The anatomy of COVID-19-related conspiracy beliefs: Exploring their nomological network on a nationally representative sample.

OBJECTIVES: The outbreak of the COVID-19 pandemic was followed by the widespread proliferation of conspiracy beliefs (CBs) regarding the origin and harmfulness of the virus and a high level of hesitancy to vaccinate. We aimed to test a series of hypotheses on the correlates of CBs and vaccination, including socio-demographic factors, personality dispositions, somatic health, stressful experiences during pandemics, and psychological distress. METHOD: The sample (N = 1203), was based on a multistage probabilistic household sampling representative of the general population. The subjects were randomly split into two approximately equal subgroups, enabling cross-validation. Based on the findings in the exploratory, the SEM model was tested in the confirmatory subsample. RESULTS: The correlates of CBs were Disintegration (proneness to psychotic-like experiences), low Openness, lower education, Extraversion, living in a smaller settlement and being employed. The correlates of vaccination were older age, CBs and larger places of living. Evidence on the role of stressful experiences and psychological distress in CBs/vaccination was not found. The findings of moderately strong and robust (cross-validated) paths, leading from Disintegration to CBs and from CBs to vaccination were the most important ones. DISCUSSION: Conspiratorial thinking tendencies-related to health-related behaviour such as vaccination-appear to be, to a considerable extent, manifestations of the mechanisms that are part of our stable, broad, trait-like thinking/emotional/motivational/behavioural tendencies, primarily proneness to psychotic-like experiences & behaviours.

Do people diagnosed with psychosis spectrum disorders share the same personality space as the general population? Big Five complemented by the proneness to psychotic-like experiences/behaviors.

OBJECTIVE: Disintegration is a recently proposed broad, trait-like reconceptualization of the proneness to psychotic-like experiences/behaviors. METHODS: We tested the assumption that the 6-factor model (Five-Factor traits plus Disintegration) was the most adequate one and that it was invariant across clinical and non-clinical populations. The clinical sample (n = 161) consisted of patients who had at least one psychotic episode, duration of illness less than 10 years, currently in remission. The general population (n = 409) was matched with the patient sample by age, gender, and education. NEO PI-R and DELTA were used to measure personality dimensions in both samples. Invariance of one to six-factor solutions was tested by Exploratory Structural Equation Modeling. RESULTS: We found that: (a) several criteria for deciding on the number of factors to retain converged to the conclusion that the assumed 6-factor model was the most adequate one, (b) the assumed factorial structure appeared to satisfy the criteria for the scalar invariance across the two samples, (c) all nine Disintegration subdimensions separated from the Big Five, forming the Disintegration factor, and (d) Disintegration was unrelated to Openness. CONCLUSION: The Big Five personality structure-complemented with disintegration-was invariant across individuals from the general population and patients with psychosis.

Correction: A mathematical model describing the localization and spread of influenza A virus infection within the human respiratory tract.

[This corrects the article DOI: 10.1371/journal.pcbi.1007705.].

Factorial Structure of the Serbian Version of the Clinical Assessment Interview for Negative Symptoms - Evidence for Three Factors of Negative Symptoms.

Introduction: Negative symptoms are a common occurrence in patients with psychosis spectrum disorders. Previous analysis of the latent structure of the Clinical Assessment Interview for Negative Symptoms (CAINS) - which was developed to advance the assessment of negative symptomatology - showed two underlying sub-domains (Motivation and Pleasure; Expression). Recent findings indicate that a more complex structure might be more applicable. Aim: To evaluate the psychometric properties of the Serbian version of the CAINS in a sample of outpatients (N = 67) with psychosis spectrum disorders. Materials and Methods: Negative symptoms and general level of psychopathology were assessed with Serbian translations of the CAINS, the 53-item version of the Brief Symptom Inventory (BSI), and the 24-item version of the Brief Psychiatric Rating Scale (BPRS). Principal component analysis (PCA) was carried out on the CAINS items, and correlation analyses were done to assess its convergent and discriminant validity. Results: Our results showed an excellent internal consistency (Cronbach's alpha = 0.92). PCA revealed a three-component solution consisting of Expressiveness and Motivation for Social and Family Relationships (Factor 1), Motivation for Vocational Activities (Factor 2), and Motivation for Recreation (Factor 3). Convergent validity was supported by significant correlations with the Negative symptoms domain of the BPRS (Factor 1, 0.695, p < 0.01; Factor 2, 0.352, p < 0.05; Factor 3, 0.452, p < 0.01). When assessing discriminant validity, weak correlations were found with BPRS and BSI scores. Conclusion: The Serbian version of CAINS is a valid, reliable and useful tool for the assessment of negative symptomatology. Our findings support a three-factor structure of CAINS, which indicates that the construct is more complex than envisaged by the original conceptualization of two distinct factors.

Correction: A mathematical model describing the localization and spread of influenza A virus infection within the human respiratory tract.

[This corrects the article DOI: 10.1371/journal.pcbi.1007705.].

Maintenance phase treatment of psychotic disorders in outpatients from Serbia - focus on long-term benzodiazepine use.

Introduction: Prescribing trends in maintenance therapy of patients with primary psychotic disorders (PSD) may vary worldwide. Present study aimed to investigate prescription patterns in a sample of outpatients with PSD from Serbia.Methods: In a sample of 73 PSD outpatients we analysed the rate of antipsychotic polypharmacy and psychotropic polypharmacy, concomitant continual benzodiazepine use, and associations between therapy, psychotic symptoms and quality of life.Results: Maintenance therapy (median daily dose 321 mg of chlorpromazine equivalents) predominantly consisted of monotherapy with second generation antipsychotics (45.2%), followed by antipsychotic polypharmacy based on first and second generation combination (25.0%). The median number of psychotropic drugs was 3. Benzodiazepines were continually prescribed to more than 60% of patients (mean daily dose 2.9 ± 2.0 mg lorazepam equivalents). Patients with benzodiazepine use had significantly more psychotropic medications and more antipsychotic polypharmacy, poorer quality of life and more severe psychopathology in comparison to another group.Conclusion: The present study demonstrated new information regarding the prescription patterns of psychotropic drugs in outpatients with PSD in Serbia, amplified with clinically relevant information. This study also revealed distinct prescription patterns concerning antipsychotic/benzodiazepine polypharmacy. Overall, such findings are likely to contribute to improving clinical practice and care for patients with PSD in general.KeypointsPresent exploratory research aimed to elucidate trends of antipsychotics polypharmacy and concomitant use of psychotropic medications including benzodiazepines in the maintenance treatment of outpatients with schizophrenia and other psychotic disorders, amplified with clinically relevant information (symptoms and quality of life).'Antipsychotic (AP) polypharmacy' was defined as concurrent use of more than one AP for at least 1 month; 'Psychotropic polypharmacy' was defined as the combination of AP and a different class of psychotropic drugs medication for at least one month.The median number of prescribed psychotropic drugs was 3 (mean 3.1 ± 1.1) and the average AP daily dose was moderate (median 321 mg of chlorpromazine equivalents). However, the rates of AP polypharmacy (45.2%) and benzodiazepine prescription on a continual basis (>60%) found in our sample could be considered relatively high.Outpatients with higher AP daily dose and higher BPRS symptom score were receiving more benzodiazepines.For improvement of the local, as well as general clinical practice and care for patients with psychotic disorders, and for education in psychiatry, such analyses need to be done on a regular basis and on larger samples.

A mathematical model describing the localization and spread of influenza A virus infection within the human respiratory tract.

Within the human respiratory tract (HRT), virus diffuses through the periciliary fluid (PCF) bathing the epithelium. But virus also undergoes advection: as the mucus layer sitting atop the PCF is pushed along by the ciliated cell's beating cilia, the PCF and its virus content are also pushed along, upwards towards the nose and mouth. While many mathematical models (MMs) have described the course of influenza A virus (IAV) infections in vivo, none have considered the impact of both diffusion and advection on the kinetics and localization of the infection. The MM herein represents the HRT as a one-dimensional track extending from the nose down towards the lower HRT, wherein stationary cells interact with IAV which moves within (diffusion) and along with (advection) the PCF. Diffusion was found to be negligible in the presence of advection which effectively sweeps away IAV, preventing infection from disseminating below the depth at which virus first deposits. Higher virus production rates (10-fold) are required at higher advection speeds (40 µm/s) to maintain equivalent infection severity and timing. Because virus is entrained upwards, upper parts of the HRT see more virus than lower parts. As such, infection peaks and resolves faster in the upper than in the lower HRT, making it appear as though infection progresses from the upper towards the lower HRT, as reported in mice. When the spatial MM is expanded to include cellular regeneration and an immune response, it reproduces tissue damage levels reported in patients. It also captures the kinetics of seasonal and avian IAV infections, via parameter changes consistent with reported differences between these strains, enabling comparison of their treatment with antivirals. This new MM offers a convenient and unique platform from which to study the localization and spread of respiratory viral infections within the HRT.

Prostatectomía radical laparoscópica. ¿Afecta la anatomía patológica de la pieza en la forma de seguimiento posterior? / Laparoscopic radical prostatectomy. Does the histopathological examination of the specimen have an effect on the postoperavie follow-up?

OBJETIVO. Analizar la capacidad predictiva del Gleason definitivo, la afectación extracapsular y la afectación de márgenes respecto a la recurrencia bioquímica y al PSA Doubling Time, en pacientes con prostatectomía radical. MATERIAL Y MÉTODO. Estudio retrospectivo. Se realizó un análisis de supervivencia de Kaplan-Meyer y una comparación de medias del PSA DT mediante la “t” de Student. RESULTADOS. De 110 pacientes estudiados, 9 presentaron recidiva bioquímica. La media de seguimiento fue de 22.57 meses. La media de meses libres de recurrencia bioquímica fue de 65.28 meses para Gleason <7 y de 35.29 meses para ?7 (p=0.03). La media de PSA DT en el grupo con afectación extracapsular fue de 24.83 meses mientras que en los que no la tenían fue de 35.66 (p=0,028). CONCLUSIONES. Pese al limitado número de pacientes y el escaso tiempo de seguimiento demostramos que un Gleason elevado, o la afectación extracapsular pueden indicar la necesidad de un seguimiento más exhaustivo (AU)

OBJECTIVE. Our aim was to analyze the predictive ability of final Gleason score, extracapsular extension and peritumoral margins affection with regard to the biochemical relapse and the PSA Doubling Time, in patients treated with radical prostatectomy. MATERIAL AND METHODS. Retrospective study. The Kaplan Meier method was used for survival analysis. The nonpaired Student's t test was used to compare the mean PSA DT. RESULTS. Of the 110 patients studied, 9 presented biochemical relapse. Median follow-up period was 22.57 (DE 16,2) months. Mean time from surgery to biochemical relapse was 65.28 months for Gleason <7 and 35.29 months for ?7 (p=0.03). The average PSA-DT for the patients in the group with extracapsular affection was 24.83 months whereas in the group without extension it was 35.66 (p=0.028). CONCLUSIONS. Despite the limited number of patients and the scarce follow-up time, our study suggests that patients with high Gleason grade or extracapsular affection are likely to need of a more exhaustive control (AU)

[Stigmatization of a person visiting psychiatrist depends on observer's gender].

INTRODUCTION: The two types of stigmatization are social stigma, which includes discrimination, underestimation and distance in various social circumstances and personal stigma, which includes private relation i.e. a contact in person with stigmatized subject. Majority of recent publications has shown gender asymmetry in stigmatization (mostly indicating male predominance in stigmatizing processes), whereas the opposite data can be also found in some publications. The present study was aimed at exploring the relation of students' gender with their tendency to stigmatize subjects visiting a psychiatrist and at analyzing whether the gender influences the process of stigmatization. MATERIAL AND METHODS: The survey included 523 students (227 on the second and 296 on the sixth year of School of Medicine, University of Belgrade). The instrument consisted of a vignette with questionnaire (14 items). Four versions of vignette were distributed: with/without "label" and male/female subject in the vignette. RESULTS: A more personal stigmatization was evident in the female students (p < 0.05). while no gender-differences existed in social stigmatization (p > 0.05). The stigmatization positively correlated with the intimacy of student's relation with the subject going to a psychiatrist. A higher rate of stigmatization was evident if the vignette was showing a person of the opposite gender. DISCUSSION AND CONCLUSION: This is a unique study which analyzes separately the gender of a stigmatizing subject versus the subject being stigmatized and types of stigmatization. The data obtained should contribute to recognizing, understanding and controlling the widespread problem of stigma.

Hepatic abscess secondary to a rosemary twig migrating from the stomach into the liver.

The ingestion of a foreign body that penetrates the gastric wall and migrates to the liver, where it causes an abscess is uncommon. A case of an ingested rosemary twig perforating the gastric antrum, then migrating to the liver, complicated by hepatic abscess and Staphylococcus aureus sepsis is reported. A 59-year-old man without a history of foreign body ingestion was admitted to our hospital because of sepsis and epigastralgia, which had progressively worsened. No foreign body was identified at preoperative imaging, but a rosemary twig was discovered during laparotomy. The liver abscess and sepsis were controlled successfully with surgery and antibiotics. This unusual condition should be kept in mind when dealing with cases of hepatic abscess, or even sepsis of unknown origin. Despite the improvement of non-surgical techniques such as percutaneous drainage and interventional endoscopy, surgery still remains important in the treatment of hepatic abscess caused by an ingested foreign body.

[Effects of nitrous oxide on middle ear pressure].

INTRODUCTION: Recent literature data suggest that permanent or reversible hearing loss may occur after general anesthesia. The etiology varies, while hearing loss following middle ear surgery is attributed to exposure to nitrous oxide (N,0). The objective of our study was to measure, using tympanometry, the middle air pressure change caused by nitrous oxide during general anesthesia and to establish its emetogenic effects during the postoperative period. MATERIAL AND METHODS: This academic (non-commercial) prospective study included two groups of patients (a total of 58), with ASA status I, II and III. The study group (n 30) consisted of patients undergoing unilateral ear surgery. In this group, the intratympanic pressure was measured in the unoperated (healthy) ear before and during the surgery. The control group (n 28) patients underwent nose, throat or neck surgical interventions. This group underwent measurement of bilateral intratympanic pressure in healthy ears, before and during the surgery. Both groups were operated under general balanced anesthesia. Pain, nausea and antiemetics were monitored during the first 24 postoperative hours. Statistical analysis was performed using the Mann-Whitney-Wilcoxon test. RESULTS: This perioperative study confirmed the following: highly significant (p < 0.001) increase in intratympanic pressure in nonoperated ears in the study group and significant (p < 0.05) in controls. However, there was no statistical significance (p > 0.05) between groups. Pain was more freguent in controls, and nausea in the study group, but without significant difference (p > 0.05). CONCLUSIONS: Postoperative audiometry findings showed no conductive or sensorineural hearing loss after interventions. Nitrous oxide can be used in general balanced anesthesia with discontinuation 15 to 45 minutes before insertion of the tvmpanic membrane and completion of middle ear surgery.

The role of exocytosis in the apocrine secretion of milk lipid globules in mouse mammary gland during lactogenesis.

Functional relations between exocytotic vesicle membranes, plasmalemma and milk fat globule membranes (MFGM) were studied during the final stages of mouse mammary gland differentiation, in the gland during full lactation and in the postpartum gland in which the synthesis of secretory products was partly inhibited by application of 2-Br-alpha-ergocryptine. Analysis of ultrathin sections, freeze-fracture replicas, scanning electron microscopy and application of a cytochemical marker filipin showed that the apocrine secretion of lipid globules was closely related to the exocytosis of milk proteins. During the last days of gestation the secretion of lipid globules resulted from many exocytotic events of the secretory vesicles that accumulated and fused around the cytoplasmic lipid droplets. Seldom the lipid droplet protruded partly into the gland lumen and a part of its surface became covered with the apical plasmalemma. Although apical plasmalemma became more important in the formation of MFGM in the postpartum period, we could still confirm a direct contribution of secretory vesicle membranes to the final detachment of the lipid globule. The application of 2-Br-alpha-ergocryptine hindered the apocrine secretion of the lipid globules and a situation similar to the situation in the prepartum gland was observed.