The Body Image Virtual Reality Assessment (BIVRA): Measuring the body representation through virtual reality.

Our physical and psychological well-being is significantly influenced by how we perceive our body, in addition to our thoughts and emotions associated with it. Dysfunctional body perceptions and attitudes play a key role in the development and maintenance of severe conditions such as eating disorders in both males and females. Given its relevance, some attempts have been made to improve body image assessment methods in terms of perceptual accuracy and body satisfaction taking advantage of technological advances such as virtual reality. However, existing applications have mainly focused on women and clinical conditions. In this study, we presented the Body Image Virtual Reality Assessment (BIVRA), a virtual reality figure rating scale to assess body image in both male and female subjects. We tested BIVRA's ability to measure perceptual accuracy and compared its results with a standardized body satisfaction questionnaire. Additionally, we investigated gender differences. BIVRA was found to be effective in assessing body image. We observed that a perceptually based task successfully captured both low and high levels of body representations, shedding light on the significant gender differences. The association between BIVRA and the body satisfaction questionnaires was moderated by gender, with a stronger association for women. While further validation of BIVRA is needed to fully exploit its potential, our results suggest that the integration of virtual reality into the assessment of body image and related disorders may significantly enhance our understanding of individuals struggling with body image issues and has the potential to advance current methods and techniques.

Metaverse in Mental Health: The Beginning of a Long History.

PURPOSE OF REVIEW: We review the first pilot studies applying metaverse-related technologies in psychiatric patients and discuss the rationale for using this complex federation of technologies to treat mental diseases. Concerning previous virtual-reality applications in medical care, metaverse technologies provide the unique opportunity to define, control, and shape virtual scenarios shared by multi-users to exploit the "synchronized brains" potential exacerbated by social interactions. RECENT FINDINGS: The application of an avatar-based sexual therapy program conducted on a metaverse platform has been demonstrated to be more effective concerning traditional sexual coaching for treating female orgasm disorders. Again, a metaverse-based social skills training program has been tested on children with autism spectrum disorders, demonstrating a significant impact on social interaction abilities. Metaverse-related technologies could enable us to develop new reliable approaches for treating diseases where behavioral symptoms can be addressed using socio-attentive tasks and social-interaction strategies.

Remote photoplethysmography (rPPG) in the wild: Remote heart rate imaging via online webcams.

Remote photoplethysmography (rPPG) is a low-cost technique to measure physiological parameters such as heart rate by analyzing videos of a person. There has been growing attention to this technique due to the increased possibilities and demand for running psychological experiments on online platforms. Technological advancements in commercially available cameras and video processing algorithms have led to significant progress in this field. However, despite these advancements, past research indicates that suboptimal video recording conditions can severely compromise the accuracy of rPPG. In this study, we aimed to develop an open-source rPPG methodology and test its performance on videos collected via an online platform, without control of the hardware of the participants and the contextual variables, such as illumination, distance, and motion. Across two experiments, we compared the results of the rPPG extraction methodology to a validated dataset used for rPPG testing. Furthermore, we then collected 231 online video recordings and compared the results of the rPPG extraction to finger pulse oximeter data acquired with a validated mobile heart rate application. Results indicated that the rPPG algorithm was highly accurate, showing a significant degree of convergence with both datasets thus providing an improved tool for recording and analyzing heart rate in online experiments.

Egocentric and Allocentric Spatial Memory for Body Parts: A Virtual Reality Study.

Extensive literature elucidated the mechanisms underlying the ability to memorize the positions of objects in space. However, less is known about the impact that objects' features have on spatial memory. The present study aims to investigate differences in egocentric and allocentric object-location memory between hand stimuli depicted in a first-person perspective (1PP) or in a third-person one (3PP). Fifty-two adults encoded spatial positions within a virtual museum environment featuring four square buildings. Each of these buildings featured eight paintings positioned along the walls, with two pictures displayed on each of the four walls. Thirty-two stimuli were employed, which represented pictures of the right hand performing various types of gestures. Half of the stimuli depicted the hand in the 1PP, while the other half depicted the hand in the 3PP. Both free and guided explorations served as encoding conditions. Immediately after that, participants underwent a two-step object-location memory task. Participants were provided with a map of the museum and asked to identify the correct building where the image was located (allocentric memory). Then, they were presented with a schematic representation of the exhibition room divided into four sections and instructed to select the section where they thought the picture was located (egocentric memory). Our findings indicate a memory performance boost associated with egocentric recall, regardless of the perspective of the bodily stimuli. The results are discussed considering the emerging literature on the mnemonic properties of body-related stimuli for spatial memory.

Binaural hearing in monaural conductive or mixed hearing loss fitted with unilateral Bonebridge.

Objective: To determine the benefits of binaural hearing rehabilitation in patients with monaural conductive or mixed hearing loss treated with a unilateral bone conduction implant (BCI). Methods: This monocentric study includes 7 patients with monaural conductive or mixed hearing loss who underwent surgical implantation of a unilateral BCI (Bonebridge, Med-El). An ITA Matrix test was performed by each patient included in the study - without and with the BCI and in three different settings - to determine the summation effect, squelch effect and head shadow effect. Subjective hearing benefits were assessed using the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. Results: The difference in signal to noise ratio of patients without and with BCI was 0.79 dB in the summation setting (p < 0.05), 4.62 dB in the head shadow setting (p < 0.05) and 1.53 dB (p = 0.063) in the squelch setting. The APHAB questionnaire revealed a subjective discomfort in the presence of unexpected sounds in patients using a unilateral BCI (aversiveness score) compared to the same environmental situations without BCI, with a mean discomfort score of 69.00% (SD ± 21.24%) with monaural BCI versus 25.67% (SD ± 16.70%) without BCI (difference: -43.33%, p < 0.05). In terms of global score, patients wearing a unilateral Bonebridge implant did not show any significant differences compared to those without hearing aid (difference: -4.00%, p = 0.310). Conclusions: Our study shows that the use of a unilateral BCI in patients affected by monaural conductive or mixed hearing loss can improve speech perception under noise conditions due to the summation effect and to the decrease of the head shadow effect. However, since monaural BCIs might lead to discomfort under noise conditions in some subjects, a pre-operative assessment of the possible individual benefit of a monaural BCI should be carried out in patients affected by unilateral conductive or mixed hearing loss in order to investigate the possible additional effect of the fitting of hearing aids.

PAD-mediated citrullination is a novel candidate diagnostic marker and druggable target for HPV-associated cervical cancer.

Citrullination is an emerging post-translational modification catalyzed by peptidyl-arginine deiminases (PADs) that convert peptidyl-arginine into peptidyl-citrulline. In humans, the PAD family consists of five isozymes (PADs 1-4, 6) involved in multiple diseases, including cancer. Given that high-risk (hr) human papillomaviruses (HPVs) are the etiological agents of cervical cancer, in this study, we sought to determine whether PAD-mediated protein citrullination would play a functional role in the HPV-driven transformation of epithelial cells. Here we show that both total protein citrullination and PAD4 expression levels are significantly associated with cervical cancer progression. Specifically, epithelial immunostaining for PAD4 revealed an increasingly higher histoscore from low-grade (CIN1) to high-grade (CIN2, CIN3) cervical intraepithelial neoplasia, and invasive squamous cell carcinoma (SCC) lesions, raising the attractive possibility that PAD4 may be used as tumor staging markers. Furthermore, taking advantage of the epidermoid cervical cancer cell line CaSki, which harbors multiple copies of the integrated HPV16 genome, we show that the expression of E6 and E7 HPV oncoproteins is impaired by treatment with the pharmacological pan-PAD inhibitor BB-Cl-amidine. Consistently, p53 and p21, two targets of HPV oncoproteins, are upregulated by the PAD inhibitor, which undergoes cell growth arrest and apoptosis. Altogether, these findings highlight a novel mechanism by which hrHPVs alter host regulatory pathways involved in cell cycle and survival to gain viral fitness, raising the possibility that PADs may represent an attractive target for developing novel host-targeting antivirals effective in preventing cervical cancer progression.

Artificial Intelligence: A Game-Changer for Mental Health Care.

Starting from the escalating global burden of mental health disorders, exacerbated by the COVID-19 pandemic, the article examines the potential of artificial intelligence (AI) to revolutionize mental health care. With nearly one in five adults facing mental health issues and suicide ranking as a leading cause of death among the young, the strained mental health system seeks innovative solutions. The text discusses the rapid evolution of AI, particularly in image analysis for early physical health diagnoses, and its promising applications in mental health, including predictive analytics for various disorders. AI's ability to analyze written language, speech characteristics, and physiological signals from wearables offers avenues for remote monitoring and early prognosis. Despite the need to address ethical considerations, particularly biases in data sets and concerns about potential patient detachment, the article advocates for AI as a complementary tool rather than a replacement for human involvement in mental health services. Overall, the article emphasizes the transformative potential of AI in enhancing diagnostics, monitoring, and treatment strategies for mental health disorders.

Exploring the Remediation of Behavioral Disturbances of Spatial Cognition in Community-Dwelling Senior Citizens with Mild Cognitive Impairment via Innovative Technological Apparatus (BDSC-MCI Project): Protocol for a Prospective, Multi-Center Observational Study.

Spatial navigation (SN) has been reported to be one of the first cognitive domains to be affected in Alzheimer's disease (AD), which occurs as a result of progressive neuropathology involving specific brain areas. Moreover, the epsilon 4 isoform of apolipoprotein-E (APOE-ε4) has been associated with both sporadic and familial late-onset AD, and patients with mild cognitive impairment (MCI) due to AD are more likely to progressively deteriorate. Spatial navigation performance will be examined on a sample of 76 community-dwelling senior citizens (25 healthy controls; 25 individuals with subjective cognitive decline (SCD); and 26 patients with MCI due to AD) via a virtual computer-based task (i.e., the AppleGame) and a naturalistic task (i.e., the Detour Navigation Test-modified version) for which a wearable device with sensors will be used for recording gait data and revealing physiological parameters that may be associated with spatial disorientation. We expect that patients with MCI due to AD and APOE-ε4 carriers will show altered SN performances compared to individuals with SCD and healthy controls in the experimental tasks, and that VR testing may predict ecological performance. Impaired SN performances in people at increased risk of developing AD may inform future cognitive rehabilitation protocols for counteracting spatial disorientation that may occur during elders' traveling to unfamiliar locations. The research protocol has been approved by the Ethics Committee of the Istituto Auxologico Italiano. Findings will be published in peer-reviewed medical journals and discussed in national and international congresses.

Beyond traditional training: Integrating data from semi-immersive VR dual-task intervention in Parkinsonian Syndromes. A study protocol.

Completing cognitive and motor tasks simultaneously requires a high level of cognitive control in terms of executive processes and attentional abilities. Most of the daily activities require a dual-task performance. While walking, for example, it may be necessary to adapt gait to obstacles of the environment or simply participate in a conversation; all these activities involve more than one ability at the same time. This parallel performance may be critical in the cognitive or motor load, especially for patients with neurological diseases such as Parkinsonian Syndromes. Patients are often characterized by a crucial impairment in performing both tasks concurrently, showing a decrease in attention skills and executive functions, thus leading to increased negative outcomes. In this scenario, the accurate assessment of the components involved in dual-task performance is crucial, and providing an early specific training program appears to be essential. The objective of this protocol is to assess cognitive and motor components involved in dual-task performance and create a training program based on ecological activities focusing on executive and motor functions. Thus, we will employ Virtual Reality to provide semi-immersive, multisensory, ecological, standardized, and realistic experiences for rehabilitative purposes in patients with Parkinsonian Syndromes, considering its high prevalence in aging and the incidence of motor and cognitive dysfunctions in this population. Moreover, we propose to integrate the great amount of different data provided by dual-task and Virtual Reality system, using machine learning techniques. These integrations may increase the treatment's reliability in terms of better prognostic indexes and individualized training.

Learning in the Metaverse: Are University Students Willing to Learn in Immersive Virtual Reality?

Immersive virtual reality (IVR) technology provides several educational affordances that make it a valuable tool for learning, especially from a constructivist learning perspective. Combined with the increasing availability of Metaverse social platforms, such as ENGAGE and AltSpace VR, where students and teachers can meet and work together, IVR may transform how students learn and interact with educational content. However, little is known about students' attitudes toward IVR in education. To address this gap, we surveyed 329 undergraduate students from different universities in Italy. We used the Unified Theory of Acceptance and Use of Technology (UTAUT) to predict students' intention to adopt IVR for learning. We further explored the role that different individual factors, including students' learning styles, affordances perceptions, and personal innovativeness, have on their attitudes toward IVR. A hierarchical multiple regression analysis revealed that the four constructs of the UTAUT, namely performance expectancy, effort expectancy, social influence, and facilitating conditions were the strongest predictors of students' intention to use IVR in education and that individual factors only had little impact on it. Based on these results, this study provides helpful indications for researchers and educators who wish to introduce IVR effectively in educational contexts. Given the new possibilities provided by Metaverse applications based on IVR technology for learning, it is indeed crucial to fully understand the attitudes different stakeholders in education have toward adopting this technology in educational contexts.

Searching for the Metaverse: Neuroscience of Physical and Digital Communities.

What distinguishes real-world communities from their online counterparts? Social and cognitive neuroscience research on social networks and collective intentionality will be used in the article to answer this question. Physical communities are born in places. And places engage "we-mode" neurobiological and cognitive processes as behavioral synchrony, shared attention, deliberate attunement, interbrain synchronization, and so on, which create coherent social networks of very different individuals who are supported by a "wisdom of crowd." Digital technologies remove physical boundaries, giving people more freedom to choose their activities and groups. At the same time, however, the lack of physical co-presence of community members significantly reduces their possibility of activating "we-mode" cognitive processes and social motivation. Because of this, unlike physical communities that allow interaction between people from varied origins and stories, digital communities are always made up of people who have the same interests and knowledge (communities of practice). This new situation disrupts the "wisdom of crowd," making the community more radical and less accurate (polarization effect), allowing influential users to wield disproportionate influence over the group's beliefs, and producing inequalities in the distribution of social capital. However, a new emergent technology-the Metaverse-has the potential to reverse this trend. Several studies have revealed that virtual and augmented reality-the major technologies underlying the Metaverse-can engage the same neurobiological and cognitive "we-mode" processes as real-world environments. If the many flaws in this technology are fixed, it might encourage people to engage in more meaningful and constructive interactions in online communities.

Interoceptive technologies for psychiatric interventions: From diagnosis to clinical applications.

Interoception-the perception of internal bodily signals-has emerged as an area of interest due to its implications in emotion and the prevalence of dysfunctional interoceptive processes across psychopathological conditions. Despite the importance of interoception in cognitive neuroscience and psychiatry, its experimental manipulation remains technically challenging. This is due to the invasive nature of existing methods, the limitation of self-report and unimodal measures of interoception, and the absence of standardized approaches across disparate fields. This article integrates diverse research efforts from psychology, physiology, psychiatry, and engineering to address this oversight. Following a general introduction to the neurophysiology of interoception as hierarchical predictive processing, we review the existing paradigms for manipulating interoception (e.g., interoceptive modulation), their underlying mechanisms (e.g., interoceptive conditioning), and clinical applications (e.g., interoceptive exposure). We suggest a classification for interoceptive technologies and discuss their potential for diagnosing and treating mental health disorders. Despite promising results, considerable work is still needed to develop standardized, validated measures of interoceptive function across domains and before these technologies can translate safely and effectively to clinical settings.

Toward a Humane Metaverse: Challenges and Opportunities.

The metaverse, an emerging digital universe blurring the lines between reality and virtuality, offers a view into a future where human interaction transcends physical boundaries. In this article, we analyze the multidimensional facets of the metaverse, scrutinizing the landscape of challenges and opportunities it offers. The article delves into the challenges faced by human society in adapting to the metaverse, including the digital divide, ethical dilemmas, the level of trust, and the potential erosion of social and physical reality. Amid the allure of boundless creativity, questions arise about the very essence of human experience-identity, empathy, social relationships, life satisfaction, and the nature of reality itself. The metaverse, with all its complexities, challenges us to redefine the boundaries of human interaction, urging us to tread cautiously while embracing the limitless possibilities it presents. As we venture "toward a humane metaverse," we must navigate the intricate interplay of technology and humanity, shaping a future where the virtual realm enhances, rather than diminishes, the richness of the human experience.

A Pilot Multisensory Approach for Emotional Eating: Pivoting from Virtual Reality to a 2-D Telemedicine Intervention during the COVID-19 Pandemic.

BACKGROUND AND OBJECTIVES: Emotional eating (EE), or eating in response to negative emotions or stress, can be understood as a manifestation of difficulties regulating emotions among individuals with eating disorders. To date, many virtual reality treatments for eating disorders have focused on body image or exposure methods and have not exclusively targeted EE. There has been a call made by experts in the field for a "new generation" of virtual reality interventions, capable of utilizing virtual reality's potential more fully. We developed a novel emotion regulation (ER) intervention based upon virtual reality to improve EE among adults with an eating disorder diagnosis. The study hypothesized that a novel ER protocol utilizing evidence-based strategies, as well as innovative techniques, would be feasible and acceptable and show preliminary signals of effectiveness for EE. MATERIALS AND METHODS: Due to COVID-19, the study pivoted from the original completely immersive intervention to a 2-D intervention deliverable over telehealth. Twenty-one patients were recruited from the Adult Eating Disorders Program within Stanford University to receive seven weekly one-hour virtual experiences (VEs) focusing on ER. Participants were not randomized but, as part of a pragmatic study design, chose between the novel VE-Emotion Regulation (VE-ER) intervention or continuing their treatment as usual. Before and after the seven sessions, participants completed an assessment by filling out online questionnaires. RESULTS: Overall, VE-ER treatment was feasible, and the participant and therapist acceptability of VE-ER treatment was fairly high. In terms of preliminary effectiveness, the results showed a significant reduction in the frequencies of disordered eating behaviors in both groups, but a greater improvement in EE in the VE-ER group and a significant reduction in emotion dysregulation after the treatment. CONCLUSIONS: This novel pilot study makes a valuable contribution to the scant literature by demonstrating the feasibility, acceptability, and preliminary effectiveness of combining somatic, multisensory, and cognitive manipulations delivered via telemedicine to help patients with EE to manage their emotions. The findings can serve as the basis for larger, controlled studies evaluating the translation of the somatic marker theory from the research literature into real-world U.S. clinic settings.

Mental health meets computational neuroscience: A predictive Bayesian account of the relationship between interoception and multisensory bodily illusions in anorexia nervosa

Mental health disorders pose a significant challenge to society. The Bayesian perspective on the mind offers unique insights and tools that may help address a variety of mental health conditions. Psychopathological dysfunctions are often connected to altered predictive and active inference processes, in which cognitive and physiological pathogenic beliefs shape the clinical condition and its symptoms. However, there is a lack of general empirical models that integrate cognitive beliefs, physiological experience, and symptoms in healthy and clinical populations. In this study, we examined the relationship between altered predictive mechanisms, interoception, and pathological bodily distortions in healty individuals and in individuals suffering from anorexia nervosa (AN). AN patients (N=15) completed a Virtual Reality Full-Body Illusion along with interoceptive tasks twice: at hospital admission during an acute symptomatological phase (Time 1) and after a 12-week outpatient clinical weight-restoring rehabilitative program (Time 2). Results were compared to a healthy control group. Our findings indicated that higher levels of interoceptive metacognitive awareness were associated with a greater embodiment. However, unlike in healthy participants, AN patients' interoceptive metacognition was linked to embodiment even in multisensory mismatching (asynchronous) conditions. In addition, unlike in healthy participants, higher interoceptive metacognition in AN patients was related to prior abnormal bodily distortions during the acute symptomatology phase. Prediction errors in bodily estimates predicted posterior bodily estimate distortions after the illusion, but while this relationship was only significant in the synchronous condition in healthy participants, there was no significant difference between synchronous and asynchronous conditions in AN patients. (AU)

The multisensory mind: a systematic review of multisensory integration processing in Anorexia and Bulimia Nervosa.

Individuals with Anorexia Nervosa and Bulimia Nervosa present alterations in the way they experience their bodies. Body experience results from a multisensory integration process in which information from different sensory domains and spatial reference frames is combined into a coherent percept. Given the critical role of the body in the onset and maintenance of both Anorexia Nervosa and Bulimia Nervosa, we conducted a systematic review to examine multisensory integration abilities of individuals affected by these two conditions and investigate whether they exhibit impairments in crossmodal integration. We searched for studies evaluating crossmodal integration in individuals with a current diagnosis of Anorexia Nervosa and Bulimia Nervosa as compared to healthy individuals from both behavioral and neurobiological perspectives. A search of PubMed, PsycINFO, and Web of Sciences databases was performed to extract relevant articles. Of the 2348 studies retrieved, 911 were unique articles. After the screening, 13 articles were included. Studies revealed multisensory integration abnormalities in patients affected by Anorexia Nervosa; only one included individuals with Bulimia Nervosa and observed less severe impairments compared to healthy controls. Overall, results seemed to support the presence of multisensory deficits in Anorexia Nervosa, especially when integrating interoceptive and exteroceptive information. We proposed the Predictive Coding framework for understanding our findings and suggested future lines of investigation.

Diagnoses of Anorexia Nervosa and Bulimia Nervosa have increased dramatically in recent years, taking on the characteristics of a mental health emergency. More research is therefore needed to better understand these conditions, especially given their complex and multifaceted nature. Patients affected by these conditions report significant alterations in body-self experience. Body experience results from a cross-modal integration process in which information from different sensory modalities and spatial frames is combined. Therefore, we systematically reviewed studies that focused on multisensory integration in patients affected by Anorexia Nervosa and Bulimia Nervosa, as it may play a key role in the onset and maintenance of these pathologies. Studies in this review found multisensory integration difficulties in patients with Anorexia Nervosa, but not enough studies were retrieved to draw conclusions regarding Bulimia Nervosa. We discussed findings trying to link behavioral, neuropsychological, and neuroscientific evidence in light of the predictive coding framework to provide a different perspective on patients' distorted body experiences. This may lead to new insights to refine our understanding of these complex and poorly understood disorders.