Tag: pubmed

J Acquir Immune Defic Syndr. 2025 Oct 6. doi: 10.1097/QAI.0000000000003767. Online ahead of print.

ABSTRACT

BACKGROUND: Advanced HIV disease is a major contributor to the slowing decline in HIV-related deaths globally. However, limited data exist on which individuals with advanced HIV are at highest risk of death.

METHODS: A retrospective cohort study was nested within a larger cohort of 13 primary care HIV treatment facilities in Khayelitsha, South Africa. All adults who had a CD4 count less than 200cells/mm3 between 1 January 2017 and 31 March 2021 were enrolled. Descriptive statistics were calculated, and the cohort was then restricted to those who had linked vital status information. We evaluated risk factors for mortality using Kaplan-Meier curves, and univariable and multivariable Cox Proportional Hazards models.

RESULTS: Between 19% and 28% of the larger cohort (n=72,102) were estimated to have advanced HIV disease at any point during the study period. Of these individuals, 20% were on treatment, 40% were disengaged from care and 40% were treatment naïve at enumeration. Overall mortality was 12%, with mortality highest in the first year (6,8%) following enumeration. There were 608, 371, and 370 deaths among those disengaged, on ART, and ART naïve respectively representing 14%, 17%, and 8% of individuals in each group. Over a quarter of all participants were found to have current tuberculosis at enrolment into the cohort.

CONCLUSION: ART-exposed individuals with advanced HIV disease contribute substantially to ongoing HIV-related mortality in South Africa. Improved adherence and retention strategies within HIV programmes could reduce this mortality.

PMID:41052372 | DOI:10.1097/QAI.0000000000003767

Personal Disord. 2025 Oct 6. doi: 10.1037/per0000746. Online ahead of print.

ABSTRACT

It has been posited that extremely high or extremely low levels of any personality trait in the five-factor model can be maladaptive. However, the Alternative Model of Personality Disorders in Section III of the Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5) is composed almost exclusively of unipolar maladaptive traits. The lack of maladaptively low neuroticism and high extraversion fails to fully cover psychopathy; the lack of maladaptively high extraversion fails to cover histrionic personality disorder; the lack of maladaptively high agreeableness fails to cover dependent personality disorder; and the lack of maladaptively high conscientiousness fails to cover obsessive-compulsive personality disorder. The goal of this study was to discern whether Five-Factor Model Personality Disorder (FFMPD) scales demonstrate incremental validity over the Personality Inventory for DSM-5 (PID-5) in capturing variance in symptom measures of each of these personality disorders. A combined sample of N = 733 completed an online questionnaire battery that included the PID-5 and FFMPD scales for psychopathy, histrionic personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder, along with symptom measures for each of these conditions. A series of hierarchical regression models was conducted in which each symptom measure was regressed on the PID-5 (entered in Step 1) and the corresponding FFMPD measure (entered in Step 2). Results suggest that adding the FFMPD measure to the models accounted for significantly more variance in its corresponding symptom measure than the PID-5 alone. Taken together, these results suggest that maladaptive variants of personality traits that are often considered healthy (e.g., low neuroticism, high extraversion) confer important information about personality disorder symptoms and functioning and should be included in the Alternative Model of Personality Disorders. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:41051863 | DOI:10.1037/per0000746

J Nurs Educ. 2025 Oct;64(10):670-673. doi: 10.3928/01484834-20250515-03. Epub 2025 Oct 1.

ABSTRACT

BACKGROUND: Determining the extent of incivility in nursing education is critical for creating potential interventions. A survey to measure incivility, stress, well-being, and program satisfaction was developed by faculty in one Canadian nursing program.

METHOD: A cross-sectional research design was used to pilot the survey. Descriptive statistics including correlations were used to analyze the data.

RESULTS: Some of the participants reported observing other students making negative verbal remarks (42.9%) to faculty or other students, while 26.8% of participants engaged in indirect negative remarks. Receiving and engaging in incivility were strongly correlated. Fifty percent of the participants were academically stressed, correlating with incivility. Students generally were satisfied with their academic program.

CONCLUSIONS: Although incivility is reported as occurring in nursing education, not all students observed, received, or engaged in uncivil behaviors. Receiving incivility was associated with nursing students engaging in uncivil behaviors, highlighting a need for strategies to prevent or mitigate the perpetuation of incivility in undergraduate nursing education.

PMID:41051858 | DOI:10.3928/01484834-20250515-03

J Psychopathol Clin Sci. 2025 Oct 6. doi: 10.1037/abn0001069. Online ahead of print.

ABSTRACT

This article contends that many of the chief complaints about the Diagnostic and Statistical Manual of Mental Disorders can be obviated by a set-theoretic, combinatorial approach. Arbitrary cutoffs, polythetic criteria, and category heterogeneity can be avoided by using a data-driven approach that assesses whether particular symptom combinations represent sufficient conditions for clinical benchmarks at an acceptable level of conditional probability. Using data from the National Comorbidity Survey-Replication, this study employed generalized anxiety disorder, major depressive disorder, posttraumatic stress disorder, and the union of major depressive disorder and generalized anxiety disorder as exemplars and set a target probability threshold of p ≥ .90 for sufficiency. All possible symptom combinations were generated for each subsample, with sample sizes of N = 1,948, N = 2,285, N = 777, and N = 3,129, respectively. Sufficient sets were identified for diagnosis, clinical distress, and functional impairment. Establishing sufficiency reduced the number of possible symptom combinations by at least 94% (M = 98.7%, SD = 1.79%). Finally, in a large, randomly split-halved subsample (N = 6,656), sufficient sets were identified at p ≥ .90 and tested in the holdout data. Results yielded an average conditional probability of .91 (SD = .03), reinforcing the robustness and generalizability of the current methods. These results suggest that a large amount of the heterogeneity in symptom combinations in internalizing disorders may be nested and reducible. Thus, much of the combinatorial information in the symptom presentations of these disorders may be overlapping and there may be core features of psychopathology that are sufficient to produce fidelity without requiring additional complexity. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:41051852 | DOI:10.1037/abn0001069

Dev Psychol. 2025 Oct 6. doi: 10.1037/dev0002084. Online ahead of print.

ABSTRACT

Subjective aging predicts various developmental outcomes, including cognitive functioning. However, associations could be bidirectional. We focused on central dimensions of subjective aging (subjective age; self-perceptions of aging related to social losses, physical losses, and ongoing development) and investigated reciprocal longitudinal associations with perceptual-motor speed, both at the between-person level (i.e., Do individuals with more positive subjective aging trajectories exhibit better cognitive performance trajectories?) and within-person level (e.g., Is an individuals’ cognitive performance poorer than their typical trajectory on measurement occasions when their subjective aging is less positive than their typical trajectory?). We used data from the German Ageing Survey (n = 15,898; aged 40-95 years; observation period: 2002-2017, up to five occasions; mean number of observations: 2.1; sample sizes between 2002 and 2017: 4,334; 7,668; 4,800; 9,703; 6,551). Using autoregressive latent trajectory models with structured residuals, we controlled for sociodemographic, social, and health-related factors. At the between-person level, higher levels of perceptions related to ongoing development and lower levels of perceptions related to physical and social loss were associated with higher levels of perceptual-motor speed. Linear decline in perceptual-motor speed was less steep for individuals with lower physical loss intercepts and higher ongoing development levels. While there were significant within-person synchronous associations between perceptual-motor speed and subjective aging, we found no reliable cross-lagged associations. All between-person and within-person associations of subjective age with perceptual-motor speed were not statistically significant. Our results imply that there are meaningful between-person and within-person associations between subjective aging and cognitive abilities. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:41051819 | DOI:10.1037/dev0002084

Zh Nevrol Psikhiatr Im S S Korsakova. 2025;125(9):131-138. doi: 10.17116/jnevro2025125091131.

ABSTRACT

OBJECTIVE: The aim of this study was to study the complex relationship between markers of oxidative stress and depression in patients diagnosed with Parkinson’s disease, with an emphasis on how various therapeutic interventions affect these biochemical parameters.

MATERIAL AND METHODS: The study included 60 participants (26 women and 34 men, average age 65.13±0.84 years) who received Fluvoxamine 100 mg/day as monotherapy (main group, n=30) or combination therapy (comparison group, n=30), including the antioxidant Cytoflavin and Fluvoxamine 100 mg/day. The control group consisted of 20 practically healthy elderly people. Using clinical, psychometric, and statistical research methods, the dynamics of depression symptoms and markers of oxidative stress in patients diagnosed with Parkinson’s disease were evaluated during a three-month course of treatment with Fluvoxamine and Cytoflavin.

RESULTS: During 3 months of therapy, the average score on the Hamilton depression scale in the main group decreased from 26.63±0.33 to7.22±0.5 points (p<0.01), in the comparison group from 26.51±0.29 to 12.18±1.1 points. According to the HADS scale, the average score in the main group decreased from 15.46±0.8 to 7.1±0.1 points (p<0.05), and in the comparison group from 15.14±0.8 to 9.7±1.2 points. After the therapy, all patients showed a significant slowdown in lipid peroxidation processes, an increase in the concentration of antioxidant enzymes, and a statistically significant (p<0.01) increase in the concentration of reduced glutathione, with a more significant improvement in the main group.

CONCLUSION: The results of a comparative analysis of the effectiveness of treatment of depression in patients with Parkinson’s disease showed that the use of a combination of Fluvoxamine and Cytoflavin provides a more pronounced therapeutic effect compared with Fluvoxamine monotherapy. These findings emphasize the need to integrate combined approaches into the development of new treatment strategies for depressive states based on a personalized assessment of the clinical picture of depressive disorder and biomarkers of oxidative stress.

PMID:41051815 | DOI:10.17116/jnevro2025125091131

Zh Nevrol Psikhiatr Im S S Korsakova. 2025;125(9):99-102. doi: 10.17116/jnevro202512509199.

ABSTRACT

OBJECTIVE: To analyze the efficacy of eperison in combination with botulinum toxin injections for the treatment of pain syndrome in patients with spastic torticollis (ST).

MATERIAL AND METHODS: A retrospective study was conducted to evaluate the effectiveness of eperison administration alongside botulinum therapy in 29 patients diagnosed with ST. The study employed a cross-sectional retrospective analysis of medical data. Patients receiving botulinum toxin injections at three-month intervals (a total of 6 cycles), with assessments at 2 months (4-6 cycles after each injection), were administered eperison at a dose of 150 mg/day. The efficacy of the treatments was evaluated using a validated scale: the 85-point TWSTRS (Toronto Western Spasmodic Torticollis Rating Scale), assessed three times-before each botulinum injection (on day 1), at day 14, and and at day 60 later.

RESULTS: For cycles 1-3 (botulinum toxin, without eperisone), the average TWSTRS scale score on the on day 1 of each cycle was 40.72 – 41.66; cycles 4-6 with the addition of Eperisone – 26.6-30.4 points. When comparing the average values of the TWSTRS scale for cycles 1-3 and cycles 4-6 on the «Pain» scale, t-test value was: 15.85 (p=0.000546).

CONCLUSION: The intake of the centrally acting muscle relaxant eperison resulted in a statistically significant improvement in patients with ST by the time of the next injection (paired Student’s t-test 2.77-2.92, p=0.05), including improvements in the «Pain» scale, compared to botulinum therapy without eperison in the same patients.

PMID:41051811 | DOI:10.17116/jnevro202512509199

Zh Nevrol Psikhiatr Im S S Korsakova. 2025;125(9):90-98. doi: 10.17116/jnevro202512509190.

ABSTRACT

OBJECTIVE: To study the antidepressant efficacy and the tolerability of agomelatine (Valdoxan) in daily clinical practice in patients with a depressive episode that occurred after COVID-19.

MATERIAL AND METHODS: The final analysis included 103 patients (70.9% women, average age 45 years). Of these, 78.6% have had mild COVID-19 in the last 3 months, and 21.4% have had moderate COVID-19. The average time from the onset of infection to inclusion in the study was 2.1±0.7 months. At the start of the study, 53.4% of patients had a mild depressive episode, and 46.6% had a moderate depressive episode. Clinical and psychopathological, psychometric (HAMD-17, CGI, SF-36), and statistical methods of investigation were used.

RESULTS: A significant decrease in the severity of depression was revealed. The average overall score on the HAMD-17 scale decreased compared to baseline by 2.6±3.3, 6.7±5.3, and 10.9±4.9 at weeks 2, 4, and 8 of agomelatin administration, respectively (p<0.0001). Mental and physical indicators on the SF-36 scale also significantly improved compared to baseline (p<0.0001). By the end of the study, 81.4% of patients had responded to therapy, 71.6% had achieved remission according to the criteria established in the study. It was found that the initial value of the total HAMD-17 score has a statistically significant effect (p<0.0001) on the outcome of depression therapy after COVID-19, an additional contribution is made by the prescription of COVID-19 disease. Agomelatin was well tolerated during the 8 weeks of follow-up.

CONCLUSION: The results indicate a high antidepressant and anxiolytic effectiveness and safety of agomelatine after 8 week of treatment of patients with depression after COVID-19 infection. The results of the study add to the knowledge about the antidepressant effectiveness of agomelatine and suggest that it may become a drug for the treatment of MDE in patients who have suffered COVID-19 infection.

PMID:41051810 | DOI:10.17116/jnevro202512509190

Zh Nevrol Psikhiatr Im S S Korsakova. 2025;125(9):79-89. doi: 10.17116/jnevro202512509179.

ABSTRACT

OBJECTIVE: To study the effect of magnetic resonance imaging-guided focused ultrasound (MR-FUS) on the motor and non-motor symptoms of essential tremor (ET) (cognitive functions, anxiety, depression, apathy, sleep disorders), as well as to establish association between adverse events (AEs) and the technical parameters of the surgery, postablation neuroimaging changes in the brain matter, and clinical and demographic factors.

MATERIAL AND METHODS: Twenty-two patients with disabling drug-resistant ET were prospectively evaluated prior to unilateral ventral intermediate nucleus (Vim) FUS thalamotomy, and at 24 hours, 3, 6, and 12 months postoperatively.

The change of tremor was assessed using the Clinical Rating Scale for Tremor (CRST). Non-motor symptoms were assessed using the Montreal Cognitive Assessment (MoCA), the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), the Apathy Scale, and the Epworth Sleepiness Scale. The Tinetti test was used to assess balance and gait. The quality of life for patients with ET was assessed using the Quality of Life in Essential Tremor Questionnaire (QUEST). MRI with a magnetic field strength of 3.0 T was performed immediately after surgery, as well as at 24 hours, 3, 6, and 12 months post-surgery.

RESULTS: MR-FUS led to a significant reduction in tremor in the extremities of the contralateral thalamotomy site; the mean total CRST and hemi-CRST scores decreased by 78% and 80% (p<0.0001), respectively, with a significant persistence of the improvement at 12 months after surgery by 63% and 64% (p=0.012), respectively. The quality of life of patients with ET significantly improved at 6 and 12 months after surgery by 38% (p=0.017) and 45% (p=0.012), respectively. MR-FUS had no statistically significant impact on cognitive function, severity of apathy, anxiety, depression, or daytime sleepiness (p>0.05). Mild adverse events occurred in 45% of patients immediately after surgery, and most of the AEs regressed by Month 3 of follow-up. The lesion volume and postoperative edema were significantly correlated with a decrease in the total CRST score at 6 and 12 months postoperatively (r=-1, p=0.01). The results of the correlation analysis showed that patients with AEs after FUS-thalamotomy had larger foci of necrosis and postoperative edema, and also had a significantly shorter duration of surgery (p=0.042). However, the number of sonications (both verification and therapeutic), the power of ultrasound waves, and the maximum exposure temperatures in the patients of the compared groups did not differ significantly.

CONCLUSION: The results of an open prospective study confirmed the effectiveness of unilateral FUS thalamotomy of the Vim nucleus of the thalamus for the treatment of ET. There was no significant effect on the non-motor manifestations of ET. All reported AEs were mild and transient. The risk of AEs was determined by the volume of the lesion and postoperative edema, as well as the duration of surgery.

PMID:41051809 | DOI:10.17116/jnevro202512509179

J Phys Chem Lett. 2025 Oct 6:10639-10646. doi: 10.1021/acs.jpclett.5c02193. Online ahead of print.

ABSTRACT

We present a methodology for accelerating the estimation of the free energy from path integral Monte Carlo simulations by considering an intermediate artificial reference system where interactions are inexpensive to evaluate numerically. Using the spherically averaged Ewald interaction as this intermediate reference system for the uniform electron gas, the interaction contribution for the free energy was evaluated up to 18 times faster than the Ewald-only method. Furthermore, an extrapolation technique with respect to the quantum statistics was tested and applied to alleviate the Fermion sign problem. Combining these two techniques enabled the evaluation of the free energy for a system of 1000 electrons, where both finite-size and statistical errors are below chemical accuracy. The general procedure can be applied to systems relevant for planetary and inertial confinement fusion modeling with low to moderate levels of quantum degeneracy.

PMID:41051799 | DOI:10.1021/acs.jpclett.5c02193