Objective: To investigate the effect of vanillic acid (VA) on a Cuprizone (Cup) demyelinating rat model and the mechanisms behind such effect. Methods: Thirty adult male Sprague Dawley (SD) rats were randomly divided into three groups: control, Cuprizone, and VA groups. Cuprizone was administrated at a dose of 450 mg/kg per day orally via gastric gavage for 5 weeks. The nerve conduction velocity (NCV) was studied in an isolated sciatic nerve, and then the sciatic nerve was isolated for histopathological examination, electron microscope examination, immunohistochemical staining, and biochemical and PCR assay. The level of IL17 was detected using ELISA, while the antioxidant genes Nrf2, HO-1 expression at the level of mRNA, expression of the myelin basic protein (MBP), interferon-gamma factor (INF)-γ and tumor necrosis factor (TNF)-α, and apoptotic marker (caspase-3) were measured using immunohistochemistry in the sciatic nerve. Results: There was a significant reduction in NCV in Cup compared to normal rats (p < 0.001), which was markedly improved in the VA group (p < 0.001). EM and histopathological examination revealed significant demyelination and deterioration of the sciatic nerve fibers with significant improvement in the VA group. The level of IL17 as well as the expression of INF-γ and caspase-3 were significantly increased with a significant reduction in the expression of MBP, Nrf2, and HO-1 in the sciatic nerve (p < 0.01), and VA treatment significantly improved the studied parameters (p < 0.01). Conclusion: The current study demonstrated a neuroprotective effect for VA against the Cup-induced demyelinating rat model. This effect might be precipitated by the inhibition of inflammation, oxidative stress, and apoptosis.

Background: The literature shows a strong association between level of education and the risk of developing Coronary Heart Disease (CHD). However, the extent to which this association attenuates after accounting for sociodemographic characteristics and cardiovascular risk factors in a survey-weighted national sample warrants further evaluation. Objective: We aimed to assess the association between educational attainment and angina and myocardial infarction (MI) across age groups in a nationally representative U.S. sample. Methods: The study analyzed 2021 Behavioral Risk Factor Surveillance System (BRFSS) data from 438,693 adults, a nationally representative telephone survey of U.S. adults. The dataset was accessed from the Centers for Disease Control and Prevention BRFSS website in February 2023. Angina and MI were identified based on self-reported physician diagnoses. Analyses included adults aged 18 years and older with no missing data for education and outcomes. Results: In survey-weighted analyses with college graduates as the reference group, lower educational attainment was associated with higher odds of angina and MI, compared with college graduates. In the fully adjusted model (Model 2), attending high school was associated with higher odds of angina (OR 1.439) and MI (OR 2.390). Conclusions: Lower educational attainment is associated with higher odds of angina and MI, particularly among younger adults. Although the magnitude of these associations was attenuated after adjustment for sociodemographic and cardiovascular risk factors, the persistence of the association underscores the importance of considering educational disparities in cardiovascular risk assessment.

Background Insulin therapy is a cornerstone in the management of Type 2 Diabetes Mellitus (T2DM), although its relationship with cardiovascular outcomes remains an area of discussion. While it effectively used in managing either types of diabetes, evidence regarding its cardiovascular safety is mixed. Objective To investigate the association between insulin therapy, timing and duration, and cardiovascular outcomes among adults with T2DM, while accounting for biological, psychological, and social factors, using data from the 2022–2023 Behavioral Risk Factor Surveillance System (BRFSS). Methods Multivariate logistic regression was used on a de-identified cross-sectional BRFSS data of adults with self-reported T2DM to estimate the association between insulin use and cardiovascular outcomes, while adjusting for age, hypertension, dyslipidemia, smoking status, psychological comorbidities, and medication use. Results Insulin users exhibited significantly higher rates of coronary heart disease (21.8% vs. 14.2%) and stroke (13.4% vs. 6.6%) compared to non-users (p < 0.001). It was found that early initiation and longer duration of insulin therapy were independently associated with increased cardiovascular risk. These associations persisted after adjusting for biological and psychosocial variables. Conclusion In this nationally representative sample, insulin therapy, particularly when initiated early or sustained long-term, was associated with higher odds of cardiovascular morbidity in adults with T2DM. These findings highlight the need for individualized treatment approaches that consider both glycemic control and broader biopsychosocial factors.

Background: Autoimmune hemolytic anemia (AIHA) is a rare and potentially life-threatening condition in the pediatric population. While often associated with autoimmune or lymphoproliferative disorders, its occurrence in conjunction with benign ovarian tumors, such as mature cystic teratomas, is exceptionally rare. Case presentation: A 13-year-old previously healthy female presented with a one-week history of progressive pallor, jaundice, and fatigue. Initial laboratory tests revealed severe anemia (Hb 5.6 g/dL), elevated LDH, indirect hyperbilirubinemia, undetectable haptoglobin, and a positive direct antiglobulin test (DAT) for IgG, confirming warm AIHA. Imaging studies, including pelvic ultrasound and MRI, identified a large complex cystic ovarian mass, consistent with a mature cystic teratoma. The patient underwent exploratory laparotomy with right salpingo-oophorectomy without requiring blood transfusions. Postoperatively, there was complete resolution of hemolysis, normalization of laboratory values, and no recurrence over a 2-month follow-up period. Conclusion: This case highlights a diagnostic challenge and underscores the importance of recognizing paraneoplastic AIHA in children, even in the context of benign tumors. It also supports a potential autoimmune–tumor association, emphasizing the value of timely diagnosis and surgical intervention.

Background: Chronic stress is a major determinant of physical and psychological health, yet validated instruments for assessing long-term psychosocial stress remain limited in Arabic-speaking populations. Objective: The present study aimed to translate and culturally adapt the 9-item Trier Inventory for Chronic Stress (TICS-9) into Arabic and to evaluate its psychometric properties in an adult sample. Methods: The English 9-item short version of the TICS was translated following International Test Commission guidelines, including independent forward translations, back-translation, and expert committee review to ensure conceptual and linguistic equivalence. A cross-sectional online survey was conducted among 291 Arabic-speaking adults in Saudi Arabia. Internal consistency was assessed using Cronbach’s alpha and McDonald’s omega. Confirmatory factor analysis (CFA) was performed using robust weighted least squares estimation (WLSMV) appropriate for ordinal data. Construct-related evidence was explored using hierarchical regression analyses with demographic and medical variables. Results: The Arabic TICS-9 demonstrated excellent internal consistency (α = 0.876; ω = 0.904). CFA provided preliminary support for a unidimensional structure with moderate to strong standardized loadings (0.583–0.819). Model fit showed a mixed pattern in the initially specified model but improved after theoretically justified post hoc residual correlations were added between item pairs with overlapping content. Income was inversely associated with chronic stress scores after adjustment for education, work status, and marital status. Depression was associated with higher stress scores after controlling for other chronic conditions. Conclusion: These findings provide initial evidence of internal consistency and preliminary structural support for the Arabic TICS-9 in Saudi Arabic-speaking adults. Further studies are needed to evaluate test–retest reliability, convergent validity, and measurement invariance across populations.