The analgesic effects and neural oscillatory mechanisms of virtual reality scenes based on distraction and mindfulness strategies in human volunteers.

BACKGROUND: Virtual reality (VR) has been widely used as a non-pharmacological adjunct to pain management. However, there is no consensus on what type of VR content is the best for pain alleviation and by what means VR modulates pain perception. We used three experiments to explore the analgesic effect of VR scenes in healthy adult volunteers. METHODS: We first compared the effect of immersive VR on pain perception with active (i.e. non-immersive, two-dimensional video) and passive (i.e. no VR or audiovisual input) controls at both subjective perceptual (Experiment 1) and electrophysiological (electroencephalography) levels (Experiment 2), and then explored possible analgesic mechanisms responsible for VR scenes conveying different strategies (e.g. exploration or mindfulness; Experiment 3). RESULTS: The multisensory experience of the VR environment lowered pain intensity and unpleasantness induced by contact heat stimuli when compared with two control conditions (P=0.001 and P<0.001, respectively). The reduced pain intensity rating correlated with decreased P2 amplitude (r=0.433, P<0.001) and increased pre-stimulus spontaneous gamma oscillations (r=-0.339, P=0.004) by 32-channel electroencephalography. A VR exploration scene induced a strong sense of immersion that was associated with increased pre-stimulus gamma oscillations (r=0.529, P<0.001), whereas a VR mindfulness meditation scene had a minor effect on immersive feelings but induced strong pre-stimulus alpha oscillations (r=-0.550, P<0.001), which led to a comparable analgesic effect. CONCLUSIONS: Distinct neural mechanisms are responsible for VR-induced analgesia, deepening our understanding of the analgesic benefits of VR and its neural electrophysiological correlates. These findings support further development of digital healthcare.

Long-term post-traumatic stress symptoms in COVID-19 survivors and its risk factors: a two-year longitudinal cohort study.

The COVID-19 pandemic has led to widespread mental health problems, necessitating the investigation of longitudinal mental health changes, associated risk factors, and neural mechanisms in survivors. We recorded demographics, mental health, social support, and potential exposures in survivors at 3 months (n = 189), 6 months (n = 47), and 2 years (n = 69) post-discharge and collected brain imaging data at the second timepoint. Control groups included non-COVID-19 locals (3 months: n = 188, 6 months: n = 42, 2 years: n = 71). Results indicated that female survivors exhibited higher post-traumatic stress symptoms (PTSS) and depression levels than female controls for up to 2 years, along with higher anxiety level for up to 6 months. Male survivors had higher PTSS, depression, and anxiety levels than male controls at 2 months. Moreover, COVID-related trauma and low social support were risk factors for PTSS and negative emotions in survivors. Neuroimaging revealed increased amygdala activity in male survivors and correlations between hippocampus activity and depression symptoms as well as between right hippocampus activity and social support. Our study emphasized the importance of monitoring mental wellness in COVID-19 survivors and underscored the crucial role of social support in mitigating mental health problems.

Risk Factors for Admission Within a Hospital-Based COVID-19 Home Monitoring Program.

Background: Despite increasing vaccination rates, coronavirus disease 2019 (COVID-19) continues to overwhelm heath systems worldwide. Few studies follow outpatients diagnosed with COVID-19 to understand risks for subsequent admissions. We sought to identify hospital admission risk factors in individuals with COVID-19 to guide outpatient follow-up and prioritization for novel therapeutics. Methods: We prospectively designed data collection templates and remotely monitored patients after a COVID-19 diagnosis, then retrospectively analyzed data to identify risk factors for 30-day admission for those initially managed outpatient and for 30-day re-admissions for those monitored after an initial COVID-19 admission. We included all patients followed by our COVID-19 follow-up monitoring program from April 2020 to February 2021. Results: Among 4070 individuals followed by the program, older age (adjusted odds ratio [aOR], 1.05; 95% CI, 1.03-1.06), multiple comorbidities (1-2: aOR, 5.88; 95% CI, 2.07-16.72; ≥3: aOR, 20.40; 95% CI, 7.23-57.54), presence of fever (aOR, 2.70; 95% CI, 1.65-4.42), respiratory symptoms (aOR, 2.46; 95% CI, 1.53-3.94), and gastrointestinal symptoms (aOR, 2.19; 95% CI, 1.53-3.94) at initial contact were associated with increased risk of COVID-19-related 30-day admission among those initially managed outpatient. Loss of taste/smell was associated with decreased admission risk (aOR, 0.46; 95% CI, 0.25-0.85). For postdischarge patients, older age was also associated with increased re-admission risk (aOR, 1.04; 95% CI, 1.01-1.06). Conclusions: This study reveals that in addition to older age and specific comorbidities, the number of high-risk conditions, fever, respiratory symptoms, and gastrointestinal symptoms at diagnosis all increased odds of COVID-19-related admission. These data could enhance patient prioritization for early treatment interventions and ongoing surveillance.

Time to SARS-CoV-2 PCR Clearance in Immunocompromising Conditions: Is Test-Based Removal From Isolation Necessary in Severely Immunocompromised Individuals?

To determine the association between immunosuppression and time to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) clearance, we studied 3758 adults retested following initial SARS-CoV-2 infection. Cox proportional hazards models demonstrated delayed PCR clearance with older age, multiple comorbidities, and solid organ transplant but not by degree of immunocompromise. These findings challenge current retesting practices.

Phylogenetic relationships of four endemic genera of the Phasianidae in China based on mitochondrial DNA control-region genes.

The taxonomic status of some genera within the Phasianidae remains controversial. To demonstrate the phylogenetic relationships of four endemic genera (Tetraophasis, Ithaginis, Crossoptilon and Chrysolophus) and other 11 genera of Phasianidae in China, a total of 1070 nucleotides of mitochondrial DNA (mtDNA) control-region genes were sequenced. There are 376 variable sites including 345 parsimony sites. The genetic distance ranged from 0.067 (Chrysolophus and Phasianus) to 0.181 (Perdix and Bambusicola) among the 15 genera. Maximum likelihood method was used to construct a phylogenetic tree, which grouped all the genera into two deeply divergent clades. Perdix was shown to be a non-partridge genus. Alternatively, it appears ancestral to either partridges or pheasants. The sibling taxa of the four endemic genera were Lophophorus, Tragopan, Lophura and Phasianus, respectively. Calibrated rates of molecular evolution suggested that the divergence time between the four genera and related taxa was 4.00-5.00 million years ago, corresponding to the Pliocene. Considering their molecular phylogenetics, fossil and geographical distribution patterns, the four endemic genera might have originated in the southwestern mountains in China.

Potentially Avoidable Hospital Readmissions in Patients With Advanced Cancer.

PURPOSE: Patients with cancer often prefer to avoid time in the hospital; however, data are lacking on the prevalence and predictors of potentially avoidable readmissions (PARs) among those with advanced cancer. METHODS: We enrolled patients with advanced cancer from September 2, 2014, to November 21, 2014, who had an unplanned hospitalization and assessed their patient-reported symptom burden (Edmonton Symptom Assessment System) at the time of admission. For 1 year after enrollment, we reviewed patients' health records to determine the primary reason for every hospital readmission and we classified readmissions as PARs using adapted Graham's criteria. We examined predictors of PARs using nonlinear mixed-effects models with binomial distribution. RESULTS: We enrolled 200 (86.2%) of 232 patients who were approached. For these 200 patients, we reviewed 277 total hospital readmissions and identified 108 (39.0%) of these as PARs. The most common reasons for PARs were premature discharge from a prior hospitalization (30.6%) and failure of timely follow-up (28.7%). PAR hospitalizations were more likely than non-PAR hospitalizations to experience symptoms as the primary reason for admission (28.7% v 13.0%; P = .001). We found that married patients were less likely to experience PARs (odds ratio, 0.30; 95% CI, 0.15 to 0.57; P < .001) and that those with a higher physical symptom burden were more likely to experience PARs (odds ratio, 1.03; 95% CI, 1.01 to 1.05; P = .012). CONCLUSION: We observed that a substantial proportion of hospital readmissions are potentially avoidable and found that patients' symptom burdens predict PARs. These findings underscore the need to assess and address the symptom burden of hospitalized patients with advanced cancer in this highly symptomatic population.

{µ-6,6'-Dieth-oxy-2,2'-[ethane-1,2-diylbis(nitrilo-methyl-idyne)]diphenolato}trinitratoholmium(III)nickel(II).

In the title heteronuclear Ni(II)-Ho(III) complex (systematic name: {µ-6,6'-dieth-oxy-2,2'-[ethane-1,2-diylbis(nitrilo-methyl-idyne)]diphenolato-1κ(4)O(1),O(1'),O(6),O(6'):2κ(4)O(1),N,N',O(1')}trinitrato-1κ(6)O,O'-holmium(III)nickel(II)), [HoNi(C(20)H(22)N(2)O(4))(NO(3))(3)], with the hexa-dentate Schiff base compartmental ligand N,N'-bis-(3-ethoxy-salicyl-idene)ethyl-enediamine (H(2)L), the Ho and Ni atoms are doubly bridged by two phenolate O atoms of the Schiff base ligand. The coordination of Ni is square-planar with the donor centers of two imine N atoms and two phenolate O atoms. The holmium(III) center has a tenfold -coordination environment of O atoms, involving the phenolate O atoms, two eth-oxy O atoms and two O atoms each from the three nitrates. Weak C-H⋯O and O⋯Ni [3.383 (4) Å] inter-actions generate a two-dimensional zigzag sheet.

{µ-6,6'-Dimeth-oxy-2,2'-[ethane-1,2-diylbis(nitrilo-methyl-idyne)]diphenolato}-µ-nitrato-dinitratoholmium(III)zinc(II).

In the title heteronuclear Zn(II)-Ho(III) complex (systematic name: {µ-6,6'-dimeth-oxy-2,2'-[ethane-1,2-diylbis(nitrilo-methyl-idyne)]diphenolato-1κ(4)O(1),O(1'),O(6),O(6'):2κ(4)O(1),N,N',O(1'))-µ-nitrato-1:2κ(2)O:O'-dinitrato-1κ(4)O,O'-holmium(III)zinc(II)), [HoZn(C(18)H(18)N(2)O(4))(NO(3))(3)], with the hexa-dentate Schiff base compartmental ligand N,N'-bis-(3-methoxy-salicyl-idene)ethyl-enediamine (H(2)L), the Ho and Zn atoms are triply bridged by two phenolate O atoms of the Schiff base ligand and one nitrate ion. The five-coordinate Zn atom is in a square-pyramidal geometry with the donor centers of two imine N atoms, two phenolate O atoms and one of the bridging nitrate O atoms. The Ho(III) center has a ninefold coordination environment of O atoms, involving the phenolate O atoms, two meth-oxy O atoms, two O atoms from two nitrate ions and one from the bridging nitrate ion. Weak inter-molecular C-H⋯O inter-actions generate a two-dimensional double-layer structure.

Simulated warming enhances biological invasion of Solidago canadensis and Bidens frondosa by increasing reproductive investment and altering flowering phenology pattern.

Phenological and reproductive shifts of plants due to climate change may have important influences on population dynamics. Climate change may also affect invasive species by changing their phenology and reproduction, but few studies have explored this possibility. Here, we investigated the impact of climate change on the phenology, reproduction and invasion potential of two alien Solidago canadensis and Bidens frondosa and one native weed, Pterocypsela laciniata, all of which are in the Asteraceae family. The three species responded to simulated climate change by increasing reproductive investments and root/leaf ratio, prolonging flowering duration, and while the two alien species also displayed a mass-flowering pattern. Moreover, our experimental results indicated that the alien invasive species may have greater phenological plasticity in response to simulated warming than that of the native species (P. laciniata). As such, climate change may enhance the invasion and accelerate the invasive process of these alien plant species.

Simulated warming shifts the flowering phenology and sexual reproduction of Cardamine hirsuta under different Planting densities.

Climate warming can shift the reproductive phenology of plant, and hence dramatically reduced the reproductive capacity both of density-dependent and -independent plant species. But it is still unclear how climate warming affects flowering phenology and reproductive allocation of plant under different planting densities. Here, we assessed the impact of simulated warming on flowering phenology and sexual reproduction in the ephemeral herb Cardamine hirsuta under four densities. We found that simulated warming delayed the onset of flowering averagely for 3.6 days but preceded the end of flowering for about 1 day, which indicated climate warming shortened the duration of the flowering. And the flowering amplitude in the peak flowering day also dramatically increased in the simulated warming treatment, which caused a mass-flowering pattern. Climate warming significantly increased the weights of the fruits, seeds and seed, but reduced fruit length and sexual reproductive allocation under all the four densities. The duration of flowering was shortened and the weights of the fruits, seeds and seed, and sexual reproductive allocation were reduced under The highest density.

Combination of longitudinal and circumferential three-dimensional esophageal dose distribution predicts acute esophagitis in hypofractionated reirradiation of patients with non-small-cell lung cancer treated in stereotactic body frame.

PURPOSE: To evaluate dosimetric predictors of acute esophagitis (AE) and clinical outcome of patients with non-small-cell lung cancer (NSCLC) receiving reirradiation. METHODS AND MATERIALS: Seventeen patients with NSCLC received reirradiation to the lung tumors/mediastinum, while immobilized in stereotactic body frame (SBF). CT simulation and hypofractionated three-dimensional radiotherapy were used. Two axial segments of esophagus contours merged together were defined as esophagus disc (ED). For each ED, the percentage (%) of the volume of esophageal circumference treated to % of prescribed dose (PD) was assessed. Number of EDs with 50% or any % of volume (V) of esophageal circumference receiving more than or equal to (>/=) 50%, 80%, and 100% of PD (50% V >/=50% PD; 50% V >/=80% PD; any % V >/=100% PD) were calculated. These dosimetric variables and the length of the esophagus within the radiation therapy (RT) port were correlated with AE using exact Wilcoxon test. RESULTS: A median RT dose was 32 Gy with a median fraction size of 4 Gy. Eleven of 13 patients presenting with pain and/or shortness of breath had complete or partial resolution of symptoms. Median survival time from the start of reirradiation in SBF until death was 5.5 months. AE was observed in 7 patients and resolved within 3 months of RT completion. No Grade 3 or higher events were noticed. The length of the esophagus within RT port did not predict for AE (p = 0.71). However, an increased number of EDs predicted for AE for the following dosimetric variables: 50% V >/=50% PD (p = 0.023), 50% V >/=80% PD (p = 0.047), and any % V >/=100% PD (p = 0.004). Patients with at least 2 EDs receiving >/=100% PD to any % V of circumference had AE compared to those with zero EDs. CONCLUSIONS: Reirradiation using hypofractionated three-dimensional radiotherapy and SBF immobilization is an effective strategy for palliation of symptoms in selected patients with recurrent NSCLC. The length of the esophagus in the RT field does not predict for AE. However, an increasing number of EDs displaying the combination of longitudinal and circumferential three-dimensional dose distribution along the esophagus is a valuable predictor for AE.

[Temporal and spatial dynamics of reproductive modules of endangered plant Disanthus cercidifolius var. longipes natural populations].

Based on field observation data, this paper studied the flowering phenology and the temporal and spatial dynamics of the reproductive modules of endangered plant Disanthus cercidifolius var. longipes natural populations. The results showed that there were certain differences of the flowering phenology among the populations in different communities, e. g., in pure forest, the average flowering duration of individuals was the longest (75 d), while the flowering synchrony was the lowest (0.717 d), but in bamboo forest, the flowering duration of individuals was the shortest (47 d), while its flowering synchrony was the highest. The numbers of reproductive branches and inflorescences were increased with increasing individual age, and reached the highest at the age of 30 - 35 yr. At the elevation of 810 m, the numbers of individual reproductive branches and inflorescences reached the peak, and there were significant differences among the crown levels. The reproductive branch number of individuals and the inflorescences per reproductive branch were the highest in pure forest, being 411.39 and 7. 857, respectively, while the inflorescences per reproductive branch in bamboo forest were notably lower than those in other communities. The abortive ratio of reproductive modules of young individuals was higher than that of the older ones in the flower-bud, flowering, and fruit phases. The abortion of reproductive modules had no correlation with their distributed elevation, but some correlations existed with their development time, distributed crown levels and communities. The major factor affecting the abortive ratio of individual reproduction modules was probably the illumination condition in the distributed communities.