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Severe pain is a widespread health problem in need of novel treatment approaches. In the current study we used real water to give virtual objects (i.e., animated virtual water) more realistic physical properties (wet liquid qualities). Healthy volunteers aged 18–34 participated in a within-subject randomized study comparing participants’ worst pain during brief thermal stimuli with (1) No Immersive Virtual Reality (VR), versus (2) during VR + no tactile feedback versus (3) VR + real water (with tactile feedback from co-located real objects). Tactile feedback significantly decreased pain intensity (VR analgesia, p  < 0.01), compared to VR with no tactile feedback, and compared to No VR (baseline). Tactile feedback made the virtual water feel significantly more real, increased participant’s sense of presence, and both VR conditions were distracting (significantly reduced accuracy on an attention demanding task). As a non-pharmacologic analgesic, mixed reality reduced pain by 35% in the current study, comparable to the analgesia from a moderate dose of hydromorphone in previous published experimental studies. Tactile feedback also significantly increased avatar embodiment, the participants illusion of ownership of the virtual hands, which has potential to improve the effectiveness of avatar therapy for chronic pain in future studies. Mixed reality should be tested as treatment in pain patients.

Digital health tools are emerging as a promising solution for optimizing Deep Brain Stimulation (DBS) therapy for neurodegenerative diseases such as Parkinson’s Disease (PD), addressing challenges of therapy maintenance, care access, and discrete assessments. Wearable technology and mobile health platforms can offer remote monitoring capabilities, allowing for real-time virtual programming with optimization of patients’ therapy, use of digital biomarkers that can help identify the onset, symptoms, medication-related fluctuations and side-effects, and response to DBS treatment. Through an investigational remote monitoring application (RM app) integrating patient-reported outcomes (PROs) and objective data using wearables, we aimed to develop an accessible, data-driven digital tool to monitor patient symptoms and deliver low-burden and easy-to-access DBS therapy. The platform is designed to be compatible with several consumer-grade wearables and ensures patient data privacy and security. We conducted a feasibility study to test the tool’s effectiveness in a large-scale DBS study, where subjects received a home-monitoring kit consisting of an iPhone and Apple Watch, pre-configured with the RM app to enable remote data collection. Compliance in this paper is defined as adherence to the RM app and Apple watch usage. Analysis of 67 subjects from the study demonstrated an average compliance rate of 63.3% for daily check-ins, 85.5% for monthly surveys and 61.9% for passive data with an average of 55 days of post-implant data. The study highlights the feasibility of frequent monitoring in the early post-implant period that could lead to optimal outcomes for patients. The platform developed can further optimize study execution and be extended to other chronic conditions treated with neuromodulation implants such as depression and pain.

Digital health can drive patient-centric innovation in neuromodulation by leveraging current tools to identify response predictors and digital biomarkers. Iterative technological evolution has led us to an ideal point to integrate digital health with neuromodulation. Here, we provide an overview of the digital health building-blocks, the status of advanced neuromodulation technologies, and future applications for neuromodulation with digital health integration.

There is an urgent need to improve the clinical management of major depressive disorder (MDD), which has become increasingly prevalent over the past two decades. Several gaps and challenges in the awareness, detection, treatment, and monitoring of MDD remain to be addressed. Digital health technologies have demonstrated utility in relation to various health conditions, including MDD. Factors related to the COVID-19 pandemic have accelerated the development of telemedicine, mobile medical apps, and virtual reality apps and have continued to introduce new possibilities across mental health care. Growing access to and acceptance of digital health technologies present opportunities to expand the scope of care and to close gaps in the management of MDD. Digital health technology is rapidly evolving the options for nonclinical support and clinical care for patients with MDD. Iterative efforts to validate and optimize such digital health technologies, including digital therapeutics and digital biomarkers, continue to improve access to and quality of personalized detection, treatment, and monitoring of MDD. The aim of this review is to highlight the existing gaps and challenges in depression management and discuss the current and future landscape of digital health technology as it applies to the challenges faced by patients with MDD and their healthcare providers.

Intermedial artworks are deemed effective when they draw from the roots of the most basic, universal elements of materiality, concept, sensation, and/or experience, melding disparate elements into an inextricable novelty. As hybrid artifacts, they take up an unusual degree of substance1 in one dimension or another, and can at times be difficult to categorize, describe, or document. Nonetheless, the potential for intermedial expressions to resonate with their viewership is strengthened by the depths to which the artist ventures, and through such a process the most far-reaching and complexly interconnected issues of our time can be made approachable on the personal level.The work documented and realized herein developed from the idea of addressing the issue of global textile waste on a personal level. Inspired by the need to perform basic clothing repair, I began exploring textile-based art practices during the 2020 pandemic lockdown, studied them formally at the University of Maine from Fall ’20 to the time of publication, and greatly benefitted from the culture of ecological ethics, forest management, and community-engaged art flourishing at and around the University. My path of research-oriented artistic production has led me to participate directly in many facets of the reuse economy of central Maine and beyond; at times I have operated as a volunteer in a Catholic mission’s thrift store, and as an employee of a donation-based shop. I have both attended and hosted workshops, “skill-shares”, and other events in a variety of settings, from guest presenter at a public high school to spontaneous runway model at a fashion show for upcycled streetwear. Focusing primarily on ubiquitous textile artifacts, such as the graphic t-shirt, in conjunction with universally attainable and applicable projects such as tote bags, pockets, written messages, and drawstring pouches, I have developed an artistic practice geared towards inspiring in the viewer/wearer a newfound appreciation for textile materiality as a function of their embodied experience—ideally empowering them to begin independently addressing their textile footprint. The body of artwork associated with my studies culminated in a gallery-centered event, named You Are What You Wear, where participants were encouraged to wear, and offered from a shared selection, garments with visible repair work and customization—thus allowing an imaginative glimpse at the potential for healing and self-expression through textile work.With the abundance of textile material available for those of us on this side of the manufacturing cycle, the means by which we address the inefficiencies and injustices of global textile production cannot be solely derived from a sustainability mindset; there must also be celebration of abundance: freedom to make mistakes, generosity, gratitude, and discovery. Through analysis of my work and the concepts which support it, I intend to show that worn textiles and the associated actions of repair are inherent parts of the human experience, and how creative work can encourage a more mindful and harmonious relationship with textile materiality. Aided by a series of informal interviews conducted over the last two years, I will also present analysis derived from a variety of perspectives that I hope will show that the reuse economy as found across donation centers, second hand retail, volunteer labor, sewing workshops, and other social structures, is a viable and important lens through which one can perceive a community.

Virtual reality (VR) and augmented reality (AR) interventions are emerging as promising tools in the treatment of pediatric chronic pain conditions. However, in this young field, there is little consensus to guide the process of engaging in the development and evaluation of targeted VR-based interventions. The INOVATE-Pain (Interdisciplinary Network on Virtual and Augmented Technologies for Pain management) consortium aims to advance the field of VR for pediatric chronic pain rehabilitation by providing guidance for best practices in the design, evaluation, and dissemination of VR-based interventions targeting this population. An interdisciplinary meeting of 16 academics, clinicians, industry partners, and philanthropy partners was held in January 2020. Reviewing the state of the field, the consortium identified important directions for research-driven innovation in VR and AR clinical care, highlighted key opportunities and challenges facing the field, and established a consensus on best methodological practices to adopt in future efforts to advance the research and practice of VR and AR in pediatric pain. The consortium also identified important next steps to undertake to continue to advance the work in this promising new area of digital health pain interventions. To realize the promise of this realm of innovation, key ingredients for success include productive partnerships among industry, academic, and clinical stakeholders; a uniform set of outcome domains and measures for standardized evaluation; and widespread access to the latest opportunities, tools, and resources. The INOVATE-Pain collaborative hopes to promote the creation, rigorous yet efficient evaluation, and dissemination of innovative VR-based interventions to reduce pain and improve quality of life for children.

Augmented and virtual reality devices are being actively investigated and implemented for a wide range of medical uses. However, significant gaps in the evaluation of these medical devices and applications hinder their regulatory evaluation. Addressing these gaps is critical to demonstrating the devices’ safety and effectiveness. We outline the key technical and clinical evaluation challenges discussed during the US Food and Drug Administration’s public workshop, “Medical Extended Reality: Toward Best Evaluation Practices for Virtual and Augmented Reality in Medicine” and future directions for evaluation method development. Evaluation challenges were categorized into several key technical and clinical areas. Finally, we highlight current efforts in the standards communities and illustrate connections between the evaluation challenges and the intended uses of the medical extended reality (MXR) devices. Participants concluded that additional research is needed to assess the safety and effectiveness of MXR devices across the use cases.

Sexual function, and in particular erectile capacity, declines with age in men. The present study attempted to identify possible sensory/neural and autonomic factors related to this decline. Data on self-reported sexual activity and functioning, as well as erectile response to visual erotic stimulation, were gathered from 39 healthy, sexually functional men ranging in age from 21 to 82. In addition, four parameters of putative significance to sexual functioning were measured: penile electrical and vibrotactile thresholds, pudendal somatosensory evoked potentials, penile autonomic response to ischemia, and blood testosterone. Results indicated significant age-related decreases in self-reported frequency of sexual activity and in erectile response to erotica. Furthermore, penile sensitivity, response to penile ischemia, and somatosensory evoked potentials showed age-related changes. In contrast, self-reported erectile capacity, ratings of overall sex life, and levels of testosterone did not change over age groups. These findings suggest that decreasing erectile capacity in aging men may be related to decreasing sensory/neural and autonomic functioning, but they also indicate that factors other than the frequency of and potency for sexual response are important to the overall rating of sex life.

Computational Medical Extended Reality (CMXR), brings together life sciences and neuroscience with mathematics, engineering and computer science. It unifies computational science (scientific computing) with intelligent extended reality and spatial computing for the medical field. It significantly differs from previous \"Clinical XR\" or \"Medical XR\" terms, as it is focusing on how to integrate computational methods from neural simulation to computational geometry, computational vision and computer graphics with deep learning models to solve specific hard problems in medicine and neuroscience: from low/no-code/genAI authoring platforms to deep learning XR systems for training, planning, operative navigation, therapy and rehabilitation.