Can virtual nature improve patient experiences and memories of dental treatment? A study protocol for a randomized controlled trial

Background Dental anxiety and anxiety-related avoidance of dental care create significant problems for patients and the dental profession. Distraction interventions are used in daily medical practice to help patients cope with unpleasant procedures. There is evidence that exposure to natural scenery is beneficial for patients and that the use of virtual reality (VR) distraction is more effective than other distraction interventions, such as watching television. The main aim of this randomized controlled trial is to determine whether the use of VR during dental treatment can improve the overall dental experience and recollections of treatment for patients, breaking the negative cycle of memories of anxiety leading to further anxiety, and avoidance of future dental appointments. Additionally, the aim is to test whether VR benefits dental patients with all levels of dental anxiety or whether it could be especially beneficial for patients suffering from higher levels of dental anxiety. The third aim is to test whether the content of the VR distraction can make a difference for its effectiveness by comparing two types of virtual environments, a natural environment and an urban environment. Methods/design The effectiveness of VR distraction will be examined in patients 18 years or older who are scheduled to undergo dental treatment for fillings and/or extractions, with a maximum length of 30 minutes. Patients will be randomly allocated into one of three groups. The first group will be exposed to a VR of a natural environment. The second group will be exposed to a VR of an urban environment. A third group consists of patients who receive standard care (control group). Primary outcomes relate to patients’ memories of the dental treatment one week after treatment: (a) remembered pain, (b) intrusive thoughts and (c) vividness of memories. Other measures of interest are the dental experience, the treatment experience and the VR experience. Trial registration Current Controlled Trials ISRCTN4144280

Higgs Sector in Extensions of the MSSM

Extensions of the Minimal Supersymmetric Standard Model (MSSM) with additional singlet scalar fields solve the important mu-parameter fine tuning problem of the MSSM. We compute and compare the neutral Higgs boson mass spectra, including one-loop corrections, of the following MSSM extensions: Next-to-Minimal Supersymmetric Standard Model (NMSSM), the nearly-Minimal Supersymmetric Standard Model (nMSSM), and the U(1)'-extended Minimal Supersymmetric Standard Model (UMSSM) by performing scans over model parameters. We find that the Secluded U(1)'-extended Minimal Supersymmetric Standard Model (sMSSM) is identical to the nMSSM if three of the additional scalars decouple. The dominant part of the one-loop corrections are model-independent since the singlet field does not couple to MSSM particles other than the Higgs doublets. Thus, model-dependent parameters enter the masses only at tree-level. We apply constraints from LEP bounds on the Standard Model and MSSM Higgs boson masses and the MSSM chargino mass, the invisible Z decay width, and the Z-Z' mixing angle. Some extended models permit a Higgs boson with mass substantially below the SM LEP limit or above theoretical limits in the MSSM. Ways to differentiate the models via masses, couplings, decays and production of the Higgs bosons are discussed.Comment: 65 pages, 15 figures. Figure replaced and typos corrected. Version to appear in Phys. Rev.

Advancing the potential impact of future scenarios by integrating psychological principles

Engaging with the future to make better decisions in the present is key for sustainable development and climate change responses. In this conceptual paper, we suggest a scenario building approach that connects psychological principles of future thinking with future scenario development in order to advance the impact of scenarios. Future scenario work currently does not sufficiently consider processes of human communication, emotion, cognition and has only begun to focus on people’s local contexts in recent years. We argue that more understanding of psychological processes, such as cognitive biases and heuristics, as well as psychological distance, which typically occur in future thinking, can improve the impact of scenarios. Specifically, we provide a psychological basis for systematically integrating emotion-evoking aspects into future scenario development, using tailored narratives and visuals to make content tangible and meaningful for a broad spectrum of audiences, and adapting content temporally, spatially, and linguistically to audiences, in combination with inclusive and creative co-creation of scenarios and sustainable solutions. We explain why this approach has the potential to overcome some recognised cognitive biases hampering scenario impact and intended sustainable change pro�cesses, and can therefore support the co-development of sustainable and inclusive policies and solutions that empower and connect individuals, communities, and decision makers

Co-created Future Scenarios as a Tool to Communicate Sustainable Development in Coastal Communities in Palawan, Philippines

Scenarios can be used to communicate potential future changes and engage and connect different audiences in exploring sustainable solutions. Communicating scenarios using creative visualisation, co-creation and a focus on local contexts are especially promising. This research is conducted on the island of Palawan in the Philippines as part of the GCRF Blue Communities project. With a quasi-experimental design, we investigate the psychological and emotional effects of the engagement with future scenarios as a tool for communicating sustainability. Together with local stakeholders and community members, three distinct, locally relevant scenario narratives (Business as Usual, Best Case, and Worst Case) have been co-created. Subsequently, a sample of N = 109 local high school students was asked to creatively engage with these scenario narratives. Intentions to engage in sustainable behaviour, perceived behavioural control, ascription of responsibility, consideration of future consequences, six basic emotions and connectedness to place were assessed before and after the activity via paper-pencil administrated questionnaires. A mixed-model analysis showed significant increases in intentions to engage in sustainable behaviour, however, this increase disappeared when consideration of future consequences was added as a covariate, suggesting a mediating effect. The level of consideration of future consequences also increased significantly after engaging with any of the future scenarios, which questions the common interpretation of consideration of future consequences as a trait variable. Perceived behavioural control significantly increased following the engagement with each of the scenarios whereas ascription of responsibility and connectedness to place did not show any changes. Overall, the two most emotion evoking scenarios, Best Case Scenario and Worst Case Scenario, turn out as superior over the Business as Usual Scenario, which points to the relevance of emotional framing for effective messaging in our sample. This is the first systematic, quantitative assessment of the effects of future scenarios as a communication tool

Virtual capacity building for international research collaborations in times of COVID-19 and #Flygskam

In the wake of the current global pandemic, international travel is restricted. This poses substantial challenges for research relationships aiming to build capacity and foster co-creation to achieve the Sustainable Development Goals, where global collaboration and communication is paramount. This is especially challenging when it comes to interactive dialogues that go beyond the typical one-way structure of online learning. Considerations on structural, technical and behavioral levels are needed to not only deal with these challenges but rather to take advantage of the new situation. This commentary outlines the lessons learned from an internationally operating project, co-developed to cope with travel restrictions. We discuss implications for future reduction of international travel to reduce carbon in the context of climate change

Searching for the Layered Structure of Space at the LHC

Alignment of the main energy fluxes along a straight line in a target plane has been observed in families of cosmic ray particles detected in the Pamir mountains. The fraction of events with alignment is statistically significant for families with superhigh energies and large numbers of hadrons. This can be interpreted as evidence for coplanar hard-scattering of secondary hadrons produced in the early stages of the atmospheric cascade development. This phenomenon can be described within the recently proposed "crystal world," with latticized and anisotropic spatial dimensions. Planar events are expected to dominate particle collisions at a hard-scattering energy exceeding the scale \Lambda_3 at which space transitions from 3D \rightleftharpoons 2D. We study specific collider signatures that will test this hypothesis. We show that the energy-spectrum of Drell-Yan scattering and the parton momenta sum rule are significantly modified in this framework. At the LHC, two jet and three jet events are necessarily planar, but four jet events can test the hypothesis. Accordingly, we study in a model-independent way the 5\sigma discovery reach of the ATLAS and CMS experiments for identifying four jets coplanarities. For the extreme scenario in which all pp \to 4 jet scattering processes become coplanar above \Lambda_3, we show that with an integrated luminosity of 10(100) fb^{-1} the LHC experiments have the potential to discover correlations between jets if \Lambda_3 \alt 1.25(1.6) TeV.Comment: To be published in Phys. Rev.

Multiple ultrasound cavitation-enabled treatments for myocardial reduction

Abstract Background Ultrasound myocardial cavitation enabled treatment (MCET) is an image-guided method for tissue reduction. In this study, a strategy of fractionated (multiple) treatments was tested for efficacy. Methods Dahl SS rats were anesthetized and prepared for treatment with a focused ultrasound transducer in a warm water bath. Aiming at the anterior left ventricular wall was facilitated by imaging with a 10 MHz phased array (10S, GE Vivid 7, GE Vingmed Ultrasound, Horten, Norway). MCET was accomplished at 1.5 MHz by pulse bursts of 4 MPa peak rarefactional pressure amplitude, which were intermittently triggered 1:8 from the ECG during infusion of a microbubble suspension for cavitation nucleation. Test groups were sham, a 200 s treatment, three 200 s treatments a week apart, and a 600 s treatment. Treatment outcome was observed by plasma troponin after 4 h, echocardiographic monitoring and histology at 6 wk. Results The impacts of the fractionated treatments summed to approximately the same as the long treatment; e. g. the troponin result was 10.5 ± 3.2 for 200 s, 22.7 ± 5.4 (p < 0.001) for the summed fractionated treatments and 29.9 ± 6.4 for 600 s (p = 0.06 relative to the summed fractionated). While wall thickness was not reduced for the fractionated treatment, tissue strain was reduced by 35% in the target area relative sham (p < 0.001). Conclusion The ability to fractionate treatment may be advantageous for optimizing patient outcome relative to all-or nothing therapy by surgical myectomy or alcohol ablation.https://deepblue.lib.umich.edu/bitstream/2027.42/139057/1/40349_2017_Article_107.pd

The effect of trastuzumab on cardiac function in patients with HER2-positive metastatic breast cancer and reduced baseline left ventricular ejection fraction

We investigated the effect of trastuzumab on cardiac function in a real‐world historic cohort of patients with HER2‐positive metastatic breast cancer (MBC) with reduced baseline left ventricular ejection fraction (LVEF). Thirty‐seven patients with HER2‐positive MBC and baseline LVEF of 40% to 49% were included. Median LVEF was 46% (interquartile range [IQR] 44%‐48%) and median follow‐up was 18 months (IQR 9‐34 months). During this period, the LVEF did not worsen in 24/37 (65%) patients, while 13/37 (35%) patients developed severe cardiotoxicity defined as LVEF 5%‐points below baseline) in 3/13 (23%) patients and irreversible (defined as absolute LVEF increase 5%‐points below baseline) in 3/13 (23%) patients. Likelihood of reversibility was numerically higher in patients who received cardio‐protective medications (CPM), including ACE‐inhibitors, beta‐blockers and angiotensine‐2 inhibitors, compared to those who did not receive any CPM (71% vs 13%, P = .091). Sixty‐five percent of patients who received trastuzumab for HER2‐positive MBC did not develop severe cardiotoxicity during a median follow‐up of 18 months, despite having a compromised baseline LVEF. If severe cardiotoxicity occurred, it was at least partly reversible in more than two‐thirds of the cases. Risks and benefits of trastuzumab use should be balanced carefully in this vulnerable population

Mixing Chiral Polytopes

An abstract polytope of rank n is said to be chiral if its automorphism group has two orbits on the flags, such that adjacent flags belong to distinct orbits. Examples of chiral polytopes have been difficult to find. A "mixing" construction lets us combine polytopes to build new regular and chiral polytopes. By using the chirality group of a polytope, we are able to give simple criteria for when the mix of two polytopes is chiral