the final analytic cohort included 346,405 exclusive ACEI users and 77,018 exclusive ARB users. Exposure Exclusive treatment with either ACEIs or ARBs. Cancer incidence analyses were conducted during an active follow-up period from 2002 through 2024, allowing for a two-year exposure window. Main outcomes and measures The primary outcome was diagnosis of any cancer. Secondary outcomes included the ten most prevalent cancer types diagnosed during follow-up. Cancer incidence rates, odds ratios (ORs), age at diagnosis, and time from treatment initiation to cancer diagnosis were compared between treatment groups after adjustment for age, sex, and exposure duration. Results During follow-up, overall cancer incidence differed between treatment groups. ACEI therapy was associated with lower overall odds of cancer than ARB therapy. Associations varied across specific cancer types, with lower odds observed among ACEI users for several common malignancies, whereas no meaningful difference was observed for leukemia. Differences in age at diagnosis and time to diagnosis were also observed between treatment groups. Conclusions and relevance In this large population-based cohort, long-term cancer risk differed between patients treated exclusively with ACEIs and those treated exclusively with ARBs. While the observational design precludes causal inference, the findings contribute to the ongoing evaluation of the long-term oncologic safety profiles of RAAS-modulating therapies. Further prospective and mechanistic studies are needed to clarify the biological basis and clinical significance of these associations.

EAGF: a four-pillar ethical AI governance framework for trustworthy cybersecurity in 5G renewable energy IoT systems

Small-scale irrigators’ intentions to adapt water use behaviour to climate variability in South Africa

This study aimed to determine the impacts of climate variability on smallholder maize producers’ water use behaviour and the factors that influence their decision-making in the Vhembe District Municipality, Limpopo Province, South Africa. This study utilized a survey from 366 smallholder maize irrigators, Theory of Planned Behaviour (TPB), and Structural Equation Modelling (SEM). The TPB posits that behavioural intentions can influence actual behaviour of individuals and groups, and it consists of three behavioural factors, namely attitude, subjective norms, and perceived behavioural control. Findings indicated that most of the farmers (96%) in the study area were dependent on farming as their primary occupation and livelihood. Most of the farmers were senior citizens with the mean age being between 51–60 and above 61 years of age, majority of the respondents (71%) had secondary education level and majority of the farmers (40%) had less than 10 years of farming experience and 35% had between 11–20 years of farming experience. In addition, the findings revealed that attitude, subjective norms, and perceived behavioural control significantly influence the small-scale farmers’ intentions to adapt to climate variability. The results suggest that as farmers’ attitudes become positive, their intentions to adapt enhance, and the perceptions of adaptation behaviours have a significant impact on individual farmers’ willingness to adapt. In addition, attitude and subjective norms have a substantial influence on the intentions of behavioural changes of farmers’ adaptation. However, perceived behavioural control does influence Intention but has a minor impact compared to attitudes and norms. Therefore, socio-psychological issues should be taken into consideration to improve smallholder farmers’ adoption of sustainable water use practices. This could raise smallholders’ livelihoods and agricultural productivity.

Quantum-classical hybrid learning framework for Parkinson’s disease prediction using acoustic and clinical features

Don’t let AI steal all the joy: what scientists won’t give up to chatbots

Multi-district molecular surveillance of dengue virus in Pakistan reveals serotype cycling and recurrent DENV-2 dominance, 2021–2025

Dengue virus (DENV) remains a major public health concern in Pakistan, with recurrent seasonal outbreaks and shifting serotype patterns. Understanding temporal and geographic trends in circulating serotypes is essential for improving surveillance and outbreak preparedness. This study aimed to characterize the spatio-temporal distribution and serotype dynamics of DENV detected through molecular surveillance in Pakistan between 2021 and 2025. NS1-positive dengue cases were tested at the National Institute of Health (NIH), Islamabad, using real-time reverse transcription polymerase chain reaction (qRT-PCR) for serotyping. Demographic, temporal, and geographic data were analyzed to assess the distribution of DENV infections and circulating serotypes over the study period. Among 1,644 NS1-positive dengue cases tested, 1,162 were confirmed by qRT-PCR. DENV-2 was the predominant serotype overall, accounting for 78.4% of confirmed infections, followed by DENV-1 (21.4%) and DENV-3 (0.09%). Temporal analysis showed that DENV-2 predominated during 2021 and 2022, was temporarily replaced by DENV-1 in 2023, and re-emerged as the dominant serotype in 2024 and 2025. Dengue transmission demonstrated strong seasonal patterns, with most cases occurring during the post-monsoon months of September and October. Gender-Age distribution showed majority of cases in males (66%), particularly those aged 21–40 years. Geographically, most confirmed cases were reported from Rawalpindi and Islamabad, reflecting the primary referral catchment of the surveillance system, while additional cases were detected from several other districts, including Peshawar, Nowshera, Mansehra, and Karachi. These findings highlight dynamic shifts in DENV serotype circulation in Pakistan and emphasize the need for sustained molecular surveillance to guide public health responses.

Comparative machine learning analysis of energy and exergy performance in evacuated tube solar air heater with pierced twisted tape

Non-invasive biomarkers of perioperative stress in ophthalmic surgeons: Heart rate variability, cortisol and salivary copeptin in a feasibility study

Surgeons are exposed to acute perioperative stress that may compromise performance and patient safety. Objective, non-invasive biomarkers are essential to quantify and manage this stress. This prospective, quasi-experimental feasibility study aimed to describe the acute dynamics of heart rate (HR), heart rate variability (HRV), salivary cortisol, and salivary copeptin in ophthalmic surgeons during routine cataract surgery, while assessing the feasibility of measuring copeptin in human saliva for the first time. Fifteen ophthalmologists from three public hospitals were assessed on a resting day (baseline) and on a surgical day involving routine cataract procedures. HR and HRV (SDNN, RMSSD, pNN50, LF/HF) were recorded with a Polar H9 chest strap and a validated mobile application, and saliva samples were collected for cortisol and copeptin (a neurohormone released by the posterior pituitary gland) at four perioperative time points (arrival at hospital, pre-scrub, immediately post-surgery, and 30 min post-surgery). Repeated-measures analyses and correlation tests were performed. At rest, participants showed a mean HR 72.5 ± 15 beats·min ⁻ ¹ and salivary cortisol 0.41 ± 0.29 µg·dl ⁻ ¹, and detectable salivary copeptin levels (2.3 ± 0.7 pmol·l ⁻ ¹). On the surgical day, HR (66.6 ± 8.8 beats·min ⁻ ¹) and cortisol (0.21 ± 0.10 µg·dl ⁻ ¹) decreased significantly at 30 min post-surgery compared with pre-intervention values (74.0 ± 11.3 beats·min ⁻ ¹ and 0.47 ± 0.30 µg·dl ⁻ ¹, respectively), consistent with stress relief, while HRV indices displayed inverse patterns. Although a slight elevation in copeptin levels was observed during the surgical day (from 2.07 ± 0.42 at baseline to 2.50 ± 0.67 2.3 ± 0.7 pmol·l ⁻ ¹ immediately before surgery), this change did not reach statistical significance. In conclusion, the performance of routine cataract surgery triggers specific neuroendocrine responses in ophthalmologists. These findings support the use of multi-modal biomarkers to monitor perioperative strain and its potential impact on surgical performance.