Determinants of cue-elicited alcohol craving and perceived realism in Virtual Reality environments among patients with alcohol use disorder

The identification of variables that can modulate the efficacy of cue exposure using virtual reality (VR) is crucial. This study aimed to explore determinant variables of cue-elicited alcohol craving and perceived realism (PR) of environments and alcoholic beverages during a VR cue-exposure session among alcohol use disorder (AUD) outpatients. A prospective cohort study was conducted amongst 72 outpatients with AUD from a clinical setting. Alcohol craving experienced during VR exposure and PR of virtual environments and alcoholic drinks were evaluated after a VR session of exposure to alcohol-related contexts and cues. Sociodemographic, psychological and consumption characteristics were examined as possible predicting variables. Multiple linear regression analyses showed that the AUD severity and PR of beverages were predictors of cue-elicited alcohol craving. Educational level, PR of beverages and age were predictors of the PR of VR environments. In relation to the PR of VR beverages, cue-elicited alcohol craving and the PR of environments were predictors. A simple mediational model was also performed to analyze the influence of the PR of beverages on the relationship between the AUD severity and alcohol craving experienced during VR exposure: an indirect or mediational effect was found. PR of alcoholic beverages was (1) a key predictor of the PR of VR environments (and vice versa) and the alcohol craving (and vice versa) experienced during VR cue-exposure sessions using ALCO-VR software among AUD patients and (2) a mediator between AUD severity and cue-elicited alcohol craving

Craving and Anxiety Responses as Indicators of the Efficacy of Virtual Reality-Cue Exposure Therapy in Patients Diagnosed with Alcohol use Disorder

Introduction: Virtual Reality (VR) technology has shown promising results as an assessment and treatment instrument in substance use disorders, particularly in attempts to reduce craving. A common application of the VR technology in treatment is based on cue-exposure therapy (CET). Following from previous results, the present case series is part of a larger project aiming to test the efficacy of the Virtual Reality-Cue Exposure Therapy (VR-CET) versus Cognitive-Behavioral Therapy (CBT). Method: Eight patients between ages 40 and 55 (Mage = 49, SD = 5.54) from the Addictive Behaviors Unit at the Hospital Clinic of Barcelona participated in this study after providing written informed consent. Patients were randomly assigned to the VR-CET group (three patients) or the CBT group (five patients). The protocol of the clinical trial consisted of a pre-treatment session (the initial assessment session), six sessions of CBT or VR-CET, and a post-treatment session (post-assessment session). The VR-CET sessions consisted of exposure to alcohol-related cues and environments aiming to reduce anxiety and craving responses to alcohol-related stimuli. The CBT sessions consisted of classical standardized therapy for the treatment of addictions, as previously applied in other clinical trials. In the pre- and post-treatment sessions, patients completed several measures of alcohol craving and anxiety and visual analog scales (VAS) during VR exposure. Results: Our data indicated a significant reduction in both groups in all scores of craving and anxiety responses, as assessed by the different instruments. In addition, the VR-CET group obtained lower scores on anxiety and craving responses than the CBT group. Conclusions: In this ongoing project, the first phase of the clinical trial showed significant improvements in terms of craving and anxiety reduction in both groups, emphasizing that VR-CET can be as efficient as CBT. In addition, patients in the VR-CET group obtained slightly better scores than patients in the CBT group, suggesting the clinical potential of the VR technology in the treatment of substance use disorders. We propose that VR-based CET can be a useful complement to existing treatment methods for AUD patients

Parámetros reproductivos y distribución geográfica potencial de las áreas de anidación de Grus canadensis nesiotes (Aves, Gruidae) en Cuba: implicaciones para su conservación

Grus canadensis nesiotes (grulla cubana) es una subespecie endémica de Cuba que se encuentra en peligro de extinción. A pesar de estar directamente relacionada con los humedales, no existen estudios que contribuyan a su gestión y conservación. Por ello, se registraron parámetros reproductivos de la subespecie durante ocho temporadas reproductivas entre 2005 y 2015 en un humedal de Cuba; asimismo, se modeló y caracterizó la distribución geográfica potencial de las áreas de anidación, y se analizó su representación dentro de las áreas protegidas (AP). Para elaborar el modelo, se utilizaron el algoritmo de máxima entropía y variables de hábitat (100  m de tamaño de píxel). Para caracterizar la distribución potencial, se calculó la superficie ocupada por cada uso de suelo y tipo de vegetación dentro de dicha área de distribución. Se empleó el mismo procedimiento para calcular la superficie de la distribución que está protegida. Se localizaron 151  nidos en herbazales de ciénaga. Se trataba de plataformas simples sobre suelo húmedo o agua; los más grandes se observaron en 2006. El 70% de los nidos tuvieron dos huevos (1,7 huevos/nido) y el 63,5% fueron exitosos con 1,6 polluelos/nido exitoso. El hábitat potencial de anidación es estrecho (242 km2) y se localiza en el centro del humedal. De la distribución prevista, la superficie con alta probabilidad de presencia es del 13,8%. El 60% del herbazal de ciénaga de la zona del estudio estaba comprendido dentro de la distribución potencial, mientras que la proporción de cultivos (1,2%) y pastizales (2,1%) era baja. Las AP gestionadas solo protegen el 39,1% de la distribución potencial de los sitios de anidación y el 12% de las zonas con alta probabilidad. Se proponen tres sitios prioritarios para estudiar la anidación de la subespecie y hacer un seguimiento de la misma. Las medidas de conservación de la subespecie deberían considerar la distribución geográfica potencial de los sitios de anidación dentro y fuera de las AP.Grus canadensis nesiotes (grulla cubana) es una subespecie endémica de Cuba que se encuentra en peligro de extinción. A pesar de estar directamente relacionada con los humedales, no existen estudios que contribuyan a su gestión y conservación. Por ello, se registraron parámetros reproductivos de la subespecie durante ocho temporadas reproductivas entre 2005 y 2015 en un humedal de Cuba; asimismo, se modeló y caracterizó la distribución geográfica potencial de las áreas de anidación, y se analizó su representación dentro de las áreas protegidas (AP). Para elaborar el modelo, se utilizaron el algoritmo de máxima entropía y variables de hábitat (100  m de tamaño de píxel). Para caracterizar la distribución potencial, se calculó la superficie ocupada por cada uso de suelo y tipo de vegetación dentro de dicha área de distribución. Se empleó el mismo procedimiento para calcular la superficie de la distribución que está protegida. Se localizaron 151  nidos en herbazales de ciénaga. Se trataba de plataformas simples sobre suelo húmedo o agua; los más grandes se observaron en 2006. El 70% de los nidos tuvieron dos huevos (1,7 huevos/nido) y el 63,5% fueron exitosos con 1,6 polluelos/nido exitoso. El hábitat potencial de anidación es estrecho (242 km2) y se localiza en el centro del humedal. De la distribución prevista, la superficie con alta probabilidad de presencia es del 13,8%. El 60% del herbazal de ciénaga de la zona del estudio estaba comprendido dentro de la distribución potencial, mientras que la proporción de cultivos (1,2%) y pastizales (2,1%) era baja. Las AP gestionadas solo protegen el 39,1% de la distribución potencial de los sitios de anidación y el 12% de las zonas con alta probabilidad. Se proponen tres sitios prioritarios para estudiar la anidación de la subespecie y hacer un seguimiento de la misma. Las medidas de conservación de la subespecie deberían considerar la distribución geográfica potencial de los sitios de anidación dentro y fuera de las AP.Reproductive parameters and potential geographical distribution of nesting areas of Grus canadensis nesiotes (Aves, Gruidae) in Cuba: conservation implications Grus canadensis nesiotes (Cuban sandhill crane) is an endemic and endangered subspecies from Cuba. Protection of wetland habitats is essential for survival of this species, but studies that could contribute to its management and conservation are lacking. In this study we recorded the reproductive parameters of Grus canadensis nesiotes in eight breeding seasons between 2005 and 2015 in a wetland of Cuba. We modeled and characterized the potential geographical distribution of the nesting areas, analyzing its representation within protected areas. Maximum entropy algorithm and habitat variables were used for modeling (100 m of pixel size). To characterize the potential distribution we calculated each land–use–vegetation within the potential distribution. We used the same procedure to determine the extent of the protected area. A hundred and fifty–one nests were located in marsh grasslands. These nests were simple platforms built on wet soil/water; the largest nests were observed in 2006. Seventy percent of nests had two eggs (1.7 eggs/nest) and 63.5% were successful with 1.6 chicks per successful nest. The potential nesting habitat is a narrow stretch (242 km2) located in the center of the wetland. The area with high probability of presence makes up 13.8% of the predicted distribution. Sixty percent of marsh grassland of the study area was included in the potential distribution, while the proportion of crops (1.2%) and pastures (2.1%) was low. Managed protected areas cover only 39.1% of the potential distribution of the nesting sites and 12% of the high probability areas. We propose three priority sites to study and monitor nesting of the subspecies. Species conservation actions should consider the potential geographical distribution of nesting sites both inside and outside the protected areas

Attentional bias, alcohol craving, and anxiety implications of the virtual reality cue-exposure therapy in severe alcohol use disorder: a case report

Aims: Attentional bias (AB), alcohol craving, and anxiety have important implications in the development and maintenance of alcohol use disorder (AUD). The current study aims to test the effectiveness of a Virtual Reality Cue-Exposure Therapy (VR-CET) to reduce levels of alcohol craving and anxiety and prompt changes in AB toward alcohol content. Method: A 49-year-old male participated in this study, diagnosed with severe AUD, who also used tobacco and illicit substances on an occasional basis and who made several failed attempts to cease substance misuse. The protocol consisted of six VR-CET booster sessions and two assessment sessions (pre- and post-VR-CET) over the course of 5 weeks. The VR-CET program consisted of booster therapy sessions based on virtual reality (VR) exposure to preferred alcohol-related cues and contexts. The initial and final assessment sessions were focused on exploring AB, alcohol craving, and anxiety using paper-and-pencil instruments and the eye-tracking (ET) and VR technologies at different time points. Results: Pre and post assessment sessions indicated falls on the scores of all instruments assessing alcohol craving, anxiety, and AB. Conclusions: This case report, part of a larger project, demonstrates the effectiveness of the VR-CET booster sessions in AUD. In the post-treatment measurements, a variety of instruments showed a change in the AB pattern and an improvement in craving and anxiety responses. As a result of the systematic desensitization, virtual exposure gradually reduced the responses to significant alcohol-related cues and contexts. The implications for AB, anxiety and craving are discussed

Lessons from the operation of the "Penning-Fluorescent" TPC and prospects

We have recently reported the development of a new type of high-pressure Xenon time projection chamber operated with an ultra-low diffusion mixture and that simultaneously displays Penning effect and fluorescence in the near-visible region (300 nm). The concept, dubbed `Penning-Fluorescent' TPC, allows the simultaneous reconstruction of primary charge and scintillation with high topological and calorimetric fidelity

Predictors of Changes in alcohol craving levels during a virtual reality cue exposure treatment among patients with alcohol use disorder

Background/Objective: Determining the predictive variables associated with levels of alcohol craving can ease the identification of patients who can benefit from treatments. This study aimed to describe changes (improvement or no change/deterioration) in alcohol craving levels and explore the predictors of these changes from admission to discharge in outpatients with alcohol use disorder (AUD) undergoing treatment-as-usual (TAU), or treatment-as-usual supplemented with virtual reality cue-exposure therapy (TAU + VR-CET). Method: A prospective cohort study was conducted amongst 42 outpatients with AUD (n = 15 TAU + VR-CET and n = 27 TAU) from a clinical setting. Changes in the levels of alcohol craving between admission and discharge were assessed with the Multidimensional Alcohol Craving Scale. Sociodemographic characteristics (age, gender, education, and socioeconomic and civil status), cognitive-a ective behavioral patterns (AUD severity, abstinence duration, psychiatric comorbidity, state anxiety, attentional bias, and substance use), and type of treatment (TAU + VR-CET and only TAU) were also evaluated. Results: The TAU + VR-CET group showed greater changes of improvement in the levels of alcohol craving than the TAU group ( 2 = 10.996; p = 0.001). Intragroup changes in alcohol craving from pre to post-treatment were significant in the TAU + VR-CET group ( 2 = 13.818; p = 0.003) but not within the TAU group ( 2 = 2.349; p = 0.503). The odds of an improvement in any of the craving levels between pre- and post-test was 18.18 (1/0.055) times higher in the TAU + VR-CET group with respect to the TAU group. The use of illicit drugs in the month prior to the test increased the odds of having a positive change by 18.18 (1/0.055) with respect to not having consumed. Conclusions: Including VR-CET in TAU programs may provide benefits in the treatment of AUDs mainly among patients with intense alcohol craving and individuals having used illicit substances prior to treatment

Diabetes-induced changes in endothelial mechanisms implicated in rabbit carotid arterial response to 5-hydroxytryptamine

The influence of diabetes on endothelial mechanisms implicated in the response of isolated rabbit carotid arteries to 5-hydroxytryptamine (5-HT)was studied. 5-HT induced a concentrationdependent contraction that was potentiated in arteries from diabetic rabbits with respect to that in arteries from control rabbits. Endothelium removal potentiated 5-HT contractions in arteries from both control and diabetic rabbits but increased the maximum effect only in arteries from diabetic rabbits. Incubation of arterial segments with Nº-nitro-L-arginine(L-NA)enhanced the contractile response to 5-HT. This L-NA enhancement was greater in arteries from diabetic rabbits than in arteries from control rabbits. Aminoguanidine did not modify the 5-HT contraction in arteries from control and diabetic rabbits. Indomethacin inhibited the 5-HT-induced response, and this inhibition was higher in arteries from control rabbits than in arteries from diabetic rabbits. In summary, diabetes enhances the sensitivity of the rabbit carotid artery to 5-HT. In control animals, the endothelium modulated the arterial response to 5-HT by the release of both nitric oxide (NO) and a vasoconstrictor prostanoid. Diabetes enhances endothelial constitutive NO activity and impairs the production of the endothelial vasoconstricto

Diabetes potentiates acetylcholine-induced relaxation in rabbit renal arteries

The response of rabbit renal arteries to acetylcholine and its endothelial modulation in diabetes were investigated. Acetylcholine induced concentration-related endothelium-dependent relaxation of renal arteries that was significantly more potent in diabetic rabbits than in control rabbits. Pretreatment with NG-nitro-L-arginine L-NOArg., indomethacin, or L-NOArg plus indomethacin induced partial inhibition of acetylcholine-induced relaxation. Inhibition induced by L-NOArg plus indomethacin was significantly higher in arteries from diabetic rabbits than in arteries from control rabbits. In renal arteries depolarised with KCl 30 mM and incubated with L-NOArg plus indomethacin, acetylcholine-induced relaxation was almost abolished in both groups of rabbits and this response was not different from that obtained in arteries without endothelium. Sodium nitroprusside induced concentration-dependent relaxation of renal arteries from control and diabetic rabbits without significant differences between the two groups of animals. These results suggest that diabetes potentiates the acetylcholine-induced relaxation in rabbit renal arteries. Increased release of nitric oxide and prostacyclin could be responsible for the enhanced relaxant potency of acetylcholine in diabetes

Experimental diabetes induces hyperreactivity of rabbit renal artery to 5-hydroxytryptamine

The influence of diabetes on the response of isolated rabbit renal arteries to 5-hydroxytryptamine (5-HT) was examined. 5-HT induced a concentration-related contraction that was higher in arteries from diabetic rabbits than in arteries from control rabbits. Endothelium removal did not significantly modify 5-HT contractions in arteries from control rabbits but enhanced the response to 5-HT in arteries from diabetic rabbits. Incubation with NG-nitro-L-arginine (L-NA) enhanced contractions to 5-HT in arteries from control and diabetic rabbits. In arteries with endothelium, this L-NA enhancement was lower in diabetic rabbits than in control rabbits. In arteries without endothelium, incubation with L-NA enhanced the maximal contractions to 5-HT in control rabbits but did not in diabetic rabbits. Indomethacin inhibited 5-HT-induced contraction of arteries from control rabbits and enhanced the maximal contraction to 5-HT of arteries from diabetic rabbits. In summary, diabetes enhances contractile response of rabbit renal artery to 5-HT. In control animals, this response is regulated by both endothelial and non-endothelial (neuronal) nitric oxide (NO) and by a vasoconstrictor prostanoid. Diabetes impairs the release of non-endothelial NO and the vasoconstrictor prostanoi