Limited use of virtual reality in primary care physiotherapy for patients with chronic pain.

BACKGROUND: Chronic pain is a disabling condition which is prevalent in about 20% of the adult population. Physiotherapy is the most common non-pharmacological treatment option for chronic pain, but often demonstrates unsatisfactory outcomes. Virtual Reality (VR) may offer the opportunity to complement physiotherapy treatment. As VR has only recently been introduced in physiotherapy care, it is unknown to what extent VR is used and how it is valued by physiotherapists. The aim of this study was to analyse physiotherapists' current usage of, experiences with and physiotherapist characteristics associated with applying therapeutic VR for chronic pain rehabilitation in Dutch primary care physiotherapy. METHODS: This online survey applied two rounds of recruitment: a random sampling round (873 physiotherapists invited, of which 245 (28%) were included) and a purposive sampling round (20 physiotherapists using VR included). Survey results were reported descriptively and physiotherapist characteristics associated with VR use were examined using multivariable logistic regression analysis. RESULTS: In total, 265 physiotherapists participated in this survey study. Approximately 7% of physiotherapists reported using therapeutic VR for patients with chronic pain. On average, physiotherapists rated their overall experience with therapeutic VR at 7.0 and "whether they would recommend it" at 7.2, both on a 0-10 scale. Most physiotherapists (71%) who use therapeutic VR started using it less than two years ago and use it for a small proportion of their patients with chronic pain. Physiotherapists use therapeutic VR for a variety of conditions, including generalized (55%), neck (45%) and lumbar (37%) chronic pain. Physiotherapists use therapeutic VR mostly to reduce pain (68%), improve coordination (50%) and increase physical mobility (45%). Use of therapeutic VR was associated with a larger physiotherapy practice (OR = 2.38, 95% CI [1.14-4.98]). Unfamiliarity with VR seemed to be the primary reason for not using VR. DISCUSSION: Therapeutic VR for patients with chronic pain is in its infancy in Dutch primary care physiotherapy practice as only a small minority uses VR. Physiotherapists that use therapeutic VR are modestly positive about the technology, with large heterogeneity between treatment goals, methods of administering VR, proposed working mechanisms and chronic pain conditions to treat.

The effectiveness of a virtual reality teaching module on advance care planning and advance decision for medical professionals.

BACKGROUND: The concepts of advance care planning (ACP) and advance decisions/directives (ADs) are widely recognized around the world. The Patient Right to Autonomy Act in Taiwan, the first of its kind in Asia, went into effect in 2019. However, a lack of knowledge and confidence regarding ACP and ADs is a barrier for medical professionals in discussing ACP and ADs with their patients. In addition, in Asian countries, physicians tend to make family-centered decisions, which influence how they can implement ADs. METHODS: Virtual reality (VR) is known for its immersive and interactive simulation experience and can upgrade medical education. We developed a VR teaching module to help medical professionals better understand ACP and ADs, with assessment tools integrated into the module. The participants were asked to answer seven knowledge items embedded in the module and fill out the surveys regarding attitudes toward ACP and ADs and confidence in implementing ADs before and after the module. They also reported behaviors related to ADs before and three months after the VR experience. RESULTS: From July 2020 to June 2022, 30 physicians and 59 nurses joined the study, and 78.7% of them had no prior experience in hospice care. After learning from the VR module, all 89 participants were able to answer all seven items correctly. The results showed a slightly more positive attitude toward ACP and ADs (scores: 32.29 ± 3.80 versus 33.06 ± 3.96, p < .05) and more confidence in implementing ADs (scores: 13.96 ± 2.68 versus 16.24 ± 2.67, p < .001) after the VR module. Changes in AD-related behaviors (scores: 11.23 ± 4.01 versus 13.87 ± 4.11, p < .001) were also noted three months after the VR experience. CONCLUSIONS: This study found that medical professionals may have better knowledge of ACP and ADs, slightly improved attitudes toward ACP and ADs, and greater confidence in implementing ADs after experiencing the VR module. Most importantly, the findings suggested that using a VR format may help motivate medical professionals to perform essential behaviors related to ADs, including introducing ADs to their patients and discussing ADs with their own family.

Virtual Inspection System for Pumping Stations with Multimodal Feedback.

Pumping stations have undergone significant modernization and digitalization in recent decades. However, traditional virtual inspections often prioritize the visual experience and fail to effectively represent the haptic physical properties of devices during inspections, resulting in poor immersion and interactivity. This paper presents a novel virtual inspection system for pumping stations, incorporating virtual reality interaction and haptic force feedback technology to enhance immersion and realism. The system leverages a 3D model, crafted in 3Ds Max, to provide immersive visualizations. Multimodal feedback is achieved through a combination of haptic force feedback provided by a haptic device and visual information delivered by a VR headset. The system's data platform integrates with external databases using Unity3D to display relevant information. The system provides immersive 3D visualizations and realistic force feedback during simulated inspections. We compared this system to a traditional virtual inspection method that demonstrated statistically significant improvements in task completion rates and a reduction in failure rates when using the multimodal feedback approach. This innovative approach holds the potential to enhance inspection safety, efficiency, and effectiveness in the pumping station industry.

Virtual Experience Toolkit: An End-to-End Automated 3D Scene Virtualization Framework Implementing Computer Vision Techniques.

Virtualization plays a critical role in enriching the user experience in Virtual Reality (VR) by offering heightened realism, increased immersion, safer navigation, and newly achievable levels of interaction and personalization, specifically in indoor environments. Traditionally, the creation of virtual content has fallen under one of two broad categories: manual methods crafted by graphic designers, which are labor-intensive and sometimes lack precision; traditional Computer Vision (CV) and Deep Learning (DL) frameworks that frequently result in semi-automatic and complex solutions, lacking a unified framework for both 3D reconstruction and scene understanding, often missing a fully interactive representation of the objects and neglecting their appearance. To address these diverse challenges and limitations, we introduce the Virtual Experience Toolkit (VET), an automated and user-friendly framework that utilizes DL and advanced CV techniques to efficiently and accurately virtualize real-world indoor scenarios. The key features of VET are the use of ScanNotate, a retrieval and alignment tool that enhances the precision and efficiency of its precursor, supported by upgrades such as a preprocessing step to make it fully automatic and a preselection of a reduced list of CAD to speed up the process, and the implementation in a user-friendly and fully automatic Unity3D application that guides the users through the whole pipeline and concludes in a fully interactive and customizable 3D scene. The efficacy of VET is demonstrated using a diversified dataset of virtualized 3D indoor scenarios, supplementing the ScanNet dataset.

Content Analysis of Three-Dimensional Model Technologies and Applications for Construction: Current Trends and Future Directions.

The proliferation of digital technologies is substantially transforming inspection methodologies for construction activities. Although the implementation of a three-dimensional (3D) model has emerged as an advantageous, feasible inspection application, the selection of the most suitable 3D models is challenging due to multiple technology options. The primary objectives of this study were to investigate current trends and identify future technologies for 3D models in the construction industry. This study utilized systematic reviews by identifying and selecting quality journals, analyzing selected articles, and conducting content analysis and meta-analysis to identify dominant themes in 3D models. Results showed that the top technologies used to model construction projects are building information models, remote sensing, stereo vision system/photo processing programs, and augmented reality/virtual reality. The main benefits and challenges of these technologies for modeling were also determined. This study identified three areas with significant knowledge gaps for future research: (1) the amalgamation of two or more technologies to overcome project obstacles; (2) solution optimization for inspections in remote areas; and (3) the development of algorithm-based technologies. This research contributes to the body of knowledge by exploring current trends and future directions of 3D model technologies in the construction industry.

The Virtual Reality Radiology Workstation: Current Technology and Future Applications.

Virtual reality (VR) and augmented reality (AR) technology hold potential across many disciplines in medicine to expand the delivery of education and healthcare. VR-AR applications in radiology, in particular, have gained prominence and have demonstrated advantages in many areas within the field. Recently, VR software has emerged to redesign the physical radiology workstation (ie, reading room) to expand the possibilities of diagnostic interpretation. Given the novelty of this technology, there is limited research investigating the potential applications of a simulated radiology workstation. In this review article, we explore VR-simulated reading room technology in its current form and illustrate the practical applications this technology will bring to future radiologists and learners. We also discuss the limitations and barriers to adopting this technology that must be overcome to truly understand its potential benefits. VR reading room technology offers great potential in radiology, but further research is needed to appreciate its benefits and identify areas for improvement. The findings and insights presented in this review contribute to the ongoing discourse on future technological advancements in radiology and healthcare, offering valuable recommendations for further research and practical implementation.

Feasibility and Utility of a Virtual Reality Laboratory Exercise in an Undergraduate Neuroscience Course.

To improve undergraduate students' understanding of neuroanatomy and structure, we leveraged existing virtual reality infrastructure to create a novel dissection assignment in an undergraduate neuroscience course. Students completed a virtual reality dissection of the central nervous system that augmented status quo instruction in lecture and textbook format. We found that such an assignment is feasible at a regional comprehensive university with intrauniversity partnerships that are mutually beneficial. Results showed positive engagement from students and feasibility of incorporating virtual reality in undergraduate neuroscience courses.

Using Immersive Virtual Reality to Classify Pediatric Thoracolumbar Spine Injuries.

Objective This study aimed to assess the reliability and reproducibility of the AO Spine Thoracolumbar Injury Classification System by using virtual reality (VR). We hypothesized that VR is a highly reliable and reproducible method to classify traumatic spine injuries. Methods VR 3D models were created from CT scans of 26 pediatric patients with thoracolumbar spine injuries. Seven orthopedic trainees were educated on the VR platform and AO Spine Thoracolumbar Injury Classification System. Classifications were summarized by primary class and subclass for both rater readings performed two weeks apart with image order randomized. Intra-observer reproducibility was quantified by Fleiss's kappa (kF) for primary classifications and Krippendorff's alpha (aK) for subclassifications along with 95% confidence intervals (CIs) for each rater and across all raters. Inter-observer reliability was quantified by kF for primary classifications and aK for subclassifications along with 95% CIs across all raters for the first read, the second read, and all reads combined. The interpretations were as follows: 0-0.2: slight; 0.2-0.4: fair; 0.4-0.6: moderate; 0.6-0.8: substantial; and >0.8: almost perfect agreement. Results A total of 364 classifications were submitted by seven raters. Intra-observer reproducibility ranged from moderate (kF=0.55) to almost perfect (kF=0.94) for primary classifications and from substantial (aK=0.68) to almost perfect (aK=0.91) for subclassifications. Reproducibility was substantial across all raters for the primary class (kF=0.71; 95% CI=0.61-9.82) and subclass (aK=0.79; 95% CI=0.69-0.86). Inter-observer reliability was substantial (kF=0.63; 95% CI=0.57-0.69) for the first read, moderate (kF=0.58; 95% CI=0.52-0.64) for the second read, and substantial (kF=0.61; 95% CI=0.56-0.65) for all reads for primary classifications. For subclassifications, inter-observer reliability was substantial (aK=0.74; 95% CI=0.58-0.83) for the first read, second read (aK=0.70; 95% CI=0.53-0.80), and all reads (aK=0.72; 95% CI=0.60-0.79). Conclusions Based on our findings, VR is a reliable and reproducible method for the classification of pediatric spine trauma, besides its ability to function as an educational tool for trainees. Further research is needed to evaluate its application for other spine conditions.

Cybersickness in People with Multiple Sclerosis Exposed to Immersive Virtual Reality.

Together with the wide range of possible benefits for the rehabilitation/training of people with multiple sclerosis (pwMS) and other neurologic conditions, exposure to immersive virtual reality (VR) has often been associated with unpleasant symptoms, such as transient dizziness, headache, nausea, disorientation and impaired postural control (i.e., cybersickness). Since these symptoms can significantly impact the safety and tolerability of the treatment, it appears important to correctly estimate their presence and magnitude. Given the existing data scarcity, this study aims to assess the existence and severity of possible adverse effects associated with exposure to immersive VR in a cohort of pwMS using both objective measurements of postural control effectiveness and subjective evaluations of perceived symptoms. To this aim, postural sway under upright quiet posture (in the presence and absence of visual input) of 56 pwMS with an Expanded Disability Status Scale score (EDSS) in the range of 0-6.5 (mean EDSS 2.3) and 33 unaffected individuals was measured before and after a 10-min immersive VR session and at 10 min follow-up on the basis of center of pressure (COP) trajectories. The severity of cybersickness symptoms associated with VR exposure was also self-rated by the participants using the Italian version of the Simulator Sickness Questionnaire (SSQ). Temporary impairments of postural control in terms of significantly increased sway area were observed after the VR session only in pwMS with mild-moderate disability (i.e., EDSS in the range of 2.5-6.5) in the presence of visual input. No changes were observed in pwMS with low disability (EDSS 0-2) and unaffected individuals. In contrast, when the visual input was removed, there was a decrease in sway area (pwMS with mild-moderate disability) and COP path length relating to the use of VR (pwMS with mild-moderate disability and unaffected individuals), thus suggesting a sort of "balance training effect". Even in this case, the baseline values were restored at follow-up. All participants, regardless of their status, experienced significant post-VR side effects, especially in terms of blurred vision and nausea. Taken together, the findings of the present study suggest that a short immersive VR session negatively (eyes open) and positively (eyes closed) impacts the postural control of pwMS and causes significant disorientation. However, such effects are of limited duration. While it is reasonable to state that immersive VR is sufficiently safe and tolerable to not be contraindicated in the rehabilitation/training of pwMS, in order to reduce possible negative effects and maximize the efficacy, safety and comfort of the treatment, it appears necessary to develop specific guidelines that consider important factors like individual susceptibility, maximum exposure time according to the specific features of the simulation, posture to adopt and protocols to assess objective and perceived effects on participants.

Authenticity and presence: defining perceived quality in VR experiences.

This work expands the existing understanding of quality assessments of VR experiences. Historically, VR quality has focused on presence and immersion, but current discourse emphasizes plausibility and believability as critical for lifelike, credible VR. However, the two concepts are often conflated, leading to confusion. This paper proposes viewing them as subsets of authenticity and presents a structured hierarchy delineating their differences and connections. Additionally, coherence and congruence are presented as complementary quality functions that integrate internal and external logic. The paper considers quality formation in the experience of authenticity inside VR emphasizing that distinguishing authenticity in terms of precise quality features are essential for accurate assessments. Evaluating quality requires a holistic approach across perceptual, cognitive, and emotional factors. This model provides theoretical grounding for assessing the quality of VR experiences.

[Learn playfully, operate seriously : The new era of surgical training]. / Spielerisch lernen, ernsthaft operieren : Die neue Ära der chirurgischen Ausbildung.

BACKGROUND: Traditional surgical training and further education has historically involved long working hours and hands-on experience within the framework of a teacher-apprentice relationship; however, changes in regulatory policy in the USA and subsequently in Switzerland and the European Union from 2003, led to restrictions in the working hours of medical residents. As a result the traditional method of surgical training "see one, do one, teach one" has come under scrutiny, prompting a search for alternative training methods beyond the confines of the operating theater. OBJECTIVE: This publication highlights the possibilities and limitations associated with the use of virtual reality (VR) and gamification in surgical training and further education. It examines the ability of these technological resources to enhance the effectiveness and engagement of medical residents and the feasibility of incorporating them into the surgical training curriculum. MATERIAL AND METHODS: The study was based on a literature search for current developments in surgical training, VR and gamification. Furthermore, various studies and projects that investigated the use of VR and gamification in medical training and further education were analyzed. RESULTS AND DISCUSSION: In this investigation it could be shown that the use of VR reduces the perioperative risks and improves the training environment and learning. The use of gamification also increases the motivation and engagement of the medical residents. As a result the quality of medical education can be improved by the fusion of VR and gamification.

Development and Implementation of a Stress Monitoring Paradigm Using Virtual Reality Simulation During the COVID-19 Pandemic.

Healthcare providers, particularly during the COVID-19 crisis, have been forced to make difficult decisions and have reported acting in ways that are contrary to their moral values, integrity, and professional commitments, given the constraints in their work environments. Those actions and decisions may lead to healthcare providers' moral suffering and distress. This work outlines the development of the Moral Distress Virtual Reality Simulator (Moral Distress VRS) to research stress and moral distress among healthcare workers during the COVID-19 pandemic. The Moral Distress VRS was developed based on the agile methodology framework, with three simultaneous development streams. It followed a two-week sprint cycle, ending with meetings with stakeholders and subject matter experts, whereby the project requirements, scope, and features were revised, and feedback was provided on the prototypes until reaching the final prototype that was deployed for in-person study sessions. The final prototype had two user interfaces (UIs), one for the participant and one for the researcher, with voice narration and customizable character models wearing medical personal protective equipment, and followed a tree-based dialogue scenario, outputting a video recording of the session. The virtual environment replicated an ICU nursing station and a fully equipped patient room. We present the development process that guided this project, how different teams worked together and in parallel, and detail the decisions and outcomes in creating each major component within a limited deadline. Finally, we list the most significant challenges and difficulties faced and recommendations on how to solve them.

QoS-driven resource allocation in fog radio access network: A VR service perspective.

While immersive media services represented by virtual reality (VR) are booming, They are facing fundamental challenges, i.e., soaring multimedia applications, large operation costs and scarce spectrum resources. It is difficult to simultaneously address these service challenges in a conventional radio access network (RAN) system. These problems motivated us to explore a quality-of-service (QoS)-driven resource allocation framework from VR service perspective based on the fog radio access network (F-RAN) architecture. We elaborated details of deployment on the caching allocation, dynamic base station (BS) clustering, statistical beamforming and cost strategy under the QoS constraints in the F-RAN architecture. The key solutions aimed to break through the bottleneck of the network design and to deep integrate the network-computing resources from different perspectives of cloud, network, edge, terminal and use of collaboration and integration. Accordingly, we provided a tailored algorithm to solve the corresponding formulation problem. This is the first design of VR services based on caching and statistical beamforming under the F-RAN. A case study provided to demonstrate the advantage of our proposed framework compared with existing schemes. Finally, we concluded the article and discussed possible open research problems.

The effect of non-immersive virtual reality radiographic positioning simulation on first-year radiography students' image evaluation performance.

INTRODUCTION: Optimal radiographic image quality is critical because it affects the accuracy of the reporter's interpretation. Radiographers have an ethical obligation to obtain quality diagnostic images while protecting patients from unnecessary radiation, including minimizing rejected and repeated images. Repeated imaging due to positioning errors have increased in recent years. METHODS: This study evaluated the effectiveness of non-immersive virtual reality (VR) simulation on first-year students' evaluation of positioning errors on resultant knee and lumbar spine images. Crossover intervention design was used to deliver radiographic image evaluation instruction through traditional lecture and guided simulation using non-immersive VR to 33 first-year radiography students at a single academic institution located across four geographic program locations. Pre- and post-test knowledge assessments examined participants' ability to recognize positioning errors on multiple-choice and essay questions. RESULTS: Raw mean scores increased on multiple choice questions across the entire cohort for the knee (M = 0.82, SD = 3.38) and lumbar spine (M = 2.91, SD = 3.69) but there was no significant difference in performance by instructional method (p = 0.60). Essay questions reported very minimal to no raw mean score increases for the knee (M = 0.27, SD = 2.78) and lumbar spine (M = 0.00, SD = 2.55), with no significant difference in performance by instructional method (p = 0.72). CONCLUSION: Guided simulation instruction was shown to be as effective as traditional lecture. Results also suggest that novice learners better recognize image evaluation errors and corrections from a list of options but have not yet achieved the level of competence needed to independently evaluate radiographic images for diagnostic criteria. IMPLICATIONS FOR PRACTICE: Non-immersive VR simulation is an effective tool for image evaluation instruction. VR increases access to authentic image evaluation practice by providing a simulated resultant image based off the students' applied positioning skills.

Virtual, mixed, and augmented realities: A commentary on their significance in cognitive neuroscience and neuropsychology.

The integration of virtual, mixed, and augmented reality technologies in cognitive neuroscience and neuropsychology represents a transformative frontier. In this Commentary, we conducted a meta-analysis of studies that explored the impact of Virtual Reality (VR), Mixed Reality (MR), and Augmented Reality (AR) on cognitive neuroscience and neuropsychology. Our review highlights the versatile applications of VR, ranging from spatial cognition assessments to rehabilitation for Traumatic Brain Injury. We found that MR and AR offer innovative avenues for cognitive training, particularly in memory-related disorders. The applications extend to addressing social cognition disorders and serving as therapeutic interventions for mental health issues. Collaborative efforts between neuroscientists and technology developers are crucial, with reinforcement learning and neuroimaging studies enhancing the potential for improved outcomes. Ethical considerations, including informed consent, privacy, and accessibility, demand careful attention. Our review identified common aspects of the meta-analysis, including the potential of VR technologies in cognitive neuroscience and neuropsychology, the use of MR and AR in memory research, and the role of VR in neurorehabilitation and therapy.

Structured Exposure Achieves High Acceptance of Immersive Technology Among Medical Students and Educators.

Virtual reality (VR) is a potent educational tool with untapped potential in medical training. However, its integration into medical schools faces challenges such as cybersickness and hesitancy among medical students and professionals. Notably, there has been no systematic assessment of the acceptance of medical educational VR applications by both students and educators. In our single-center study, we enrolled 133 medical students and 14 medical educators. Following a practical demonstration of the established VR anatomy application, Sharecare YOU VR, participants completed a self-reporting survey based on the Technology Acceptance Model (TAM), exploring user acceptance of information technologies and focusing on perceived usefulness (PU), perceived ease of use (PEU), and attitude toward using (ATU). We also sought insights into potential future applications of VR in medical education. Our findings indicate a high level of acceptance among medical students and educators upon structured exposure to VR with significantly positive responses for all three TAM variables (PU, PEU, and ATU). Intriguingly, hands-on experience influenced acceptance. Students envisioned VR's benefits in anatomy, surgery, emergency medicine, and communication skill training with patients. Both students and educators believed that VR could enhance traditional approaches and complement the existing curriculum, anticipating improved preparedness for medical students through VR training applications. In conclusion, our results demonstrate the receptivity of both students and educators to immersive technologies, including VR, in medical education. Importantly, the data suggest that the adoption of VR in this field would be welcomed rather than resisted, potentially enhancing students' self-efficacy and enriching the medical school curriculum.

Promoting stress and anxiety recovery in older adults: assessing the therapeutic influence of biophilic green walls and outdoor view.

Previous research has already provided evidence regarding the favorable impact of green walls and outdoor views on stress reduction and anxiety alleviation. However, there has been limited exploration into the combined effects of green walls and outdoor views on older adults. In this study, a between-subjects experiment was conducted using virtual reality (VR) technology with 23 participants. Following exposure to stressors, each participant underwent four randomized sessions, each lasting 5 min, in various virtual reality (VR) environments, encompassing non-biophilic and biophilic environments (including green walls, outdoor views, and their combination). Throughout the process, we measured physiological indicators of stress responses, including heart rate, heart rate variability, skin conductance levels, and blood pressure, using biometric sensors. Psychological changes in participants, including anxiety levels, were evaluated through the State-Trait Anxiety Inventory, recovery scales, and self-reported emotional assessments. In conclusion, in comparison to non-biophilic environments, older adults consistently exhibited lower stress levels, experienced superior anxiety relief, and demonstrated improved recovery in nature connectedness environments, with a notably faster recovery rate. These findings suggest that the incorporation of nature connectedness principles into the indoor environments of public activity spaces within older adults care facilities can significantly contribute to stress reduction and anxiety alleviation among older adults. Furthermore, these effects appear to be contingent on the specific types of nature connectedness environments. These results can provide substantial evidence to support the design of indoor common activity spaces within older adults care facilities.

The application of extended reality technology-assisted intraoperative navigation in orthopedic surgery.

Extended reality (XR) technology refers to any situation where real-world objects are enhanced with computer technology, including virtual reality, augmented reality, and mixed reality. Augmented reality and mixed reality technologies have been widely applied in orthopedic clinical practice, including in teaching, preoperative planning, intraoperative navigation, and surgical outcome evaluation. The primary goal of this narrative review is to summarize the effectiveness and superiority of XR-technology-assisted intraoperative navigation in the fields of trauma, joint, spine, and bone tumor surgery, as well as to discuss the current shortcomings in intraoperative navigation applications. We reviewed titles of more than 200 studies obtained from PubMed with the following search terms: extended reality, mixed reality, augmented reality, virtual reality, intraoperative navigation, and orthopedic surgery; of those 200 studies, 69 related papers were selected for abstract review. Finally, the full text of 55 studies was analyzed and reviewed. They were classified into four groups-trauma, joint, spine, and bone tumor surgery-according to their content. Most of studies that we reviewed showed that XR-technology-assisted intraoperative navigation can effectively improve the accuracy of implant placement, such as that of screws and prostheses, reduce postoperative complications caused by inaccurate implantation, facilitate the achievement of tumor-free surgical margins, shorten the surgical duration, reduce radiation exposure for patients and surgeons, minimize further damage caused by the need for visual exposure during surgery, and provide richer and more efficient intraoperative communication, thereby facilitating academic exchange, medical assistance, and the implementation of remote healthcare.

Development and Effectiveness Evaluation of 360-Degree Virtual Reality-Based Educational Intervention for Adult Patients Undergoing Colonoscopy.

Providing patients with accurate and organized information about colonoscopy, while reducing anxiety, is critical to the procedure's success. This study evaluated the impact of an immersive 360° virtual reality (VR)-based educational intervention for first-time adult colonoscopy patients regarding anxiety, attitudes, knowledge, compliance with bowel preparation, and bowel cleanliness. A quasi-experimental design with a non-equivalent control group and non-synchronized pretest-post-test clinical trial was conducted with 40 patients in the experimental group and 40 in the control group. The 360° VR intervention included two sessions: precautions before colonoscopy and the colonoscopy process. The control group received education through individual verbal explanations with written materials. The findings indicated that the VR intervention significantly improved patients' colonoscopy-related anxiety, attitudes, adherence to bowel preparation instructions, and bowel cleanliness. Utilizing 360° VR as an educational tool has the potential to enhance the effectiveness of educational programs by providing realistic information and engaging patients. These findings suggest that 360° VR has the capacity to enhance screening rates and clinical outcomes by reducing negative perceptions associated with colonoscopy. Furthermore, the application of this method can extend to diverse diagnostic testing-related nursing situations in clinical settings.

A comparative study of stereo-dependent SSVEP targets and their impact on VR-BCI performance.

Steady-state visual evoked potential brain-computer interfaces (SSVEP-BCI) have attracted significant attention due to their ease of deployment and high performance in terms of information transfer rate (ITR) and accuracy, making them a promising candidate for integration with consumer electronics devices. However, as SSVEP characteristics are directly associated with visual stimulus attributes, the influence of stereoscopic vision on SSVEP as a critical visual attribute has yet to be fully explored. Meanwhile, the promising combination of virtual reality (VR) devices and BCI applications is hampered by the significant disparity between VR environments and traditional 2D displays. This is not only due to the fact that screen-based SSVEP generally operates under static, stable conditions with simple and unvaried visual stimuli but also because conventional luminance-modulated stimuli can quickly induce visual fatigue. This study attempts to address these research gaps by designing SSVEP paradigms with stereo-related attributes and conducting a comparative analysis with the traditional 2D planar paradigm under the same VR environment. This study proposed two new paradigms: the 3D paradigm and the 3D-Blink paradigm. The 3D paradigm induces SSVEP by modulating the luminance of spherical targets, while the 3D-Blink paradigm employs modulation of the spheres' opacity instead. The results of offline 4-object selection experiments showed that the accuracy of 3D and 2D paradigm was 85.67 and 86.17% with canonical correlation analysis (CCA) and 86.17 and 91.73% with filter bank canonical correlation analysis (FBCCA), which is consistent with the reduction in the signal-to-noise ratio (SNR) of SSVEP harmonics for the 3D paradigm observed in the frequency-domain analysis. The 3D-Blink paradigm achieved 75.00% of detection accuracy and 27.02 bits/min of ITR with 0.8 seconds of stimulus time and task-related component analysis (TRCA) algorithm, demonstrating its effectiveness. These findings demonstrate that the 3D and 3D-Blink paradigms supported by VR can achieve improved user comfort and satisfactory performance, while further algorithmic optimization and feature analysis are required for the stereo-related paradigms. In conclusion, this study contributes to a deeper understanding of the impact of binocular stereoscopic vision mechanisms on SSVEP paradigms and promotes the application of SSVEP-BCI in diverse VR environments.