Founded in 1869, Goldman Sachs is the world’s second-largest investment bank by revenue and is ranked 55th on the Fortune 500 list of the largest United States corporations by total revenue. The Wall Street white-glove giant offers financing, advisory services, risk distribution, and hedging for the firm’s institutional and corporate clients. We review the firm’s Conviction List of top stock ideas monthly, seeking companies with the highest dividends and the safest profiles. With the year winding down, we decided to review the current list of high-yielding stocks that can provide secure, reliable passive income.
December could prove to be another volatile month, so growth and income investors may want to reset their portfolios.
Goldman Sachs Conviction List: the highest-yielding stocks have huge total return potential.
The Conviction List dividend stocks may get a nice boost if the Fed lowers rates at its December meeting.
Some investors get rich while others struggle because they never learned there are two completely different strategies to building wealth. Don’t make the same mistake, learn about both here.
The Goldman Sachs Conviction List is a curated list of stocks that the firm’s research team believes have a high likelihood of outperforming the market. It’s a tool for investors to identify stocks with strong growth potential, frequently updated to reflect changes in market conditions and company performance. The list aims to identify stocks where Goldman Sachs analysts have the “highest level of conviction” in their outperformance. We screened the list for dividend-paying stocks likely to receive a significant tailwind as the Federal Reserve continues on a rate-cutting cycle, and five are outstanding stocks with big, reliable dividends and strong total return potential.
Goldman Sachs is the acknowledged leader in the investment landscape on Wall Street and worldwide. The firm’s top-notch research department continues to provide institutional and high-net-worth clients with the best ideas across the investment spectrum. It is likely to continue doing so for years.
This quality REIT offers steady, reliable income, a portfolio of outstanding properties, and a rich 4.40% dividend. Brixmor Property Group (NYSE: BRX) is an internally managed real estate investment trust (REIT). The Company conducts its operations primarily through Brixmor Operating Partnership LP and subsidiaries (collectively, the Operating Partnership).
The Company owns and operates open-air retail portfolios by gross leasable area (GLA) in the United States, comprised primarily of community and neighborhood shopping centers. The Company’s portfolio consists of approximately 360 retail centers (the Portfolio) totaling over 64 million square feet of GLA.
Brixmor Property Groups’ projects include:
Dickson City Crossings
East Port Plaza
Fox Run
Gateway Plaza
Old Bridge Gateway
Pointe Orlando
Shops at Palm Lakes
Stewart Plaza
Tinley Park Plaza
Tyrone Gardens
Vail Ranch Center
Venice Village
Village at Mira Mesa
Westminster City Center
The Company’s national portfolio is primarily located within established trade areas in the top 50 Core-Based Statistical Areas (CBSAs) in the United States.
Goldman Sachs has a $32 target price for the stock, representing 22% upside.
Duke Energy is an American electric power and natural gas holding company headquartered in Charlotte, North Carolina. It is located in a growing part of the country and pays a hefty 3.44% dividend. Duke Energy Corporation (NYSE: DUK) and its subsidiaries operate as energy companies in the United States.
It operates through two segments:
The EU&I segment generates, transmits, distributes, and sells electricity in the Carolinas, Florida, and the Midwest.
To develop electricity, Duke Energy uses the following:
Coal
Hydroelectric
Natural gas
Oil
Solar and wind sources
Renewables
Nuclear fuel
This segment also sells electricity to municipalities, electric cooperative utilities, and load-serving entities.
The GU&I segment distributes natural gas to
The segment also invests in pipeline transmission projects, renewable natural gas projects, and natural gas storage facilities.
Goldman Sachs’ price target for the company is $138, representing an 11% gain from current trading levels.
With Christmas right around the corner, this is an excellent idea for growth and income investors with a solid 2.91% dividend. The Hershey Company (NYSE: HSY) is a snacks company.
The Company’s segments include:
The North America Confectionery segment is responsible for its traditional chocolate and non-chocolate confectionery market position in the United States and Canada.
This includes its business in:
Chocolate and non-chocolate confectionery
Gum and refreshment products
Protein bars
Spreads
Snack bites and mixes
Pantry and food service lines
This segment also includes its retail operations.
The North America Salty Snacks segment is responsible for its salty snacking products in the United States. This includes ready-to-eat popcorn, baked, trans-fat-free snacks, pretzels, and other snacks.
The Company’s portfolio includes chocolate and confectionery brands such as:
The Goldman Sachs target price for the stock is $220, representing a massive 30% gain for investors.
This is a way to play the energy sector on the services side, and the company pays shareholders a massive 5.15% dividend. Kodiak Gas Services, Inc. (NYSE: KGS) is a contract compression service provider in the United States, serving as a vital link in the infrastructure that enables the production, transportation, and distribution of natural gas and oil.
The Company’s segments include Contract Services and Other Services.
The Contract Services segment comprises operating Company-owned and customer-owned compression, gas treating, and cooling infrastructure that enable the production, gathering, processing, and transportation of natural gas and oil.
The Other Services segment consists of a broad range of services to support the needs of its customers, including:
Station construction
Customer-owned compression maintenance and overhaul,
Freight and crane charges
Parts sales
Ancillary time and material-based offerings
Kodiak Gas Services offers its services to:
Oil and gas producers
Midstream customers in high-volume gas gathering systems
Processing facilities
Multi-well gas lift applications
Natural gas transmission systems
Hitting the Goldman Sachs $42 target would be almost a 14% gain.
This is one of the safest ways for investors to play the energy sector, as refining capacity has shrunk while supply has increased. Valero Energy Corporation (NYSE: VLO), through its subsidiaries, is a multinational manufacturer and marketer of petroleum-based and low-carbon liquid transportation fuels, as well as petrochemical products, and pays a dependable 2.56% dividend.
The Company sells its products primarily in:
The United States
Canada
The United Kingdom
Ireland
Latin America
Valero operates through three segments:
Refining
Renewable Diesel
Ethanol
The Refining segment encompasses the operations of its petroleum refineries, the associated marketing activities for its refined petroleum products, and the logistics assets that support these operations.
The Renewable Diesel segment encompasses Diamond Green Diesel (DGD) and its associated activities, including marketing renewable diesel and renewable naphtha.
The Ethanol segment includes the operations of its ethanol plants and the associated activities involved in marketing its ethanol and co-products.
Valero Corporation owns over 15 petroleum refineries located in the United States, Canada, and the United Kingdom.
Goldman Sachs has set a target price of $197 for the stock, a gain of 16%
The fact is there are two totally different investment paths you can take right now. And while either can make you some money, choosing the right one at the right time can mean the difference between just getting by and getting truly rich. Most people don’t even realize the difference, and that mistake can be devastating for your portfolio. Whether you’re investing $1,000, or $1,000,000 today, learn the difference and put yourself on the right path. See the report.
Zoomd Technologies Ltd. reported improved third quarter profitability, with net income rising to US$3.8 million despite a 3% revenue decrease due to a one-time boost in the prior year, and announced a new global partnership with E2 Quadrat Communication aimed at expanding client acquisition ahead of the 2026 World Cup.
Alongside record cash flow and no long-term debt, Zoomd’s approach now includes seeking acquisitions and building strategic alliances to broaden its customer base and strengthen technological capabilities.
We’ll examine how Zoomd’s focus on operational efficiency and global partnerships could shape its investment story going forward.
Outshine the giants: these 25 early-stage AI stocks could fund your retirement.
For those considering Zoomd Technologies, the story is increasingly about disciplined execution and how new partnerships or M&A could speed up growth in a competitive sector. The recent news of improved profits, strong cash flow, and no long-term debt reinforce the impression of operational control, even as short-term catalysts shift. The collaboration with E2 Quadrat, timed ahead of major sporting events like the 2026 World Cup, directly addresses one key catalyst: faster client acquisition in high-potential markets. Importantly, management’s newly reiterated focus on acquisitions could boost earnings or reshape the company’s risk profile if any deals are pursued soon, a factor not recognized in earlier fair value estimates or risk assessments. Still, rapid expansion comes with the risk of execution missteps, especially if new initiatives strain resources or slow the profitable momentum seen in the last year. However, investors should note the ongoing risk that acquisitions or rapid client onboarding strain current efficiencies.
Despite retreating, Zoomd Technologies’ shares might still be trading above their fair value and there could be some more downside. Discover how much.
TSXV:ZOMD Community Fair Values as at Nov 2025
Most recent fair value estimates from 10 Simply Wall St Community members range widely, from US$1.09 to US$19.28 per share. While some see extreme upside, others remain more cautious. The possible impact of upcoming acquisitions and sector competition is a key reason why opinions diverge so much, making it essential to weigh several viewpoints as you consider Zoomd’s next phase.
Explore 10 other fair value estimates on Zoomd Technologies – why the stock might be worth 23% less than the current price!
Disagree with this assessment? Create your own narrative in under 3 minutes – extraordinary investment returns rarely come from following the herd.
A great starting point for your Zoomd Technologies research is our analysis highlighting 4 key rewards that could impact your investment decision.
Our free Zoomd Technologies research report provides a comprehensive fundamental analysis summarized in a single visual – the Snowflake – making it easy to evaluate Zoomd Technologies’ overall financial health at a glance.
Every day counts. These free picks are already gaining attention. See them before the crowd does:
This article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned.
Companies discussed in this article include ZOMD.V.
Have feedback on this article? Concerned about the content? Get in touch with us directly. Alternatively, email editorial-team@simplywallst.com
Will retailers and merchants have a strong holiday season? That depends. This year, more than most, the 2025 holiday season will actually be two holiday seasons.
If your business caters to higher-income individuals or if you’re located in a wealthier part of the country, you’ll probably have a decent holiday season. True, even the wealthy are cutting back. But according to the HR firm ADP average salaries have risen between 4.5% and 6.7% depending on whether workers stayed or switched jobs. The stock markets, though increasingly volatile, are up over 13% since the beginning of the year. And in some parts of the country, notably New York, Boston, DC and San Francisco, the average household income is over $125,000 – almost $41,000 higher than the national average. People in this demographic may be a little more cautious but they’ll spend.
Don’t believe me? Just take a walk in or near Soho, Georgetown, Presidio Heights or Beacon Hill. Restaurants selling $49 chicken parms and $16 baked potatoes … and they’re full. Vegas steakhouses are still getting $165 for a porterhouse – and the tables are packed. I searched for a room recently near Dana Point, California, and the Marriott there was sold out … at $750 a night!
But for many others? That’s a different story.
Another analysis from the HR giant Paychex reports that rises in hourly wages – those mostly earned by blue-collar workers – have been tracking below 3% for over a year (it’s currently at 2.58%).
According to Van Hesser, the chief strategist at credit rating analysis agency KBRA, the top 10% of earners account for 50% of spending. But the rest? They’re not going to spend as much this year. They’re already riddled with credit card debt. They’re mostly not participating in the stock market boom. They are barely making rent, let alone splurging on holiday gifts.
That doesn’t mean the remaining 90% of the US won’t be visiting stores. But it’s guaranteed that they’ll be spending less. Costs are much higher. Promised tax rebates and pie-in-the-sky “tariff” refunds aren’t happening this year. And with millions losing their jobs this year alone thanks to corporate mismanagement, restructurings, profit-taking and the creepage of AI, the next few years are sure to be uncertain.
The annual major surveys of retail sales are telling us just that.
For example, an S&P Global Ratings report expects holiday sales (November-December) will grow 4% in 2025 from 2024, but thanks to weaker consumer confidence on the “uncertain macroeconomic outlook” those researchers say that most of these sales increases won’t be volume related, but due to increased prices that actual retail spending when you take out inflation will “remain relatively flat”.
The consulting giant Deloitte is projecting that holiday retail sales will grow between 2.9% and 3.4% in 2025. But this is well below the 4.2% from last year’s growth and below the 10-year average of 5.2%. The reasons given are all the same: tariffs, inflation, uncertainty.
“It’s a tale of two economies,” said KRBA’s Hesser. “While wealthy consumers continue spending, the less wealthy are pulling back – evidenced by earnings misses from fast-casual dining (Chipotle, Cava) and decade-high unemployment for recent college graduates.”
Hesser also warns that the negative wealth effects that could come from an equity market correction “can create headwinds across the entire consumer landscape, from staples to discretionary categories like travel and leisure – especially as we head into the holiday season”.
So how will small businesses – my clients – fare this holiday season? Considering that for most, holiday sales make up as much as half of their annual revenue, it’s a very important question.
I’m sure the usual crowds will be out supporting them on Small Business Saturday. And for those doing business to the right demographic – the top 10% of earners, they’ll be fine. Or if they’re located in the more affluent areas of New York, Boston, DC and San Francisco they’ll be fine too. Others may have more of a challenge this year.
Using the 2 Stage Free Cash Flow to Equity, Autoliv fair value estimate is US$156
Autoliv’s US$118 share price signals that it might be 25% undervalued
Analyst price target for ALV is US$139 which is 11% below our fair value estimate
Today we’ll do a simple run through of a valuation method used to estimate the attractiveness of Autoliv, Inc. (NYSE:ALV) as an investment opportunity by estimating the company’s future cash flows and discounting them to their present value. The Discounted Cash Flow (DCF) model is the tool we will apply to do this. Before you think you won’t be able to understand it, just read on! It’s actually much less complex than you’d imagine.
Remember though, that there are many ways to estimate a company’s value, and a DCF is just one method. If you still have some burning questions about this type of valuation, take a look at the Simply Wall St analysis model.
We’ve found 21 US stocks that are forecast to pay a dividend yield of over 6% next year. See the full list for free.
We are going to use a two-stage DCF model, which, as the name states, takes into account two stages of growth. The first stage is generally a higher growth period which levels off heading towards the terminal value, captured in the second ‘steady growth’ period. To begin with, we have to get estimates of the next ten years of cash flows. Where possible we use analyst estimates, but when these aren’t available we extrapolate the previous free cash flow (FCF) from the last estimate or reported value. We assume companies with shrinking free cash flow will slow their rate of shrinkage, and that companies with growing free cash flow will see their growth rate slow, over this period. We do this to reflect that growth tends to slow more in the early years than it does in later years.
Generally we assume that a dollar today is more valuable than a dollar in the future, so we need to discount the sum of these future cash flows to arrive at a present value estimate:
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
Levered FCF ($, Millions)
US$723.3m
US$773.7m
US$734.0m
US$716.3m
US$711.2m
US$714.7m
US$724.1m
US$737.8m
US$754.8m
US$774.4m
Growth Rate Estimate Source
Analyst x13
Analyst x9
Analyst x1
Est @ -2.41%
Est @ -0.71%
Est @ 0.48%
Est @ 1.32%
Est @ 1.90%
Est @ 2.31%
Est @ 2.59%
Present Value ($, Millions) Discounted @ 8.4%
US$667
US$659
US$577
US$520
US$476
US$441
US$413
US$388
US$366
US$347
(“Est” = FCF growth rate estimated by Simply Wall St) Present Value of 10-year Cash Flow (PVCF) = US$4.9b
We now need to calculate the Terminal Value, which accounts for all the future cash flows after this ten year period. For a number of reasons a very conservative growth rate is used that cannot exceed that of a country’s GDP growth. In this case we have used the 5-year average of the 10-year government bond yield (3.3%) to estimate future growth. In the same way as with the 10-year ‘growth’ period, we discount future cash flows to today’s value, using a cost of equity of 8.4%.
Present Value of Terminal Value (PVTV)= TV / (1 + r)10= US$16b÷ ( 1 + 8.4%)10= US$7.0b
The total value is the sum of cash flows for the next ten years plus the discounted terminal value, which results in the Total Equity Value, which in this case is US$12b. The last step is to then divide the equity value by the number of shares outstanding. Compared to the current share price of US$118, the company appears a touch undervalued at a 25% discount to where the stock price trades currently. Remember though, that this is just an approximate valuation, and like any complex formula – garbage in, garbage out.
NYSE:ALV Discounted Cash Flow November 30th 2025
The calculation above is very dependent on two assumptions. The first is the discount rate and the other is the cash flows. If you don’t agree with these result, have a go at the calculation yourself and play with the assumptions. The DCF also does not consider the possible cyclicality of an industry, or a company’s future capital requirements, so it does not give a full picture of a company’s potential performance. Given that we are looking at Autoliv as potential shareholders, the cost of equity is used as the discount rate, rather than the cost of capital (or weighted average cost of capital, WACC) which accounts for debt. In this calculation we’ve used 8.4%, which is based on a levered beta of 1.211. Beta is a measure of a stock’s volatility, compared to the market as a whole. We get our beta from the industry average beta of globally comparable companies, with an imposed limit between 0.8 and 2.0, which is a reasonable range for a stable business.
See our latest analysis for Autoliv
Strength
Weakness
Opportunity
Threat
Valuation is only one side of the coin in terms of building your investment thesis, and it ideally won’t be the sole piece of analysis you scrutinize for a company. DCF models are not the be-all and end-all of investment valuation. Preferably you’d apply different cases and assumptions and see how they would impact the company’s valuation. For instance, if the terminal value growth rate is adjusted slightly, it can dramatically alter the overall result. What is the reason for the share price sitting below the intrinsic value? For Autoliv, we’ve put together three important items you should consider:
Risks: For instance, we’ve identified 2 warning signs for Autoliv that you should be aware of.
Future Earnings: How does ALV’s growth rate compare to its peers and the wider market? Dig deeper into the analyst consensus number for the upcoming years by interacting with our free analyst growth expectation chart.
Other High Quality Alternatives: Do you like a good all-rounder? Explore our interactive list of high quality stocks to get an idea of what else is out there you may be missing!
PS. The Simply Wall St app conducts a discounted cash flow valuation for every stock on the NYSE every day. If you want to find the calculation for other stocks just search here.
Have feedback on this article? Concerned about the content?Get in touch with us directly. Alternatively, email editorial-team (at) simplywallst.com.
This article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned.
Working from home used to be an extraordinary concession in extraordinary times—namely, the Covid-19 pandemic that kept us all in our jammies for at least the better part of a year. While many of us have returned to the office to some extent, some vestiges remain. That includes the enduring popularity of at-home walking pads. They’re compact, affordable treadmills that you can slide under a standing desk to rack up some miles and improve your focus while you work.
I’m a recent convert, mainly because it’s so easy to just check if I broke 10,000 steps that day and hop on a walking pad for 20 minutes while watching some holiday rom-com. So it is with great pleasure that I report that our best walking pad, the Urevo CyberPad for Home, is now an unbelievable $139 off.
Photograph: Adrienne So
Unlike most affordable walking pads, the CyberPad has a 14 percent incline. That’s steep enough for a pretty solid workout, even if the speed does not exceed 4 mph. Reviewer Kristin Canning said that she found it smooth and responsive, and her knees didn’t hurt even after hours of walking. It also comes with a Bluetooth remote as well as an app (iOS, Android). You can control the pad with either, and it also has a display screen on the front of the pad that shows speed, incline, time, distance, and calories.
It also has some fun features that you might not see on other, even more expensive pads. With the app, you can control lights that run along the rails of the CyberPad. For well under $500, this is a sturdy, versatile addition to your home office.
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Airlines have averted the threat of major global travel disruption after rushing to fix a software glitch on Airbus A320 jets caused by intense solar radiation.
Carriers worked through Friday night and into the weekend after aviation regulators said they must fix the problem before resuming flights.
American Airlines, Delta Air Lines and Air India were among those that said they had completed software updates by Saturday, along with European low-cost operators Wizz Air and EasyJet.
Data from flight tracker FlightAware showed most big airports reporting good traffic flow, although some had minor problems.
In the US, where the glitch threatened to disrupt the busy Thanksgiving travel weekend, transportation secretary Sean Duffy said in a social media post on Saturday that carriers had “reported great progress” and were “on track to meet the deadline of this Sunday at midnight to complete the work”.
Some airlines, however, were harder hit. Colombia’s Avianca said on Friday that more than 70 per cent of its fleet was affected and that it was halting ticket sales until December 8.
In Asia, Japan’s ANA said on Sunday that it had completed the software updates on all the affected aircraft but that the work had resulted in a “significant number” of domestic flight delays and cancellations over the weekend. The carrier cancelled 95 flights on Saturday, affecting about 13,200 passengers.
Guillaume Faury, chief executive of Airbus, apologised to airline customers and passengers for the “significant logistical challenges and delays”. The manufacturer’s teams were “working round the clock” to enable carriers to “get planes back in the sky”, Faury wrote in a social media post on Saturday.
Airbus on Friday had warned that a “significant” number of its A320 family of aircraft, the world’s most widely flown commercial jet, needed an immediate software update after finding that intense solar flare radiation could corrupt data critical to the functioning of flight controls.
About 6,000 aircraft, half of the global fleet in service, were affected. Most of the jets have been able to undergo an uncomplicated software fix by reverting to a previous version — a process that takes about two to three hours. But about 900 aircraft require a change in hardware, which will take longer.
Airbus discovered the issue after a JetBlue Airways flight between the US and Mexico suffered a control problem and a sudden drop in altitude, which forced an emergency landing in Tampa, Florida.
The investigation traced the problem to a flight system that sends commands from the pilot’s sidestick to elevators at the rear of the plane. Those elevators control the aircraft’s pitch or nose angle.
Randomized controlled trials (RCTs) are gold standard for evaluating intervention efficacy. Yet, for complex physical interventions like acupuncture, establishing an adequate placebo control remains challenging.1 Common placebo procedures include shallow needling (SN), non-penetrating needle device (NPND), non-acupoint needling, and needling at acupoints not traditionally indicated for the target condition, either alone or in combination.2 A critical question is which placebo technique is optimal.
Wang et al recently addressed this using a Bayesian Network Meta-Analysis (NMA) in primary insomnia (PI). They concluded that NPND is preferable to SN as a placebo control in acupuncture RCTs for PI, citing comparable effects on reducing PSQI scores and altering objective sleep parameters, but a lower overall ranking for NPND on the SUCRA curve, suggesting weaker therapeutic activity.3
While we acknowledge the rigor of this study, we respectfully offer a different perspective to stimulate further discussion.
Evidence for NPND Inertness Remains Restricted
An ideal control should be physiologically inert, exerting no therapeutic effect while ensuring participant blinding.1 Validating NPND necessitates rigorous demonstration of inertness. Wang et al reported no significant difference between NPND and non-acupuncture controls in improving subjective sleep—but this relied on only two trials: one with a no-treatment control (n = 16)4 and another permitting any insomnia treatment except acupuncture and herbal medicine—potentially including CBTi or hypnotics (n = 49).5 This limited evidence introduces substantial uncertainty. Furthermore, if NPND produces outcomes comparable to conventional treatments, it might possess intrinsic efficacy rather than being inert. Future studies should compare within-group outcomes before and after NPND intervention to confirm inertness.
Beyond Efficacy: Practical Considerations in Placebo Selection
Wang et al’s conclusion—that NPND is preferable to SN based exclusively on therapeutic outcomes in sleep—oversimplifies the methodological complexity of acupuncture RCTs. Practical factors must also be considered.
First, insomnia treatment often involves head acupoints (eg, GV20, EX-HN1),6 typically needled transversely (≤15° relative to the skin surface). NPND like Streitberger or Park devices relies on adhesive bases and perpendicular application, making them unsuitable for simulating transverse needling. Moreover, in participants with abundant scalp hair, device adhesion is often compromised, potentially necessitating shaving—a requirement that further undermines feasibility in clinical trials.
Second, blinding efficacy with NPND may be inadequate in participants familiar with acupuncture. Pilot data from our previous RCT on perimenopausal insomnia revealed that participants could readily distinguish NPND from real needles based on tactile sensation and perceived penetration. Consequently, we substituted NPND with SN at non-insomnia-relevant acupoints. The sham group achieved a Bang’s Blinding Index of −0.14 (within −0.20 to 0.20), indicating successful blinding.7
The Unique Advantages of SN as a Control Should Not Be Overlooked
Beyond enhancing blinding credibility through a more authentic needling sensation, SN offers additional advantages over NPND, including: (1) Superior cost-effectiveness and accessibility, as it utilizes standard acupuncture needles instead of costly specialized devices; (2) Enhanced clinical relevance and external validity, by reframing the research question around a clinically meaningful dose-response relationship (ie, therapeutic deep needling versus minimal shallow needling), the findings of which directly inform real-world practice; (3) Greater ethical acceptability, owing to the mild physiological stimulus provided even at non-indication points, thereby alleviating concerns associated with administering a completely inert intervention.
While NPND remains appropriate in certain contexts—such as acupuncture-naïve populations in Western settings, or trials restricted to perpendicularly needled acupoints (eg, HT7, PC6)—SN may be preferable in East Asian participants familiar with acupuncture, in RCTs involving scalp acupoints, or when budget constraints are considerable.
Conclusion
In RCTs of acupuncture for insomnia, placebo selection should not only consider inertness but also other factors such as blinding effect, applicability across different needling techniques, costs, cultural context, and ethics. Rather than pursuing a single “ideal” placebo, we recommend making context-specific choices tailored to the study population, clinical setting, and research objectives. Adopting such a nuanced and flexible approach can enhance the internal validity of RCTs while ensuring the clinical relevance of the findings.
Abbreviations
CBTi, Cognitive Behavioral Therapy for Insomnia; NMA, Network Meta-Analysis; NPND, Non-Penetrating Needle Device; PI, Primary Insomnia; PSQI, Pittsburgh Sleep Quality Index; RCT(s), Randomized Controlled Trial(s); SN, Shallow Needling; SUCRA, Surface Under the Cumulative Ranking; TCM, Traditional Chinese Medicine.
Data Sharing Statement
Data availability is not applicable as no new data was generated or analyzed in this communication.
Author Contributions
Fei-Yi Zhao – Conceptualization, Formal analysis, Investigation, Writing – original draft; Wen-Jing Zhang – Formal analysis, Supervision, Writing – review & editing; Qiang-Qiang Fu – Conceptualization, Formal analysis, Investigation, Writing – review & editing. All authors gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Funding
No funding was received.
Disclosure
The authors declare no competing interests.
References
1. Zhang CS, Tan HY, Zhang GS, Zhang AL, Xue CC, Xie YM. Placebo devices as effective control methods in acupuncture clinical trials: a systematic review. PLoS One. 2015;10(11):e0140825. doi:10.1371/journal.pone.0140825
2. Appleyard I, Lundeberg T, Robinson N. Should systematic reviews assess the risk of bias from sham–placebo acupuncture control procedures? Eur J Int Med. 2014;6(2):234–243. doi:10.1016/j.eujim.2014.03.004
3. Wang Y, Wu M, Zhang J, et al. Is Sham acupuncture equally effective for primary insomnia? A Bayesian network meta-analysis. Nat Sci Sleep. 2025;17:1997–2012. doi:10.2147/NSS.S541797
4. Xu SF, Sun YN, Wang S, Wu JY, Yin P. Clinical observation of electroacupuncture at Baihui (GV20) and Shenting (GV24) for the treatment of primary insomnia. Sichuan J Tradit Chin Med. 2014;32(5):154–156.
5. Lee B, Kim BK, Kim HJ, et al. Efficacy and safety of electroacupuncture for insomnia disorder: a multicenter, randomized, assessor-blinded, controlled trial. Nat Sci Sleep. 2020;12:1145–1159. doi:10.2147/NSS.S281231
6. Zhao FY, Spencer SJ, Kennedy GA, et al. Acupuncture for primary insomnia: effectiveness, safety, mechanisms and recommendations for clinical practice. Sleep Med Rev. 2024;74:101892. doi:10.1016/j.smrv.2023.101892
7. Zhao FY, Zheng Z, Fu QQ, et al. Acupuncture for comorbid depression and insomnia in perimenopause: a feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial. Front Public Health. 2023;11:1120567. doi:10.3389/fpubh.2023.1120567
The upmarket bakery chain Gail’s is planning 40 more outlets after sales rose by a fifth last year as it opened 36 new bakeries and sales to supermarkets increased.
The cafe and retailer, which currently has 185 sites, said sales rose to £278m in the year to the end of February but that pre-tax losses widened to £7.8m, from £7.4m a year before, as costs rose and it spent millions on opening new outlets.
Gail’s directors said staff and energy costs had risen, hitting profit margins, while it spent £51m on store reopening costs.
Sales at its retail arm rose almost 23%, more than double the pace of its wholesale division, which supplies clients including Waitrose, Ocado and Amazon from bakeries in London, Manchester and Bath.
A Gail’s spokesperson told the Propel trade journal: “We are pleased to have delivered strong year-on-year growth. This performance is underpinned by the increasing demand for high-quality, nutrient dense food, and by the support of the communities we serve. We will continue to build on this momentum by growing with purpose and remaining committed to improving access to good food.”
Speaking at a conference organised by Propel this month, Tom Molnar, who co-founded Gail’s 20 years ago, said the business was “still early in our growth”.
He said: “We do have a lot of bakeries now, but it took 20 years to get there. It wasn’t easy, and it wasn’t very fast. Twice, we had to stop growing altogether, because we didn’t think that we could be better; we were worried about getting consumed by speed. We’re still early in our growth. You take McDonald’s, Greggs or any other successful food business here in the UK – they operate from thousands of sites, and we’re still below 200.”
Gail’s owners, led by the private equity group Bain Capital, last year reportedly hired the financial advisory company Goldman Sachs to help find new investors in an effort to drive expansion. The chain was said to be worth as much as £500m.
The bakery was founded by Yael (Gail) Mejia in the early 1990s serving restaurants and other venues in London. In 2003, Molnar and a few others joined Mejia and the group opened the first bakery cafe in Hampstead in 2005.
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The rapidly expanding chain has become an unlikely political bellwether – used by the Liberal Democrats to help identify areas where voters might be ready to switch from the Conservatives.
Its expansion has also spurred local protests, including a heated one in Walthamstow, east London, where a petition to stop a Gail’s opening was signed by hundreds of residents. A new branch in Brighton was spray-painted with the world “boring” and a large image of a penis, according the local newspaper the Argus.