The atmosphere of constant scrutiny of academic ability that prevails in medical colleges may leave some students at risk of expressing feelings of intellectual fraudulence and phoniness. Impostor phenomenon (IP) traits have been associated with anxiety, depression, job dissatisfaction, and poor professional performance. Internationally trained junior doctors exhibit stronger IP feelings than colleagues trained within their own country of citizenship. These feelings may develop during student life. International universities are diverse and complex environments where students may be emersed in a cultural milieu alien to their societies of origin, leading to feelings of isolation. Individuals with IP traits often perceive themselves as the “only one” experiencing this phenomenon, resulting in further isolation and negative self-evaluation, especially among women and underrepresented minorities. IP has also been linked to low self-esteem among students. This study assessed the prevalence of IP and its relationship to self-esteem among students at a campus of a European medical college with a large international student body situated in the Middle East. The self-administered questionnaires: Clance's Impostor Phenomenon Scale (CIPS) and Rosenberg's Self-Esteem Scale (RSES) were completed by 290 medical students (58.3% females). Participants' median (range) age was 19 years (16–35). Students were of 28 different nationalities; the largest proportions were from Gulf Corporation Council (GCC) countries. The prevalence of low self-esteem was 18.6%, while 45.2% of the students demonstrated traits suggestive of IP. There was a strongly negative correlation between CIPS and RSES (r = −0.71). No significant gender differences were found in IP. Similarly, no differences in IP were found when comparing between age groups, previous experience in higher education or year of study. Multivariate analysis showed that students from GCC countries had higher levels of self-esteem relative to students from other regions. Low self-esteem was a strong predictor of IP. Country of origin may influence students' self-esteem studying in international university settings.

Curcumin displays anticancer properties; however, some issues with the drug delivery mode limit its therapeutic use. Although reformulation and derivatization of curcumin have improved its bioavailability, curcumin derivatives may not retain the same anticancer properties as the parent compound. The present study investigated the anticancer properties of two curcumin complexes, the iron‑curcumin [Fe(Cur)3] and boron‑curcumin [B(Cur)2] complexes, in the MDA‑MB‑231 breast cancer cell line. The cellular localization of curcumin, B(Cur)2 and Fe(Cur)3 was determined by fluorescence microscopy. Cell proliferation, migration and invasion were also analysed. Furthermore, apoptosis‑associated proteins were detected by using a proteome profiler array, and ion channel gene expression was analysed by reverse transcription‑quantitative PCR. The results demonstrated that the three compounds were localized in the perinuclear and cytoplasmic regions of the cell, and displayed cytotoxicity with IC50 values of 25, 35 and 8 µM for curcumin, B(Cur)2 and Fe(Cur)3, respectively. In addition, the three compounds inhibited cell invasion, whereas only curcumin and B(Cur)2 inhibited cell migration. Furthermore, cell exposure to curcumin resulted in an increase in the relative expression of the two key proapoptotic proteins, cytochrome c and cleaved caspase‑3, as well as the antiapoptotic protein haem oxygenase‑1. In addition, curcumin increased the expression levels of the voltage‑gated potassium channels Kv2.1 and Kv3.2. Similarly, the expression levels of the chloride channel bestrophin‑1 and the calcium channel coding gene calcium voltage‑gated channel auxiliary subunit γ4 were increased following exposure to curcumin. Taken together, these results indicated that Fe(Cur)3 and B(Cur)2 may display similar anticancer properties as curcumin, suggesting that chemical complexation may be considered as a strategy for improving the potency of curcumin in the treatment of breast cancer.

Breast cancer is the most common cancer diagnosed among females worldwide. Although breast cancer survival has largely improved in the past 30 years, it remains highly heterogeneous in its response to treatment. Triple-negative breast cancer (TNBC) is a subtype of breast cancer that lacks the expression of the estrogen receptor (ER), progesterone receptor (PR) and epidermal growth factor receptor-2 (Her2). While TNBC may initially be responsive to chemotherapy, recurrence and subsequent high mortality rates are frequently reported. Studies have shown curcumin and its derivatives to be effective against TNBC cell lines in vitro. To improve its anti-cancer effects, we have synthesized Fe³⁺–curcumin (Fe–Cur₃) and Cu²⁺–curcumin (CD) complexes and investigated them experimentally. Further, CD was encapsulated into a poly(styrene)-co-maleic acid (SMA) micelle to enhance its stability. We assessed the cytotoxicity of these formulations both in vitro and in vivo. SMA–CD demonstrated dose-dependent cytotoxicity and abolished TNBC tumor growth in vivo. The encapsulation of the curcumin–copper complex improved its anti-cancer activity without overt adverse effects in a murine model of TNBC. These results provide evidence and insights into the value of nanoformulations in enhancing drug-delivery and increasing the potential therapeutic efficacy of curcumin derivatives.

High-fidelity clinical simulation is currently a well-established teaching tool. However, high-fidelity representations of patients in critical conditions have the potential to elicit emotions among learners and impact their cognitive load (CL). Teaching with clinical simulation may induce both emotional and cognitive overloads. The relationship between anxiety and CL during clinical simulation was studied. Forty-one undergraduate medical students participated in this study; 19 males and 22 females. The state-anxiety component of State-Trait Anxiety Inventory was administered during clinical simulation teaching sessions at time points: pre-scenario, post-scenario and post-debriefing. The Cognitive Load Scale (Leppink et al.) questionnaire was also completed post-scenario. This assessed the three components of CL: intrinsic cognitive load (ICL), extraneous cognitive load (ECL) and self-perceived learning (SPL). Median CL scores for ICL, ECL and SPL were compared between groups of low-anxiety and high-anxiety participants using a Mann-Whitney U test. State-anxiety scores were high for both the pre-scenario and post-scenario time points with a significant reduction following post-debriefing. The median (interquartile range) state-anxiety scores were 41.0 (33.0–50.0), 46.0 (33.0–52.0) and 31.0 (23.0–39.0) for the pre-scenario, post-scenario and post-debriefing time points respectively. Students with high state-anxiety had higher ECL scores (median = 2.0) than students with low state-anxiety (median = 0.9) at the post scenario time point (U = 220, p = 0.043). No statistical relation was seen with state-anxiety for either ICL or SPL. State-anxiety immediately after the simulation scenario is associated with ECL but not ICL or SPL.

Higher education institutions are accustomed to sudden and abrupt jolts that provoke poor enrollments, unviable courses, unsustainable practices, budget cuts, and job losses. Such a situation arose with the worldwide education crisis of COVID-19 and the global mandate to shift to online teaching and learning. Policies and guidelines were based on available solutions, often implemented by leaders with limited experience in online education. As a result, the focus was on transitioning to online teaching rather than creating pragmatic policy changes. This article explores the practices in higher education institutions during the COVID-19 pandemic and investigates how the crisis affected teaching and learning across different countries. It also offers insights into the adaptations made during and after the pandemic, particularly within public health education, workforce training, and healthcare, along with actionable suggestions for integrating artificial intelligence (AI) and lessons learned from COVID-19 into these sectors. To highlight the potential benefits of AI in public health education, we discuss how AI-driven epidemiological modeling could play a crucial role in future outbreak preparedness, using the ongoing monkeypox virus (Mpox) outbreaks as a case study. As Mpox continues to emerge as a potential global health threat, the shift to remote learning during the COVID-19 pandemic has demonstrated the importance of preparing the educational system for future uncertainties, including new outbreaks. The pandemic has shown how disruptions can catalyze reforms in public health education, workforce training, and healthcare systems. Looking ahead, AI holds significant potential in transforming epidemic and pandemic preparedness by predicting outbreaks, understanding their trajectories, and even forecasting the individual impact of diseases by analyzing immune responses. Integrating AI into pandemic response frameworks could save lives and strengthen readiness for future health crises.

Sarcoidosis is an inflammatory disease characterized by the formation of granulomas in various organs, leading to inflammation and potential organ dysfunction. Symptoms often start with general signs like fatigue, fever, and weight loss, but vary depending on the affected organ. Diagnosis is challenging due to its diverse clinical presentation and lack of a definitive test, while treatment is complicated by the disease’s variable course, requiring a personalized approach. This review explores the role of genetic and environmental factors in sarcoidosis etiology, examines current challenges in diagnosis and treatment, and discusses how understanding etiology informs patient management and future treatment strategies.