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Individuals starting a recovery journey enter recovery housing with diverse sociodemographic backgrounds, substance use histories, and levels of recovery capital, which influence the length of stay in recovery housing. This study examined which admission characteristics correspond to length of stay in recovery residences and used survival mixture clustering to characterise heterogeneity in retention trajectories. This study included data from 2534 residents across 61 U.S. recovery residences between 2019 and 2023. Cox proportional-hazards regression identified baseline correlates of length of stay, with cluster-robust standard errors at the residence level. A complementary survival mixture clustering algorithm jointly modelled latent retention trajectories and survival functions using sociodemographic characteristics, recovery capital, barriers, unmet service needs, and substance use indicators. Older age, higher quality of life, greater recovery group participation, an unmet alcohol treatment need, and criminal legal system involvement associated with longer stays. By contrast, a history of cannabis use, drug use within 90 days before admission, and an unmet drug treatment need associated with shorter stays. Survival mixture clustering supported a nine-cluster solution, with median lengths of stay ranging from 29 to 91 days. Clusters with shorter stays exhibited lower recovery capital, higher unmet needs, and greater recent substance use, whereas longer-stay clusters demonstrated higher quality of life, stronger engagement with support structures, and higher proportions of criminal legal system involvement. Model discrimination was modest overall, indicating that baseline characteristics explain only part of the variation in retention trajectories. Residents reporting recent drug use before admission to recovery housing or an unmet drug treatment need may benefit from proactive support at admission, while peer engagement and structured support pathways may promote longer lengths of stay. Because effect sizes were modest and discharge outcomes were heterogeneous, these findings should inform adaptive and equity-conscious service responses rather than individual risk classification. Future research should disaggregate accrual and loss of recovery capital during initial residence and distinguish between disengagement and recovery-readiness exits.

Place significantly impacts health and belonging, yet little is known about how place and loneliness intersect for people with chronic conditions. This qualitative study examined how people with chronic illness experience places in their daily lives, and how these place-based experiences shape feelings of loneliness. We conducted in-depth interviews, walking interviews and photo-elicitation with 40 participants across urban and regional Australia, analysing how place relationships intersected with loneliness and illness experiences. Our analysis revealed three distinct patterns. 'Effortless belonging' characterised those with pre-existing advantages (spatial stability, economic security, established networks) who maintained unconscious protective buffers against loneliness through deep place familiarity despite illness. 'Strategic spatial negotiation' described participants who actively curated place engagement - using home as refuge during symptomatic periods while selecting accessible public spaces to maintain social identity. 'Geographic disenfranchisement' emerged where chronic illness compounded structural vulnerabilities (poverty, housing instability, marginalisation) creating compromised place connections where locality intensified rather than alleviated loneliness. Findings reveal chronic illness fundamentally but not uniformly reshapes place-loneliness relationships by intersecting with existing structural conditions to create divergent spatial experiences. For participants with structural advantages, bodily vulnerabilities were buffered by stable place connections, while those with pre-existing disadvantages experienced chronic illness as compounding spatial marginalisation. Strong place attachment could coexist with spatial constraint, particularly in disadvantaged areas, challenging assumptions about the inherent benefits of place belonging. Findings underscore the need for spatially-informed interventions addressing structural inequalities (housing instability, inaccessible spaces, socioeconomic disadvantage) that determine whether chronic illness becomes a pathway to place-based connection or disconnection.

This study evaluated the influence of prior gabapentin administration, associated or not with integrative practices, on sedation scores, physiological parameters, and propofol requirement in cats sedated with dexmedetomidine undergoing elective orchiectomy. Forty healthy cats (3.76 ± 0.69 kg) were enrolled (T0) and randomized into four groups (n = 10). GAB group received gabapentin (100 mg administered orally) under standard housing, GAB-GCW group received the same treatment but was housed in a cat ward with integrative practices. Control groups received placebo in a cat ward with integrative practices (GCW) or standard housing (GC). After 120 minutes, all cats received dexmedetomidine (5 µg/kg IM). Heart rate (HR), respiratory rate (RR), systolic blood pressure (SBP), temperature and sedation scores were assessed before (T1) and 30 minutes after dexmedetomidine (T2). Propofol induction dose, recovery times and quality were recorded. In T1, GAB-GCW showed higher sedation scores [6 (3-9)] than GAB [3 (2-5)] and GC [3 (1-5)], but not GCW. In T2, GAB [9 (2-12)] and GAB-GCW [7.5 (5-12)] scored higher than GC and GCW. Propofol requirements were lower in GAB (4.2 ± 1.9 mg/kg) than GCW (6.8 ± 1.5 mg/kg) and GC (7.2 ± 2 mg/kg) but not GAB-GCW (5.4 ± 1.7 mg/kg). Gabapentin had no effect on physiological variables or recovery. In conclusion, 100 mg of gabapentin given 120 minutes before handling enhances dexmedetomidine sedation and provides a significant propofol-sparing effect for anesthetic induction in cats, although integrative practices alone appear to have limited impact on these outcomes.

The aim of this study was to evaluate the association between socioeconomic status (SES) and all-cause mortality among individuals with diabetes. We also examined how individual SES components, including income, employment, education, and housing conditions, were associated with mortality risk. Following PRISMA 2020 guidelines, we searched PubMed, Embase, the Cochrane Library, and Web of Science through September 2025. Eligible studies included adults with type 1 or type 2 diabetes reporting associations between SES indicators (income, education, occupation, or area-level deprivation) and all-cause mortality. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models based on heterogeneity (I2). Publication bias was assessed using funnel plots and Egger's test. Nineteen studies were included. Low SES was associated with a higher risk of all-cause mortality (OR&#x202f;=&#x202f;1.67; 95% CI: 1.49-1.88; p&#x202f;<&#x202f;0.00001). Similar associations were observed across income, education, housing, and employment domains. Heterogeneity was substantial (I 2&#x202f;=&#x202f;99%), indicating considerable variability across studies. Sensitivity analyses showed that no single study materially influenced the pooled estimate, and publication bias appeared minimal. Low socioeconomic status is associated with increased mortality among individuals with diabetes. Addressing socioeconomic inequalities through improved access to education, employment opportunities, healthy environments, and equitable healthcare may help reduce survival disparities and mitigate the overall burden of diabetes. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1248984, identifier PROSPERO (CRD420251248984).

Housing is a key social determinant of health, yet little is known about how homelessness shapes migrants' health in Nordic welfare states where legal status, labour market attachment and welfare entitlements are unevenly distributed. This article examines how homelessness affects the physical and mental health of migrants, and how structural barriers limit their capacity to navigate access to health care. Exploratory mixed-methods study combining registry data on shelter use in Oslo (2019-2023) and interviews with ten frontline health and social care staff at a long-term, NGO-run shelter. Analyses were informed by precarious citizenship and structural vulnerability. Homeless migrants represented a heterogeneous group in terms of citizenship status and health problems. Migrants' region of origin influenced their resident status, the uncertainty of their situation, and the duration of their stay. Homelessness interacted with migrants' pre-existing vulnerabilities, such as precarious legal and economic status, language barriers, limited access to public services, and untreated chronic disease, to accelerate health decline. Precarious citizenship can be enacted through gendered arenas of exploitation, with consequences for safety, access to care and possibilities for recovery. Homelessness among migrants reflects structural vulnerability and contributes to cumulative disadvantage. Homelessness is not simply a backdrop to migrant ill-health; it is an active health risk that exacerbates disease, disrupts treatment, and limits recovery. Shelters and low-threshold services play a crucial bridging role by enabling access to treatment and rehabilitation. Addressing migrant health inequities requires rights-based approaches and integrated policies linking housing stability and health care access.

In response to recurrent epizootics of highly pathogenic avian influenza (HPAI), France launched a national vaccination programme targeting ducks in October 2023. It was completed by a three-pillar post-vaccination surveillance system, comprising enhanced passive surveillance, active virological testing, and end-point serological testing. Using national-level data from mandatory reporting systems, this study (i) evaluates the implementation of the post-vaccination surveillance system during its first year, and (ii) presents initial results regarding the detection of avian influenza virus (AIV) circulation in vaccinated flocks through this surveillance programme. A total of 18,881 enhanced passive surveillance operations were recorded across 1604 establishments, representing a coverage rate of 55.2%. In addition, 17,951 active surveillance operations were conducted in 2011 establishments, with virological testing performed in 89.0% of targeted sites and serological testing in 83.4%. All surveillance items considered, 92.3% of the establishments housing vaccinated ducks carried out at least one surveillance operation over the studied period. The three surveillance components proved complementary: AIV prevalence at the establishment level was estimated at 6.8%, 7.3% and 13.7% through passive surveillance, active virological testing, and end-point serological testing, respectively, with only low pathogenic AIV detected. These findings underscore (i) the unprecedented scale of AIV surveillance within the French duck farming sector, (ii) the importance of evaluating stakeholders' adherence as a prerequisite for assessing surveillance effectiveness; (iii) the interest of monitoring AIV circulation to detect the potential emergence of antigenically modified virus strains and to inform timely adjustments to control strategies.

Social frailty is defined as the risk of losing the necessary resources to meet basic social needs. This study aimed to assess social frailty and its associated factors in older adults in Kashan in 2023. In this cross-sectional study, 250 older adults were selected through multistage random sampling from comprehensive health centers. Data collection instruments included a demographic questionnaire, abbreviated mental test, social frailty scale, Lubben social network scale, and a specific quality of life scale. Data were analyzed using Jamovi v.2.3.28. Associated factors were identified using independent t-tests, analysis of variance, Pearson correlation coefficient, and multiple linear regression. The mean social frailty score was 1.244 (&#xb1;&#x2009;1.345), and it was estimated to be 1.077-1.411 (on a scale of 0-6) in the community. Additionally, 65.2% of participants had at least one component of social frailty. Standard multiple linear regression showed that five variables were independently associated with social frailty: social isolation, quality of life, housing type, health insurance coverage, and age (F&#x2009;=&#x2009;9.834, p&#x2009;<&#x2009;0.001). These variables explained 40.3% of the observed variance. This study highlights the social frailty of older adults covered by comprehensive health centers. Longitudinal studies are needed to determine whether implementing programs targeting these associated factors could potentially reduce the risk of social frailty among older adults in Iran.

This pilot study investigates whether trained behavioral tasks may serve as early, non-invasive indicators of distress in high-severity disease models in laboratory rats. Therefore, six Wistar rats in a diethylnitrosamine-induced hepatocellular carcinoma model, were trained to perform two tasks: lockbox solving and scale climbing. They were assessed over 18&#x2009;weeks by body weight, hair corticosterone (hCORT), and Grimace Scale. Changes in task performance time and hCORT levels were observed and revealed a three-phase pattern. Initially, poor task performance (mean lockbox solving time 22&#x2009;s) and elevated hCORT (mean 10.8&#x2009;pg/mg) indicated a process of adaptation to the experiment. This was followed by improved performance (mean lockbox solving time 2&#x2009;s) and reduced hCORT (mean 7.9&#x2009;pg/mg), suggesting acclimatization. Later, performance declined again (mean lockbox solving time 9&#x2009;s), accompanied by rising hCORT (mean 8.3&#x2009;pg/mg), likely reflecting tumor progression and repeated anesthesia exposure. Lockbox solving appeared more variable than scale climbing. Acute stressors, such as room changes and prolonged anesthesia, had an impact on lockbox solving and scale climbing. After the initial housing room change lockbox solving time increased from 20&#x2009;s to 49&#x2009;s while scale climbing time rose from 12&#x2009;s to 26&#x2009;s. Case observations confirmed that task performance deficits coincided with illness or larger tumor burden. These findings support the use of trained behavior as a sensitive tool to detect distress. This approach could improve welfare monitoring in long-term or high-severity animal studies.

Long-acting ART (LA-ART) regimens available or in development are emerging alternatives to daily oral HIV treatment, designed to improve adherence. We explored preference heterogeneity for LA-ART among people living with HIV (PLWH) in Kenya and investigated their association with sociodemographic and psychosocial characteristics. We designed a discrete choice experiment (DCE) to elicit preferences for LA-ART attributes among 700 PLWH recruited from three clinics in Nairobi Kenya (January 2023-February 2024). Each participant answered 17 choice-tasks, each with 2 hypothetical LA-ART alternatives and current daily oral therapy. Each LA-ART profile was defined by mode (long-acting pills, injections under the skin, injections into the muscle, and implants), pain, frequency, location of treatment, pre-treatment time undetectable, pre-treatment negative reaction testing, and late-dose leeway. Participants answered demographic and psychosocial questions and provided consent to link their clinical data. We fitted a latent-class model to the DCE data, assigned class membership to each participant, and estimated a multinomial logit model to explore associations between participant characteristics and class membership. We found three classes in our DCE data and labeled them based on which hypothetical LA-ART formulation they preferred over their current daily oral therapy: LA-Implant (41% of the sample), LA-Injection-or-Oral (subcutaneous or intramuscular injection; 38%) and LA-Oral (21%) classes. All classes preferred "clinic" of over "home" for treatment location. Compared to LA-Oral participants, the other two classes had more experience with and less aversion to injections and had started ART more recently. LA-Implant participants were more likely to have housing insecurity. LA-Injection-or-Oral participants were less likely to be a female sex worker and to have a monthly income; and more likely to be a man who has sex with men or male sex worker, to have private insurance, and to have easier access to a clinic. Results provide a deeper understanding of the LA-ART preference landscape. Understanding PLWH preferences for these therapies is crucial to increasing their acceptance and uptake as regimens become available and could aid in the development of preference-informed interventions.

Wealth inequality is a central dimension of social stratification, yet the early-life processes underlying its emergence remain insufficiently understood. This article examines whether childhood residential mobility contributes to adult wealth accumulation, through which developmental pathways, and under what conditions. Drawing on longitudinal data from the 1958 National Child Development Study, I link residential histories from birth to age 16 to homeownership and net financial wealth at age 33. Childhood mobility is conceptualised as a multidimensional process that captures the frequency and timing of moves, as well as whether residential change coincided with school disruption. The results reveal a clear stratified pattern. Occasional moves are largely benign by early adulthood, but repeated mobility is associated with lower wealth and reduced access to homeownership, especially when it extends into adolescence or disrupts schooling. Mediation analyses indicate that these associations operate more clearly through adolescent psychosocial difficulties than through cognitive performance. Moderated mediation models further indicate that psychosocial pathways are concentrated among children who are outside financially secure owner-occupied households at age 16. By highlighting how childhood residential instability becomes embedded in later wealth accumulation, this study extends sociological accounts of stratification beyond labour market outcomes to the developmental and housing foundations of asset inequality.

Despite the recognition of substance use and sex work as public health issues, the intersection of these areas, especially within the rural US, is an area of special importance. The Rural Opioid Initiative comprises of eight research cohorts spanning 10 states and 65 rural US counties. Between 1/2018-3/2020, individuals who reported past 30-day substance injection or opioid misuse were recruited. Analyses were restricted to people who use drugs (PWUD) who reported trading "vaginal or anal sex for drugs, money, housing, or other things you need" in the past 30 days. We analyzed cross-sectional associations between injection drug use and sexual behaviors associated with hepatitis C virus (HCV)/HIV infection transmission, access to harm reduction, and HCV status among PWUD and engaged in sex work in rural US areas. Of the 2045 participants, 9% (n=180) reported engagement with sex work, with just over half being women (58% [n=104]). In adjusted models, people who engaged in sex work, compared to PWUD who did not, had higher prevalence ratios of past 30-day receptive syringe sharing (adjusted prevalence ratio [aPR]=1.69, 95% Confidence Interval [95%CI]=1.44-1.98), practice of multiple injections per injection episode (aPR = 1.28, 95% CI = 1.15-1.43), practice of syringe mediated drug sharing (aPR=1.50, 95% CI=1.32-1.71), condomless sex (aPR=1.62, 95% CI=1.48-1.77) and condomless sex with someone who injects drugs (aPR=2.05, 95% CI=1.76-2.39). PWUD engaged in sex work were less likely to report easy condom access (aPR=0.88, 95% CI=0.80-0.96), while no significant differences were observed for most other harm reduction access measures. PWUD engaged in sex work in the rural US had higher likelihood of injection drug use and sexual behaviors associated with HCV/HIV infection transmission, while having lower use of and access to condoms. This study emphasizes the importance of ensuring affordable access to condoms within the context of harm reduction services, especially given the limited access to health care and supportive services, particularly in rural communities.

Juvenile delinquency is closely linked to complex psychosocial and value-based developmental trajectories. This study compares life-course narratives (childhood and school experiences, daily life structure), value orientation, self-concept, and standardized self-reports of emotions among adolescents with delinquent behavior, adolescents with psychiatric disorders, and healthy peers. Using a mixed-methods design, narrative interviews were conducted with all three groups (N&#x2009;=&#x2009;48). Participants were asked to describe their feelings in relation to these domains in order to assess emotional processing, measured by the Positive and Negative Affect Schedule (PANAS). Compared with their healthy peers, narratives from adolescents with delinquent behavior were characterized by greater strain across their developmental course. These descriptions were marked by housing and caregiving instability, insecure bonding experiences with primary caregivers, difficulties in forming coherent and socially oriented value systems, and a tendency toward self-concepts marked by overcompensation. Regarding emotional experience, PANAS results indicate that both the delinquent and psychiatric groups reported higher levels of negative affect than healthy adolescents. Although adolescents with psychiatric disorders also reported adversity, their narratives tended to reflect greater variability in protective factors and more opportunities to benefit from therapeutic and relational support. The findings suggest that delinquent behavior may arise from the cumulative interplay of early adversity, environmental instability, disrupted relational experiences, and challenges in developing individualized values and stable, non-compensatory self-concepts. These results highlight the importance of interventions that address potential moral injury, strengthen reliable relational contexts, and promote socially integrated value orientations. Qualitative approaches provide important insights into these mechanisms and should complement quantitative assessments when working with high-risk youth.

Conversion of unstructured biomedical literature into structured knowledge for identifying cross-domain associations between biological entities remains a challenging task. SigMine is an automated pipeline constructed to mine biomedical literature to identify significantly associated biological entities. SigMine performs biomedical entity recognition from PMC articles using the EuropePMC Annotation API. Advanced entity recognition was performed using Python scripting, NCBI E-Utilities, and an n-gram algorithm followed by extensive data cleaning and mapping against standard databases. Statistical evaluation identified significantly co-occurring entities. The entire workflow was automated through a modular framework developed in Python v3.13 with a Tkinter-based Graphical User Interface. SigMine enhances usability while retaining the flexibility to use new dictionaries for annotation. SigMine was used to construct a literature-derived potential human Opportunistic Pathogens Database (OPathDb), housing 5,626 potential opportunistic pathogens significantly co-occurring with 1440 diseases and 7121 genes mined from 25,000 PMC articles. Additional annotation of 598 significantly co-occurring metabolites and 30 affected tissues is available for 3204 and 227 pathogens, respectively. OpathDb has a user-friendly query interface searchable by organism, disease, tissue, gene, protein and metabolite available at https://www.opathdb.cbsblab-nsut.in . Organism-entity associations can be visualized as weighted networks, with color-coded nodes and significance-scaled edges. Significant associations of opportunistic pathogens like Akkermansia mucinifila with colorectal cancer and Segatella copri with glucose intolerance can be identified through OpathDb. Through this database, the SigMine framework demonstrates conversion of unstructured text in vast and heterogenous corpora into standardized and well-organized information. Statistically inferred associations in OPathDb are potential candidates for clinical and experimental validation.

In the United Kingdom (UK) and the Republic of Ireland (ROI), European badgers (Meles meles) are recognised as a reservoir host of Mycobacterium bovis (M. bovis), which they can transmit to cattle. Badgers are also suspected to contribute to the maintenance of Mycobacterium bovis in other European countries, including Spain and France. Therefore, badger vaccination can be used as a tool for the prevention and control of M. bovis infection in cattle. We present individual-level immunological and bacteriological data collected between 2002 and 2020 from 374 individual captive badgers from the UK, ROI and Spain. The data were generated through standardised experimental protocols developed for badgers and optimised in the ROI (experimental challenge protocol) and at the Animal and Plant Health Agency (APHA, UK) (immunological protocols). The analysis aimed to measure antigen-specific T-cell responses and antibody responses in BCG vaccinated and non-vaccinated badgers before and after experimental infection (challenge) with live bacteria M. bovis. The data were generated from individual badgers repeatedly sampled between seven and 16 times every two-to-three weeks. The data are blood-based immunological assays and bacterial culture results of clinical samples. The dataset also includes husbandry information (sex, original social group, housing pen), physiological measurements (temperature and weight), vaccine details (type, formulation, route, dose and strain) and M. bovis challenge parameters (dose concentration).

The use of copper oxide nanoparticles (CuO NPs) is increasing in biomedical applications and various industrial sectors. The increased use of these nanoparticles raises concerns regarding their potential neurotoxicological consequences on copper homeostasis. The present study established a CuO NP feeding-based Drosophila melanogaster model to investigate copper-induced toxicity with emphasis on glial-associated neurodegenerative mechanisms. The CuO NP of average size of &#x223c;88&#x202f;nm was synthesised in-house and exposed to flies through oral mode. The locomotor abnormality was investigated in larvae and adults, indicating neuronal dysfunction at both early and late developmental stages. Propidium iodide and 4',6-diamidino-2-phenylindole staining confirmed early cellular damage in the eye-antennal imaginal disc of the 3rd instar larvae. Scanning electron microscope - energy-dispersive X-ray spectroscopy analysis revealed the copper deposition in the gut and brain of the third instar larvae, which confirms the systemic uptake. The markers of genotoxic stress are the increased levels of reactive oxygen species and micronuclei formation in gut epithelial cells, while reduced pupal count is an indicator of developmental impairment due to copper toxicity. Compromised neuroglial interactions were evidenced by cone cell abnormalities and photoreceptor degeneration in pupae and adults. Moreover, the alterations of the acetylcholinesterase (AchE) activity indicated an impairment of the cholinergic neurotransmission. In conclusion, the results indicate that dietary exposure to CuO NP induces oxidative stress, developmental defects, and glial-related neurodegenerative changes. The results establish the fruit fly as a relevant in vivo model for the study of CuO NP toxicity and related neurologic disorders.

This study aims to translate and adapt the University of California San Diego Performance-Based Skills Assessment Extended Range (UPSA-2-ER) to Chinese for assessing independent living skills of people with severe mental illness in Hong Kong. An expert panel was conducted to evaluate the translation, content validity, and cultural relevance. The UPSA-2ER (HK) was administered to 30 Hong Kong Chinese with severe mental illness (SMI) to examine the inter-rater reliability and 210 more to examine the internal consistency, structural validity and predictive validity. Sixty-six participants also completed the Chinese Functional Needs Assessment (CFNA) for concurrent validity. Good content validity was established with modifications of items to address cultural relevance. Both inter-rater reliability (ICC ranged from 0.98 to 0.99) and internal consistency (Cronbach's &#x3b1;&#xa0;=&#xa0;0.97) of total score were excellent, while internal consistency of sub-domains ranged from fair to excellent (Cronbach's &#x3b1; ranged from 0.76 to 0.96). In Rasch analysis, raw variance explained by measures &#x2265;40% was interpreted as good in terms of unidimensionality (Sumintono & Widhiarso, 2015), study results provided modest evidence that the UPSA-2ER(HK) has a unidimensional structure, as the variance explained by the items was 43.5% and the unexplained variance in the 1st contrast was 4.4%. Classification & regression tree analysis showed that the UPSA-2ER(HK) correctly classified 78.5% of the 210 participants into their residential status of independent living, halfway house or long stay care home. For concurrent validity, the UPSA-2ER(HK) demonstrated high correlation with the local golden standard, CFNA (r&#xa0;=&#xa0;0.82). The results showed that the instrument has satisfactory psychometric properties for assessing capacity to perform community living tasks.

Indoleamine 2,3-dioxygenase 1 (IDO1) facilitates tumoral immune evasion via the kynurenine (Kyn) pathway, while ABCB1-mediated efflux drives multidrug resistance. Previously, miconazoles were reported as potent IDO1 inhibitors and some azole antifungals inhibit efflux pumps. Herein, we report a miconazole analogue, 1g, which inhibits both mechanisms. An in-house library of miconazole analogues, incorporating oxime ether derivatives with imidazole and pyrazole rings, was screened against Kyn production in IDO1-expressing SK-OV-3 and HeLa cells, yielding the hit pyrazole derivative 1g (IC50(Kyn)&#x202f;=&#x202f;&#x223c;5.8&#xb5;M). In vitro LDH assay showed minimal cytotoxicity for 1g and it was well tolerated by in vivo zebrafish model at 2&#x202f;&#xd7;&#x202f;IC50(Kyn-SK-OV-3) concentrations. Molecular modelling and biochemical assays indicated apo-form preference for 1g, which suppressed Kyn production without affecting IDO1 protein levels or inducing apoptosis. In indirect co-cultured models, 1g reversed Kyn-mediated immunosuppression, significantly restoring pro-IL1B and TNF levels in LPS-induced THP-1 macrophages. Furthermore, 1g restored Jurkat T cell proliferation, aggregate formation, and PDCD1 expression independent of direct 1g exposure, confirming a Kyn-dependent mechanism. Finally, 1g inhibited ABCB1 function in a dose-dependent manner and enhanced the sensitivity of ABCB1-expressing cells to paclitaxel, demonstrating its efficacy as a multidrug resistance (MDR) reversal agent. Our findings characterised 1g as a promising low-micromolar dual inhibitor of apo-IDO1 and ABCB1 with minimal cytotoxicity. It simultaneously disrupts the immunosuppressive Kyn axis and modulates ABCB1-mediated efflux, which provides a robust pharmacological basis for further development of next-generation combinatorial therapies.