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We investigated the influence of some estradiol derivatives on the thermal and structural properties of binary mixtures of cholesteryl enantate and cholesteryl myristate. The characterization of the mesophases was made by polarizing optical microscopy, differential scanning calorimetry and X-ray diffraction. A considerable shift of the phase transition temperature I→Ch, as well as the temperature of formation of the SmA* phase was observed. Besides phase sequences and phase transition temperatures the measurements enabled the determination of some molecular parameters of the mixtures: the thickness of smectic layers and the longitudinal spacing distance in the cholesteric phase (d) and the average distance between the long axes of neighboring molecules (D). [ABSTRACT FROM AUTHOR]

Background: Although chronic subjective tinnitus is one of the most common symptoms, the background of its pathophysiological mechanism and etiology is not fully understood. No studies are exploring various affective temperaments in persons with chronic tinnitus. Methods: We included in this study 57 patients with tinnitus who filled out the Serbian 41-item version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto questionnaire (TEMPS-A) and a short sociodemographic questionnaire. Patients were assessed using audiometry (measuring the hearing threshold for frequencies of 250, 500, 1,000, 2,000, 4,000, and 8,000 Hz) and tympanometry. Results: Our research showed that patients with chronic tinnitus predominantly had anxious affective temperament [anxious-cognitive (AnxC): 26.23 %, anxious-somatic (AnxS): 25.6 %). AnxS was dominant in people without hearing loss (46 %) and males (37.39 %). AnxC was dominant in people with a significant hearing loss and females (30.3 %). Both AnxS and AnxC temperaments correlated with hearing loss in the right ear more than in the left one. Conclusion: Our study revealed that anxious temperaments (AnxC and AnxS) were predominant in patients with chronic subjective tinnitus. Affective temperaments could play a significant role in explaining this disorder's currently unclear pathophysiology of, but further research is needed. HIPPOKRATIA 2020, 24(2): 77-83. [ABSTRACT FROM AUTHOR]

Objective: Bipolar disorders (BD) are characterized by highly recurrent nature, necessitating adequate maintenance treatment for long-term disorder control. This study aimed to investigate real-world prescribing patterns among outpatients with BD, focusing on the utilisation of antidepressants (AD) and benzodiazepines (BDZ)., Methods: We analysed prescription patterns of the five main groups of psychotropic medications (antipsychotics, mood stabilizers, AD, BDZ, and anticholinergic medications) and their relationships with basic socio-demographic and clinical data in a sample of 107 clinically stable BD outpatients (75.7% female, age 44.8 ± 11.7)., Results: Maintenance therapy predominantly involved polypharmacy (92.5%), with mood stabilizers (87.9%) and antipsychotics (80.4%, predominantly second-generation) being the most commonly prescribed. Our findings highlight a high percentage of patients prescribed AD (50.5%) and BDZ (54.2%). BDZ patients, compared to the non-BDZ group in maintenance treatment, were significantly older with longer psychiatric history and a decreased likelihood of comorbid personality disorder diagnoses., Conclusions: This study offers insights into prescribing practices within a university psychiatric clinic in the Western Balkans. The prevalent use of polypharmacy in real-world clinical settings, along with high percentage of patients prescribed AD and BDZ, suggests a gap between guideline recommendations and clinical practice, indicating a lack of consensus or standardized approaches in clinical practice.

Objective: Various factors may influence the attitudes of medical students towards euthanasia, including personal values, beliefs, and personality traits. The objective of this study was to examine the attitudes of 2 nd and 5 th year medical students about euthanasia and the relationship between these attitudes and students' personality traits., Methods: Medical students from the Universities of Kragujevac and Belgrade, Serbia, participated in this study. A questionnaire was administered assessing attitudes toward euthanasia and student personality traits (honesty-humility, emotionality, extraversion, agreeableness, conscientiousness, and openness using the HEXACO-60)., Results: More than 50% of students in the second year and 60% of students in the fifth year were supportive of euthanasia. Students in the 5 th year were 2.5 times more likely to express a concern that euthanasia needs to be clearly regulated by law compared to students in the second year. Adjusted analyses indicated that lower levels of honesty-humility and emotionality were positively correlated with students' belief that euthanasia should be legalized., Conclusion: Many medical students in Serbia have a positive attitude towards euthanasia. It is important to consider the possible influences of culture, religion, and the law on attitudes towards euthanasia. Undergraduate medical training should include more hours dedicated to palliative care and end-of-life topics to raise awareness of patients' preferences in this regard., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The Brief Psychiatric Rating Scale (BPRS) is a useful tool for measuring the severity of psychopathological symptoms among patients with psychosis. Many studies, predominantly in Western countries, have investigated its factor structure. This study has the following aims: (a) to further explore the factor structure of the BPRS-Expanded version (BPRS-E, 24 items) among outpatients with psychotic disorders in Southeast European countries; (b) to confirm the identified model; and (c) to investigate the goodness-of-fit of the three competing BPRS-E factor models derived from previous studies. The exploratory factor analysis (EFA) produced a solution with 21 items grouped into five factors, thus supporting the existence of a fifth factor, i.e., Disorganization. A follow-up confirmatory factor analysis (CFA) revealed a 19-item model (with two items removed) that fit the data well. In addition, the stability of two out of three competing factor models was confirmed. Finally, the BPRS-E model with 5 factors developed in this cross-national study was found to include a greater number of items compared to competing models., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Bajraktarov, Blazhevska Stoilkovska, Russo, Repišti, Maric, Dzubur Kulenovic, Arënliu, Stevovic, Novotni, Ribic, Konjufca, Ristic, Novotni and Jovanovic.)

Background: Maintenance therapy of patients with primary psychosis spectrum disorders (PSD) in the Western Balkans has received limited interest so far. The present study aimed to investigate long-term prescription patterns among outpatients with PSD., Methods: Information about prescription of antipsychotics (AP), benzodiazepines (BZD) and other psychotropic medication over a 6-month period was collected from outpatients ( n = 134; ICD-10 diagnosis F20-29) recruited by a larger multi-site study, to find mean daily number of psychotropic drugs, AP prescription patterns (including AP daily dose, route of administration, monotherapy vs . polypharmacy) and BZD utilization (long-term add-on BZD therapy). Additionally, sex-differences in the variables were explored., Results: Clinically stable outpatients (age 41.7 ± 11.0; male 62.7%; duration of untreated illness 12.7 ± 8.7 years; mean number of lifetime hospitalizations 2.6 ± 0.7) were prescribed 2.8 ± 1.1 psychotropic medications daily. The mean 6-month AP dose was 14.2 ± 7.8 mg olanzapine equivalents. Long-acting injectable AP was prescribed to 25.2% of the patients. Long-term AP monotherapy was found in 52.7% patients and most of them were prescribed second generation AP (65.2%). Long-term AP polypharmacy (42.7%) was more common in males ( p = 0.015). The most frequent co-prescription patterns were first generation AP plus clozapine. The highest rate of long-term AP co-prescription was found for BZD (in 42.7% cases, average 6-months daily dose of 2.8 ± 2.7 mg lorazepam equivalents) and anticholinergics (33.6%)., Conclusion: Existing appropriately designed interventions aiming to safely switch the inappropriate therapeutic regimens, i.e. very high prevalence of long-term AP polypharmacy and non-rational BZD co-prescription, should be implemented in the region of Western Balkans., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Maric, Andric Petrovic, Russo, Jerotic, Ristic, Savić, Pemovska, Milutinovic, Ribic, Markovska-Simoska, Dzubur Kulenovic and Jovanovic.)

The degree of polymerization for dimethacrylate resin-based materials (BisGMA, TEGDMA, UDMA, HEMA) ranges from 55 to 75%. Literature data indicate that polymerization efficacy depends, among other factors, on the type of methacrylate resin comprising the material. The aim of this study was to evaluate the polymerization efficacy of four dental cement materials characterized by different polymerization mechanisms using FTIR analysis. In the present study, the FTIR method was adopted to analyze the degree of polymerization efficacy of four resin-based dental cement materials, two of which were self-cured and two were dual-cured cements. The IR spectral analysis was performed 24 h after the polymerization of the cementitious material. RelyX ARC cement exhibits the lowest polymerization efficacy (61.3%), while that of Variolink II (85.8%) and Maxcem Elite is the highest (90.1%). Although the efficacy of self-cured cements appears to be superior, the difference is not statistically significant ( p = 0.280). Polymerization efficacy largely depends on the chemical structure of the material in terms of the presence of a particular methacrylate resin and less on the polymerization mechanism itself, i.e., whether it is a self-cured or dually cured dental cement. Thus, in clinical practice, cementitious materials with a higher proportion of TEGDMA compared with BisGMA are recommended.

Background: Negative symptoms are core features of schizophrenia and very challenging to be treated. Identification of their structure is crucial to provide a better treatment. Increasing evidence supports the superiority of a five-factor model (alogia, blunted affect, anhedonia, avolition, and asociality as defined by the NMIH-MATRICS Consensus); however, previous data primarily used the Brief Negative Symptoms Scale (BNSS). This study, including a calibration and a cross-validation sample ( n = 268 and 257, respectively) of participants with schizophrenia, used the Clinical Assessment Interview for Negative Symptoms (CAINS) to explore the latent structure of negative symptoms and to test theoretical and data-driven (from this study) models of negative symptoms. Methods: Exploratory factor analysis (EFA) was carried out to investigate the structure of negative symptoms based on the CAINS. Confirmatory factor analysis (CFA) tested in a cross-validation sample four competing theoretical (one-factor, two-factor, five-factor, and hierarchical factor) models and two EFA-derived models. Result: None of the theoretical models was confirmed with the CFA. A CAINS-rated model from EFA consisting of five factors (expression, motivation for recreational activities, social activities, vocational, and close/intimate relationships) was an excellent fit to the data (comparative fix index = 0.97, Tucker-Lewis index = 0.96, and root mean square error of approximation = 0.07). Conclusions: This study cannot support recent data on the superiority of the five-factor model defined by the NMIH-MATRICS consensus and suggests that an alternative model might be a better fit. More research to confirm the structure of negative symptoms in schizophrenia, and careful methodological consideration, should be warranted before a definitive model can put forward and shape diagnosis and treatment of schizophrenia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Russo, Repisti, Blazhevska Stoilkovska, Jerotic, Ristic, Mesevic Smajic, Uka, Arenliu, Bajraktarov, Dzubur Kulenovic, Injac Stevovic, Priebe and Jovanovic.)

The 60-item HEXACO (HEXACO-60) Personality Trait Inventory may be strategically more important for researchers compared to the 100-item HEXACO. The aim of this study was to assess the psychometric properties of the 60-item HEXACO questionnaire in the Serbian language. This cross-sectional study, conducted at three of five Faculties of Medicine during the summer semester of the 2016/2017 academic year, included 617 students. Relevant data were collected by an anonymous questionnaire. Cronbach's α and McDonald's ω coefficients for the total scale were .71 and .72, respectively. Apart from Agreeableness, all other domains showed an adequate level of internal consistency (both Cronbach's α and McDonald's ω coefficients were >.70). Random data eigenvalues obtained on the parallel analysis had higher values than initial exploratory factor analysis eigenvalues up to the sixth factor. Accordingly, it was concluded that six factors should be extracted from the Serbian HEXACO-60. These factors corresponded in item distribution with the original ones. Based on the confirmatory factor analysis, using both 60 items and 24 facets, overall goodness of fit of the Serbian HEXACO-60 was acceptable. Moreover, there were no domains with completely invalid indices, as there were at least two indices that were acceptable for each domain. The Serbian version of the HEXACO-60 has acceptable psychometric properties. This shorter version with 60 items may be more suitable for brief surveys or when the time allocated to fill in a questionnaire is limited., (© 2021 Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.)

Cariprazine is currently approved for the treatment of patients with schizophrenia (USA and EU), and for manic, depressive, and episodes with mixed features in bipolar I disorder (USA): several randomized controlled studies have also explored its efficacy in patients with major depressive disorder. This review summarizes its current therapeutic uses and potential advantages for treating the main symptoms of schizophrenia, bipolar I and major depressive disorder, considering its pharmacodynamic properties, efficacy, and tolerability. Its predominantly D3 receptor preferring affinity, with functional selectivity according to the prevailing neuronal environment, contributes to its efficacy across a wide array of psychopathological symptoms (including reality distortion, disorganized thought, negative symptoms, mood disturbance, anhedonia, and cognitive impairment), and to a favorable side effect profile. Cariprazine may be a "drug of choice" in patients with predominant negative and cognitive symptoms of schizophrenia, as well as those with metabolic syndrome. Further investigation of its relative efficacy when compared to aripiprazole or other active comparators is warranted. Its effectiveness in the treatment of bipolar mania, bipolar I depression and bipolar I episodes with mixed features, with minimal accompanying metabolic changes is well-established. The longer half-life and delayed time to relapse in patients diagnosed with schizophrenia when compared to other second-generation antipsychotics represent other advantages, given the high rates of non-adherence and frequent relapses seen in clinical practice. Its efficacy in overlapping symptom domains in other major psychiatric disorders appears promising., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Batinic, Ristic, Zugic and Baldwin.)

Objective: Despite clozapine being the most effective treatment for treatment-resistant schizophrenia (TRS), a clear explanation as to why it is underutilized and why its initiation is delayed remains unclear. The first aim of the study was to conduct a nation-wide assessment of both the psychiatrists' attitudes of the obstacles for prescribing clozapine as well as their prescription practices. The second aim was to make recommendations, based on the results obtained, for improving the Serbian clozapine guidelines., Methods: A questionnaire was conducted consisting of two parts. One regarded the clinical characteristics of the psychiatrists, while the second contained questions about indications for clozapine initiation, clozapine prescribing tendencies, and barriers to clozapine use. The questionnaire was sent to 302 Serbian psychiatrists., Results: With 161 out of the 302 psychiatrists returning the questionnaires, the response rate was 53.3%. Nearly 60% of the psychiatrists treated 10 or more patients with clozapine, with TRS being the most common indication. Only four psychiatrists (2.5%) had no patients currently on clozapine. Psychiatrists indicated that their fear of agranulocytosis (68%) constituted the greatest obstacle for clozapine prescription, followed closely by weight gain (56%), and sedation (39%). Despite their fear of agranulocytosis, only 83.9% of the psychiatrists monitored leukocytes regularly., Conclusion: In general, psychiatrists in Serbia seem to be confident in prescribing clozapine, even in the absence of clear monitoring guidelines and the possibility of therapeutic drug monitoring. In order to reduce obstacles for clozapine prescription, monitoring laxity, and an overreliance on personal experience, we recommend three modifications of the existing clozapine guideline., Competing Interests: Conflict of interest statement: The authors declare that there is no conflict of interest., (© The Author(s), 2021.)

Background: Although chronic subjective tinnitus is one of the most common symptoms, the background of its pathophysiological mechanism and etiology is not fully understood. No studies are exploring various affective temperaments in persons with chronic tinnitus., Methods: We included in this study 57 patients with tinnitus who filled out the Serbian 41-item version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto questionnaire (TEMPS-A) and a short sociodemographic questionnaire. Patients were assessed using audiometry (measuring the hearing threshold for frequencies of 250, 500, 1,000, 2,000, 4,000, and 8,000 Hz) and tympanometry., Results: Our research showed that patients with chronic tinnitus predominantly had anxious affective temperament [anxious-cognitive (AnxC): 26.23 %, anxious-somatic (AnxS): 25.6 %). AnxS was dominant in people without hearing loss (46 %) and males (37.39 %). AnxC was dominant in people with a significant hearing loss and females (30.3 %). Both AnxS and AnxC temperaments correlated with hearing loss in the right ear more than in the left one., Conclusion: Our study revealed that anxious temperaments (AnxC and AnxS) were predominant in patients with chronic subjective tinnitus. Affective temperaments could play a significant role in explaining this disorder's currently unclear pathophysiology of, but further research is needed. HIPPOKRATIA 2020, 24(2): 77-83., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright 2020, Hippokratio General Hospital of Thessaloniki.)

Background: Structural retinal architecture in living organisms became measurable with the development of optical coherence tomography (OCT) scanners. Single-layer analysis with spectral-domain OCT, among other techniques, may provide further insight into pathological changes in complex brain disorders such as psychosis spectrum disorders (PSD)., Methods: This study investigated potential thinning of retinal layers (retinal nerve fiber layer - RNFL, macular volume, macular thickness, ganglion cell-inner plexiform layer- GC-IPL, optic cup volume and cup-to-disk ratio) using a spectral-domain OCT device in 33 non-acute PSD patients (illness duration 5.9 ± 3.9 years) and 35 healthy controls., Results: In comparison to age and gender matched controls, patients had bilateral reductions in GC-IPL layer thickness and macular volume. Macular central subfield thinning was found in the right eye, while average macular thickness was lower in the left eye only. RNFL thinning was not observed in patients in comparison to controls, but we noticed that status of this layer could be affected by daily dose of antipsychotics and by illness duration., Conclusion: Taken together, our results reveal that retinal thinning is present in young adults with PSDs, but in comparison to the literature we found more prominent changes in both GC-IPL and macular volume/thickness, than in RNFL. Our findings may reflect synaptic loss and neuronal atrophy in non-acute young patients with psychosis., (Copyright © 2019 Elsevier Inc. All rights reserved.)

BACKGROUND While several tests can be used in the laboratory evaluation of composite resin-based cement materials, the push-out test remains the most prevalent. Due to difficulties in sample preparation, as well as a highly complex procedure, we attempted to develop an alternative method for testing the bond strength of dental resin cement materials. MATERIAL AND METHODS Ninety-six experimental samples of 2 dual-cure resin cements and 1 fiber post system were prepared for the 2 testing procedures: the push-out test and the modified Microbond test. The degree of monomer conversion was measured by Fourier-transform infrared spectroscopy. RESULTS The push-out test results indicated that the bond strength of dual-cure resin cement differs depending on the tooth root region to which it is applied (p<0.05), In addition, our findings show that Variolink II exhibits a much lower bond strength relative to RelyX ARC. These findings were confirmed by the modified Microbond test results. The monomer conversion rate results indicate average conversion rates of 85.81% and 61.35% for RelyX ARC and Variolnik II, respectively. CONCLUSIONS Our study confirms the practical utility of the modified Microbond test in the assessment of bond strength of dental cement resin-based materials. The proposed test method is particularly useful given that, relative to the push-out test, it requires a much smaller number of preparation and execution steps, thus reducing the potential for introducing errors, while increasing the reliability of the obtained findings.

Background: Previous studies examining sex-differences in facial emotion recognition (FER) in psychosis yielded inconsistent results. Although females are considered to be superior in FER in health, it remains unclear whether the specific sex-difference is present in psychosis. We aimed to examine whether women and men differ in FER ability in health and in psychosis, and to explore potential sex differences in the illness' effects on FER., Methods: Remitted psychotic patients and controls were assessed using the CANTAB Emotion Recognition Task (ERT) examining accuracies/response latencies in identifying basic emotional expressions. General linear model was performed to assess the effects of group, sex and their interactions on ERT performance., Results: Healthy females showed FER advantage in comparison to healthy males, while the aforementioned sex-difference was not observed in remitted psychotic patients. Our results also demonstrated the existence of overall FER deficit in psychosis in comparison to healthy controls, as well as the differential illness' effects on the recognition accuracy of facial expression of anger in males and females-suggesting that females with psychotic disorders undergo more profound deterioration of FER ability than their male counterparts., Conclusion: The assessment of sex-differences in FER and other important features of psychosis is important for better understanding of its neurobiological basis and for the development of targeted treatments for improved functioning.

Objectives:: Dysphagia and impaired saliva control are common in children and adolescents with congenital and developmental disabilities. The aim of the present review was to investigate the evidence base for oral sensory-motor interventions in children and adolescents with dysphagia or impaired saliva control secondary to congenital or early-acquired disabilities and to make recommendations regarding methods for intervention., Methods:: A review of the literature from 2000 to 2016, including oral sensory-motor intervention studies for children and adolescents (3-18 years of age) with dysphagia or impaired saliva control secondary to congenital or early-acquired disabilities, was performed. The literature search included the PubMed, CINAHL, Medline, SpeechBITE, OVID, ERIC, Cochrane, and Google Scholar databases. Primary studies were evaluated on a 4-grade scale using the Grading of Recommendations Assessment, Development and Evaluation., Results:: Twenty primary studies of oral sensory-motor interventions for dysphagia and 6 studies for the treatment of impaired saliva control fulfilled the inclusion criteria. Of these, 3 were randomized, controlled trials. Five systematic reviews and 16 narrative reviews were also included. Limited and moderately strong recommendations were made on the basis of the grading results from the primary studies. The studies reported good results, but study design was often insufficient, and the study groups were small. The systematic reviews confirmed the lack of high scientific support for oral sensory-motor interventions in children and adolescents with congenital and developmental disabilities., Conclusions:: There is an urgent need for high-quality studies that could serve as the basis for strong recommendations relating to oral sensory-motor interventions for children with dysphagia and impaired saliva control.

Objectives: To evaluate the influence of education and training on quality of tooth color matching., Material and Methods: Dental students (N = 174), matched the color of eight shade tabs in a viewing booth, using VITA Linearguide 3D-Master shade guide. The experimental group had color education and training between the before and after session. The control group did not have any additional information in between two sessions. Color differences between the task tabs and selected tabs were calculated using CIE formulas. The score for the best match (smallest color difference) was 10 points, the 2nd best match 9 points, down to 1 point for the 10th best match. Means and standard deviations were calculated. Differences were analyzed using the Student t-test., Results: Shade matching scores in the experimental group were significantly better after education and training (p < 0.001), with a mean score before and after shade matching sessions of 7.06 (1.19) and 8.43 (0.92), respectively. The percentage of students in the experimental group that selected one of three best matches increased 24.3%. The control group exhibited no significant improvement in the after session., Conclusions: Within the limitations of the study, education and training improved students' shade matching skills., Clinical Significance: While the vast majority of dental restorations and practically all restorations in the esthetic zone are tooth colored, the profession as a whole is far from perfect when it comes to accurate shade matching. Education and training can improve shade matching ability: enhanced esthetics of dental restorations, increased patient satisfaction, and a reduced number of color corrections are some of the notable benefits and rewards. (J Esthet Restor Dent 00:000-000, 2016) J Esthet Restor Dent 28:287-294, 2016)., (© 2016 Wiley Periodicals, Inc.)

Poly(D,L-lactide) synthesis using tin(II) 2-ethylhexanoate initiated ring-opening polymerization (ROP) takes over 30 hours in bulk at 120 °C. The use of microwave makes the same bulk polymerization process with the same initiator much faster and energy saving, with a reaction time of about 30 minutes at 100 °C. Here, the poly(lactide) synthesis was done in a microwave reactor, using frequency of 2.45 GHz and maximal power of 150 W. The reaction temperature was controlled via infra-red system for in-bulk-measuring, and was maintained at 100 °C. Different molar ratios of monomer and initiator, [M]/[I], of 1,000, 5,000 and 10,000 were used. The achieved average molar masses for the obtained polymers (determined by gel permeation chromatography) were in the interval from 26,700 to 112,500 g/mol. The polydispersion index was from 2.436 to 3.425. For applicative purposes, the obtained material was purified during the procedure of microsphere preparation. Microspheres were obtained by spraying a fine fog of polymer (D,L-lactide) solution in tetrahydrofuran into the water solution of poly(vinyl alcohol) with intensive stirring.