Early Nursing Intervention in Children with Viral Meningitis

Aim: To explore the effect of a WeChat peer education program in children with severe viral meningitis combined with respiratory failure. Design: Retrospective cohort study. Methods: Patients who had severe viral meningitis combined with respiratory failure, were admitted to the hospital from March 2017 to June 2018, and who received the WeChat-based nursing intervention were included. Patients who received routine nursing were used as controls. The family’s emotional state, self-care ability, and rehabilitation were analyzed. Results: There were 37 patients in the WeChat group (19 boys (51.3%) and 18 girls (48.7%);mean of 5.1 ± 2.4 years of age) and 37 controls (20 boys (54.1%) and 17 girls (45.9%);mean of 5.9 ± 2.4 years of age) (all P > 0.05). After nursing, improvements in the self-assessed anxiety score and self-assessed depression score were better in the WeChat group (anxiety: -29.2% vs. -20.3%, P = 0.015;depression: -25.2% vs. -15.4%, P = 0.009). After nursing, the improvements in the condition management ability scale and condition management difficulty scale scores were better in the WeChat group (ability: +80.5% vs. +44.4%. P = 0.001;difficulty: +58.4% vs. +37.8%, P = 0.003). After nursing, the improvement in the Fugl-Meyer score was better in the WeChat group (+138.0% vs. +53.0%, P Conclusion: Early nursing intervention combined with WeChat peer education can improve the emotional state of children with severe viral meningitis combined with respiratory failure and their caregivers. Impact: Viral meningitis is associated with a good prognosis, but central nervous system complications can be observed. Early intervention is the key to a good prognosis. Internet-based nursing and coaching can improve self-efficacy and care ability in patients with various conditions, as well as improve the emotional state of the children and their caregivers. The research might have an impact on any children’s hospital that deals with viral meningitis.

The Gut Brain Connection

The gut-brain connection is a bidirectional communication system that links the gut microbiome to the central nervous system (CNS). The gut-brain axis communicates through a variety of mechanisms, including the release of hormones, neurotransmitters, and cytokines. These signaling molecules can travel from the gut to the brain and vice versa, influencing various physiological and cognitive functions. Emerging therapeutic strategies targeting the gut-brain connection include probiotics, prebiotics, and faecal microbiota transplantation (FMT). Probiotics are live microorganisms that are similar to the beneficial bacteria that are naturally found in the gut. Prebiotics are non-digestible fibers that feed the beneficial bacteria in the gut. FMT is a procedure in which faecal matter from a healthy donor is transplanted into the gut of a person with a diseased microbiome. Probiotics, prebiotics, and FMT have been shown to be effective in treating a variety of gastrointestinal disorders, and there is growing evidence that they may also be effective in treating neurological and psychiatric disorders. This review explores the emerging field of the gut-brain connection, focusing on the communication pathways between the gut microbiome and the central nervous system. We summarize the potential roles of gut dysbiosis in various neurological and psychiatric disorders. Additionally, we discuss potential therapeutic strategies, research limitations, and future directions in this exciting area of research. More research is needed to fully understand the mechanisms underlying the gut-brain connection and to develop safe and effective therapies that target this pathway. However, the findings to date are promising, and there is the potential to revolutionize the way we diagnose and treat a variety of neurological and psychiatric disorders.

The Relation between Mental Workload and Face Temperature in Flight Simulation

In this research, we study the relationship between mental workload and facial temperature of aircraft participants during a simulated takeoff flight. We conducted experiments to comprehend the correlation between work and facial temperature within the flight simulator. The experiment involved a group of 10 participants who played the role of pilots in a simulated A-320 flight. Six different flying scenarios were designed to simulate normal and emergency situations on airplane takeoff that would occur in different levels of mental workload for the participants. The measurements were workload assessment, face temperatures, and heart rate monitoring. Throughout the experiments, we collected a total of 120 instances of takeoffs, together with over 10 hours of time-series data including heart rate, workload, and face thermal images and temperatures. Comparative analysis of EEG data and thermal image types, revealed intriguing findings. The results indicate a notable inverse relationship between workload and facial muscle temperatures, as well as facial landmark points. The results of this study contribute to a deeper understanding of the physiological effects of workload, as well as practical implications for aviation safety and performance.

Decision-Making and Management of Self-Care in Persons with Traumatic Spinal Cord Injuries: A Preliminary Study

Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.

Evidence for the Reliability and Validity of the Arabic Version of the Student Risk Screening Scale for Internalizing and Externalizing Behaviors (SRSS-IE)

School-based universal screening for behavioral/emotional risk is a necessary first step to providing services in an educational setting for students with emotional and behavioral disorders (EBDs). Psychometric properties are critical to making decisions about choosing a screening instrument. The purpose of the present study was to examine the psychometric properties of the student risk screening scale for internalizing and externalizing behaviors (SRSS-IE). Participants included 3145 students and their teachers. Item-level analyses of the current sample supported the retention of all items. The internal consistency of the SRSS items ranged from 0.83 to 0.85. Convergent validity between the SRSS-IE and a well-established screening tool, the strength and difficulties questionnaire (SDQ), was found for the total score (r = 0.70). Additionally, the results of this study demonstrate strong social validity, suggesting the SRSS-IE to be a useful and functional screening tool. We conclude that the SRSS-IE is a valid and reliable instrument for assessing the level of emotional and behavioral difficulties among elementary students.

Electroencephalogram Signal Correlations between Default Mode Network and Attentional Functioning

Attentional issues may affect acquiring new information, task performance, and learning. Cortical network activities change during different functional brain states, including the default mode network (DMN) and attention network. We investigated the neural mechanisms underlying attentional functions and correlations between DMN connectivity and attentional function using the Trail-Making Test (TMT)-A and -B. Electroencephalography recordings were performed by placing 19 scalp electrodes per the 10 - 20 system. The mean power level was calculated for each rest and task condition. Non-parametric Spearman’s rank correlation was used to examine the correlation in power levels between the rest and TMT conditions. The most significant correlations during TMT-A were observed in the high gamma wave, followed by theta and beta waves, indicating that most correlations were in the parietal lobe, followed by the frontal, central, and temporal lobes. The most significant correlations during TMT-B were observed in the beta wave, followed by the high and low gamma waves, indicating that most correlations were in the temporal lobe, followed by the parietal, frontal, and central lobes. Frontoparietal beta and gamma waves in the DMN may represent attentional functions.

Correlation Study of Neurotransmitter and Immune Levels in Pre-Hospital Emergency Nurses with Post-Traumatic Stress Disorder

Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency nurses who experienced traumatic events and those who did not develop PTSD and healthy people. How: Post-traumatic Stress Disorder Self-Rating Scale (PCL-C) tests were performed on pre-hospital emergency nurses in PTSD group, non-PTSD group and healthy control group, and the plasma monoamine neurotransmitters and serum cytokines were determined by double-antibody sandwich ABC-ELISA assay using enzyme-linked adsorption kit provided by Shanghai Xitang Biotechnology Co., Ltd. Results: 1) There were statistically significant differences in PCL-C scores between PTSD group, non-PTSD group and healthy group (p α between PTSD group, non-PTSD group and healthy group (p Conclusion: Pre-hospital emergency nurses should have early psychological intervention and guidance to reduce the occurrence of PTSD in emergency and emergency nurses.

The Diagnostic Value of Oligoclonal Band Detection in Viral Encephalitis

Objective: This study aims to explore the differences in cerebrospinal fluid oligoclonal band (CSF-OCB) expression among different age groups in viral encephalitis and its reference value for diagnosis. Methods: Forty-two patients with viral encephalitis were divided into two groups: 25 adults and 17 children. The presence of oligoclonal bands in the cerebrospinal fluid (CSF) was detected using polyacrylamide gel electrophoresis, and CSF routine analysis was conducted for comparative analysis. Results: The CSF-OCB positivity rate was higher in the adult group (48%) compared with the pediatric group (11.76%), with a statistically significant difference (P Conclusion: 1) The expression of CSF-OCB positivity in patients with viral encephalitis is age-related, with higher positivity rates observed in adults compared to children. 2) Although CSF oligoclonal band detection is not a specific diagnostic marker for viral encephalitis in adults, it still holds certain reference value.

Effects of Pearl Yangxin Anshen Decoction on HAMD and PTSD-SS Scores, Cytokines and Related Metabolites in Patients with Post-Traumatic Stress Disorder

Objective: This paper aims to observe the Pearl Yangxin Anshen Decoction to influence the score of HAMD and PTSD-SS, the changes of the cytokines and the related metabolic product in patients with PTSD. Methods: From June 2015 to May 2016, in the traditional Chinese medicine clinics of Hainan Province People’s Hospital, there were 50 patients with PTSD, the age were from 30 to 60, they were randomly divided into treatment group (25 cases) and control group (25 cases), then compared the scores of HAMD and PTSD-SS between the two groups, searched the changes of cytokines and the related metabolic product. Results: In the treatment group: before and after treatment the scores of PTSD-SS were 65.64 ± 7.02, 28.32 ± 4.18, and the scores of HAMD were 29.28 ± 1.97, 11.72 ± 2.13;In the control group: before and after treatment the scores of PTSD-SS were 63.24 ± 6.16, 31.40 ± 4.29, the scores of HAMD were 30.24 ± 2.05, 13.08 ± 2.30. After 3 months patients in treatment group the scores of PTSD-SS and HAMD were lower than the control group (t = 2.570, P = 0.013, t = -2.1640, P = 0.035). In the control group: before and after 3 months treatment the IL-2 levels respectively were 79.84 ± 26.46 pg/ml, 56.18 ± 22.67 pg/ml, the IL-6 levels respectively were 110.83 ± 47.65 pg/ml, 59.67 ± 44.68 pg/ml, the IL-8 levels respectively were 73.11 ± 78.51 pg/ml, 55.83 ± 81.94 pg/ml, the NE levels respectively were 420.04 ± 674.75 pg/ml, 185.31 ± 417.91 pg/ml, the MDA levels respectively were 112.35 ± 62.87 ng/ml, 60.42.33 ± 53.64 ng/ml, the NO levels were 126.6 ± 47.4 μmol/L, 78.6 ± 45.7 μmol/L, the VIP levels were 396.6 ± 144.4 pg/ml, 122.4 ± 111.5 pg/ml. In the treatment group: before and after 3 months treatment the IL-2 levels respectively were 86.00 ± 32.29 pg/ml, 53.84 ± 27.01 pg/ml, the IL-6 levels respectively were 108.21 ± 44.60 pg/ml, 42.46 ± 42.16 pg/ml, the IL-8 levels respectively were 81.48 ± 94.19 pg/ml, 54.07 ± 84.15 pg/ml, the NE levels respectively were 392.93 ± 592.84 pg/ml, 243.85 ± 588.45 pg/ml, the MDA levels respectively were 117.58 ± 63.37 ng/ml, 45.91 ± 38.94 ng/ml, the NO levels respectively were 135.9 ± 46.4 μmol/L, 72.6 ± 46.6 μmol/L, the VIP levels respectively were 414.0 ± 140.1 pg/ml, 185.8 ± 105.3 pg/ml. In the two groups as the extension of treatment time, the content of IL-2, IL-8, IL-6, NE, MDA, NO, and VIP were gradually reduced, and the level of reduction of the treatment group patients was higher than the control group, the change of ACTH and SOD levels just the opposite. Conclusion: The Pearl Yangxin Anshen Decoction could improve the symptoms of psychological anxiety, depression and other psychological problems in patients with PTSD, and influence the change of cytokines and related metabolites product.

Detection and Recuperation of Mental Fatigue

Mental fatigue is a complex state that results from prolonged cognitive activity. Symptoms of mental fatigue can include change in mood, motivation, and temporary deterioration of various cognitive functions involved in goal-directed behavior. Extensive research has been done to develop methods for recognizing physiological and psychophysiological signs of mental fatigue. This has allowed the development of many AI-based models to classify different levels of fatigue, using data extracted from eye-tracking device, EEG, or ECG. In this paper, we present an experimental protocol which aims to both generate/measure mental fatigue and provide effective strategies for recuperation via VR sessions paired with EEG and eye tracking devices. This paper first provides a comprehensive state-of-the-art of mental fatigue predictive factors, measurement methods, and recuperation strategies. Then the paper presents an experimental protocol resulting from the state-of-the-art to 1) generate and measure mental fatigue and 2) evaluate the effectiveness of virtual therapy for fatigue recuperation, using a virtual reality (VR) simulated environment. In our work, we successfully generated mental fatigue through completion of cognitive tasks in a virtual simulated environment. Participants showed significant decline in pupil diameter and theta/alpha score during the various cognitive tasks. We trained an RBF SVM classifier from Electroencephalogram (EEG) data classifying mental fatigue with 95% accuracy on the test set. Finally, our results show that the time allocated for virtual therapy did not improve pupil diameter in post-relaxation period. Further research on the impact of relaxation therapy on relaxation therapy should allocate time closer to the standard recovery time of 60 min.

Diagnostic Prospectives with Tau Protein and Imaging Techniques to Detect Development of Chronic Traumatic Encephalopathy

Brain damage sustained from repeated blows in boxing, wrestling, and other combat sports has serious physical and mental health consequences. The degenerative brain disease, chronic traumatic encephalopathy (CTE), presents clinically with memory loss, aggression, difficulty in rational thinking and other cognitive problems. This spectrum, which mimics Alzheimer’s disease, is diagnosed post-mortem through a brain biopsy in many professional athletes. However, little is known about the process of development and how to identify vulnerable individuals who may be on course for developing CTE. Boxing is a sport that has a severe toll on athletes’ health, primarily on their brain health and function. This review addresses the concerns of brain injury, describes the pathologies that manifest in multiple scales, e.g., molecular and cognitive, and also proposes possible diagnostic and prognostic markers to characterize the early onset of CTE along with the aim to identify a starting point for future precautions and interventions.

Thermally Dependent Behaviour of Cold-Blooded Animals: Overcoming Two Temperature Barriers on the Way to Warm-Blooded

Background: The temperature preferences of cold-blooded animals are different for different groups of animals and are closely related to their evolutionary status and level of adaptive capabilities. The range of preferred temperatures for reptiles (28°C - 32°C) coincides with the zone of temperature-dependent increase in the rate of the M-cholinergic reaction in the brain, which was previously found in warm-blooded neurons. The growth of the M-cholinergic process contributes to the transition of adaptive behavior to a higher level. Of the cold-blooded, only reptiles actively use thermoregulatory behavior as a tool to achieve a temperature optimum. This paper is devoted to the study of the behavior of red-eared turtles aimed at reaching the range of preferred temperatures. Temperature conditions necessary for the survival of different groups of cold-blooded animals are compared and the reason for temperature preferences is discussed. Methods: The behavior of turtles was studied under conditions of variable solar radiation and in a 3-section terrarium with gradual temperature ranges: 23°C - 24°C;28°C - 31°C and 45°C - 50°C. Results: It was found that prolonged (up to 1.5 hours) heating at a temperature of 45°C - 50°C was the best way to achieve the preferred temperatures. This method of heating results in increasing the temperature of the shell to an average of 37°C, followed by a very slow decrease during 4 - 6 hours within the limits that closely coincided with the preferred level. Conclusion: The results obtained demonstrate that the main function of the turtle shell is to accumulate heat and keep it for a long time in a variable climate. The preferred temperature achieved in this case is necessary for the temperature-dependent transition of the rate of the M-cholinergic reaction in the brain to a higher level, which creates more significant adaptive capabilities. The temperature range of the M-cholinergic process has two inflection points at 27°C - 29°C and 34°C - 36°C. In accordance with these values, the temperature preferences of cold-blooded animals are divided into three groups: 0°C - 28°C (fish and amphibians);28°C - 32°C (reptiles) and 34°C - 36°C (dinosaurs). Different ranges of preferred temperatures correspond to three stages of adaptive development.

Mathematical Model for Stroke and White Matter Hyperintensities

A mathematical model was developed to predict the risk of having a stroke as a person ages. The age component was derived from the concept that the change in risk of stroke with age is a function of the current risk of developing a stroke. This equation modeled the trend with age reported in the literature for two different data sets with R2 values of 0.97 or better for both men and women. A second equation of a similar nature was developed to predict the accumulation of white matter hyperintensities, WMH, as a person ages. It appears that each equation includes a set of common risk factors. This set of common risk factors allows an individual’s risk for stroke to be based on measured WMH. A third equation links WMH with the risk of developing a stroke. This equation allows an individual to use measured WMH from brain scans to predict the future risk of developing a stroke. In theory, a person with a relatively high measurement of WMH can project future risk for stroke with age and use counter measures such as exercise and medications to keep other risk factors low as a person continues to age.

Reproducibility of Test-Retest Cortical Evoked Responses in Patients with Focal Epilepsy

This exploratory study examined the short-term reliability of cortical auditory evoked responses recorded from patients undergoing whole-head scalp elec-troencephalography (EEG) monitoring to assess their candidacy for surgical treatment of intractable focal seizures. Participants were 26 patients with either left-sided (N = 13) or right-sided focal epilepsy admitted to the hospital for continuous scalp EEG monitoring for possible epilepsy surgery planning. Cortical auditory evoked responses were recorded over multiple days from scalp EEG electrodes using tones presented binaurally in a passive oddball paradigm. Test-retest intervals were 1 - 6 days (mean 2 days). Test-retest reproducibility of the auditory N1 response was assessed by paired t-test (latency) and cross-correlation analysis (amplitude and latency). Within-patient comparisons of test-retest auditory N1 peak latencies revealed no significant differences. The cross-correlation coefficient indicated high test-retest reproducibility of the N1 waveform (rcc = 0.88). Seizure lateralization was not associated with asymmetries in N1 latencies or amplitudes. An N1 amplitude asymmetry (right > left) in patients with focal seizures originating from the left hemisphere was initially observed, but disappeared when patients with prior resections were excluded, suggesting that reduced left hemisphere tissue volume may account for the smaller N1 amplitudes. Test-retest reliability of cortical auditory evoked responses was unexpectedly high in patients with focal epilepsy regardless of seizure lateralization or localization. These findings challenge the view that neural responses are intrinsically unstable (unreliable) in patients with seizures.

Some Characteristics of Neurons in the Reticular Nucleus of the Thalamus (Preliminary Data)

Our general understanding of the function of neurons is that dendrites receive information that is relayed to the axon, where action potentials are initiated and propagated to eventually trigger neurotransmitter release at synaptic terminals. Although for a number of neuron types in the mammalian brain, many neuron types do not follow this classical polarity pattern. In fact, dendrites may be the site of action potentials initiation and propagation. It should be noted that convincing evidence has been obtained for the existence of dendritic action potentials in hippocampal and neocortical neurons. With regard to the dendrite potentials of thalamic neurons in general and specifically the reticular nucleus of the thalamus, it has not yet been reported. The results of this study demonstrate, for the first time, that generation of spike potentials of different amplitudes was observed in the activity of the thalamic reticular nucleus neurons. The generation of one action potential does not interfere with the generation of another, and a spike potential of smaller amplitude can occur at the ascending or descending phase of the spike potential of large amplitude. It can be argued that the spike potentials of lower amplitudes arising in the thalamic reticular nucleus neuron are of dendrite origin. Given both the strategic position and the functional purpose of the TRN, it can be assumed that the neurons of this structure must each time be discharged with spike potentials in order to carry out their modulating effect on other areas of the nervous system of the brain without leakage.

Do Planetary Transits Predict Synchronicity Experience?

Synchronicity involves the experience of personal meaning entangled with ambiguous coincidences in time. Ambiguity results from incomplete information about the chances of various events occurring. The problem that this study addresses is the lack of empirical research on synchronicity. This study sought to address this problem by exploring the astrological hypothesis that planetary transits predict synchronicity events. Synchronicities were compared with the probability distributions of planetary transits. In comparison with the base rate prediction, planetary transits were not a significant predictor of synchronicity events. The findings of this study provide new insight into the complex, multifaceted, and ambiguous phenomenon of synchronicity. The concept of ambiguity tolerance plays a significant role in synchronicity research since ambiguity cannot be completely eliminated.

Effects of Comprehensive Rehabilitation on Patients with Progressive Multifocal Leukoencephalopathy Due to Systemic Lupus Erythematosus: A Case Report

Introduction: Little is known about the feasibility and effectiveness of rehabilitative treatment for systemic lupus erythematosus (SLE) in individuals with progressive multifocal leukoencephalopathy (PML). We describe a patient with SLE complicated by PML and ameliorated by comprehensive rehabilitation. We also review the epidemiology, pathology, imaging characteristics, and treatment of PML. Patient Concerns: We found a patient with SLE with PML improved by multidisciplinary rehabilitation techniques. Diagnoses, Interventions, and Outcomes: We diagnosed a PML with a 13-year history of SLE and lupus nephritis after longtime immunosuppressive therapy. The patient underwent a comprehensive, multifaceted rehabilitation program, including drug therapy, integrated physical therapy, occupational therapy, acupuncture, music therapy, computer-aided cognitive rehabilitation training, and behavioral management training. This rehabilitation program improved her motor function and activities of daily living. Conclusions: Her condition improved in the short term through comprehensive rehabilitation, including physical, speech, and cognitive therapy. Therefore, we recommend comprehensive rehabilitation to improve the function and activities of daily living in patients with PML.

Effects of Different Feedback Conditions on Sensorimotor Adaptation Revealed in a Mirror Reversal Paradigm

Humans are able to overcome sensory perturbations imposed on their movements through motor learning. One of the key mechanisms to accomplish this is sensorimotor adaptation, an implicit, error-driven learning mechanism. Past work on sensorimotor adaptation focused mainly on adaptation to rotated visual feedback—A paradigm known as visuomotor rotation. Recent studies have shown that sensorimotor adaptation can also occur under mirror-reversed visual feedback. In visuomotor rotation, sensorimotor adaptation can be driven by both endpoint and online feedback [1] [2]. However, it’s not been clear whether both kinds of feedback can similarly drive adaptation under a mirror reversed perturbation. We performed a study to establish what kinds of feedback can drive adaptation under mirror reversal. In the first two conditions, the participants were asked to ignore visual feedback. In the first condition, we provided mirror reversed online feedback and endpoint feedback. We reproduced previous findings showing that online feedback elicited adaptation under mirror reversal. In a second condition, we provided mirror reversed endpoint feedback. However, in the second condition, we found that endpoint feedback alone failed to elicit adaptation. In a third condition, we provided both types of feedback at the same time, but in a conflicting way: endpoint feedback was non-reversed while online feedback was mirror reversed. The participants were asked to ignore online visual feedback and try to hit the target with help from veridical endpoint feedback. In the third condition, in which veridical endpoint feedback and mirror reversed online feedback were provided, adaptation still occurred. Our results showed that endpoint feedback did not elicit adaptation under mirror reversal but online feedback did. This dissociation between effects of endpoint feedback and online feedback on adaptation under mirror reversal suggests that adaptation under these different kinds of feedback might in fact operate via distinct mechanisms.

Non-School Day Catch-Up Sleep among Pupils in Japan

Backgrounds: Weekend catch-up sleep is the difference in sleep duration between the weekend and weekdays, and reflects sleep debt, whose significance is hypothesized to be altered by weekday sleep duration. This study aimed to assess this hypothesis. Methods: Multiple-comparison tests and multiple-regression analyses were conducted on questionnaires asking various lifestyle habits obtained from 2722 pupils in grades 5 to 12 and stratified by groups of pupils with shorter (≤7 hours) or longer (>7 hours) sleep duration on the nights before schooldays. Results: The percentage of pupils in negative non-school day catch-up sleep category was 6.6%, whereas that in non-school day catch-up sleep > 2 hours was 14.4%. In comparison with the reference category (non-school day catch-up sleep of zero), multiple comparison tests on lifestyle habits revealed significantly longer screen time in the shorter sleep-duration group of pupils with negative non-school day catch-up sleep and those with non-school day catch-up sleep > 2 hours. This analysis also demonstrated a significantly longer screen time in the longer sleep-duration group of pupils with non-school day catch-up sleep > 2 hours. Physical activity in pupils with negative non-school day catch-up sleep in the longer sleep-duration group was significantly longer, while that in pupils with non-school day catch-up sleep > 2 hours in the shorter sleep-duration group was significantly shorter. In the longer sleep-duration group, pupils with non-school day catch-up sleep > 2 hours showed poorer academic performance. Multiple regression analysis revealed that longer physical and after-school activities were significantly associated with non-school day catch-up sleep decrease in both the study groups. In the longer sleep-duration group, male gender, shorter screen time, and higher standardized body mass index were significantly associated with decreased non-school day catch-up sleep. Conclusions: Sleep duration before school days contributed differently to the non-school day catch-up sleep evaluation.

Virtual Reality as an Adjunct to Ketamine Infusion Therapy Increases Patient Satisfaction in the Management of Chronic Pain and Depression: A Retrospective Pilot Study

The management of patients with concomitant chronic pain (CP) and Major Depressive Disorder (MDD) remains challenging for clinicians. Current chronic pharmacologic management is often unsuccessful, or has intolerable side effects to the patients. While not restricted to patients with chronic pain, these patients are often diagnosed with depression, presenting with symptoms such as poor mood, anhedonia, and altered cognitive processes. It is estimated that a substantial proportion of treated patients do not derive a substantive benefit from traditional pharmacological treatments for depression. The present study involved a retrospective review of cases, exploring the patient-reported satisfaction with and tolerability of a novel use of virtual reality (VR), coined KVR, as an adjunct to intravenous ketamine infusion therapies. Specifically, the ketamine-virtual reality protocol was employed as a potential adjunctive intervention for patients suffering from chronic pain and depression. Visual Analog Scores (VAS) associated with pain were significantly lower on the third than on the first assessment day. Montgomery-?sberg Depression Rating Scale (MADRS) scores improved following infusion and across days (i.e., sessions). Lastly, 2/3 of patients preferred the use of VR with their ketamine infusion. The results are considered in terms of implementing prospective studies to examine whether the combination therapies have a synergistic benefit and the nature and magnitude of clinically meaningful treatment effects, if any.