Background: Society's information regarding practices, attitudes, and knowledge influences the society's behaviors and practices toward COVID-19 and affects preventive measures and disease control. Aim: This study aims to assess the knowledge, attitude, and practices towards COVID-19 in the young adults of the Iraqi general population. Materials and Methods: Cross-sectional study web-based survey conducted between 30th September 2023 to 31st January 2024. The data was gathered through an electronic questionnaire. The survey was conducted in the Iraqi population and included male and female participants aged ≥ 18 years. A self-administered structured questionnaire was used for data gathering. The questionnaire consists of items to get information from the participants: risk factors, knowledge, attitudes and practices toward SARS-CoV-2 infection, and social and demographic characteristics. An Arabic version of the questionnaire was prepared. The questionnaire consists of the knowledge part, which includes 11 questions, while attitudes include 10 questions and practices include 8 questions. The knowledge was evaluated on the basis of the correct answer and converted to a score of 5. While for the attitudes, a 5-point Likerttype scoring system was created for responses (1- strongly disagree; 2- disagree; 3-neutral; 4- agree; 5- strongly agree). For the practices, a 5-point Likert score is used for response evaluation (5- always; 4- often; 3- sometimes; 2- rarely; 1-never). The questionnaire link was sent online to the participants via Facebook, Instagram, Telegram, and WhatsApp. The questionnaire participants replied in the Microsoft Excel sheet. An ANOVA test was used to determine the differences in significance between the KAP items and within the section of each KAP. Post-hoc test used for analysis of significance between K and A, K and P, A and P. The significance of the differences between groups was determined using the chi-square test. The analysis was performed using SPSS version 20. Results: There were 1484 participants, with a survey response rate of 86.7% (1484/1712). The majority of the participants (69.3%) were in the age group of 18 to 25 years, and 85.9% of them were B.Sc., M.Sc., Ph.D., and college students. 90.5% were from urban areas, and 27.6% participated in an online course for COVID-19. The mean score of knowledge was 3.04 ± 0.84, which means that the mean correct answer of the knowledge item was 61%. The highest correctly answered question (87%) was regarding the preventive measures for COVID-19 infection, followed by the main symptoms of COVID-19 (76.5%). The lowest correctly answered question (27%) was regarding the mortality rate of COVID-19, followed by complications of COVID-19 (38.1%). The total knowledge mean score was 61% of the scale (score 3.04/5), and this indicated that 61% of the population has good knowledge regarding the COVID- 19 pandemic. Additionally, there were high significance (p < 0.01) differences between the knowledge item score and the correct answer. A post-hoc test indicated a significant difference (p = 0.0305) in item scores between knowledge and practices, but there was no significant difference between knowledge versus attitudes or between attitudes versus practices. Attitudes mean score was 3.6 and 72% frequency of correct answers for the items. A significant number of participants expressed worry about themselves, their family members, friends, or society (64.8%) getting infected. Thus, about 1/3 of the participants were not worried about getting an infection. However, 18.4% of participants did not express any as they gave a neutral answer. It is interesting that 80.3% of the participants believed that an asymptomatic patient could transmit the virus to others. The survey indicated a rate with an average of 12.5% to 36% of neutral responses to the addressed questions. The mean score of practice was 9.98 and the correct answer frequency was 79.6%. The majority of participants (83.3%) reported an acceptable practice. Individual questions were answered correctly in a range of 88.1% to 94.7%, with the exception of carefully removing PPE and discarding it in the proper place (17.1%). Conclusions: The young adults Iraqi general population had a good KAP standard. Attitudes and practice scores were higher than those of knowledge. The knowledge score mean value was 3.04 and the correct answers frequency was 61%, with the items score range of 1.4 and 4.4, while the correct answers frequency range was 27% and 87%. The mean score of attitudes was 3.6 with a range of 2.8–4.2, while the correct mean frequency was 72% with a range of 56% to 84%. The mean score of practices was 3.98 with a range of 1.6 to 4.5, while the mean frequency of the correct answer was 79.6% with a range of 32% to 90%.

Childhood maltreatment and complex post-traumatic stress disorder (cPTSD) are common among people with psychosis. Traumatic life experiences may contribute to the neural substrates of psychosis. Affective pathways to psychosis outline the role of post-traumatic sequelae, but no studies have explored the neurobiological underpinnings of cPTSD in this population. We compared two groups meeting criteria for schizophrenia-spectrum disorders, with (n = 58) and without (n = 50) comorbid cPTSD. Region of interest (ROI) analysis was used to assess structural differences in ROIs identified by meta-analyses as overlapping between PTSD and psychosis. The cPTSD group showed enlarged limbic regions, including the bilateral anterior insula and left parahippocampus, and smaller prefrontal regions, including the left medial orbitofrontal cortex (mOFC). In the right mOFC, specific voxel volumes were larger, and others smaller, in the cPTSD group. All differences, aside from hippocampal volume, survived whole-brain analysis corrected for multiple comparisons. Post-hoc analyses indicated trends suggesting bilateral insula and mOFC volume correlated positively, whereas parahippocampal volume correlated negatively, with cPTSD symptom severity. To conclude, in people with comorbid cPTSD and psychosis, post-traumatic sequelae may be underpinned by anatomical differences in regions implicated in emotion regulation, especially the regulation of fear, supporting the neural characterisation of affective psychosis pathways.

Transdiagnostic psychopathology among individuals with co-occurring problematic pornography use and alcohol use problems.

Phenotype-stratified treatment response in obese atrial fibrillation: Post-hoc cluster analysis of the PRAGUE-25 randomized trial.

Sustained seizure freedom without intolerable adverse events is the main goal of epilepsy treatment, but may be challenging to achieve for some patients, particularly following the failure of multiple anti-seizure medications (ASMs). A majority of days without seizures is another important clinical outcome that can lead to meaningful improvement in quality of life. The objective of this post-hoc analysis was to evaluate the percentage of seizure-free days by responder groups during the open-label extension (OLE) of study C017 with a focus on patients who achieved near-seizure freedom that was sustained during the duration of the study (≥ 90%-< 100% responders group). The study also evaluated retention rates and the impact of concomitant antiseizure medications. Study C017 (NCT01866111) was a double-blind, randomized, placebo-controlled, dose-response trial evaluating adults 18-70years old who were taking 1-3 concomitant ASMs. Participants completed the 18-week double-blind treatment period and entered the OLE. This post-hoc analysis quantified the proportion of seizure-free days by responder category and by number and type of concomitant ASMs. The occurrence and severity of treatment-emergent adverse events during the OLE were also reported. Sixty (16.9%) of the 354 study participants were≥90%-< 100% responders (median age 42.5years, 46.7% [n=28] female, median number of concomitant ASMs at baseline was 2). The study population also included 91 (25.7%) patients who were≥50%-< 75% responders, 62 (17.5%) patients who were≥75%-< 90% responders, and 13 (3.7%) patients who were 100% responders. The median duration of cenobamate exposure was 5.6years for the≥90%-< 100% responders; 1.8years for the non-responders; 5.5years for the≥50%-< 75% responders; 5.5years for the≥75%-< 90% responders; and 5.6years for the 100% responders. The percentage of seizure-free days during the entire OLE was 97.9% in the≥90%-< 100% responder group, compared to 93.5% in the≥75%-< 90% group and 83.9% in the≥50%-< 75% group. The number and mechanism of action of concomitant ASMs did not meaningfully impact the proportion of days without seizures. The percentage of days with seizures in the≥90%-< 100% responder group declined from 33.2% at baseline to 1.2% at Year 5. At Year 5, the≥90%-< 100% responder group had a high retention rate (90%). The most commonly occurring adverse events were dizziness, somnolence, and headache. Participants taking cenobamate who achieved≥90%-< 100% responder rates were seizure-free for nearly 98% of days during the 5years of the OLE. These results suggest that a high reduction of seizure burden can be achieved and maintained by many people with epilepsy taking cenobamate.

In patients with treatment-resistant depression (TRD), the efficacy and tolerance of intranasal esketamine (ESK) spray, alone or combined with oral antidepressants, has been supported by clinical trials and observational studies. The French real-world ESKALE study assessed the benefit of ESK in 157 patients with TRD. In this post-hoc analysis of the ESKALE study we aimed to describe the evolution of depressive symptoms (using the Montgomery Åsberg Depression Rating Scale [MADRS]) and to identify potential factors associated with response during the 4-week induction treatment period. Data from 128 patients were analyzed. The mean MADRS total score (after adjusting) significantly decreased during the first week of ESK treatment by 7.5 points (95% CI: 9.2 to -5.7; p<0.001) and at W4 by 13.5 points (95% CI: 15.3 to -11.8; p<0.001). The response rate (MADRS total score reduced by≥50%) continually increased during the 4-week induction treatment period: from 19.4% at W1 to 47.4% at W4. Multivariate analysis identified the occurrence of dissociation during the first week of treatment to be significant factor associated with ESK response at W1 (odds ratio: 3.30 [95% CI: 1.19 to 9.13]; p=0.021]). No other factors were significantly associated with ESK response at W1 or W4. This post-hoc analysis provides further evidence of a rapid response after ESK initiation in patients with TRD and that early dissociation may play a role in treatment response. However, future research is needed to investigate prognostic factors associated with ESK response in patients with TRD.

Placentation is influenced by decidual Natural Killer (dNK)1 cells. Defective placentation can lead to recurrent pregnancy loss (RPL)2 or placenta accreta spectrum (PAS)3 disorders. Interaction between Programmed Cell Death Protein 1 (PD-1)4 on NK cells and Programmed Cell Death 1 Ligand (PD-L1)5 can alter the cytokine expression and cytotoxic potential of NK cells. This study compares dNK and PD-1+ dNK cell number, number of extravillous trophoblast (EVT)6 and PD-L1+ EVTs in two patient groups that experienced either RPL or PAS disorder to a control group. For this retrospective case-control study tissue from in total 77 abortion samples (healthy women, women with RPL and PAS disorder) were immunohistochemically stained and the above-mentioned cells and receptors were counted and statistically compared between the three groups with either Kruskal Wallis or ANOVA and corresponding posthoc tests. The number of EVTs was reduced in the RPL group. There were more dNK and PD-1+dNK cells as well as a higher ratio of dNK cells compared to EVTs in the RPL group compared to the control group. Furthermore, the proportion of PD-L1+ cells in all EVT cells was higher in the RPL group compared to the control group. Our findings show that both PD-1 and PD-L1 are differentially expressed on dNK cells and EVTs in the RPL group compared to the control group. Hereby suggesting that PD-1/PD-L1 interaction might influence NK cell function and therefore might be relevant for women experiencing RPL. This may be in terms of cytokine microenvironment or cell-cell-interaction.

Attitudes toward artificial intelligence and impostor phenomenon among nursing students: A five-country cross-sectional study.

Type 2 diabetes (T2D) is a major global health concern characterized by chronic hyperglycemia and progressive multisystem involvement. One of its most prevalent complications is diabetic peripheral neuropathy which contributes to impaired neuromuscular function, reduced sensation, diminished motor control and functional disability of the upper limb (UL). We evaluated the efficacy of sensorimotor training (SMT) and resistance training (RT) on grip strength, manual dexterity and neurophysiological evaluation in patients suffering from T2D. This study might contribute to better management of UL functions in these patients. Randomized controlled trial (RCT). 96 T2D patients were allocated into RT group; SMT group; and control group. Primary outcomes i.e. grip strength and manual dexterity as well as secondary outcomes i.e. musculocutaneous nerve latency (MCNL), musculocutaneous nerve action potential amplitude (MCNAPA), axillary nerve latency (ANL) and axillary nerve action potential amplitude (ANAPA) were measured at three-time points. Data was analyzed using repeated-measures ANOVA with post-hoc testing, and a significance level of p < 0.05 was adopted. Within-group comparison pointed to a statistically significant improvement for all the variables (grip strength p < 0.05, manual dexterity p < 0.05, MCNL: p < 0.05; MCNAPA: p < 0.05; ANL: p < 0.05; ANAPA: p < 0.05) in both experimental groups. For between-group comparisons, p-value was < 0.05 for grip strength and nerve amplitude in RT group whereas p-value was < 0.05 for manual dexterity and nerve latency in SMT group. Both the experimental groups showed improvement in all the outcome variables. RT was more effective in improving grip strength and nerve amplitude whereas in SMT group, there was more improvement in manual dexterity and nerve latency. Further study was needed to generalize these results as it was a single-centered study. The online version contains supplementary material available at 10.1007/s40200-025-01839-7.

Biomechanical comparison of tendon graft suturing techniques in arthroscopic ligament reconstruction using a novel knotless method in a cadaveric model.

Adaptation of strategic innovation management to regional sustainable development: Lessons from global SMEs and the DCT approach

Classification of functional near-infrared spectroscopy (fNIRS) signals in schizophrenia and bipolar disorder using deep learning methods.

Prognostic and predictive value of radiomics-based imaging features in patients with colorectal liver metastasis receiving radioembolisation in first-line setting.

Machine learning models to detect opioid misuse in emergency department patients at triage.

Impact of AI assistance on knee MRI reading time: A real-world multicenter study

Factors associated with oropharyngeal dysphagia 3months after ICU discharge in patients undergoing invasive mechanical ventilation: A post-hoc analysis of a Brazilian multicenter prospective cohort study.

An enhanced gravitational search algorithm for feature selection in telecom churn prediction

To evaluate and compare the trueness of four commercial AI-driven segmentation tools (Diagnocat, Relu, CephX, CoDiagnostiX) and one open-source software (3D Slicer with DentalSegmentator) for dental cone-beam computed tomography (CBCT) segmentation using extracted human teeth as physical ground truth reference. Ten single-rooted teeth from two formaldehyde-fixed human donor heads were scanned using high-resolution CBCT (90 µm voxel size). Following CBCT acquisition, the teeth were extracted and digitized using an intraoral scanner (TRIOS 4) to create ground-truth reference models. DICOM datasets were processed by each segmentation software. 3D models were registered to reference scans of extracted teeth using landmark-based alignment followed by iterative closest point refinement. Surface-to-surface distances were calculated, including Hausdorff distance, root mean square distance (RMSD), mean absolute distance (MAD), median distance, and 95th percentile distance. Significant differences were observed between segmentation tools for all metrics (Friedman test, p < 0.001). Relu demonstrated the highest trueness with Mean Distance of 0.11 mm [0.09-0.11], followed by Diagnocat 0.10 mm [0.09-0.13], CoDiagnostiX 0.14 mm [0.12-0.16], 3D Slicer 0.13 mm [0.12-0.15], and CephX 0.24 mm [0.21-0.25]. Post-hoc analysis revealed significant differences between top-performing (Relu, Diagnocat) and lower-performing tools (CephX). 3D Slicer showed performance similar to that of commercial solutions. Relu and Diagnocat achieved the highest trueness for CBCT tooth segmentation when validated against physical specimens. All tested tools demonstrated clinically acceptable trueness for most applications, though performance varied considerably between platforms. This pilot study provides preliminary comparative data on AI segmentation tool trueness that may inform future larger-scale validation studies. The findings suggest performance differences between platforms that warrant further investigation before definitive clinical recommendations can be made.

Guidelines on the treatment of hypertensive patients usually refer to 'average' patients. However, in clinical practice, individual patient characteristics may differ substantially from the average. Thus, it seems worthwhile to examine the relationship between comprehensive patient profiles and blood pressure responses. We divided the patient population from the INSIGHT trial into exploration and validation cohorts and constructed composite patient profiles based on predictors of blood pressure control (age, severity of hypertension, comorbidities, and previous treatment status). Next, we tested in the exploration cohort whether blood pressure control rates and adverse effects after 6 months of therapy across these profiles differed from those in the entire patient group. Finally, we explored whether the results from the exploration cohort could be validated using another cohort. Logistic regression analysis showed that the odds of achieving blood pressure control differed substantially between patient profiles but not between treatment modalities. Patients with a less favorable profile (e.g. the combination of age above 60 years, baseline systolic pressure above 160 mmHg, and the presence of diabetes) did less well than patients with a low-risk profile (e.g. absence of organ damage). These results were confirmed in the validation cohort. We conclude that responses to antihypertensive treatment vary in a clinically important manner depending on the composite patient profiles. When found in other trials as well, a priori knowledge about response rates of various patient-profile treatment regimens may help choose the best treatment in individual patients and improve overall blood pressure control rates.

In silico post-hoc analysis of a clinically tested recombinant West Nile virus envelope protein vaccine.