A review of mechanism of action of outdoor exposure in preventing myopia incidence and progression

Various studies have suggested several environmental,pharmacological,medical,and optical interventions and some are in use but their efficacy in myopia control may be transient,and the cellular,molecular,and biochemical mechanisms involved unclear.Daylight exposure is currently regarded as an effective and enduring strategy in the control of myopia development and progression.However,the mechanism behind the effect of outdoor exposure and its association with genetic predisposition and other relatively more significant environmental factors on myopia is still a conundrum.This review focuses on survey-based and intervention-based studies carried out to propose a mechanism that accounts for myopia development and important for its control.

Evaluation and Projection of Population Exposure to Temperature Extremes over the Beijing−Tianjin−Hebei Region Using a High-Resolution Regional Climate Model RegCM4 Ensemble

Temperature extremes over rapidly urbanizing regions with high population densities have been scrutinized due to their severe impacts on human safety and economics.First of all,the performance of the regional climate model RegCM4 with a hydrostatic or non-hydrostatic dynamic core in simulating seasonal temperature and temperature extremes was evaluated over the historical period of 1991–99 at a 12-km spatial resolution over China and a 3-km resolution over the Beijing−Tianjin−Hebei(JJJ)region,a typical urban agglomeration of China.Simulations of spatial distributions of temperature extremes over the JJJ region using RegCM4 with hydrostatic and non-hydrostatic cores showed high spatial correlations of more than 0.8 with the observations.Under a warming climate,temperature extremes of annual maximum daily temperature(TXx)and summer days(SU)in China and the JJJ region showed obvious increases by the end of the 21st century while there was a general reduction in frost days(FD).The ensemble of RegCM4 with different land surface components was used to examine population exposure to temperature extremes over the JJJ region.Population exposure to temperature extremes was found to decrease in 2091−99 relative to 1991−99 over the majority of the JJJ region due to the joint impacts of increases in temperature extremes over the JJJ and population decreases over the JJJ region,except for downtown areas.Furthermore,changes in population exposure to temperature extremes were mainly dominated by future population changes.Finally,we quantified changes in exposure to temperature extremes with temperature increase over the JJJ region.This study helps to provide relevant policies to respond future climate risks over the JJJ region.

Combined proteomic and metabolomic studies on the liver of Amur sturgeon Acipenser schrenckii under titanium dioxide nanoparticle exposure

Nanomaterials,particularly titanium dioxide nanoparticles(TiO_(2)-NPs),are extensively utilized across various industries.However,their environmental release has raised concerns regarding their potential ecological and environmental impacts.The reproductive toxicity of TiO_(2)-NPs in fish species has attracted considerable attention,yet conflicting research outcomes have been reported.We investigated the effects of TiO_(2)-NPs exposure on the liver of juvenile Amur sturgeon Acipenser schrenckii using label-free proteomic and untargeted metabolomic analyses.The experiment included a control group and three groups exposed to different concentrations of TiO_(2)-NPs(low,TL;medium,TM;high,TH).Compared to the control group,9,19,and 25 proteins and 35,73,and 158 metabolites were differentially expressed in the TH,TM,and TL TiO_(2)-NP-exposed groups,respectively.The differentially expressed genes(DEGs)were enriched in the Kyoto Encyclopedia for Genes and Genomes(KEGG)pathways related to glycolysis and gluconeogenesis.Moreover,among the 126 correlated proteins,the most enriched pathways were associated with endocytosis and protein processing in the endoplasmic reticulum.Notably,syringic acid was significantly downregulated across all three TiO_(2)-NP-exposed groups.To obtain a comprehensive overview of the TiO_(2)-NP-induced expression changes,a co-regulated network of proteins and metabolites associated with TiO_(2)-NPs exposure was constructed.Exposure to TiO_(2)-NPs led to enrichment and alteration of pathways related to immune responses,including endocytosis,protein processing in the endoplasmic reticulum,and peroxisome proliferator-activated receptor(PPAR)signaling.In conclusion,our findings indicate that exposure to TiO_(2)-NPs might disrupt glucose metabolism and induce immune responses,thus contributing to our understanding of the environmental impacts of nanomaterials and highlighting the need for further research and development of potential mitigation strategies.

The value of toxicological analysis in acute poisoning patients with uncertain exposure histories:a retrospective and descriptive study from an institute of poisoning

BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.METHODS:This was a retrospective and descriptive study from an institute of poisoning.Patient registration information and test reports spanning the period from April 1,2020 to March 31,2022,were obtained.Patients with uncertain exposure histories and who underwent toxicological analysis were included.Clinical manifestations and categories of toxics were analyzed.RESULTS:Among the 195 patients with positive toxicological analysis results,the main causes of uncertain exposure history was disturbance of consciousness(62.6%),unawareness(23.6%)and unwillingness or lack of cooperation(13.8%).The predominant clinical manifestations were disturbed consciousness(62.6%),followed by vomiting and nausea(14.4%)and liver function abnormalities(8.7%).A comparison of clinical manifestations between patients with positive and negative(n=99)toxicological analyses results revealed significantly different proportions of disturbances in consciousness(63%vs.21%),dizziness(1.5%vs.5.1%),multi-organ failure(1.5%vs.7.1%),and local pain(0 vs 4%).The main categories of substances involved were psychiatric medications(23.1%),sedatives(20.5%),insecticides(13.8%),and herbicides(12.8%).CONCLUSION:The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific,and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.

Comprehensive analysis of advanced glycation end-products in commonly consumed foods:presenting a database for dietary AGEs and associated exposure assessment

Advanced glycation end-products(AGEs)are a group of heterogeneous compounds formed in heatprocessed foods and are proven to be detrimental to human health.Currently,there is no comprehensive database for AGEs in foods that covers the entire range of food categories,which limits the accurate risk assessment of dietary AGEs in human diseases.In this study,we first established an isotope dilution UHPLCQq Q-MS/MS-based method for simultaneous quantification of 10 major AGEs in foods.The contents of these AGEs were detected in 334 foods covering all main groups consumed in Western and Chinese populations.Nε-Carboxymethyllysine,methylglyoxal-derived hydroimidazolone isomers,and glyoxal-derived hydroimidazolone-1 are predominant AGEs found in most foodstuffs.Total amounts of AGEs were high in processed nuts,bakery products,and certain types of cereals and meats(>150 mg/kg),while low in dairy products,vegetables,fruits,and beverages(<40 mg/kg).Assessment of estimated daily intake implied that the contribution of food groups to daily AGE intake varied a lot under different eating patterns,and selection of high-AGE foods leads to up to a 2.7-fold higher intake of AGEs through daily meals.The presented AGE database allows accurate assessment of dietary exposure to these glycotoxins to explore their physiological impacts on human health.

Association between Exposure of Rare Earth Elements and Outcomes of In Vitro Fertilization-Embryo Transfer in Beijing

Objective The study aimed to investigate the impact of rare earth elements(REEs)exposure on pregnancy outcomes of in vitro fertilization-embryo transfer(IVF-ET)by analyzing samples from spouses.Methods A total of 141 couples were included.Blood and follicular fluid from the wives and semen plasma from the husbands,were analyzed for REEs using inductively coupled plasma mass spectrometry(ICP-MS).Spearman's correlation coefficients and the Mann–Whitney U test were used to assess correlations and compare REE concentrations among three types of samples,respectively.Logistic models were utilized to estimate the individual REE effect on IVF-ET outcomes,while BKMR and WQS models explored the mixture of REE interaction effects on IVF-ET outcomes.Results Higher La concentration in semen(median 0.089 ng/mL,P=0.03)was associated with a lower fertilization rate.However,this effect was not observed after artificial selection intervention through intracytoplasmic sperm injection(ICSI)(P=0.27).In semen,the REEs mixture did not exhibit any significant association with clinical pregnancy.Conclusion Our study revealed a potential association between high La exposure in semen and a decline in fertilization rate,but not clinical pregnancy rate.This is the first to report REEs concentrations in follicular fluid with La,Ce,Pr,and Nd found at significantly lower concentrations than in serum,suggesting that these four REEs may not accumulate in the female reproductive system.However,at the current exposure levels,mixed REEs exposure did not exhibit reproductive toxicity.

Autophagy Alleviates Cold Exposure-induced Tight Junction Injury in Murine Ileum

Cold exposure is a pervasive stressor in the polar and subpolar regions,exerting both acute and chronic effects on individuals.This environmental factor is known to induce physiological stress,compromise immune response efficacy,and increase susceptibility to various diseases.Chronic cold exposure,characterized by repetitive nonconsecutive exposure to suboptimal temperatures over an extended duration.

Increased population exposures to extreme precipitation in Central Asia under 1.5℃ and 2℃ global warming scenarios

The increase in extreme precipitation(EP)may pose a serious threat to the health and safety of population in arid and semi-arid regions.The current research on the impact of EP on population in Central Asia(CA)is insufficient and there is an urgent need for a comprehensive assessment.Hence,we opted for precipitation and temperature data under two Shared Socioeconomic Pathways(SSP2-4.5 and SSP5-8.5)from ten Global Climate Models(GCMs),which were obtained from the NASA Earth Exchange Global Daily Downscaled Projections(NEX-GDDP-CMIP6).By integrating population data in 2020 and 2050(SSP2 and SSP5),we investigated the future changes in EP and population exposure in CA under 1.5℃and 2℃global warming scenarios(GWSs).Our analysis indicates that EP in CA is projected to increase with global warming.Under the SSP5-8.5,the maximum daily precipitation(Rx1day)exhibits an average response rate to global warming of 3.58%/K(1.99-4.06%/K).With rising temperatures,an increasing number of areas and populations in CA will be impacted by EP,especially in the Fergana valley.Approximately 25%of the population(land area)in CA is exposed to Rx1day with increases of more than 8.31%(9.32%)under 1.5℃GWS and 14.18%(13.25%)under 2℃GWS.Controlling temperature rise can be effective in reducing population exposures to EP.For instance,limiting the temperature increase to 1.5℃instead of 2℃results in a 2.79%(1.75%-4.59%)reduction in population exposure to Rx1day.Finally,we found that climate change serves as the predominant factor influencing the population exposure to EP,while the role of population redistribution,although relatively minor,should not be disregarded.Particularly for prolonged drought,the role of population redistribution manifests negatively.

Surface ozone in global cities:A synthesis of basic features,exposure risk,and leading meteorological driving factors

Long-term exposure to high surface ozone(O_(3))concentrations,a complex oxidative atmospheric pollutant,can adversely impact human health.Based on O_(3)monitoring data from 261 cities worldwide in 2020,generalized additive model(GAM)and spatial data analysis(SDA)methods were applied in this study to quantitatively evaluate the spatiotemporal distribution of O_(3)concentration,exposure risk,and dominant meteorological factors.Results indicated that over 40%of the cities worldwide were exposed to harmful O_(3)concentration ranges(40-60μg/m^(3)),with most cities distributed in China and India.Moreover,significant seasonal variations in global O_(3)concentrations were observed,presenting as summer(45.6μg/m^(3))>spring(47.3μg/m^(3))>autumn(38.0μg/m^(3))>winter(33.6μg/m^(3)).Exposure analysis revealed that approximately 12.2%of the population in 261 cities were exposed to an environment with high O_(3)concentrations(80-160μg/m^(3)),with about 36.32 million people in major countries.Thus,the persistent increase in high O_(3)levels worldwide is a critical factor contributing to threats to human health.Furthermore,GAM results indicated temperature,relative humidity,and wind speed as primary determinants of O_(3)variability.The synergy of meteorological factors is critical for understanding O_(3)changes.Our findings are important for enforcing robust air quality policies and mitigating public risk.

Effect of long-term thermal exposure on microstructure of laser-welded UNS N10003 alloy

The evolution of the microstructure and tensile rupture mechanism of laser welds in UNS N10003 alloy exposed to 700℃are investigated.Fine M_(6)C carbides precipitate around the primary eutectic M_(6)C-γcarbides in the fusion zone after 100 h of exposure.During long-term thermal exposure,the size of the fine M_(6)C carbides increased.The eutectic M_(6)C-γcarbides in the as-welded fusion zone transformed into spherical M_(6)C carbides as the exposure time extends to 10000 h.Additionally,the spherical M_(6)C particles exhibit size coarsening with increasing exposure time.The tensile properties of the welded joints are not adversely affected by the evolution of eutectic M_(6)C-γcarbides and the coarsening of M_(6)C carbides.

Lone-Star retractor perineal exposure method for laparoscopic abdominal perineal resection of rectal cancer

BACKGROUND The abdominal perineal resection(APR),historically referred to as Mile’s proce-dure,stands as a time-honored surgical intervention for rectal cancer manage-ment.Advancements in surgical techniques and the advent of neoadjuvant therapies have significantly improved the rate of sphincter preservation among patients afflicted with rectal cancer,including those with ultralow rectal cancer.Despite these improvements,APR maintains its irreplaceable role in the clinical landscape,particularly for cases involving low rectal cancer with encroachment on the external anal sphincter or levator ani muscles.Optimal perineal exposure stands as a pivotal phase in APR,given that the precision of this maneuver is directly correlated with both the safety of the surgery and the patient’s subse-quent long-term prognosis.AIM To evaluate the value of Lone-Star retractor(LSR)perineal exposure method in the treatment for laparoscopic APR of rectal cancer.METHODS We reviewed the records of 38 patients with rectal cancer at Anqing Municipal Hospital from January 2020 to December 2023,including 20 patients who underwent the APR procedure with a LSR perineal exposure method(LSR group)and 18 patients who underwent the APR procedure with a conventional perineal exposure method(control group).In the LSR group,following incision of the skin and subcutaneous tissue,the LSR was placed and dynamically adjusted according to the surgical plane to fully expose the perineal operative field.RESULTS A total of 38 patients underwent laparoscopic APR,none of whom were found to have distant metastasis upon intraoperative exploration.Perineal blood loss,the postoperative hospital stays and the wound pain scores in the LSR group were significantly lower than those in the control group.A single surgeon completed the perineal operation significantly more often in the LSR group than in the control group(P<0.05).The incidence of infection via the perineal incision in the LSR group was significantly lower than that in the control group(P<0.05).No cases of distant metastasis or local recurrence were found among the patients at the postoperative follow-up.CONCLUSION The application of the LSR technique might be helpful for performing perineal exposure during APR for rectal cancer and could reduce the incidence of perineal complications,shorten the postoperative hospital stay,improve postoperative pain,and allow one surgeon to perform the perineal operation.

Behavior of transporting pipeline sections without and with hydrogen exposure based on full-scale tests

Pipeline transport of hydrogen is one of today’s economic and environmental challenges.In order to find safe and reliable application of both existing gas and build new pipelines,it is essential to carry out tests on full-scale pipeline section,including the potentially more dangerous places than the main pipe,the girth welds.For the investigations,pipeline sections of P355NH steel with girth welds were prepared and exposed to pure hydrogen at twice the maximum allowable operating pressure for 41 days.Subsequently,full-scale burst tests were carried out and specimens were cut and prepared from the typical locations of the failed pipeline sections for mechanical,and macro-and microstructural investigations.The results obtained were evaluated and compared with data from previous full-scale tests on pipeline sections without hydrogen exposure.The results showed differences in the behavior of pipeline sections loaded in different ways,with different characteristics of the materials and the welded joints,both in the cases without hydrogen exposure and in the cases exposed to hydrogen.

Spatial Optimization Strategies for High Temperature Heat Exposure Based on Thermally Vulnerable Populations and Case Studies

The objective of this study is to investigate the factors that contribute to brittleness and to identify strategies for mitigating these factors in populations with varying degrees of thermal vulnerability,based on the potential impact of extreme heat exposure on human survival and habitability.The physiological condition of lower adaptability to high temperature environments and the assessment of individuals who may have higher tolerance time in high temperature environments based on spatial perspectives suggest the need for targeted spatial optimization strategies for commuters and disadvantaged populations.This is demonstrated through a case study.These optimization measures encompass a variety of aspects,including the integration of transportation systems,the expansion of grey space corridors,the improvement of green space layout,and the implantation of green infrastructure.The study aims to reduce the exposure time of thermally vulnerable individuals to high temperature environments through spatial optimization strategies,to enhance the resilience of urban green spaces to heat stress,and to reduce the probability of heat-wave occurrence.

Feasibility of Integrating Leprosy Post-Exposure Prophylaxis with Single-Dose Rifampicin (LPEP) into Routine Leprosy Control Program in Bukedi and Teso Regions in Uganda

Background: World Health Organization recommends the implementation of contact tracing and Leprosy Post Exposure prophylaxis (LPEP) to interrupt the chain of transmission. To accelerate the uptake of this recommendation, a cross-sectional study among contacts of leprosy patients was conducted to investigate the feasibility of integrating leprosy systematic contact tracing and post-exposure prophylaxis (PEP) into the routine leprosy control program. Methods: This was a mixed methods cross-sectional study. The study was implemented in Kumi, Ngora, Serere, Soroti, Budaka and Kibuku Districts. Results: The 45 enrolled index patients (97.8% of the registered) identified a total of 135 contacts, of which 134 (99·2%) consented and were screened. Among them, one new leprosy patient was identified and started on treatment with multidrug therapy (MDT). All the eligible contacts, received the prophylactic treatment with Single Dose Rifampicin (SDR). Overall, SDR was administered to 133(98.5% of the listed contacts) with no adverse event reported. Factors associated with successful contact investigation and management included: Involvement of index patients, health care workers during the contact screening and SDR A administration, counselling of the index patients and contacts by the health care works, LPEP being administered as Directly observed Therapy (DOT) among others. Results Interpretation: The integration of leprosy post-exposure prophylaxis with administration of SDR and contact tracing is feasible, generally accepted by the patient, their contacts and health workers and can be integrated into the National Leprosy control programmes with minimal additional efforts once contact tracing has been established. Therefore, we recommend integration of administration of SDR in to the routine leprosy control program.

The Influence of Aerial Exposure on Sea Anemones Aulactinia veratra Mucin Genes Expression Using the RNA Sequencing

Mucin genes are the main component of mucus. The sea anemone species, Aulactinia veratra (Phylum Cnidaria) contains different types of mucin genes. In the intertidal zone, A. veratra is found to be exposed to air during the low tide and produces large quantities of mucus as an external covering. The relation between low tide and mucus secretion is still unclear, and what is the role of mucin during arial exposure is not yet investigated. This study hypothesised that the mucin genes in A. veratra would have significantly high expression in response to aerial exposure. Therefore, the aim of current study was to examine and analyses the response of A. veratra mucins in response to an experiment involving three hours of aerial exposure. To achieve this, aim the RNA-sequencing and bioinformatics analyses were used to examine the expression profile of A. veratra mucin genes in response to aerial exposure. The generated results have shown that, Mucin4-like and mucin5B-like were up-regulated in response to the three hours of aerial exposure in A. veratra. This finding shows a significant role of mucin5B-like and mucin4-like genes in response to air stress at low tide. The data generated from this study could be used in conjunction with future mucin gene studies of sea anemones and other cnidarians to compare A. veratra mucin gene expression results across time, and to extend our understanding of mucin stress response in this phylum.

Asbestos Exposure during Gasket Removal from Aircraft Engine

We have previously evaluated asbestos exposure associated with various maintenance procedures on light aircraft. The purpose of this study was to evaluate asbestos exposure during engine maintenance on light aircraft. This test was designed to evaluate the potential for asbestos exposure to mechanics and others who remove asbestos-containing engine gaskets from reciprocating style aircraft engines. Utilized in this test was an air cooled, horizontally opposed, aviation gasoline burning engine, assembled during 1986 and operated intermittently up into 2015, having accumulated 1680 hours run time. Nearly 75% of the asbestos-containing gaskets installed during 1986 were still in place at the time of testing. Chrysotile asbestos contents of such gaskets ranged from 55% to 60% by area, for those of sheet style and 5% by area, for the spiral wound metal/asbestos style. Despite the levels of effort required to effect gasket removals, the professional aircraft mechanic was not exposed to airborne asbestos fibers at the lower limits of sampling and analytical detection achieved;all of which were substantially less than the current Occupational Safety and Health Administration Permissible Exposure Limits for asbestos. The results of this testing indicate an absence of gasket related asbestos exposure risk to mechanics who work with light aircraft engines, including those having asbestos-containing gaskets. These results are consistent with the findings of Mlyarek and Van Orden who studied the asbestos exposure risk occasioned during overhaul of larger radial style reciprocating aircraft engines [1].

Expression levels of K_(ATP)channel subunits and morphological changes in the mouse liver after exposure to radiation

BACKGROUND ATP sensitive K+(K_(ATP))channels are ubiquitously distributed in various of cells and tissues,including the liver.They play a role in the pathogenesis of myocardial and liver ischemia.AIM To evaluate the radiation-induced changes in the expression of K_(ATP)channel subunits in the mouse liver to understand the potential role of K_(ATP)channels in radiation injury.METHODS Adult C57BL/6 mice were randomly exposed toγ-rays at 0 Gy(control,n=2),0.2 Gy(n=6),1 Gy(n=6),or 5 Gy(n=6).The livers were removed 3 and 24 h after radiation exposure.Hematoxylin and eosin staining was used for morphological observation;immunohistochemical staining was applied to determine the expression of K_(ATP)channel subunits in the liver tissue.RESULTS Compared with the control group,the livers exposed to 0.2 Gyγ-ray showed an initial increase in the expression of Kir6.1 at 3 h,followed by recovery at 24 h after exposure.Exposure to a high dose of 5.0 Gy resulted in decreased expression of Kir6.1 and increased expression of SUR2B at 24 h.However,the expression of Kir6.2,SUR1,or SUR2A had no remarkable changes at 3 and 24 h after exposure to any of these doses.CONCLUSION The expression levels of Kir6.1 and SUR2B in mouse liver changed differently in response to different radiation doses,suggesting a potential role for them in radiation-induced liver injury.

Incidence and Management of Occupational Blood Exposure (OBE) among Medical Students at the University of Bangui

Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way as workers in this sector, although they actively participate in the routine care provided to patients in the various hospital departments. The objective of our study is to determine the incidence of these accidents and their medical and administrative management among these victims (medical students) not classified in the category of workers. Materials and Method: This was a cross-sectional study carried out over three months from January 15 to March 14, 2023. The study population consisted of all medical students at the Faculty of Health Sciences at the University of Bangui. Regularly enrolled students from 2nd to 7th year, on placement in hospitals in the Central African Republic and who gave their informed consent were included. Data were collected through a self-administered questionnaire. Results: A cross-sectional study was carried out among medical students concerning the incidence and management of accidents involving exposure to blood in the Central African Republic. Of the 254 students included, three (9%) had already been correctly vaccinated against the viral hepatitis B virus, 198 (77.9%) reported still having access to personal protective equipment, 133 students (52.4%) reported being victims of OBE in the past 12 months. The main types of OBE were stings (62%), followed by liquid splashes (32%) and cuts (6%). Among the 133 victims, 92.9% carried out immediate hand disinfection or abundant eye washing, 41.9% obtained the serology of the source patient and 37% reported the accident to their supervisor. Conclusion: It is important that students benefit from better prevention and management of these accidents.

Assessment of Heavy Metal Exposure in Soils of Ihwrekreka Communities, Delta State, Nigeria

Crude oil pollution in the Niger Delta, perpetrated by both local communities and industrial actors, has brought about soil pollution with its consequent ecological, human health and food challenges. The purpose of this research was to examine the concentration and distribution of heavy metals in soil from communities contaminated by crude oil in Niger Delta, and to evaluate the potential health risks to residents from exposure to these contaminants. To achieve this, soil samples were collected from the Ihwrekreka community and analyzed for heavy metal content using inductively coupled plasma mass spectrometry (ICP-MS). The analytical results in mg/kg revealed a significant metals pollution level derived from the oil spill in the soil ranging from 4.85 - 17,078 (Cu), 1.01 - 16.1 (Cd), 0.22 - 36.8 (Cr), 8.28 - 40.9 (Ni), 7.51 - 6474 (Pb), and 8.84 - 12,851 (Zn) respectively. Most of the metals were above the permissible limits of World Health Organization, with Cu, Zn, and Pb as the most contaminating metals. Lead was found to be the main contributor to the hazard index (HI) values for both children and adults in the study area, with its concentration exceeding the permitted limits set by the WHO and the EC. The hazard index (HI) values of Pb, Cu, Zn, Cd, Ni, and Cr were significantly higher than 1. These findings suggest that the release of heavy metals from an oil-contaminated site may pose a risk to human health and the environment.

Autonomous VR Exposure Therapy for Anxiety Disorders Using Conversational AI—Ethical and Technical Implications and Preliminary Results

The need for psychotherapy is very high and the lack of care causes a lot of suffering and high costs. This paper presents an interdisciplinary approach to creating an AI-guided exposure therapy for fear of heights in virtual reality (VR). First, ethical principles for the use of conversational AI in psychotherapy were translated into technical requirements and made measurable. Based on this, an autonomous virtual reality exposure therapy was iteratively developed with a therapist. The feasibility and implementation of the ethical principles were tested with a patient. The patient was very satisfied with the VR setup. The AI therapist was also rated positively, although there is still room for improvement regarding conversational skills. Overall, the paper shows how AI can contribute responsibly to improving the psycho-therapeutic supply. It also provides guidelines that make ethical principles tangible and measurable for developers.