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Nanotherapy has emerged as a promising strategy for the targeted and efficient treatment of melanoma, the most aggressive and lethal form of skin cancer, with minimized systemic toxicity. However, the therapeutic efficacy of cobalt oxide nanoparticles (Co 3 O 4 NPs) in melanoma treatment remains unexplored. This study aimed to assess the therapeutic potential of Co 3 O 4 NPs in melanoma treatment by evaluating their impact on cell viability, genomic DNA and mitochondrial integrity, reactive oxygen species (ROS) generation and apoptosis induction in melanoma A-375 cells. Our findings demonstrated a concentration-dependent reduction in cell viability upon treatment with five Co 3 O 4 NP concentrations (0.2, 2, 20, 200, and 2000 µg/ml), with an IC50 value of 303.80 µg/ml. Treatment with this IC50 concentration significantly increased ROS generation, induced dramatic DNA damage, and disrupted mitochondrial membrane potential integrity. Flow cytometric analysis revealed apoptosis and necrosis induction following Co 3 O 4 NP exposure at the IC50 concentration value. Results of qRT-PCR analysis demonstrated remarkable dysregulation of apoptotic and mitochondrial genes, including a significant downregulation of apoptotic p53 and mitochondrial ND3 genes and marked upregulation of the anti-apoptotic gene Bcl2. These findings highlight the novel potential of Co 3 O 4 NPs as potent inducers of melanoma A-375 cell death in a concentration-dependent manner through excessive ROS production, genomic instability, mitochondrial dysfunction and dysregulation of apoptotic and mitochondrial gene expression, ultimately promoting apoptosis in A-375 cells. This study thus underscores the potential of Co 3 O 4 NPs as a promising nanotherapeutic candidate for melanoma treatment, warranting further exploration to elucidate their full biological and clinical applicability.

Pancreatic cancer is a hard-to-treat tumor with a poor prognosis. While traditional pancreatic cancer therapies can be effective, issues like cytotoxicity, low selectivity, and drug resistance still pose major challenges. Nanotechnology has shown promise in improving cancer diagnosis and treatment. Yttrium oxide nanoparticles (Y 2 O 3 -NPs), for example, have demonstrated potent selective cytotoxicity against triple negative breast cancer cells; but their effects on pancreatic cancer cells have not been explored. This study aimed to explore the impact of Y 2 O 3 -NPs on cell proliferation, DNA integrity, and oxidative stress in pancreatic cancer (PANC-1) and human skin fibroblast (HSF) cells. The cytotoxicity of Y 2 O 3 -NPs after 72 h were estimated using Sulforhodamine (SRB) cytotoxicity assay, while alkaline Comet assay was done to study genomic DNA integrity. Generation level of reactive oxygen species (ROS) and integrity of mitochondrial membrane potential were also analyzed. Apoptosis induction was investigated using Flow Cytometry and expression level of apoptotic (p53), anti-apoptotic (Bcl2) and mitochondrial (ND3) genes was measured using quantitative RTPCR. Our findings exhibited that Y 2 O 3 -NPs had strong selective cytotoxicity against PANC-1 cells with an IC50 value of 31.06 µg/ml, while having minimal effect on normal HSF cells (IC50 = 319.21 µg/ml). Treatment of PANC-1 cells with Y 2 O 3 -NPs at the IC50 concentration for 72 h significantly increased intracellular ROS levels and DNA damage, along with a notable reduction in mitochondrial membrane potential. Additionally, a significant rise in necrotic, early, and late apoptotic cells was observed, accompanied by downregulation of the anti-apoptotic Bcl2 gene and upregulation of the apoptotic p53 and mitochondrial ND3 genes. These findings highlight the selective toxicity of Y 2 O 3 -NPs towards cancerous PANC-1 cells, with minimal impact on normal cells. Y 2 O 3 -NPs appear to induce apoptosis in cancer cells by increasing ROS generation, damaging DNA, disrupting mitochondrial function, and triggering cell death. This study suggests that Y 2 O 3 -NPs may be a promising candidate for pancreatic cancer treatment. Further research is needed to fully explore their therapeutic potential.

Background Food insecurity is a growing public health problem, particularly in conflict-affected areas where households face multiple challenges that restrict their accessibility to food and other necessities. It can result in serious health issues and increased mortality, especially among vulnerable groups such as children. Objective This study aims to assess the effect of household food insecurity on the development of acute respiratory infections (ARIs) among children aged 6–23 months and determine the other factors associated with ARI in this age group. Methods A matched case-control study was carried out in three public hospitals in Sana’a city between March and May 2022. A total of 151 children presented to the three hospitals diagnosed with ARI (cases) and 302 children who presented to the same hospitals with non-ARI diagnoses were included in the study and matched by sex and age ± two months. Conditional logistic regression analysis was performed to determine the crude odds ratio (COR) and adjusted odds ratio (AOR). Results Among cases, 63.6% (96/151) of households were food insecure compared to 40.7% (123/302) of the controls. Household food insecurity was a strong predictor of ARI in children (AOR 1.72, 95% confidence interval (CI) 1.10–2.70; p  = 0.017). Children living in rented accommodation (AOR 2.29, 95% CI 1.40–3.74; p  < 0.001) and those with relatives who smoked (AOR 1.84, 95% CI 1.17–2.90; p  = 0.008) had a higher likelihood of having ARIs compared to those in non-rented dwellings and where no relatives smoked, respectively. Parental characteristics, source of water, and source of cooking fuel were not associated with ARI. Conclusion To reduce the burden of ARI among young children, it is important to prioritize the design and implementation of multi-sectoral community interventions. These interventions should include the initiation of income-generating programs aimed at alleviating household food insecurity, as well as health education campaigns to raise community awareness about the health risks associated with smoking.

Thyroid nodules, based on high-resolution ultrasonography (HRUS), are among the most common endocrine abnormalities that affect the general population because of their high estimated prevalence rates. Fine needle aspiration cytology (FNAC) is a safe, cost-effective modality to differentiate between benign and malignant thyroid nodules based on the Bethesda System for Reporting Thyroid Cytopathology (BSRTC), thus avoiding unnecessary surgery. However, categories III and IV of BSRTC remain a controversial issue in clinical practice, encompassing a wide range of risks of malignancy. Hence, our study aimed to assess the malignancy rates of thyroid nodules classified as Bethesda III and IV categories as evidenced by post-thyroidectomy histopathology; study the association between the American College of Radiologists Thyroid Image Reporting and Data System (ACR-TIRADS) score of these two categories and the postoperative histopathological analysis; and study the predictors of malignancy in these two categories. A prospective study was conducted on 242 patients who underwent FNAC throughout the study from December 2022 to August 2023. All patients who performed FNAC were primarily subjected to history taking, clinical examination, thyroid-stimulating hormone (TSH), thyroid autoantibodies (antithyroglobulin (anti-TG) and thyroid peroxidase antibodies (TPO Abs)), and HRUS with a further categorization of thyroid nodules according to the ACR-TIRADS scoring system. The cytological aspirates were categorized according to the BSRTC. Patients with Bethesda III and IV categories were resorted to surgery according to clinical factors, sonographic features, and patients' preferences. A total of 17 cases with Bethesda III and 65 patients with Bethesda IV were included. Seventy-one out of 82 patients (86.6%) underwent surgical intervention. The proportions of malignant nodules classified as TIRADS-2, TIRADS-3, TIRADS-4, and TIRADS-5 scores were 0.0, 4.5 (n=1/22), 22.7 (n=5/22), and 72.7% (n=16/22), respectively. The rate of malignancy was 18.2% (n=2/11) among class III and 33.3% (n=20/60) among class IV-categorized Bethesda thyroid nodules. In univariate logistic regression analysis, age ≥ 40 years, body mass index ≥ 30 kg/m², higher TSH, positive anti-TG antibodies, radiation exposure, irregular borders, marked hypoechogenicity, ill-defined margins, microcalcifications, solid consistency, taller than wide growth, solitary nodule, and nodule size > 2 cm, and suspicious lymph nodes were associated with higher malignancy risk. In multivariate regression analysis, positive anti-TG Abs, radiation exposure, irregular borders, taller-than-wide growth, hypoechogenicity, calcifications, and solid consistency remain to be independent predictors of malignancy. The malignancy rates of Bethesda class III and IV nodules in this study met the estimated malignancy risk proposed by BSRTC. TIRADS scores 4 and 5 confer a higher risk of malignancy in Bethesda III and IV thyroid nodules. Positive thyroglobulin antibodies and radiation exposure are independent factors of malignancy in Bethesda III and IV nodules. Moreover, ultrasound features, including irregular borders, taller-than-wider growth, hypoechogenicity, calcifications, and solid consistency, are associated with increased malignancy risk and should be considered in the surgical selection of patients.

Osteomyelitis (OM) is a serious bacterial bone infection and can be life-threatening if not treated promptly. A promising approach to manage OM involves using drug-loaded fibrous implants or scaffolds containing antibiotics, analgesics, or anti-osteoporosis medications to combat infection, reduce pain and promote bone healing, respectively. In this study, a coaxial electrospinning technology was employed to fabricate drug-loaded fibers encapsulating vancomycin hydrochloride (VAN), an antibiotic, and diclofenac sodium (DIC), an analgesic to prevent infection and alleviate post-surgical pain. The fibers were characterized using scanning electron microscopy (SEM) which indicated that the drug-loaded (DL) coaxial fibers had smooth surfaces and lacked beads and pores. The drug loading of the DL coaxial fibers was estimated by high-performance liquid chromatography (HPLC), and the results were calculated as 75 ± 4 µg/mL for VAN and 82 ± 3 µg/mL for DIC. The drug release was also measured by HPLC, which showed a rapid initial release, i.e., 59% for VAN and 75% for DIC within the first day, followed by a sustained slow release reaching approximately 92% and 79%, respectively after 264 h. The antimicrobial assay zone of inhibition confirmed the antibacterial activity of the DL fibers against Staphylococcus aureus . The cell viability assessments on the drugs alone against human dermal fibroblasts (HFF-1) demonstrated that the VAN and DIC combination is safe at concentrations up to 250 µg/mL but required careful dosing due to time-dependent cytotoxicity. Overall, the study highlights the potential use of VAN and DIC-loaded coaxial electrospun fibers as a localized drug delivery system for OM treatment, offering controlled drug release, effective antibacterial action, and biocompatibility.

Background Preeclampsia is a hypertensive disorder of pregnancy associated with significant maternal and neonatal morbidity and mortality. Osteoprotegerin (OPG), a glycoprotein involved in vascular homeostasis, has emerged as a potential biomarker for disease severity. This study aimed to evaluate serum OPG levels in pregnant women with and without late-onset preeclampsia and to assess its correlation with disease severity and clinical outcomes. Methods This case–control study was conducted at Ain Shams University Maternity Hospital between August 2022 and January 2024. Ninety pregnant women with gestational age ≥ 34 weeks were enrolled and equally divided into three groups: normotensive controls ( n  = 30), mild late-onset preeclampsia ( n  = 30), and severe late-onset preeclampsia ( n  = 30). Clinical assessments, laboratory investigations, and serum OPG levels (measured by ELISA) were compared among groups. Correlation, multivariate regression, and receiver operating characteristic (ROC) curve analyses were performed. Results Serum OPG levels were significantly higher in women with late-onset preeclampsia, particularly in the severe group ( p  < 0.0001). Elevated OPG levels were strongly correlated with adverse perinatal outcomes, including fetal growth restriction, preterm delivery, NICU admission, and cesarean delivery. Multivariate regression analysis demonstrated that OPG levels were independently associated with preeclampsia severity and adverse perinatal outcomes. ROC analysis showed excellent diagnostic performance of OPG in identifying severe late-onset preeclampsia (AUC = 0.976), with sensitivity and specificity of 93.3%. Conclusion Serum OPG levels are significantly elevated in late-onset preeclampsia and correlate closely with disease severity and adverse maternal and fetal outcomes. OPG shows promise as a clinical biomarker for identifying severe late-onset preeclampsia, although its utility in mild disease appears limited.

Standardization of skin tests is essential for detecting allergen sensitization, confirming diagnoses, and guiding treatment of allergen-induced conditions. The rise in drug-induced reactions presents a challenge to healthcare practitioners, as incomplete or inaccurate drug allergy histories can compromise patient safety and result in medication errors. Drug hypersensitivity reactions (DHR) are akin to allergic responses, triggered by either the active ingredient or excipients in a drug. Distinguishing between a drug allergic reaction and a predictable adverse drug reaction (ADR) is vital in clinical practice. Cutaneous testing, a common diagnostic modality, uses non-irritant drug concentrations, tested and validated for key drug classes. This article collects up-to-date concentrations, serving as a reference for healthcare practitioners. These concentrations vary but are generally prepared by dissolving the commercial form of the drug’s tablet or capsule content in normal saline, white petrolatum, or sterile water for irrigation. However, the lack of data and standardized protocols on optimal non-irritant drug concentrations for oral dosage forms has led to variability in these tests’ sensitivity, specificity, and performance.

Background Israeli population is primarily comprised of Jews (74%) and Arabs (21%). Previous studies suggested a higher incidence of cerebrovascular risk factors (CVRF) and dementia among Israeli Arabs. We evaluated potential cognitive disparities between community‐dwelling Arabs and Jews diagnosed with at least one CVRF. Method 96 participants (age: 66.6± 5.3; education: 14.8± 4.1), 52 Arabs (age: 64.4± 5; education: 15.3±2.6), and 44 Jews (age: 69.1± 4.4; education: 14.8± 4.1) without known cognitive impairment and with at least one CVRF were prospectively enrolled. All participant completed a cognitive symptoms questionnaire (in their primary language) and underwent the Montreal Cognitive Assessment (MoCA) and the Tablet‐based Cognitive Assessment Tool (TabCAT) Brain Health Assessment (BHA) battery, including the TabCAT Favorites (associative memory), Match (executive functions and processing speed) and Line Orientation (visuospatial skills) tasks. Demographic and clinical characteristics were analyzed using the Student’s t‐test for continuous variables and Chi‐squared tests for categorical data. Results Arab participants were younger (p≤0.001) than Jews, education was similar (p = 0.26). Cognitive complaints were reported by 32 (33%) participants, (24% Arab,9% Jews). Participants with cognitive complaints exhibited significantly lower scores on Match (p = 0.005), but not on Favorites (p = 0.28), Line Orientation (p = 0.48), and MoCA (p = 0.62). Arabs scored significantly worse on Match (p = 0.006) while Jews scored worse on Line Orientation (p = 0.004). Performance was similar on the Favorites (p = 0.4) and MoCA (p = 0.2). When focusing on participants with cognitive complaints Arabs exhibited significantly lower scores on Match (p = 0.036) while Jews had lower scores on Line Orientation (p = 0.06). No significant differences were observed on Favorites (p = 0.4) or MoCA (p = 0.2). Among participants without cognitive complaints no significant differences were observed between Jews and Arabs on Match (p = 0.29), Favorites (p = 0.99) or MoCA (p = 0.65). Jews had lower scores on Line Orientation (p = 0.04). Conclusion TabCAT‐BHA proved superior to MoCA in depicting subtle cognitive impairment in people with CVRF. Despite being younger, Arabs exhibited higher prevalence of cognitive complaints and were more impaired on executive functions while Jews on visuospatial tasks.

Background The Israeli population, primarily comprised of Israeli Jews (74%) and Arabs (21%), is one of the most diverse aging societies around the world. The need for brief, accurate, and culturally appropriate cognitive measures in Israel is high, as they can facilitate early detection of cognitive disorders across clinical settings. We examined the discrimination accuracy and concurrent validity of the brief Tablet‐based Cognitive Assessment Tool (TabCAT) Brain Health Assessment (BHA) battery in a multicultural Israeli sample. Methods Participants were 79 Hebrew and Arabic speaking older adults (age: 67±6; 58% female; education: 15±4). Clinically normal participants (n = 63) were community‐dwelling individuals with no self‐ or informant‐reported cognitive symptoms or functional decline. Cognitively impaired participants (n = 16) with diagnoses of mild cognitive impairment (n = 15) or dementia (n = 1) were recruited from a large neurology center. Diagnoses were based on the published clinical criteria, and all patients underwent comprehensive neurological and neuropsychological evaluations independent of study procedures. All participants completed the TabCAT‐BHA and the Montreal Cognitive Assessment (MoCA) in their primary language. Logistic regressions with ROC curves were used to examine discrimination accuracy, controlling for age, sex, education, and testing language. Concurrent validity was evaluated against the MoCA indices for the same domains. Results The TabCAT‐BHA battery showed excellent discrimination accuracy (AUC = .99, sensitivity = .81, and specificity = .95) outperforming the MoCA (AUC = .94, sensitivity = .63, specificity = 0.97). Moderate associations were observed between TabCAT Favorites (associative memory) and MoCA Memory Index (r = .49, P < .001), and between TabCAT Match (executive functions) and MoCA Executive Index (r = .64, P < .001). Weaker associations were found between TabCAT Line Orientation (visuospatial skills) and MoCA Visuospatial Index (r = ‐.27, P = .02). Conclusions Our preliminary findings support the validity of the 10‐minute TabCAT‐BHA battery in culturally diverse Israeli older adults. The battery exhibited excellent performance in detecting cognitive impairment in our sample outperforming a widely used brief cognitive assessment tool, the MoCA. Future studies, including development of Israel‐specific normative data and replication of these results in larger samples, are ongoing.

Israeli population is primarily comprised of Jews (74%) and Arabs (21%). Previous studies suggested a higher incidence of cerebrovascular risk factors (CVRF) and dementia among Israeli Arabs. We evaluated potential cognitive disparities between community-dwelling Arabs and Jews diagnosed with at least one CVRF. 96 participants (age: 66.6± 5.3; education: 14.8± 4.1), 52 Arabs (age: 64.4± 5; education: 15.3±2.6), and 44 Jews (age: 69.1± 4.4; education: 14.8± 4.1) without known cognitive impairment and with at least one CVRF were prospectively enrolled. All participant completed a cognitive symptoms questionnaire (in their primary language) and underwent the Montreal Cognitive Assessment (MoCA) and the Tablet-based Cognitive Assessment Tool (TabCAT) Brain Health Assessment (BHA) battery, including the TabCAT Favorites (associative memory), Match (executive functions and processing speed) and Line Orientation (visuospatial skills) tasks. Demographic and clinical characteristics were analyzed using the Student's t-test for continuous variables and Chi-squared tests for categorical data. Arab participants were younger (p≤0.001) than Jews, education was similar (p = 0.26). Cognitive complaints were reported by 32 (33%) participants, (24% Arab,9% Jews). Participants with cognitive complaints exhibited significantly lower scores on Match (p = 0.005), but not on Favorites (p = 0.28), Line Orientation (p = 0.48), and MoCA (p = 0.62). Arabs scored significantly worse on Match (p = 0.006) while Jews scored worse on Line Orientation (p = 0.004). Performance was similar on the Favorites (p = 0.4) and MoCA (p = 0.2). When focusing on participants with cognitive complaints Arabs exhibited significantly lower scores on Match (p = 0.036) while Jews had lower scores on Line Orientation (p = 0.06). No significant differences were observed on Favorites (p = 0.4) or MoCA (p = 0.2). Among participants without cognitive complaints no significant differences were observed between Jews and Arabs on Match (p = 0.29), Favorites (p = 0.99) or MoCA (p = 0.65). Jews had lower scores on Line Orientation (p = 0.04). TabCAT-BHA proved superior to MoCA in depicting subtle cognitive impairment in people with CVRF. Despite being younger, Arabs exhibited higher prevalence of cognitive complaints and were more impaired on executive functions while Jews on visuospatial tasks.