Background/Objectives: Chronic non-malignant pain (CNMP) affects 46.4% of adults in Saudi Arabia and often requires interdisciplinary care, including mental health services. Despite this need, mental health integration remains limited. This study explored healthcare providers’ perceptions of integrating mental health services into CNMP management and identified barriers and facilitators to interdisciplinary collaboration. Methods: A cross-sectional survey was conducted among 114 healthcare providers across Saudi Arabia. Using the Theoretical Domains Framework (TDF), domains such as knowledge, skills, beliefs about capabilities and consequences, reinforcement, and social influences were assessed. Data were analyzed using descriptive statistics, correlation analyses, and multiple regression. Results: Positive perceptions of mental health integration were significantly associated with beliefs about capabilities (r = 0.31, p = 0.001) and beliefs about consequences (r = 0.40, p < 0.001), as well as skills (r = 0.30, p = 0.001) and reinforcement (r = 0.26, p = 0.005). Multiple regression confirmed beliefs about capabilities (B = 0.208, p = 0.001) and consequences (B = 0.237, p < 0.001) as independent predictors, explaining 31.9% of the variance in perceptions (R² = 0.319, adjusted R² = 0.285). Emotional responses, such as stress, were potential barriers but did not independently predict perceptions. Systemic challenges included limited referral pathways and insufficient mental health resources. Conclusion: Confidence in professional abilities and recognition of the benefits of collaboration are key drivers of positive perceptions toward mental health integration in CNMP care. Interventions that enhance provider confidence, emphasize interdisciplinary benefits, and strengthen organizational support may improve engagement with mental healthcare services in Saudi Arabia.

Tumor Microenvironment (TME) is a major determinant of tumor progression, immune evasion, metastasis, and therapeutic resistance, yet its complexity remains inadequately represented by conventional preclinical models. Two-dimensional cell cultures and animal models often fail to reproduce the cellular heterogeneity, biomechanical forces, vascular architecture, and dynamic biochemical gradients of human tumors, limiting their predictive value for clinical translation. Patients derived organoids (PDOs) and organ-on-chip (OoC) technology has recently been developed to create biomimetic platforms retaining patient-specific tumor characteristics and reproducing physiologically relevant tumor microenvironments by the control of tumor microenvironment perfusion. The review highlights the potential of using the organoid-on-chip approach to combine with nanomedicine for the next generation of precision oncology approaches to engineering the TME. We emphasize the engineering principles of organoid-on-chip platforms such as shear stress, oxygen and nutrient gradients, extracellular matrix remodeling, and multicellular interactions, which are all important factors in regulating the behavior of tumors. Special focus is on the mechanism of transport of nanoparticles, cellular uptake, intracellular trafficking, endosomal escape, and drug release in TME, which are relevant to acidic pH, hypoxia, ROS, enzymes, glutathione and ATP. The review also explores the current strategies for TME engineering which include extracellular matrix remodeling, immune reprogramming, vascular normalization, metabolic modulation, and biomechanical regulation. Additionally, recent innovations combining AI, digital twin, multi-omics, spatial transcriptomics, single-cell sequencing, and high-content imaging with organoid-on-a-chip platforms are presented as promising solutions for designing nanoparticles for better therapeutic efficacy, predicting responses to drugs, and personalized drug screening. Organoid-on-chip-guided nanomedicine holds great promise as a clinically relevant and effective platform for predictive cancer modeling, for rapid drug development, and for personalized precision oncology. Graphical Abstract

Background/Objectives: Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide. Individuals with hypertension (HTN) and type 2 diabetes mellitus (T2DM) are at particularly high risk; however, awareness of cardiovascular risk within the broader community and among high-risk subgroups remains suboptimal. This study aimed to assess CVD risk awareness and its correlates among adults in the Northern Border Region of Saudi Arabia, with a particular focus on individuals with HTN and/or T2DM. Methods: A descriptive, quantitative, cross-sectional survey was conducted among adults aged 18–50 years residing in the Northern Border Region of Saudi Arabia. An anonymous online questionnaire was distributed via social media between October 2025 and January 2026. The survey incorporated a 22-item scale assessing HTN knowledge, T2DM knowledge, and CVD risk awareness (Heart Disease Fact items). Participants were categorized according to self-reported diagnosis (no diagnosis, HTN, T2DM, or both). Descriptive statistics, non-parametric tests, and multivariable regression analyses were used to evaluate knowledge scores and predictors of CVD risk awareness. Results: A total of 458 participants completed the survey. Overall knowledge was moderate (mean 12.40/22; 56.4%), with relatively higher scores for HTN (73.2%) and T2DM knowledge (68.8%), but markedly lower CVD risk awareness (30.8%). Fewer than half of participants correctly answered key CVD items, particularly those related to asymptomatic disease progression and lipid (HDL) concepts. Only 21.6% achieved good awareness (≥75%). In multivariable analyses, higher educational level, positive family history of cardiometabolic disease, and the presence of HTN and/or T2DM were independent predictors of higher awareness. Conclusions: CVD risk awareness is suboptimal among adults in the Northern Border Region, including those with established HTN and T2DM. The observed gap between disease-specific knowledge and CVD risk awareness highlights the need for targeted, structured risk communication strategies in primary care, particularly for individuals with lower educational attainment and no family history of CVD.