Values play important roles in science, yet their influence on ethical and scientific recommendations is overlooked. This paper examines how interactions between values complicate the uptake of recommendations. We discuss two challenges: (i) value trade-offs, where one value is pursued at the cost of another, and (ii) value synergies, where values reinforce each other. We argue that overlooking trade-offs leads to unrealistic recommendations, while oversimplifying synergies leads to ineffective ones. Both hinder the uptake of recommendations. We propose strategies to address these issues, illustrated by the 2023 National Academies of Sciences report on the use of population descriptors in genomics.

Rural and low-socioeconomic status women face social determinants of health barriers leading to disproportionately low rates of breast cancer screening and markedly reduced participation in clinical trials. To address this gap, we developed the WeCARE (Women’s Engagement for Cancer Awareness, Resources, and Education) intervention using a community-engaged approach. This paper describes how Community Advisory Board feedback informed the development of Mayo Clinic Health System’s WeCARE intervention components. Their input was systematically analyzed using the Consolidated Framework for Implementation Research (CFIR 2.0) to identify determinants of acceptability, appropriateness, and feasibility and to guide actionable refinements to intervention content and delivery.

Conceptual design methods rarely optimize both requirement fit and cross-principle compatibility, leaving a gap in generating coherent early-stage solutions. Here, we introduce a mixed-integer linear programming formulation that selects one solution principle per function while jointly minimizing local requirement mismatch and system-level incompatibility. Using a small case study, we show how a trade-off parameter controls the balance between functional quality and integration robustness. The results demonstrate that the approach enables transparent, compatibility-aware conceptual synthesis.

Balloon-expandable Edwards SAPIEN 3 (23 mm) and MyVal OCTACOR (21.5 mm) valves were tested in 3D-printed silicone tubes using a low-pressure, water-perfused simulator with ultrasound and video monitoring. Balloons were inflated in 2 mm increments from 18 to 30 mm. Both valves were easily inflated from 18 to 24 mm with 2–3 atm inflation pressures and required 5.5 atm and 7 atm, respectively, to reach an inner diameter of 26 mm at the outflow level for the SAPIEN 3 and OCTACOR valves. Further expansion was not achievable. At 18 mm, leaflet opening was mildly asymmetric, but laminar flow was preserved. Circular geometry improved at 20 mm and normalised at 22 mm for both valves. At 24 mm, SAPIEN 3 showed trivial regurgitation, while OCTACOR exhibited a central coaptation defect with mild-to-moderate regurgitation. At 26 mm, SAPIEN 3 leaflets were maximally stretched yet functional with central regurgitation, whereas OCTACOR failed with leaflet tears at the frame attachment. These results indicate both valves can be implanted at small diameters and stepwise dilated to nominal size, tolerating overexpansion up to 3 mm for SAPIEN 3 (+13% overexpansion) and 4.5 mm for OCTACOR (+20.9% overexpansion) at outflow level, with SAPIEN 3 remaining functional and OCTACOR requiring valve-in-valve replacement. Pending clinical validation, this versatility could support their use for infant mitral and pulmonary replacements as alternatives to the Melody valve; though, under- or overexpansion should be reserved for clinically essential situations.

We report a 40-year-old man (167 cm, 69 kg) with a complex surgical history, including repaired coarctation of the aorta and a Bentall procedure with mechanical valve replacement, who presented with recurrent, haemodynamically significant coarctation of the aorta, severe arterial hypertension, and a challenging 17 mm diameter mismatch between the aortic arch and descending aorta. As surgery was declined, a tailored hybrid solution was adopted: deployment of a custom thoracic endograft to bridge the calibre transition, reinforced with a balloon-expandable stent to optimise luminal gain. The approach achieved complete gradient resolution without complications, allowing for discharge at 48 hours. This case underscores the feasibility of personalised hybrid repair for complex re-coarctation of the aorta.

Anxiety disorders are common and disabling. Current drugs have limited efficacy, notable side-effects and little innovation. This editorial briefly reviews past, current and emerging anxiolytic treatments, including psychedelic-assisted therapies, and highlights key themes. There remains a major need for improved medications to reduce disability and improve quality of life.

Depression is a common mental disorder and a leading cause of global disease burden. Emerging evidence supports diet as an adjunct treatment for depression. Previous studies are limited, meaning it is unclear whether improvements are directly due to dietary change. The Optimising Nutritional Psychiatry Treatment: Investigating the Mediterranean Diet to Improve Symptoms of Major Depressive Disorder (OPTIMISM) trial aims to address this gap through a sham-controlled randomised feeding trial design. The OPTIMISM trial is a 4-week double-blind, sham-controlled, randomised feeding trial. A total of forty-four participants with major depressive disorder in a current major depressive episode of moderate to severe severity will be recruited and randomised to a Mediterranean or a sham control diet, designed to reflect typical dietary intake of the general population. All food will be provided for 4 weeks. Participants will complete assessments and have blood and stool collected at baseline and 4 weeks. The primary outcome is the differential change in clinician-rated depressive severity at 4 weeks. Exploratory outcomes include patient-rated depressive and anxiety symptoms and quality of life. Potential mechanisms will be evaluated through analysis of biological samples. An additional group of twenty-two healthy individuals without depression will also be recruited and will receive a Mediterranean diet for 4 weeks; their data will determine whether clinical and biological responses to the intervention are unique to depression and whether the diet treatment modulates depression-related pathology. If the intervention diet leads to a greater reduction in depressive symptoms compared with a sham control diet, this trial will provide preliminary evidence supporting the use of a Mediterranean diet in the treatment of depression.

Lexical knowledge varies by modality, grammatical class, and, in Arabic diglossia, by the lexical distance between Modern Standard Arabic (MSA) and Spoken Arabic (SpA). We tested the effects of modality, grammatical class, and MSA–SpA distance on lexical knowledge, and interdependence between SpA and MSA. Palestinian Arabic (PA) speaking kindergarteners (N=30; mean age 5:9) completed picture naming tasks manipulating modality (comprehension and production), grammatical class (nouns and verbs), and lexical distance (identical, cognate, and unique). Scores were higher for nouns than verbs and for comprehension than production in both varieties. A graded distance effect was found (identical > cognate >unique). PA lexical knowledge predicted MSA lexical knowledge across conditions in production. These findings highlight the importance of the spoken variety in acquiring MSA vocabulary and show that linguistic distance constrains lexical acquisition in Arabic diglossia. We argue that models of vocabulary acquisition should incorporate linguistic distance and interdependence between varieties.

Corruption attracts scholar attention due to its harsh impact on people and institutions, especially in nonprofit organizations traditionally associated with altruistic intents. Although many scandals have shaken the third sector, rare are the studies that offer a true understanding of how corruption occurs. Our research provides insights into the corruption phenomenon in the context of the Syrian refugee crisis in Lebanon. The findings show the powerlessness of public institutions, the chaotic working environments of humanitarian organizations, managerial malpractices, and inefficiencies in projects, all leading to unethical choices and to corrupt behaviors perpetrated by humanitarian agencies. The theoretical model that we propose brings new understanding of the relationships between nonprofit management, coordination, and corruption in the aid sector. On the practical front, it offers suggestions to public policy makers and practitioners about preventing corruption even during crisis situations.

This article uses the case of Japan to advocate for a new theoretical approach to the study of the nonprofit sector. In particular, it examines how theoretical models based on the European and North American experiences have difficulty explaining the relationship between the nonprofit sector and the state in Japan, and argues that a state-in-society approach is better suited to explaining complex state–society relations in diverse cultural contexts. It does this by examining the evolution of social welfare service provision in Japan. This article is motivated to explain an apparent paradox: Japan’s recent efforts toward greater government decentralization and privatization of services have empowered and enlarged the nonprofit sector even as they have also expanded the scope of state authority and enhanced its legitimacy.

Civil society organizations in Lebanon have a long history, pre-dating even the existence of the Lebanese state itself, which has directly shaped their major phases of development since its creation. Based on the social origins theory and using the framework developed by Marchetti and Tocci (Peace Secur Former Pac Rev Peace Secur Glob Chang 21:201–217, 2009), this paper analyses the relationships that have developed between the state and civil society organizations in Lebanon. The main argument presented in this paper is that the scope of work of civil society organizations, in addition to their freedom of action, is directly linked to the social, political and economic development of the state. The main conclusion of this paper is that a new social contract should be forged between associations and the state in Lebanon, one that would allow them to carry out their functions properly.

The Acholla Archaeological Project is an international collaboration at the site of Acholla (Tunisia) between the Institut National du Patrimoine (INP), Dickinson College and the University of Oklahoma, with additional support from the University of Leicester and the Endangered Archaeology in the Middle East and North Africa (EAMENA) project. The first season of the project took place in June 2025, focusing on three main tasks: fieldwalking, topographic survey and architectural documentation. Over a period of two and a half weeks, an area of over 25 ha was covered by a fieldwalking team and nearly 40,000 finds were collected for study and analysis. Topographic and architectural surveys were also undertaken to begin the process of creating an updated plan of the site. The work accomplished this season has already yielded new information about Acholla and has provided a strong foundation for future fieldwork campaigns and further research at this important coastal site.

Balloon-expandable MyVal OCTACOR valves were evaluated in 3D-printed conduits under simulated flow. The 20 mm valve functioned from 16–24 mm, rupturing at 27 mm. The 29 mm expanded to 33 mm with mild insufficiency. Findings suggest OCTACOR valves may support repeated valve-in-valve procedures, with the 20 mm showing greater versatility for small-infant mitral replacements and as a potential alternative to Melody valves.