Search Results (12)

Background/Objectives: Borderline personality disorder (BPD) is a severe mental disorder characterised by emotion dysregulation, impulsivity and interpersonal hypersensitivity. Its prevalence ranges from 0.5% to 6.4%. Eye tracking and pupillometry provide objective indices of social attention and inhibitory control, but the BPD literature using these techniques has not been systematically reviewed. The aim of this work was to synthesise the empirical evidence on visuo-attentional and pupillary alterations in BPD. Methods: Following the PRISMA 2020 statement, Web of Science, Scopus and PubMed were searched up to 13 March 2026, with no date or language restrictions. Search terms combined borderline personality disorder and eye-tracking constructs. Two reviewers independently screened records with complete inter-rater agreement at the title-and-abstract stage (Cohen’s κ = 1.00); two generative artificial-intelligence assistants (ChatGPT, NotebookLM) were additionally consulted as a non-systematic plausibility check and returned no eligible studies beyond the database search. Risk of bias was appraised with the framework appropriate to each study design (RoB 2 for randomised trials and Newcastle–Ottawa Scale logic for observational studies, with ROBINS-I held in reserve for non-randomised intervention designs). Results: Seventeen studies met the inclusion criteria, with sample sizes ranging from 19 to 164 participants and predominantly adult female samples. Designs included antisaccade and oculomotor tasks, free-viewing, dot-probe, affective priming and pharmacological challenge. Four findings recurred across studies. First, patients with BPD showed an early reflexive vigilance to the eye region of emotional and neutral faces, followed by reduced time on positive stimuli during longer presentations. Second, self-reported impulsivity was elevated, but laboratory inhibition was largely preserved; the deficits that did emerge were limited to preparatory control and were greater in patients with comorbid ADHD or under induced negative affect. Third, autonomic dysregulation was indexed by lower heart-rate variability and a larger baseline pupil size; in a single longitudinal study, pupillary reactivity was prospectively associated with subsequent symptom change. Finally, intranasal oxytocin reduced amygdala-driven vigilance. Conclusions: Eye-tracking and pupillometric measures appear to capture meaningful aspects of the BPD clinical picture. The two-stage profile of early vigilance followed by reduced sustained engagement is most parsimoniously described as a vigilance–avoidance pattern, which is compatible with, but not uniquely explained by, the hypersensitivity hypothesis of emotion dysregulation. Because thirteen of the seventeen studies recruited women only, these conclusions apply primarily to adult women with BPD. Methodological heterogeneity, the predominance of female samples and the scarcity of longitudinal data justify the need for standardised protocols, transdiagnostic comparisons and the inclusion of male and gender-diverse populations in future research. Full article

Non-immersive (screen-based) virtual environments may offer a low-threshold way to elicit clinically relevant emotions while reducing barriers associated with immersive head-mounted displays. This study examined whether a non-immersive virtual scenario simulating a dirty public bathroom is associated with changes in disgust-related and anxiety-related responses in a non-clinical sample of university students, and explored links with obsessive–compulsive tendencies and contamination-related anxiety during the COVID-19 period. A total of 122 participants remotely explored the virtual environment. Before and after exposure, participants completed measures of state anxiety (EMAS-S) and disgust sensitivity (DSR); trait anxiety (EMAS-T), obsessive–compulsive symptoms (OCI-R), fear of COVID-19 (FCS), and engagement/activation during the experience were also assessed. Pre–post differences were tested using paired-sample t-tests, and associations among variables were examined via bivariate correlations. Results indicated a significant post-exposure increase in EMAS-S and DSR scores. Correlational analyses showed robust associations between disgust sensitivity and obsessive–compulsive symptoms, and between trait anxiety and fear of COVID-19. Gender and first-person videogame experience were related to subjective discomfort and activation, with higher levels reported by females and participants without gaming experience. The findings provide preliminary evidence that a remote, screen-based contamination scenario can elicit measurable disgust- and anxiety-related responses and that individual differences may shape subjective impact. However, because the study used a single-group pre–post design without a neutral VR condition or a non-VR control, causal conclusions about the effects of the virtual scenario cannot be drawn. Full article

Background/Objectives: Tick-borne encephalitis (TBE) is the most important tick-borne viral central nervous system (CNS) infection in Europe and Asia. Since the introduction of a vaccine in Austria in the late 1970s, sero-epidemiological studies on the true incidence of tick-borne encephalitis virus (TBEV) infection in the population have been difficult, because it was not possible to distinguish between vaccine- and infection-induced antibodies. The goal of our study has been to analyze the sero-epidemiology of TBEV infections, vaccination protection rate, and manifestation index of the disease in the region of interest. Methods: Applying a newly developed anti-TBEV-NS1-IgG assay and the neutralization test, the protection and infection rates in blood donors of the Austrian Federal State of Upper Austria.It is one of the first areas in Austria, where the TBEV vaccine had been rolled out and broadly used. Samples from blood donors of all districts of the Federal State of Upper Austria were screened for anti-TBEV-IgG. Positive sera were differentiated for infection- and vaccine-induced antibodies. The results were matched with donor age, gender, and geographical origin. Results: 2162 samples were analyzed. A total of 87.0% of the blood donors tested showed anti-TBEV-IgG related to past TBEV vaccination. Within the unvaccinated group, a total of 13.3% of male and 9.9% of female blood donors exhibited anti-TBEV-NS1-IgG, indicating a past TBEV infection. The anti-TBE-NS1-IgG seroprevalence was determined at 74/100,000 for the whole population and at 594/100,000 in the non-vaccinated population. The manifestation index (MI) was calculated at 2.8%. The MI is defined as the probability or percentage of infected individuals who develop clinical symptoms of a disease. Conclusions: Our data provide evidence of a continuing high risk of TBEV infection in the Federal state of Upper Austria. The non-vaccinated population has an eightfold higher infection prevalence compared to the whole population. The MI of TBEV for severe infection seems lower as detailed in previous reports. Full article

Post-Traumatic Stress Disorder (PTSD) is consistently linked to multidimensional working memory (WM) impairments, encompassing deficits in sustained attention, verbal and visuospatial processing, and executive control, with inhibitory dysfunction emerging as a key feature. This scoping review synthesizes evidence from 39 studies examining neurobiological mechanisms, trauma-related factors, genetic and hormonal influences, gender differences, and task-specific variability. Findings indicated that PTSD is associated with altered activation and connectivity in the prefrontal cortex, hippocampus, and related neural networks, often resulting in compensatory but inefficient recruitment patterns. Emotional distraction and comorbidities such as depression, alcohol use, and traumatic brain injury can exacerbate cognitive deficits. Performance impairments are evident across both emotional and neutral WM tasks, with visuospatial and updating processes being particularly vulnerable. Risk factors include chronic trauma exposure, older age, APOE ε4 allele, and the BDNF Val66Met (rs6265) polymorphism, while modulators such as oxytocin, cortisol, and physical activity show potential cognitive benefits under specific conditions. Methodological heterogeneity and limited longitudinal data restrict generalizability. These findings underscore the importance of early screening, targeted cognitive interventions, and inclusion of underrepresented populations to refine prevention and treatment strategies for PTSD-related WM deficits. Full article

Human papillomavirus (HPV) represents the most common sexually transmitted infection worldwide and a major public health challenge. Nearly all sexually active individuals will acquire HPV during their lifetime, with the highest prevalence observed in adolescents and young adults shortly after sexual debut. More than 200 genotypes have been described, ranging from low-risk types, mainly responsible for benign lesions, to high-risk types, which are associated with cervical, anogenital, and head and neck cancers. While most infections are transient and spontaneously cleared by the immune system, persistent high-risk HPV can lead to precancerous lesions and malignant transformation, often in synergy with other sexually transmitted pathogens or in the context of microbiome imbalance. The introduction of vaccines and advanced screening technologies has substantially modified prevention strategies. Vaccination coverage remains heterogeneous, with persistent gaps particularly among males due to cultural, social, and educational barriers. Schools are increasingly recognized as strategic environments to promote awareness, sex education, and gender-neutral vaccination. Innovative approaches such as microbiome modulation, therapeutic vaccines, and liquid biopsy biomarkers are emerging as promising perspectives. This review aims to provide an updated overview of HPV epidemiology, clinical impact, prevention strategies, and future frontiers, with special attention to adolescents as a priority target group. Full article

Background/Objectives: Cervical cancer is a significant issue in Indonesia, with many cases diagnosed at advanced stages. Although the human papillomavirus (HPV) vaccination has long been recommended by the WHO, it was only recently included in Indonesia’s immunization program in 2023. This study aimed to examine the existing prevention strategies and their effectiveness through systematic review of the existing literature. Methods: We searched for cost-effectiveness studies of HPV vaccination in Asia Pacific countries from inception until 23 July 2023, using MEDLINE, Embase, and the Cochrane Library databases. The search strategy included keywords and subject terms for primary prevention, HPV vaccination, cervical cancer, and selected Asia Pacific Countries (Thailand, Vietnam, China, Singapore, Malaysia, Philippines, Korea, Japan, Taiwan, Australia, New Zealand, and Hong Kong). Studies selected were limited to original research articles with full text published in English in peer-reviewed journals, describing the cost-effectiveness of HPV vaccination in cervical cancer prevention in the Asia Pacific countries. Studies were excluded if there were no full text was available, if it was the wrong study design, non-English, or not based in the specific Asia Pacific countries selected. The titles and abstracts were screened, followed by full-text reviews using Covidence software, and analyzed using Excel. Results: Forty-three studies were included for review: 51% in high-income countries (HICs), 37% in upper-middle-income countries (UMICs), and 12% in low-middle-income countries (LMICs). All studies concluded that HPV vaccination is more cost-effective than screening alone. Nonavalent HPV vaccines were more cost-effective in HICs (80%), bivalent vaccines were more cost-effective in UMICs (66%), and gender-neutral vaccination was cost-effective compared to screening in all studies conducted. Conclusions: HPV vaccination is a cost-effective prevention strategy for cervical cancer across all resource settings, offering greater value compared to screening alone. Selecting the most economically viable vaccine type and expanding to gender-neutral vaccination could enhance early prevention efforts. These findings offer guidance for Indonesia in designing evidence-based HPV vaccination policies as a part of national cancer control efforts. Further investigation is necessary to determine the optimal strategy for HPV vaccination in Indonesia. Full article

Testing for high-risk human papillomavirus (HPV) as part of primary cervical cancer screening has become more common recently. The Cobas 6800, an FDA-approved cervical screening platform, detects 14 high-risk HPVs, including HPV16 and HPV18. However, this test is limited to only women, which leads to low screening rates in trans men and other non-binary people. The cervical screening of trans men and other genders, especially those lying on the female-to-male spectrum, is equally important. Furthermore, cisgender males, particularly homosexuals, are also prone to chronic HPV infections and serve as HPV carriers, transmitting it to women and other men through sexual contact. Another limitation of the test is its invasive specimen collection, which induces discomfort and genital dysphoria. Therefore, there is a need for an innovative, less invasive method that would allow the sampling process to be more comfortable. In this study, we assess the performance of the Cobas 6800 for high-risk HPV detection in urine samples spiked with HPV16, HPV18, and HPV68. The limit of detection (LOD) was calculated using a dilution series (1.25–10,000 copies/mL) over a course of three days. Furthermore, the clinical validation was performed by calculating sensitivity, specificity, and accuracy. The limit of detection ranged from 50–1000 copies/mL depending upon the genotype. Moreover, the urine test demonstrated a high clinical sensitivity of 93%, 94%, and 90% for HPV16, HPV18, and HPV68, with 100% specificity. The overall percent agreement was calculated to be 95% for both HPV16 and HPV18, and 93% for HPV68. The high concordance, reproducibility, and clinical performance of the current assay suggest that the urine-based HPV test fulfills the requirements for its use in primary cervical screening. Moreover, it has the potential to be used for mass screening to not only identify high-risk individuals, but also to monitor vaccine effectiveness. Full article

The world is aging, and hemophilia patients are as well. The association between patients with hemophilia (PWH) and low bone mineral density is clear. However, the incidence of fractures in patients with hemophilia is inconclusive, and no research has yet explored repeated fractures among PWH. In this study, we investigated the incidence of all-site fractures, repeated fractures and osteoporotic fractures amongst PWH. The study compared the incidence of all-site fractures, repeated fractures and osteoporotic fractures occurring in all PWH who were enrolled in Taiwan’s National Health Insurance Research Database between 1997 and 2013 with an age- and gender-matched group from the general population. Eight-hundred thirty-two PWH, along with 8320 members of the general population, were included in the final analysis. After multivariate COX regression analysis with an adjustment for confounding factors, it was found that PWH experienced a higher risk of osteoporotic fracture (HR: 1.25 with 95% CI of 1.03–2.52) but only saw a neutral effect with regards to both all-sites of fracture (HR: 1.00 with 95% CI of 0.92–1.09) and repeated fractures (HR: 1.01 with 95% CI of 0.92–1.10), when compared with the general population. This 14-year population-based cohort study showed that PWH had a higher risk of osteoporotic fracture, but that hemophilia only had a neutral effect in all-sites of fracture and repeated fractures. Screening, prevention and treatment for osteoporosis and further osteoporotic fractures among PWH, in order to improve quality of life and achieve healthy aging in this particular population, remain essential. Full article

Recent global data indicates a worldwide increase in polydrug use associated with a shift from recreational to productive habits of consumption. Such non-responsible abuse of substances (alcohol, cocaine, heroin, etc.) is likely to lead to addictive disorders that are characterized by various neuropsychopharmacological effects. A main cognitive function involved in the onset and long-term maintenance of addiction is reactive inhibition, i.e., the ability to withhold a prepotent motor dominant response. In the present study, 63 (poly)drug user patients who were undergoing a detoxification program, in addition to 19 healthy controls matched for gender, age, and education, were subjected to a “contextual Go/No-Go task” with concomitant electroencephalography. Stimuli were superimposed on three contextual backgrounds: control (black screen), drug-unrelated (neutral pictures), or drug-related (pictures related to drug consumption). Of these patients, 23 were cocaine users (CU), 21 were heroin users (HU), and 19 were polydrug users (PDU). The main results showed that (1) at the behavioral level, more commission errors occurred with the PDU patients compared to the healthy controls; (2) at the neurophysiological level, specific alterations were found on classical event-related potentials that index reactive inhibition. Indeed, the higher rate of errors in the PDU group was subtended by both reduced amplitude and latency on the ∆N2 component and increased ∆P3 latency compared to controls. These data clearly suggest a more deleterious impact of polydrug use on inhibitory functions. In addition, our results provide evidence of reduced ERN amplitude in cocaine users, suggesting that impaired performance monitoring and error-processing may support impaired awareness, thereby preventing these patients from changing their behaviors. Full article

Little is known about molecular correlates of chronic tinnitus. We examined interrelationships between vascular–metabolic risk factors, perceived stress, and other routine blood values in patients with chronic tinnitus. Two-hundred patients (51% female) were screened for 49 blood parameters pertaining to vascular–metabolic risk, immune function, and redox processes. They further completed perceived stress- and tinnitus-related distress questionnaires. Following descriptive analyses, gender-specific sets of age- and tinnitus-severity-adjusted regression models investigated associations between perceived stress and blood parameters. Patients reported mildly elevated levels of perceived stress. Elevated levels of total cholesterol (65% and 61% of female and male patients, respectively), non-HDL-c (43/50%), LDL-c (56/59%), and lipoprotein_a (28/14%) were accompanied by high rates of overweight (99/100%) and smoking (28/31%). A low-level inflammatory state was accompanied by reduced reactive oxygen species (ROS)-neutralizing capacity (reduced co-enzyme Q10 and SOD1 levels). Most vascular risk factors were not correlated with perceived stress, except for fibrinogen (ß = −0.34) as well as C-reactive protein (ß = −0.31, p < 0.05) in men, and MCV (ß = −0.26, p < 0.05) in women. Interrelations between blood parameters and stress levels need to be investigated within psychobehavioural frameworks across varying distress levels. Alongside psychological interventions, a low-level inflammatory state may be a route for pharmacological therapeutics. Full article

Understanding the factors involved in the development of broadly neutralizing antibody (bNAb) responses in natural infection can guide vaccine design aimed at eliciting protective bNAb responses. Most of the studies to identify and study the development of bNAb responses have been performed in individuals who had become infected via homo- or heterosexual HIV-1 transmission; however, the prevalence and characteristics of bNAb responses in injecting drug users (IDUs) have been underrepresented. We retrospectively studied the prevalence of bNAb responses in HIV-1 infected individuals in the Amsterdam Cohort, including 50 male and 35 female participants who reported injecting drug use as the only risk factor. Our study revealed a significantly lower prevalence of bNAb responses in females compared to males. Gender, transmission route and CD4+ count at set point, but not viral load, were independently associated with the development of bNAb responses in IDUs. To further explore the influences of gender in the setting of IDU, we also looked into the Swiss 4.5k Screen. There we observed lower bNAb responses in female IDUs as well. These results reveal that the emergence of bNAbs may be dependent on multiple factors, including gender. Therefore, the effect of gender on the development of bNAb responses is a factor that should be taken into account when designing vaccine efficacy trials. Full article

The main objective of the study is to investigate the effects of age of model, gender of ob-server, and lateralization on visual screening patterns while looking at the emotional facial expressions. Data were collected through eye tracking methodology. The areas of interests were set to include eyes, nose and mouth. The selected eye metrics were first fixation dura-tion, fixation duration and fixation count. Those eye tracking metrics were recorded for different emotional expressions (sad, happy, neutral), and conditions (the age of model, part of face and lateralization). The results revealed that participants looked at the older faces shorter in time and fixated their gaze less compared to the younger faces. This study also showed that when participants were asked to passively look at the face expressions, eyes were important areas in determining sadness and happiness, whereas eyes and noise were important in determining neutral expression. The longest fixated face area was on eyes for both young and old models. Lastly, hemispheric lateralization hypothesis regarding emo-tional face process was supported. Full article