Writing about a stressful experience improves semantic clustering of memory in men, not women.

Writing about negative experiences can produce multiple benefits, including improvements in mental and emotional health. However, writing about negative experiences potentially be detrimental, as reliving and reexperiencing a negative memory can be painful. Although the emotional effects of writing about negative experiences are well established, the cognitive effects are less heavily explored, and no work to date has examined how writing about a stressful experience might influence episodic memory. We addressed this issue in the present study (N = 520) by having participants encode a list of 16 words that were organised around four semantic clusters, randomly assigning participants to write about an unresolved stressful experience (n = 263) or the events of the previous day (n = 257), and assessing their memory in a free recall task. Writing about a stressful experience did not influence overall memory performance; however, the stressful writing manipulation increased semantic clustering of information within memory for men, whereas the stressful writing manipulation did not influence semantic clustering of information within memory in women. Additionally, writing with more positive sentiment improved semantic clustering and reduced serial recall. These results provide evidence for unique sex differences in writing about stressful experiences and the role of sentiment in the effects of expressive writing.

The Evolving Spectrum of Kidney Histology in HIV-Positive Patients in South Africa.

Introduction: Sub-Saharan Africa remains challenged by the highest burden of human immunodeficiency virus (HIV), an epidemic of tuberculosis (TB), and increasing number of people with HIV (PWH) on antiretroviral therapy (ART), all of which may result in kidney injury. Methods: This observational cohort study describes the spectrum of kidney disease in PWH in South Africa, between 2005 and 2020. Kidney biopsies were analyzed in 4 time periods as follows: early ART rollout (2005-2009), tenofovir disoproxil (TDF) introduction (2010-2012), TDF-based fixed dose combination (2013-2015), and ART at HIV diagnosis (2016-2020). Logistic regression was used to identify factors associated with HIV-associated nephropathy or focal segmental glomerulosclerosis (HIVAN/FSGS) and tubulointerstitial disease (TID). Results: We included 671 participants (median age 36, interquartile range, 21-44 years; 49% female; median CD4 cell count 162 [interquartile range, 63-345] cells/mm3). Over time, ART (31%-65%, P < 0.001), rate of HIV suppression (20%-43%, P < 0.001), nonelective biopsies (53%-72%, P < 0.001), and creatinine at biopsy (242-449 µmol/l, P < 0.001) increased. A decrease in HIVAN (45%-29% P < 0.001) was accompanied by an increase in TID (13%-33%, P < 0.001). Granulomatous interstitial nephritis accounted for 48% of TID, mostly because of TB. Exposure to TDF was strongly associated with TID (adjusted odds ratio 2.99, 95% confidence interval 1.89-4.73 P < 0.001). Conclusion: As ART programs intensified and increasingly used TDF, the spectrum of kidney histology in PWH evolved from a predominance of HIVAN in the early ART era to TID in recent times. The increase in TID is likely due to multiple exposures that include TB, sepsis, and TDF as well as other insults.