This review found moderate evidence for the reduction of pain and functional impairment after IVR in patients with acute pain. Further high-quality studies are required for the conclusive judgment of its effectiveness in acute pain, to establish potential benefits for chronic pain, and for safety.

The Polhemus Isotrak is often used as an orientation and position tracking device in virtual reality e n vironments. When it is used to dynamically determine the user's viewpoint and line of sight e.g. in the case of a head mounted display the noise and delay in its measurement data causes temporal-spatial distortion, perceived by the user as jittering of images and lag between head movement and visual feedback. To tackle this problem, we rst examined the major cause of the distortion, and found that the lag felt by the user is mainly due to the delay in orientation data, and the jittering of images is caused mostly by the noise in position data. Based on these observations, a predictive Kalman lter was designed to compensate for the delay in orientation data, and an anisotropic low pass lter was devised to reduce the noise in position data. The e ectiveness and limitations of both approaches were then studied, and the results shown to be satisfactory.

Objective. To assess the efficacy of a multifaceted counseling intervention at improving physical activity participation and patient outcomes. Methods. We recruited people with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). In weeks 1-8, the immediate group received education and counseling by a physical therapist, used a Fitbit and a web application to obtain feedback about their physical activity, and received 4 follow-up calls from the physical therapist. The delay group received the same intervention in weeks 10-17. Participants were assessed at baseline and at weeks 9, 18, and 27. The primary outcome was time spent in moderate/vigorous physical activity (MVPA; in bouts of ≥10 minutes) measured with a SenseWear device. Secondary outcomes included step count, time in sedentary behavior, pain, fatigue, mood, self-management capacity, and habitual behaviors. Results. A total of 118 participants enrolled. The adjusted mean difference in MVPA was 9.4 minutes/day (95% confidence interval [95% CI]-0.5, 19.3, P = 0.06). A significant effect was found in pain (-2.45 [95% CI-4.78,-0.13], P = 0.04) and perceived walking habit (0.54 [95% CI 0.08, 0.99], P = 0.02). The remaining secondary outcomes improved but were not statistically significant. Post hoc analysis revealed a significant effect in MVPA (14.3 minutes/ day [95% CI 2.3, 26.3]) and pain (-4.05 [95% CI-6.73,-1.36]) in participants with RA but not in those with SLE. Conclusion. Counseling by a physical therapist has the potential to improve physical activity in people with inflammatory arthritis, but further study is needed to understand the intervention effect on different diseases. We found a significant improvement in pain, suggesting that the intervention might have a positive effect on symptom management. ClinicalTrials.gov identifier: NCT02554474.

Characterizing genetic influences on DNA methylation (DNAm) provides an opportunity to understand mechanisms underpinning gene regulation and disease. Here we describe results of DNA methylation-quantitative trait loci (mQTL) analyses on 32,851 participants, identifying genetic variants associated with DNAm at 420,509 DNAm sites in blood. We present a database of >270,000 independent mQTL of which 8.5% comprise long-range (trans) associations. Identified mQTL associations explain 15-17% of the additive genetic variance of DNAm. We reveal that the genetic architecture of DNAm levels is highly polygenic and DNAm exhibits signatures of negative and positive natural selection. Using shared genetic control between distal DNAm sites we construct networks, identifying 405 discrete genomic communities enriched for genomic annotations and complex traits. Shared genetic factors are associated with both blood DNAm levels and complex diseases but in most cases these associations do not reflect causal relationships from DNAm to trait or vice versa indicating a more complex genotype-phenotype map than has previously been hypothesised.

The Virtual Reality (VR) user interface style allows natural hand and body motions to manipulate virtual objects in 3D environments using one or more 3D input devices. This style is best suited to application areas where traditional two-dimensional styles fall short, such as scienti c visualization, architectural visualization, and remote manipulation. Currently, the programming e ort required to produce a VR application is too large, and many pitfalls must be avoided in the creation of successful VR programs. In this paper we describe the Decoupled Simulation Model for creating successful VR applications, and a software system that embodies this model. The MR Toolkit simpli es the development of VR applications by providing standard facilities required by a wide range of VR user interfaces. These facilities include support for distributed computing, head-mounted displays, room geometry management, performance monitoring, hand input devices, and sound feedback. The MR Toolkit encourages programmers to structure their applications to take a d v antage of the distributed computing capabilities of workstation networks improving the application's performance. In this paper, the motivations and the architecture of the toolkit are outlined, the programmer's view is described, and a simple application is brie y described.