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Cutaneous leishmaniasis is considered as one of the most concerns of the World Health Organization (WHO). The main objective of this study was to use polycaprolactone (PCL) nanofiber scaffolds in order to provide a topical drug delivery system capable of delivering glucantime (glu) and quercetin (qur) to cutaneous leishmaniasis wounds. First, PCL/glu/qur, PCL/glu, and PCL/qur nanofibers were prepared by an electrospinning method followed by characterization through scanning electron microscopy (SEM) and fourier transform infrared spectroscopy (FTIR). Subsequently, we investigated the release of the drugs from nano-scaffolds and anti-promastigote effects. Lastly, the effect of nanobandage was evaluated on 20 female inbred BALB/c mice infected with the parasite. The nanofibers were bead-free and uniform with an average diameter of 224 ± 25 nm and showed a sustained release. Results from in vivo experiments showed that the number of amastigotes and macrophages infected with the parasite and the infiltration of inflammatory cells in mice treated with PCL/qur and PCL/glu/qur nanofibers significantly decreased as compared with those treated with the PCL/glu and PCL nanofibers. Collectively, PCL/glu/qur and PCL/qur nanofibers have promising therapeutic effects in cutaneous leishmaniasis wound healing., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships that may be considered potential competing interests: EffatAlemzadeh reports were provided by Birjand University of Medical Sciences. EffatAlemzadeh reports a relationship with Birjand University of Medical Sciences that includes: employment and non-financial support. - If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Neurodegenerative disorders, such as Alzheimer's and Parkinson's diseases, share key characteristics, notably cognitive impairment and significant cell death in specific brain regions. Cognition, a complex mental process allowing individuals to perceive time and place, is disrupted in these conditions. This consistent disruption suggests the possibility of a shared underlying mechanism across all neurodegenerative diseases. One potential common factor is the activation of pathways leading to cell death. Despite significant progress in understanding cell death pathways, no definitive treatments have emerged. This has shifted focus towards less-explored mechanisms like ferroptosis, which holds potential due to its involvement in oxidative stress and iron metabolism. Unlike apoptosis or necrosis, ferroptosis offers a novel therapeutic avenue due to its distinct biochemical and genetic underpinnings, making it a promising target in neurodegenerative disease treatment. Ferroptosis is distinguished from other cellular death mechanisms, by distinctive characteristics such as an imbalance of iron hemostasis, peroxidation of lipids in the plasma membrane, and dysregulated glutathione metabolism. In this review, we discuss the potential role of ferroptosis in cognitive impairment. We then summarize the evidence linking ferroptosis biomarkers to cognitive impairment brought on by neurodegeneration while highlighting recent advancements in our understanding of the molecular and genetic mechanisms behind the condition. Finally, we discuss the prospective therapeutic implications of targeting ferroptosis for the treatment of cognitive abnormalities associated with neurodegeneration, including natural and synthetic substances that suppress ferroptosis via a variety of mechanisms. Promising therapeutic candidates, including antioxidants and iron chelators, are being explored to inhibit ferroptosis and mitigate cognitive decline., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Knee osteoarthritis (KOA) is a prevalent chronic condition characterized by inflammation and oxidative stress, particularly in individuals over 40. Dietary factors, specifically dietary acid load (DAL), may influence these pathological processes. However, the relationship between DAL and inflammatory markers, oxidative stress, and clinical features in patients with KOA remains unexplored. This cross-sectional study involved 147 participants aged 40 and above diagnosed with moderate to severe bilateral primary KOA. Dietary intake was assessed using a validated food frequency questionnaire, and DAL was quantified using Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP) indices. Clinical symptoms were evaluated using the WOMAC Index. Biochemical markers of oxidative stress and inflammation were measured from serum samples. Higher PRAL and NEAP scores were associated with increased levels of thiobarbituric acid reactive substances (TBARS) and total oxidant status (TOS), indicating elevated oxidative stress. Additionally, serum levels of inflammatory markers, including TNF-α and hs-CRP, positively correlated with higher DAL scores. Clinical assessments revealed that increased PRAL scores were related to greater severity of symptoms as measured by the WOMAC Index. This study demonstrates a significant association between dietary acid load and markers of inflammation and oxidative stress in KOA patients. These findings suggest that dietary modifications aimed at reducing acid load may serve as a beneficial adjunctive strategy in managing KOA and improving patient outcomes., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: All experiments were performed in accordance with the declaration of Helsinki and Zabol University of Medical Sciences ethical guidelines and regulations. The research protocol was approved by the Zabol University of Medical Sciences (ethics code number: IR.ZBMU.REC.1402.110). All participants signed a written inform consent before participating in the study., (© 2025. The Author(s).)

Aims: This study investigates the differences in patient demographics and outcomes between teaching and non-teaching hospitals in Iran. By analyzing these differences, it aims to provide useful information for policymakers to optimize resource allocation, improve patient care, and balance educational and service delivery goals in teaching hospitals., Materials and Methods: In this cross-sectional investigation, both teaching and non-teaching general hospitals were examined. A comprehensive analysis was carried out on 13 non-teaching and 25 teaching hospitals with homogeneity, utilizing Health Information System (HIS) data comprising 10,611,647 records through census sampling in 2019. Before employing the logistic regression models to clarify the relationship between a binary dependent variable (distinguishing teaching or non-teaching hospitals) and independent variables, we utilize the Recursive Feature Elimination (RFE) technique to select the most crucial predictor variables., Findings: the optimal logistic regression model revealed that the teaching status of hospitals played a crucial role as an indirect predictor for variables including referral patients, length of stay (<24 hours), patients with partial improvement, and those who received less than 3 services. It also emerged as a direct predictor for variables such as length of stay (>30 days), patients receiving more than the mean services, death rate, and patients with complete improvement. Moreover, the teaching status had an indirect impact on variables like outpatient cases, length of stay (>30 days), and paraclinical services, while directly predicting variables such as patients with supplementary insurance and vulnerable groups insurance type, rehabilitation services, clinic wards, and length of stay (between 4-30 days)., Conclusion: In Iranian teaching hospitals, we observed an increase in patient numbers, extended length of stay, a rise in both the quantity and complexity of services, and more intricate patient admissions. It appears that small teaching hospitals in Iran have transitioned from being referral centers to functioning as outpatient centers with active clinics.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease and can affect individuals without producing any symptoms. We aimed to explore the value of serum sirtuin-1 (Sirt-1) in the diagnosis of MASLD., Methods: This case-control study analyzed data collected from 190 individuals aged 20 to 60 years. Anthropometric parameters, demographic information, and serum biochemical variables-including glycemic parameters, lipid profiles, liver enzymes, and Sirt-1 levels-were assessed. The correlation between serum Sirt-1 and biochemical variables was examined using Pearson's correlation coefficient. Receiver operating characteristic (ROC) curve analysis was employed to evaluate the diagnostic value of serum Sirt-1 in the context of MASLD., Results: Serum Sirt-1 levels was significantly lower in the MASLD group (p < 0.001) and was inversely correlated with serum insulin (r = -0.163, p = 0.025), HOMA-IR (r = -0.169, p = 0.020) and triglyceride (r = -0.190, p = 0.009) and positively correlated with serum levels of high-density lipoprotein cholesterol (HDL-C) (r = 0.214, p = 0.003). The area under the curve (AUC) of Sirt-1 to predict the presence of MASLD was 0.76 (p < 0.001, 95% CI: 0.69, 0.82) with a sensitivity of 78.9, specificity of 61.1, positive predictive value (PPV) of 67.0%, and negative predictive value (NPV) of 74.0%. The optimal cutoff, determined using Youden's index, was 23.75 ng/mL. This indicates that serum Sirt-1 levels below 23.75 ng/mL may be indicative of MASLD., Conclusions: The present study demonstrated that serum Sirt-1 levels were significantly lower in patients with MASLD. Furthermore, these levels were correlated with various metabolic parameters, including insulin resistance and the serum lipid profile. A serum Sirt-1 level below the cutoff of 23.75 ng/mL exhibited a significant association with the presence of MASLD, suggesting its potential utility in identifying patients with this condition., Competing Interests: Declarations. Ethics approval and consent to participate: All experiments were performed in accordance with the declaration of Helsinki and Tehran University of Medical Sciences ethical guidelines and regulations. The research protocol was approved by the Tehran University of Medical Sciences (ethics code number: IR.TUMS.MEDICINE.REC.1402.630). All participants signed a written inform consent before participating in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

The Breast Imaging Reporting and Data System (BI-RADS) category 3 assessment is used for breast imaging findings considered "probably benign," with less than a 2% likelihood of malignancy. It is used to increase specificity by decreasing the number of breast biopsies. It has been validated for mammography, breast US, and emerging indications for use in contrast-enhanced breast MRI. Despite the long-term use of category 3 and numerous published studies that evaluate characteristic imaging findings appropriate for this category, there is still misuse and confusion regarding its accurate use. Imaging findings classified as category 3 require short-term follow-up to assess stability and identify changes that may warrant a biopsy for early diagnosis of breast cancer. Category 3 should not be used in a screening study without a comprehensive diagnostic evaluation that may reveal suspicious features or downgrade a finding to benign. In mammography, category 3 findings are validated for grouped round calcifications, oval circumscribed masses, and nonpalpable asymmetries. In US, category 3 can be applied to oval circumscribed parallel solid masses and complicated cysts. Category 3 can be assigned to clustered microcysts when they are very small or deep in the breast. Recent studies have yielded characteristic findings appropriate for MRI category 3 that are expected to be included in the sixth edition of the BI-RADS atlas. These include oval circumscribed masses with associated T2-hyperintense signal, focal non-mass enhancement, and foci of enhancement with associated T 2-hyperintense signal. Surveillance with short-interval imaging enables radiologists to monitor findings and act early when a change is detected. © RSNA, 2024 Supplemental material is available for this article. See the invited commentary by Cohen and Leung.

Background: Moral distress affects the well-being of health care professionals and can lead to burnout and attrition. Assessing moral distress and taking action based on this assessment are important. A new moral conflict assessment (MCA) designed to prompt action was developed and tested., Objective: To evaluate the utility of the MCA., Methods: All intensive care unit professionals in 3 hospitals were invited to attend a presentation about the MCA and to participate in semistructured interviews that followed the steps of the MCA. Transcriptions of interviews were interpreted by using qualitative content analysis., Results: Analysis of individual interviews of 7 participants and 1 focus group of 3 participants revealed that the MCA was a catalyst for expressing feelings and characterizing moral distress, but optimal use required a facilitator. Participants noted that prevention and amelioration of moral distress were determined by organizational culture issues such as consistent understanding of what can be accomplished in the intensive care unit, resolution of power imbalances among staff, and psychological safety to mention moral issues. Structural determinants included disparate work and education schedules between nurses and physicians. Leader determinants included listening to staff and ensuring accountability to address causes and consequences of moral distress. Education and communication were proposed most often as solutions for moral distress., Conclusions: The evaluation revealed positive and negative features of the MCA. Prevention and amelioration of moral distress require attention to cultural, structural, and leadership issues through education and communication., (©2025 American Association of Critical-Care Nurses.)