[This corrects the article DOI: 10.1371/journal.pone.0324846.].

Discrepancies in factors influencing low-density lipoprotein cholesterol (LDL-C) control in patients with myocardial infarction have been documented in existing literature. Assessing LDL-C control and the associated factors is a crucial initial measure for guiding future interventions aimed at enhancing health outcomes in patients with myocardial infarction (MI). This study aimed to evaluate LDL-C control status and explore the predictors of uncontrolled LDL-C in patients with myocardial infarction. Data were collected by a research pharmacist from medical records, including sociodemographic and clinical characteristics, comorbidities, prescribed medications, and biomedical parameters such as LDL-C levels among patients attending an outpatient cardiology clinic. The validated Arabic versions of the 4-item medication adherence scale and the medication beliefs questionnaire were used to evaluate medication adherence and beliefs, respectively. Binary logistic regression was implemented to investigate the predictors of LDL-C control. The results showed most of the patients (n = 255) had uncontrolled LDL-C (76.6%). Regression results revealed that smoking (OR= 2.006; 95% CI: 1.054-3.816; P = 0.034), receiving beta blockers (OR=2.211; 95% CI: 1.024-4.775; P = 0.043), and having uncontrolled blood pressure (OR=1.940; 95% CI: 1.069-3.520; P = 0.029) were independently associated with higher odds of uncontrolled LDL-C. In conclusion, in MI patients with poor LDL-C control, lowering the risk of cardiac complications and improving health outcomes require the development of focused and efficient LDL-C level management strategies. Achieving this goal will require putting strategies like smoking cessation counselling into practice and improving BP control.

INTRODUCTION:In health systems outside the United States (US) with longer biosimilar experience, use has shifted from a question of adoption to one of implementation. Tenders, formularies, and payer policies are progressively driving reference-product-to-biosimilar, biosimilar-to-biosimilar, switchback transitions, and retransitioning in routine care, posing significant clinical, operational, and governance difficulties. AREAS COVERED:This structured narrative review examines evidence published from 1 January 2015 to 15 March 2026 on repeated switching within a single reference-product family. It focuses on efficacy, safety, immunogenicity, persistence, switchback, clinician-led and non-medical switching, nocebo mechanisms, communication, patient education, device support, pharmacovigilance, and traceability. EXPERT OPINION:While data on repeated and cross-switching are promising yet nascent, particularly outside tumor necrosis factor (TNF) inhibitors and beyond short-term follow-up periods, current evidence unequivocally supports initial switching. Successful outcomes depend upon pharmacovigilance, traceability, structured communication, and device support, in addition to molecular comparability. Injection-site pain during adalimumab transitions may be attributed to citrate content, pH, injection volume, or device variations, and should not be prematurely categorized as a nocebo effect. Explicit governance frameworks for repeated-switch programs and prospective, implementation-sensitive evidence are requisite for future clinical advancements.

Dengue fever is a growing global health concern, especially in regions like the United Arab Emirates (UAE), where environmental factors and high levels of international travel increase the risk of outbreaks. Despite this, public awareness and adoption of preventive measures remain understudied. This cross-sectional study aimed to assess the public's knowledge, attitudes, and practices (KAP) regarding dengue fever and its prevention. A validated online questionnaire was distributed to 1106 individuals using convenience sampling. The results revealed significant knowledge gaps, with only 24.6% correctly identifying dengue as a viral infection and 24.5% recognizing mosquito transmission. Median knowledge scores were higher among participants with elementary education (median = 13, IQR: 13-18), postgraduate degrees (median = 12, IQR: 8-15) than among those with other education levels, and higher among those with health insurance (median = 11, IQR: 10-13) than among those without insurance. Attitudes varied significantly based on education and residency, while regression analysis showed that male gender, older age, and smoking were associated with higher practice scores. These findings emphasize the need for targeted educational campaigns and public health interventions to improve awareness and engagement with dengue prevention, particularly in vulnerable demographic groups.

INTRODUCTION:Biosimilar stewardship includes safety, appropriate use, and value. However, it faces challenges due to shortages in disproportionality methods. Artificial intelligence (AI) tools have been emerged as practical 'intelligence augmentation' strategies that strengthen, rather than replace, traditional pharmacovigilance (PV) signal management. AREAS COVERED:We conducted a narrative review with evidence mapping (Jan 2010-Nov 2025) across PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane, citation-chasing, and targeted grey/first-party sources (regulators/HTA portals, PV centers, NHS dashboards, technical documentation). We prioritized biosimilar-specific pharmacovigilance, switching/implementation, and value-tracking evidence; general PV/AI literature was used primarily to describe analytic methods and governance where it directly informs biosimilar-specific problems A study-selection summary is provided for transparency. To improve interpretability for readers, we also include brief 'deployment vignettes' describing how key AI-enabled functions are operationally implemented in routine pharmacovigilance workflows. EXPERT OPINION:Medium-term priorities include federated, KPI-linked analytics and better external validation and transportability; near-term 'assist' deployments - such as narrative NLP, normalization, de-duplication, and multi-feature ranking under human-in-the-loop governance - can quantifiably improve case completeness, traceability, and triage. To achieve reliable production use, persistent bottlenecks (class imbalance, vocabulary mapping) require clear monitoring and standard assessment procedures.

Introduction Gastric cancer is a major cause of cancer-related mortality worldwide, and early detection through screening can improve outcomes. In the United Arab Emirates (UAE), incidence is relatively low, but late-stage diagnosis, limited public awareness and no dedicated national screening programme remain concerns. This study examined knowledge, attitudes, perceived barriers and factors associated with screening uptake among UAE residents.Theory The study was informed by public health approaches to cancer prevention and early detection, focusing on how knowledge, attitudes, perceived risk, physician recommendation and access shape screening behaviour and engagement with screening.Methods A cross-sectional bilingual online survey was conducted between October 2024 and February 2025 using convenience sampling. In total, 959 UAE residents aged 18 years or older completed the questionnaire. Data were analysed using descriptive statistics and binary logistic regression.Results Participants had moderate knowledge of gastric cancer, with a median score of 18 out of 29, and generally positive attitudes towards screening. However, only 21.5% had undergone screening. Key barriers included lack of interest, absence of physician advice, fear of results and limited awareness.Discussion Findings highlight the need for culturally tailored education, stronger clinician engagement and more accessible screening pathways to improve participation.

INTRODUCTION:Although sepsis and other severe infections in intensive care are common and deadly, obtaining safe and effective exposure for vancomycin and broad-spectrum β-lactams is difficult because of substantial kinetic variability, operational difficulties with AUC-guided therapeutic drug monitoring (TDM) and model‑informed precision dosing (MIPD), and the limited effectiveness of current tools on patient-centered outcomes. AREAS COVERED:This is a narrative review of exposure-response correlations, vancomycin and β-lactam kinetic targets, and the use of artificial intelligence (AI)-driven dosing tools and TDM/MIPD in patients in intensive care units (ICUs) and other high-acuity settings. From 2005 to 2025, we searched PubMed/MEDLINE, Embase, Web of Science, IEEE Xplore, and Google Scholar for English-language research, recommendations, and methodological publications on TDM, MIPD, AI, and machine learning (ML). This review summarized information on early AI-enabled clinical decision support systems, AUC-guided vancomycin TDM, β-lactam TDM in high-risk patients, and AI models that predict drug concentrations, AUC, acute kidney injury (AKI), and composite outcomes. EXPERT OPINION:Most AI models are single-center, retrospective, and surrogate-focused. By incorporating validated AI components into multicentre procedures that prioritize explainability, data quality, usability, and prospective assessment, it has the greatest immediate advantage of enhancing guideline-aligned AUC-guided TDM and population pharmacokinetic (PopPK)//Bayesian frameworks.

INTRODUCTION:Rapid and equitable access to antiviral biologics in outbreaks is constrained by bespoke manufacturing, lengthy trials, and uneven procurement. Biosimilar antivirals could change responsiveness from single-source supply to multi-manufacturer preparedness if regulatory and chemistry, manufacturing, and controls (CMC) platforms are leveraged. AREAS COVERED:Evidence on antiviral biologic classes, orthogonal analytics, critical quality attributes, pharmacokinetic/pharmacodynamic (PK/PD) biomarkers, regulatory convergence, value assessment, and manufacturing scale-up is summarized. Platform CMC and tech-transfer enablers (e.g. single-use, modular/distributed facilities) are described alongside integration of dynamic transmission models with distributional cost-effectiveness analysis to address equity. The review evaluates how high-resolution analytical similarity, combined with comparative clinical pharmacology, can reduce the need for comparative clinical efficacy studies in selected programs. paradigm. Databases and regulatory/health technology assessment portals were searched from January 2010 to 10 October 2025. Predetermined criteria with structured extraction and consensus resolution were utilized for dual screening. EXPERT OPINION:The field is moving toward PK/PD-anchored, analytics-first pathways that, with thorough mapping of structure - function relationships, may limit the need for Phase III trials. Pre-specified PD/analytic packages are provided for each modality/virus, along with reference product batch libraries, bridging plans, reliance agreements, and standing commission regulations to operationalize this approach in an emergency.

Immunogenicity undermines the safety and effectiveness of biologics and emerging modalities. Routine workflows are constrained by drug/target interference in binding assays, matrix and dilution biases in functional assays, fragile cellular/innate readouts, and the difficulty of translating titers into patient-level risk. Advances in artificial intelligence (AI) and real-world evidence (RWE) offer practical remedies. This narrative review searched five search engines and databases and included evidence from published original research, reviews, and regulatory data, and reports between 2022 and 2025. It identifies common failure locations and links them to practical AI and RWE solutions. We outline the regulatory and data underpinnings for decision-grade RWE, provide a closed-loop blueprint, and summarize recent developments in T- and B-cell epitope prediction, neoantigen prioritization, and pharmacovigilance/NLP pipelines for case deduplication and normalization: Define laboratory panels and computable phenotypes, map multi-source data to a common model, deduplicate, train transparent internally validated models, externally validate across distributed networks, route outputs to clinic/lab actions, and continuously monitor for drift with auditable updates. AI-augmented RWE can replace assay-centric snapshots in immunogenicity assessment with a learning system that focusses on clinically significant ADA/NAb effects, targets limited laboratory resources, speeds up signal verification, and enhances post-market vigilance.

INTRODUCTION:Immunogenicity remains the principal constraint on the efficacy, safety, and re-dosing of adeno-associated virus (AAV) and lipid nanoparticle (LNP) - mRNA therapeutics. Clinical decision-making and comparability between programs are hampered by heterogeneous test formats and matrix effects. AREAS COVERED:This narrative review integrates 2023-2025 bench, translational, clinical, and regulatory evidence. Studies on binding, neutralizing, and cellular/innate tests, anti-PEG epidemiology, complement biology, and ultrasensitive digital immunoassays were identified through searches of PubMed, Web of Science, Google Scholar, and regulatory archives. We propose a panel with tiers: Tier-0 pre-screening using isotype-resolved anti-PEG and total anti-capsid; Tier-1 standardized cell-based transduction inhibition with an optional constant-serum-concentration design to reduce dilution-induced matrix bias; Tier-2 mechanistic cellular and innate panels (e.g. complement split products, cytokines, and capsid-specific T-cell assays); and Tier-3 attomolar digital assays for critical biomarkers. FUTURE PERSPECTIVE:By implementing this harmonized, matrix-aware panel, which is presented as a fit-for-purpose analytical best-practice proposal rather than an evidence-validated clinical standard, screening-failure bias can be minimized, eligibility criteria can be stabilized, and connections between assay results and dosing, monitoring, and re-dosing/deferral may be strengthened.

Antimicrobial resistance (AMR) is a major global health threat, yet longitudinal surveillance data from Jordan remain limited. This retrospective multicenter surveillance study analyzed routinely collected electronic and laboratory records from 21 Jordanian hospitals between 2013 and 2023. Microbiology records were de-duplicated using a first-isolate-per-patient-per-organism-per-year rule. Among 873,124 bacterial isolates, Escherichia coli (65.3%) predominated, followed by Klebsiella pneumoniae (16.9%), Staphylococcus aureus (12.3%), and Pseudomonas aeruginosa (5.5%). E. coli was associated with female sex and community-acquired infection, whereas K. pneumoniae and P. aeruginosa were more common in hospital settings, with K. pneumoniae strongly associated with intensive care. Although overall odds of any resistance declined significantly over time, several clinically important phenotypes increased. Methicillin-resistant S. aureus rose from 60.0% to 75.9%, while carbapenem resistance reached 4.9% in E. coli, 20.4% in K. pneumoniae, and 19.2% in P. aeruginosa by 2023. Fluoroquinolone resistance also increased, and multidrug-resistant P. aeruginosa reached 20.6%. These findings highlight a distinct AMR paradox in Jordan and underscore the need for pathogen-specific empirical therapy, strengthened antimicrobial stewardship and infection prevention, and sustained national surveillance.

Introduction:Data on artificial intelligence-supported deprescribing in Jordanian community pharmacy are still lacking. This study aimed to assess current deprescribing practices among community pharmacists in Jordan, identify the medication classes most commonly targeted for deprescribing, evaluate perceived outcomes, and determine factors associated with AI tool use in deprescribing. Methods:This was a cross-sectional survey-based study conducted among licensed community pharmacists in Jordan from 15 November 2025 to 15 March 2026 using online, in-person, and telephone recruitment. The questionnaire assessed participant and practice characteristics, deprescribing activities, digital infrastructure, and use of AI tools. For the primary analysis, AI use was operationalized specifically as self-reported AI-chatbot use, whereas other computerized decision-support tools were reported separately. The SPSS (version 29) was used to conduct descriptive statistics, chi-square tests, and multivariable logistic regression. Results:Of the 1,036 pharmacists who completed the questionnaire, 798 (77.0%) reported practicing deprescribing. The medication classes most frequently reported as targets of deprescribing-related activity were antibiotics (799, 77.1%), proton-pump inhibitors (790, 76.3%), vitamins and mineral supplements (776, 74.9%), non-opioid analgesics/nonsteroidal anti-inflammatory drugs (753, 72.7%), and antidiabetic drugs (638, 61.6%). More than half of the pharmacists (641, 61.9%) reported using a digital tool to identify deprescribing opportunities and (340, 32.8%) reported using AI chatbot. Frequently observed outcomes after deprescribing were better patient-reported health (429, 41.4%), improved adherence (417, 40.3%), and fewer side effects (417, 40.3%), whereas worsening of symptoms was reported less often (89, 8.6%). AI use was independently associated with male gender (adjusted odds ratio [AOR] 1.32, 95% confidence interval [CI] 1.01-1.73), PharmD qualification versus BPharm/BSc (AOR 1.38, 95% CI 1.02-1.87), urban practice versus rural practice (AOR 1.52, 95% CI 1.04-2.22), and reliable internet access (AOR 3.89, 95% CI 1.95-7.76). Conclusion:Deprescribing is widely reported in Jordanian community pharmacy practice, and one-third of pharmacists use AI chatbots to support deprescribing decisions. Strengthening internet access, targeted training, and equitable infrastructure may help expand AI-assisted deprescribing across practice settings.

Background:Pharmacists are well-positioned to enhance medication management and support patients; however, their participation in palliative care in the UAE remains limited due to insufficient training, unclear professional roles, and organizational constraints. Addressing these issues is vital to enable pharmacists to contribute to comprehensive, patient-centred care and improved health outcomes. Aim:To assess the knowledge, attitudes, and practices of community pharmacists in the UAE toward palliative care, and to identify perceived barriers and factors associated with suboptimal practice. Methods:A cross-sectional online survey was conducted among 431 pharmacists using convenience sampling. A validated, self-administered questionnaire assessed demographics, knowledge (true/false/I do not know), attitudes and practices (5-point Likert scales), and perceived barriers. Content validity was confirmed through expert review, and reliability was assessed using Cronbach's alpha. Quantile regression identified factors influencing palliative care practices. Results:Among 431 respondents, the median (IQR) knowledge score was 4 (3-5) out of 13, with fewer than half answering any knowledge item correctly. Attitude and practice scores showed scope for improvement, with median (IQR) values of 45 (41-48) out of 60 and 41 (37-44) out of 55, respectively. Only 10% conducted home visits, while 16% offered pain management advice. Common activities included medication monitoring (38.3%) and ensuring access to essential medicines (36%). Higher attitude scores (β = 0.375; 95% CI: 0.283-0.467) and older age (β = 0.122; 95% CI: 0.009-0.235) were associated with better practices. The main barriers were lack of training (53.4%) and limited public awareness (50.1%). Conclusion:Despite positive attitudes, pharmacists demonstrate limited knowledge and engagement in palliative care. Targeted education, integration of palliative care into pharmacy curricula, and enhanced institutional and public support are essential to strengthen pharmacists' roles in patient-centred care in the UAE.

Background:Pharmacists increasingly play clinical roles, yet patients often continue to view them primarily as dispensers. Misalignment in role expectations may undermine communication and the effective use of pharmacy services. Aim:This study aimed to examine the extent to which pharmacists and patients in Jordan share similar perceptions of their respective roles in the pharmacist-patient relationship. Methods:A cross-sectional survey was conducted from October 2024 to May 2025 with 403 pharmacists and 806 patients recruited from community pharmacies across Jordan. Participants completed parallel role perception questionnaires assessing multiple domains of pharmacist and patient roles, including information sharing and responsible behavior. Mann-Whitney U-tests were used to compare mean ranks between groups. Results:Pharmacists generally assigned higher mean ranks to both pharmacist and patient roles than patients did. For example, pharmacists reported greater agreement than patients on discussing medication side effects (mean rank 669.50 vs. 572.75, p < 0.001), helping patients manage medications (672.84 vs. 571.08, p < 0.001), and greeting patients at the prescription counter and collecting prescription information (640.53 vs. 587.23, p = 0.007). Pharmacists also rated patients' willingness to collaborate in medication management more highly than patients rated themselves (704.63 vs. 555.19, p < 0.001), indicating a consistent perception gap across the assessed roles. Conclusion:The findings highlight clear perceptual gaps between pharmacists and patients in Jordan regarding their respective roles, particularly in response behavior and information sharing. These gaps may influence pharmacist-patient interaction and collaboration, highlighting areas for further research and targeted interventions.

Three-dimensional (3D) printing offers new possibilities for producing personalized medicines within pharmacy practice. Given the United Arab Emirates' (UAE) status as a leader in healthcare innovation, understanding pharmacists' perspectives in this region is important for anticipating the potential factors that may hinder or facilitate the adoption of this technology in community pharmacy practice. Data were gathered through a cross-sectional survey of 423 licensed pharmacists practicing in community pharmacies across the UAE who were recruited through a convenience sampling approach. Respondents filled out a validated survey instrument assessing their awareness, attitudes, readiness to adopt 3D printing technology, and perceived barriers to its implementation. Recruitment took place both online and in person. The findings revealed high levels of awareness, positive attitudes, and strong readiness among participants regarding the use of 3D printing technology. Regression analysis revealed that pharmacists with medium (OR: 2.661; 95% CI: 1.176-6.022; p < 0.05) or high (OR: 5.4264; 95% CI: 2.517-11.009; p < 0.001) levels of perceived workload were more likely to fall into the high-awareness group compared with those reporting low workload. Moreover, those who were in charge of or owned the pharmacy were more likely to exhibit high awareness toward 3D printing (OR: 3.037; 95% CI: 1.758-5.246; p < 0.001). Conversely, longer working hours were linked to a decreased probability of being classified as having high attitudes (OR: 0.882; 95% CI: 0.832-0.935). Similarly, a moderate perceived workload increased the likelihood of high readiness toward 3D printing when compared with a perceived low workload (OR: 2.281; 95% CI: 1.117-4.661; p < 0.05), while spending more time with patients was linked to lower readiness (OR: 0.399; 95% CI: 0.169-0.529; p < 0.001). To conclude, pharmacists in the UAE demonstrated a strong inclination to integrate 3D printing technology into community pharmacy practice. However, barriers to adoption remain. Wider implementation is likely to require training, clear professional guidance, and practical strategies that address the concerns identified in this study.

Background and objectivesDespite the proven benefits of early cancer detection in reducing disease-related complications and deaths, participation in cancer screening programs varies across population and is influenced by multiple individual and systemic-level factors. Understanding knowledge, attitudes and practices regarding cancer screening is essential to inform effective public health strategies, Therefore, this study aimed to assess these factors among adults in the UAE.MethodsA cross-sectional study was conducted using a bilingual (English/Arabic), self-administered online questionnaire distributed via social media. The survey collected data on socio-demographic characteristics, lifestyle-related risk factors, and cancer screening practices. Cancer knowledge was assessed using 59 items covering general knowledge, screenable cancers, warning signs and symptoms, and environmental risk factors. Attitudes perceived facilitators and barriers to screening were measured using a 5-point Likert scale. Screening behavior was assessed as self-reported lifetime (“ever”) participation in any cancer screening test. Binary logistic regression analysis was performed to identify factors associated with screening practices.ResultsA total of 811 individuals completed the study questionnaire, of whom only 36.5% reported having ever undergone any cancer screening test. Higher knowledge (OR = 1.022; 95% CI: 1.007–1.037) and more positive attitudes (OR = 1.091; 95% CI: 1.062–1.120) were associated with increased screening uptake. Older age (OR = 0.970; 95% CI: 0.955–0.985) and lower income (OR = 0.689; 95% CI: 0.483–0.982) were associated with a reduced likelihood of screening. Physician recommendation (47.0%) and early detection (45.3%) were the main motivators, while fear of results (39.5%), lack of symptoms (38.6%), and unfamiliarity with screening sites (38.5%) were the most common barriers.ConclusionThe findings demonstrate moderate cancer knowledge, variable screening attitudes, and multiple behavioral and system-level barriers. Knowledge, attitudes, age, and income, were significantly associated with lifetime screening participation, while physician recommendation and early detection emerged as key motivators. Targeted educational interventions and improved healthcare system navigation may enhance screening uptake in similar populations. However, findings should be interpreted with caution due to cross-sectional design, convenience sampling, reliance on self-reported lifetime screening, and the relatively young age distribution, which may limit causal inference and generalizability.

Background: Telepharmacy, a branch of telemedicine, enables remote pharmaceutical services such as medication counseling and drug monitoring. However, the readiness of pharmacists to adopt telepharmacy remains uncertain, particularly in regions like Palestine where no prior studies have explored this topic. Aims: This study evaluated Palestinian pharmacists' perceptions, barriers, and willingness to implement telepharmacy. Methods: A cross-sectional study was conducted among 375 pharmacists in the West Bank, Palestine, using the convenience sampling method. A validated online questionnaire assessed pharmacists' knowledge, attitudes, and barriers toward telepharmacy, with Cronbach's alpha values ranging from 0.75 to 0.81, indicating good reliability. The tool demonstrated strong reliability, with Cronbach's alpha scores of 0.81 (willingness), 0.77 (attitudes), and 0.75 (barriers). Convenience sampling was employed to recruit participants from northern, central, and southern regions, ensuring geographic representation. The questionnaire comprised four sections: demographics, knowledge, attitudes, and barriers. Results: Among participants, only 36.5% were aware of telepharmacy and 39.7% had poor knowledge, but 57.8% showed high willingness to implement telepharmacy, particularly for patient counseling (82.5%) and provider communication (83.2%). The most frequently used communication tool was WhatsApp (79%), followed by phone calls (68%). Major barriers included low health literacy (78.9%), poor internet access (74.5%), and high operational costs (74.4%). Key barriers included limited health literacy (78.9%), unreliable internet access (74.5%), and high costs (74.4%). Regression analysis revealed that higher education (OR =2.1; p <0.001) and female gender (OR= 1.68; p <0.001) were associated with greater willingness. Conclusion: While Palestinian pharmacists are receptive to telepharmacy, significant barriers hinder adoption. Addressing these challenges requires targeted training, infrastructure investment, and policy support. This study fills a critical gap in the literature, as no prior research has examined telepharmacy readiness in Palestine.

Objective To assess diabetes mellitus-related knowledge, attitudes, risk perception, and preventive understanding among non-diabetic adults in Iraq. Methods This cross-sectional study used convenience, voluntary sampling to recruit adults aged 18 years or older without a prior diagnosis of diabetes mellitus from different regions of Iraq between June and October 2025. Participants completed a culturally adapted questionnaire assessing sociodemographic characteristics, diabetes mellitus knowledge, attitudes, information sources, and beliefs regarding prevention. Descriptive statistics, Mann–Whitney U tests, quantile regression, and binary logistic regression were used. Results The study included 874 participants. Nearly half (48.4%) reported a family history of diabetes mellitus. Common symptoms, such as frequent urination (89.9%) and excessive thirst (84.2%), were widely known, whereas less obvious symptoms, such as unexpected weight loss, were less well recognized. Awareness of some complications, such as loss of consciousness (94.2%) and amputation (93.8%), was high, while awareness of others, such as kidney damage (69.5%) and eye disorders (78.3%), was moderate. Quantile regression analysis showed significantly lower knowledge scores among participants without a medical background (β = −4.214, p < 0.001). In addition, higher knowledge scores were significantly associated with more positive attitudes toward diabetes mellitus (odds ratio = 1.179, 95% confidence interval: 1.108–1.255, p < 0.001), whereas older age was associated with less favorable attitudes (odds ratio = 0.545, p < 0.001). Conclusions Adults without diabetes in Iraq demonstrated a good basic understanding of diabetes mellitus; however, important gaps remain in knowledge of symptoms, complications, and key risk factors. These findings highlight the need for practical, evidence-based public health education to support prevention efforts and reduce the future burden of diabetes mellitus.

Type 1 diabetes mellitus (T1DM) is linked to a considerable rise in mortality and morbidity. Studying hospital admission trends is crucial for healthcare improvement and reducing hospital admissions. Therefore, this research aimed to examine the hospitalization profile for T1DM pediatric patients in Australia over the past 2 decades. This is a retrospective ecological longitudinal study conducted in Australia between 1998 and 2019. T1DM pediatric patients aged below 19 formed the study population. The National Hospital Disease Database was used to extract hospitalization data. Mid-year population data was extracted using the Australian Bureau of Statistics. The Pearson chi-square test for independence was applied to evaluate the difference in hospitalization rates. In Australia, there were 89,798 episodes of hospital admission for T1DM reported between 1998 and 2019. Hospitalization rate increased by 29.6% (from 55.01 [95% confidence interval (CI) 53.00-57.02] in 1998 to 71.31 [95% CI 69.22-73.41] in 2019 per 100,000 persons, P < .05). Overnight-stay episodes comprised 79.9% of all admissions. Rates of same-day hospitalization rose 1.72-fold (from 5.86 [95% CI 5.20-6.52] in 1998 to 15.93 [95% CI 14.94-16.92] in 2019 per 100,000 persons). Rates of overnight-stay hospitalization rose by 12.7% (from 49.15 [95% CI 47.25-51.05] in 1998 to 55.38 [95% CI 53.54-57.23] in 2019 per 100,000 persons). The most frequent cause of hospitalizations was T1DM with acidosis, which accounted for 43.1% of cases. Females accounted for 47,880 hospitalization episodes, representing 53.3% of the total. The age group 15 to 19 years accounted for 38.9% of hospitalization episodes. Considering these results, it is imperative to create focused strategies for adolescents with T1DM, particularly those between the ages of 15 and 19, including interventions and education that address the difficulties brought on by puberty-related factors and encourage improved adherence to diabetes care. These strategies will help lessen the cost of hospitalization and enhance the general health of these vulnerable people.