The Equivalence between Virtual and Real Feared Stimuli in a Phobic Adult Sample: A Neuroimaging Study

The clinical use of virtual reality (VR) has proven its efficacy, especially when used as an exposure technique. A prominent property of VR’s utility is its equivalence with the reality it represents. In this study, we explored this equivalence in a clinical context using neuroimaging. A sample of 32 adults with specific phobias (i.e., to cockroaches, spiders, or lizards) was divided into two groups: One was exposed to phobic stimuli using VR and the other was exposed to real phobic images (RI). We used brain activations as a dependent measure, focusing specifically on brain areas usually associated with fear processing. Whole-brain analysis detected higher activations for RI in the hippocampus, occipital, and calcarine areas. A specific analysis of the amygdala and insula also detected higher activations and extensions in response to RI, but VR stimuli also activated those areas in a significant manner. These results suggest that even in those cases where RI stimuli activate all of the brain’s fear-processing circuits, VR stimuli do so as well. This implies that VR can be useful as an exposure technique similar to RI and applied as more than a mere training mechanism.

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Azetidinimines as a Novel Series of Non-Covalent Broad-Spectrum Inhibitors of β-Lactamases with Submicromolar Activities Against Carbapenemases of Classes A, B and D

10.26434/chemrxiv.11897157.v1 ◽

2020 ◽

Author(s):

Eugénie Romero ◽

Saoussen Oueslati ◽

Mohamed Benchekroun ◽

Agathe C. A. D’Hollander ◽

Sandrine Ventre ◽

...

Keyword(s):

Escherichia Coli ◽

Broad Spectrum ◽

Resistant Strain ◽

Clinical Use ◽

Lead Compound ◽

Synthetic Methodology ◽

Lactamase Inhibitor ◽

Do So

The increasingly worrisome situation of antimicrobial resistances has pushed synthetic chemists to design original molecules that can fight these resistances. To do so, inhibiting β-lactamases, one of the main modes of resistance to β-lactam antibiotics, is one of the most sought-after strategies, as recently evidenced by the development and approval of avibactam, relabactam and vaborbactam. Yet molecules able to inhibit simultaneously β-lactamases belonging to different molecular classes remain scarce and currently there is no metallo-β-lactamase inhibitor approved for clinical use. Having recently developed a synthetic methodology to access imino-analogues of β-lactams (Chem. – Eur. J. 2017, 23, 12991,see ref) we decided to evaluate them as potential β-lactamase inhibitors and specifically against carbapenemases, which can hydrolyze and inactivate penicillins, cephalosporins and carbapenems. Herein we eport our findings that show that our newly developed family of molecules are indeed excellent β-lactamase inhibitors and that our lead compound can inhibit NDM-1 (0.1 µM), KPC-2 (0.4 µM), and OXA-48 (0.6 µM) even though these three enzymes belong to three different molecular classes of carbapenemases. This lead compound also inhibits the ESBL CTX-M-15 and the cephalosporinase CMY-2, it is metabolically stable, and can repotentiate imipenem against a resistant strain of Escherichia coli expressing NDM-1.<br><br><br>

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Systematic Review of Studies on Subliminal Exposure to Phobic Stimuli: Integrating Therapeutic Models for Specific Phobias

Frontiers in Neuroscience ◽

10.3389/fnins.2021.654170 ◽

2021 ◽

Vol 15 ◽

Author(s):

Sergio Frumento ◽

Danilo Menicucci ◽

Paul Kenneth Hitchcott ◽

Andrea Zaccaro ◽

Angelo Gemignani

Keyword(s):

Systematic Review ◽

Emotional Regulation ◽

Intertrial Interval ◽

Defense Responses ◽

Behavioral Correlates ◽

Specific Phobias ◽

Subliminal Stimulation ◽

New Form ◽

Psychophysiological Correlates ◽

Phobic Stimuli

We systematically review 26 papers investigating subjective, behavioral, and psychophysiological correlates of subliminal exposure to phobic stimuli in phobic patients. Stimulations were found to elicit: (1) cardiac defense responses, (2) specific brain activations of both subcortical (e.g., amygdala) and cortical structures, (3) skin conductance reactions, only when stimuli lasted >20 ms and were administered with intertrial interval >20 s. While not inducing the distress caused by current (supraliminal) exposure therapies, exposure to subliminal phobic stimuli still results in successful extinction of both psychophysiological and behavioral correlates: however, it hardly improves subjective fear. We integrate those results with recent bifactorial models of emotional regulation, proposing a new form of exposure therapy whose effectiveness and acceptability should be maximized by a preliminary subliminal stimulation. Systematic Review Registration: identifier [CRD42021129234].

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Psychiatric Interventions in Virtual Reality: Why We Need an Ethical Framework

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s0963180120000328 ◽

2020 ◽

Vol 29 (4) ◽

pp. 574-584

Author(s):

MARIA MARLOTH ◽

JENNIFER CHANDLER ◽

KAI VOGELEY

Keyword(s):

Virtual Reality ◽

Virtual World ◽

Ethical Issues ◽

Biomedical Ethics ◽

Ethical Framework ◽

Clinical Settings ◽

Clinical Use ◽

Clinical Context ◽

Ethical Concerns ◽

Expectation Bias

AbstractRecent improvements in virtual reality (VR) allow for the representation of authentic environments and multiple users in a shared complex virtual world in real time. These advances have fostered clinical applications including in psychiatry. However, although VR is already used in clinical settings to help people with mental disorders (e.g., exposure therapy), the related ethical issues require greater attention. Based on a thematic literature search the authors identified five themes that raise ethical concerns related to the clinical use of VR: (1) reality and its representation, (2) autonomy, (3) privacy, (4) self-diagnosis and self-treatment, and (5) expectation bias. Reality and its representation is a theme that lies at the heart of VR, but is also of specific significance in a clinical context when perceptions of reality are concerned, for example, during psychosis. Closely associated is the autonomy of VR users. Although autonomy is a much-considered topic in biomedical ethics, it has not been sufficiently discussed when it comes to applications of VR in psychiatry. In this review, the authors address the different themes and recommend the development of an ethical framework for the clinical use of VR.

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The phylogeny and ontogeny of behavior

Behavioral and Brain Sciences ◽

10.1017/s0140525x00027990 ◽

1984 ◽

Vol 7 (4) ◽

pp. 669-677 ◽

Cited By ~ 14

Author(s):

B. F. Skinner

Keyword(s):

Relative Importance ◽

Scientific Methods ◽

Learned Behavior ◽

Specific Analysis ◽

The Future ◽

Do So

AbstractResponses are strengthened by consequences having to do with the survival of individuals and species. With respect to the provenance of behavior, we know more about ontogenic than phylogenic contingencies. The contingencies responsible for unlearned behavior acted long ago. This remoteness affects our scientific methods, both experimental and conceptual. Until we have identified he variables responsible for an event, we tend to invent causes. Explanatory entities such as “instincts,” “drives,” and “traits” still survive. Unable to show how organisms can behave effectively under complex circumstances, we endow them with special abilities permitting them to do so.Behavior exhibited by most members of a species is often accepted as inherited if all members were not likely to have been exposed to relevant ontogenic contingencies. When contingencies are not obvious, it is perhaps unwise to call any behavior either inherited or acquired, as the examples of churring in honey guides and following in imprinted ducklings show. Nor can the relative importance of phylogenic and ontogenic contingencies be argued from instances in which unlearned or learned behavior intrudes or dominates. Intrusions occur in both directions.Behavior influenced by its consequences seems directed toward the future, but only past effects are relevant. The mere fact that behavior is adaptive does not indicate whether phylogenic or ontogenic processes have been responsible for it. Examples include the several possible provenances of imitation, aggression, and communication. The generality of such concepts limits their usefulness. A more specific analysis is needed if we are to deal effectively with the two kinds of contingencies and their products.

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Representing Multiple Observed Actions in the Motor System

Cerebral Cortex ◽

10.1093/cercor/bhy237 ◽

2018 ◽

Vol 29 (8) ◽

pp. 3631-3641 ◽

Cited By ~ 5

Author(s):

Emiel Cracco ◽

Christian Keysers ◽

Amanda Clauwaert ◽

Marcel Brass

Keyword(s):

Motor Cortex ◽

Motor System ◽

Brain Activity ◽

Third Party ◽

Potential Mechanism ◽

Brain Areas ◽

Fmri Study ◽

Social Encounters ◽

The Brain ◽

Do So

Abstract There is now converging evidence that others’ actions are represented in the motor system. However, social cognition requires us to represent not only the actions but also the interactions of others. To do so, it is imperative that the motor system can represent multiple observed actions. The current fMRI study investigated whether this is possible by measuring brain activity from 29 participants while they observed 2 right hands performing sign language gestures. Three key results were obtained. First, brain activity in the premotor and parietal motor cortex was stronger when 2 hands performed 2 different gestures than when 1 hand performed a single gesture. Second, both individual observed gestures could be decoded from brain activity in the same 2 regions. Third, observing 2 different gestures compared with 2 identical gestures activated brain areas related to motor conflict, and this activity was correlated with parietal motor activity. Together, these results show that the motor system is able to represent multiple observed actions, and as such reveal a potential mechanism by which third-party social encounters could be processed in the brain.

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Specific Phobias

Anxiety Disorders in Adults ◽

10.1093/oso/9780195369250.003.0009 ◽

2009 ◽

Author(s):

Vladan Starcevic, MD, PhD

Keyword(s):

Specific Phobia ◽

Treatment Model ◽

Injury Type ◽

Injection Injury ◽

Specific Phobias ◽

Blood Injection ◽

Psychiatric Conditions ◽

Phobic Stimuli ◽

The Relationship ◽

Dominant Treatment

Specific phobias (also referred to as simple phobias and isolated phobias) represent a heterogeneous group of disorders characterized by excessive and/or irrational fear of one of relatively few and usually related objects, situations, places, phenomena, or activities (phobic stimuli). The phobic stimuli are either avoided or endured with intense anxiety or discomfort. People with specific phobias are aware that their fear is unreasonable, but this does not diminish the intensity of the fear. Rather, they are quite distressed about being afraid or feel handicapped by their phobia. Specific phobias are frequently encountered in the general population, but they are relatively uncommon in the clinical setting. Most phobias have a remarkable tendency to persist, prompting an assumption that they cannot be easily extinguished because of their ‘‘purpose’’ to protect against danger. Specific phobias are deceptively simple, as they are easy to describe and recognize but often difficult to understand. There are several conceptual problems and a number of issues associated with specific phobias:… 1. Where are the boundaries of specific phobias? How can we develop better criteria on the basis of which specific phobia could be distinguished as a psychiatric disorder from fears and avoidance considered to be within the realm of ‘‘normality?’’ 2. How can specific phobias be taken seriously by both the sufferers and clinicians? 3. In view of the considerable differences between various types of specific phobias, should they continue to be grouped together? 4. Should specific phobias be grouped on the basis of whether they are driven by fear or disgust? 5. In view of its unique features, should the blood-injection-injury type of specific phobia be given a separate psychopathological, diagnostic, and nosological status? 6. Considering a significant overlap between situational phobias and agoraphobia, should they be grouped together, along a hypothetical situational phobia/agoraphobia spectrum? 7. What is the relationship between specific phobias and other psychopathology? Are they relatively isolated from other disorders, both cross-sectionally and longitudinally, or should they more appropriately be conceptualized as a predisposition to or a risk factor for some psychiatric conditions? 8. How specific are pathways that lead to specific phobias? 9. Has the dominant treatment model for specific phobias, based on exposure therapy, exhausted its potential? Is the tendency for specific phobias to persist adequately addressed by treatments derived from learning theory?

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Influence of Implant Inclination and Prosthetic Abutment Type on the Biomechanics of Implant-Supported Fixed Partial Dentures

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-18-00305 ◽

2019 ◽

Vol 45 (5) ◽

pp. 343-350 ◽

Cited By ~ 2

Author(s):

Victório Poletto-Neto ◽

Pedro Henrique Wentz Tretto ◽

Bruno Massucato Zen ◽

Ataís Bacchi ◽

Mateus Bertolini Fernandes dos Santos

Keyword(s):

Stress Reduction ◽

Finite Element Models ◽

Analysis Software ◽

3 Dimensional ◽

Implant Placement ◽

Specific Analysis ◽

Dimensional Finite Element ◽

Von Mises ◽

Von Mises Stresses ◽

Do So

Obtaining parallelism during implant placement is often difficult, leading to inclination of implants. The present study evaluated the stress distribution in 3-unit fixed partial dentures supported by 2 implants with different inclinations and prosthetic abutments. Universal castable long abutments (UCLAs) or tapered abutments were used considering 17° of implant angulation in different directions (mesial, distal, buccal, or lingual). To do so, 3-dimensional finite element models were built and exported to specific analysis software. Forces were applied to the functional cusps. Data were obtained with regard to the maximum principal and von Mises stresses (in MPa). No relevant differences were observed in the stress values in the cortical and cancellous bone nor in the prosthesis with UCLA or tapered abutments. However, a relevant stress reduction in the prosthetic screws of the tilted implant was observed when using UCLA abutments. According to the obtained results, it is possible to suggest that both UCLA or tapered abutments can be used for 3-unit fixed partial dentures when 1 of the implants is tilted. UCLA abutment might lead to less biomechanical problems related to screw loosening or fracture.

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Azetidinimines as a Novel Series of Non-Covalent Broad-Spectrum Inhibitors of β-Lactamases with Submicromolar Activities Against Carbapenemases of Classes A, B and D

10.26434/chemrxiv.11897157 ◽

2020 ◽

Author(s):

Eugénie Romero ◽

Saoussen Oueslati ◽

Mohamed Benchekroun ◽

Agathe C. A. D’Hollander ◽

Sandrine Ventre ◽

...

Keyword(s):

Escherichia Coli ◽

Broad Spectrum ◽

Resistant Strain ◽

Clinical Use ◽

Lead Compound ◽

Synthetic Methodology ◽

Lactamase Inhibitor ◽

Do So

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The Intersex Enchiridion: Naming and Knowledge

Somatechnics ◽

10.3366/soma.2011.0026 ◽

2011 ◽

Vol 1 (2) ◽

pp. 388-411 ◽

Cited By ~ 13

Author(s):

Morgan Holmes

Keyword(s):

Queer Theory ◽

Disorders Of Sex Development ◽

Clinical Use ◽

Pediatric Endocrinology ◽

Clinical Context ◽

Fundamental Knowledge ◽

Sex Development ◽

Trace Back ◽

New Guidelines ◽

Work Done

The 2006 Lawson Wilkins Pediatric Endocrinology Society (LWPES) consensus to alter clinical language from ‘intersex’ to Disorders of Sex Development (DSD) has not met its stated objective of destigmatizing the ‘intersex’ label. Rather, DSD works to paper over a problematic understanding of morphological variation as disease. This article interrogates the development of DSD terminology in the clinical context of treating intersex and argues that ‘DSD’ reinstitutionalises clinical power to delineate and silence those marked by the diagnosis; that this silencing is precisely the point of the new terminology; and that it is against that retrenchant impulse that we must protect the viability of ‘intersex’ by continuing its critical deployment. This paper is based on an application of embodiment studies models of critique, combined with an orientation grounded in queer theory to critically interrogate the development of both DSD language and of the ‘new’ guidelines for clinical use, and of the Handbook for Parents that were developed out of the 2006 LWPES meetings. Some of my critique is based on work done over an 18-year period with adults who created the contemporary intersex movement, and on my previous research (in particular: Holmes 2002 , 2008 , 2010). The point of the argument is not to determine which diagnostic language is superior, but to retain the hard-won right to secure for ourselves the ability to operate socially without the stamp of ‘disorder’ or ‘disease’ strictly delineating what counts as ‘truth’ with regard to embodiment. In this sense, the argument applies to and is drawn out of a larger disability scholarship and activism framework that refuses to permit medicine the final voice in defining our bodies and our selves. The title refers to an older handbook, the enchiridion as a gesture toward the need to retain fundamental knowledge of self that intersexed persons can trace back to a more flexible understanding of embodied differences than the language of disorder asserts in the new Handbook for Parents.

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Topographic Connectivity in a Duration Selective Cortico-Cerebellar Network

10.1101/2020.04.08.031385 ◽

2020 ◽

Author(s):

Foteini Protopapa ◽

Masamichi J. Hayashi ◽

Ryota Kanai ◽

Domenica Bueti

Keyword(s):

Magnetic Resonance ◽

High Resolution ◽

Premotor Cortex ◽

Magnetic Resonance Images ◽

Cortical Surface ◽

Functional Magnetic Resonance ◽

Brain Areas ◽

Neuroimaging Study ◽

Representation Of Time

AbstractHow does the human brain represent millisecond unit of time? A recent neuroimaging study revealed the existence in the human premotor cortex of a topographic representation of time i.e., neuronal units selectively responsive to specific durations and topographically organized on the cortical surface. By using high resolution functional Magnetic Resonance Images here, we go futher this previous work, showing duration preferences across a wide network of cortical and subcortical brain areas: from cerebellum to primary visual, parietal, premotor and prefrontal cortices. Most importantly, we identify the functional connectivity structure between these different brain areas and their duration selective neural units. The results highlight the role of the cerebellum as the network hub and that of medial premotor cortex as the final stage of duration recognition. Interstingly, when a specific duration is presented, only the communication between the units selective to that duration become particularly “active”. These findings identify duration tuning and topographic connectivity as possible mechanisms underlying our capacity of telling time.

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