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    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>mSinaptiks: An eHealth platform for Virtual and Augmented Reality mobile applications</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Alsina-Jurnet</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Del Águila</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Frank</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Peris</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Jordi</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Moreno</string-name>
          <email>Pmoreno@psiquiatria.com</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Pedro</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>2: Universitat de Vic-Universitat Central de Catalunya Sagrada Família</institution>
          ,
          <addr-line>7. 08500 Vic web:</addr-line>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>: Sinaptiks Empowerment SL. Antoni Bros</institution>
          ,
          <addr-line>128. Terrassa, Barcelona</addr-line>
        </aff>
      </contrib-group>
      <pub-date>
        <year>2015</year>
      </pub-date>
      <abstract>
        <p>The rapid growth of the Information and Communication Technologies over the past decade changed the ways in which people communicate, relate and live. The health field is not an exception to the 21st century trends, and emerging technologies such as Virtual Reality (VR) and Augmented Reality (AR) have started to play a central role for health professionals. However, most of the current VR and AR applications have prohibitive costs and a variety of interfaces and tools. This has limited the impact and the implementation of these technologies in health settings. mSinaptiks is the first eHealth platform in integrating, under a common interface, a variety of immersive VR and AR applications for the prevention, evaluation, treatment and tracking of disabling illnesses and psychological disorders. In addition, the platform integrates apps for education and professional training. mSinaptiks allows health practitioners to benefit from affordable and easy-to-use mobile-based apps to improve the quality of life of their patients.</p>
      </abstract>
      <kwd-group>
        <kwd>eHealth</kwd>
        <kwd>Virtual Reality</kwd>
        <kwd>Augmented Reality</kwd>
        <kwd>Treatment</kwd>
        <kwd>Assessment</kwd>
        <kwd>Trainning</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. INTRODUCTION</title>
      <p>Over the past decade, rapid and far-reaching technological advances have significantly
changed the way people communicate, relate and live. Technological devices and
applications that were hardly used some years ago (or even not exist) are already part of
our daily life. This is given the way to the Information and Communication Society
(Bradley, 2000), characterized by an extensive use of the Internet, computers and
mobile phones in almost every human activity.</p>
      <p>The health field is not an exception to the 21st century trends, and ICTs have started to
become common tools for diagnosis, prevention, therapy, education and training. In
particular, emerging technologies such as Virtual Reality (VR), Augmented Reality
(AR) and mobile devices are starting to play a central role for health professionals
(Botella &amp; Bretón-Lopez, 2014) due its potential to improve the efficacy and efficiency
of traditional healthcare processes.</p>
      <p>
        Recent research provides evidence on the clinical efficacy of VR and AR in the
treatment a number of anxiety disorders
        <xref ref-type="bibr" rid="ref1">(Gerardi, Cukor, Difede, Rizzo, &amp; Rothbaum,
2010; Meyerbroker &amp; Emmelkamp, 2010; Opris, Pintea, García-Palacios, Botella,
Szamosköki, David, 2012; Parsons &amp; Rizzo, 2008; Powers &amp; Emmelkamp, 2008;
Turner &amp; Casey, 2014)</xref>
        , eating disorders (Riva, Bacchetta, Baruffi, &amp; Molinari, 2002;
Riva, Manzoni, Villani, Gaggioli, &amp; Molinari, 2008), addictions (Hone-Blanchet,
Wensing &amp; Fecteau, 2014), sexual dysfunctions (Optale, Marin, Pastore, Nasta &amp;
Pianon, 2003) or pain management (García-Palacios et al., 2015). In addition, VR and
AR have been used as effective tools for cognitive and motor rehabilitation
        <xref ref-type="bibr" rid="ref2">(Turolla et
al., 2013)</xref>
        . However, despite these positive results, their implementation in clinical
settings is still sparse and limited. This is due, at least in part, to the prohibitive costs
associated with using these technologies and to the high amount of existing
applications. In fact, each application has a specific interface and uses different tools.
As a consequence, the practitioner must acquire a variety of artifacts and needs to be
highly familiarized with the specific features of each application. These issues have
limited the impact and the implementation of VR, AR and related technologies in health
settings.
      </p>
      <p>That is way Sinaptiks has developed mSinaptiks, the first eHealth platform that
integrates a variety of medical and health apps in a single interface. The platform allows
health practitioners to use affordable and easy-to-use mobile-based apps to improve the
quality of life of their patients.</p>
    </sec>
    <sec id="sec-2">
      <title>2. SINAPTIKS</title>
      <p>Sinaptiks is the developer of mobile-based applications that uses the most emerging
technologies to improve traditional healthcare processes. The company designs, creates
and validates VR and AR applications for different stakeholders, including institutions,
associations, practitioners and patients. The solutions developed by Sinaptiks are mainly
directed to clinics, hospitals, practitioners and social and health institutions (table 1).</p>
    </sec>
    <sec id="sec-3">
      <title>Field</title>
      <p>Medical</p>
      <sec id="sec-3-1">
        <title>Health</title>
      </sec>
      <sec id="sec-3-2">
        <title>Mental Health</title>
      </sec>
      <sec id="sec-3-3">
        <title>Training</title>
        <p>Founded in 2015, the company integrates a unique team composed by engineers,
designers, physicians and psychologists with more than 10 years of experience in
applying VR to mental health and higher education. The company has now created
mSinaptiks and the first applications for the platform. Sinaptiks is a company that
develops its own apps but also adapts and customizes products from selected partners
(other companies and universities).</p>
      </sec>
    </sec>
    <sec id="sec-4">
      <title>3. MOBILE SINAPTIKS</title>
      <p>mSinaptiks is the first modular platform that integrates in a single interface different
health-related apps. The platform includes a suite of mobile applications for the
evaluation, prevention, treatment and/or tracking of disabling illnesses and
psychological disorders (figure 1).
The platform has an interface for the patient and a web access service for the
practitioner (figure 2):
•
•</p>
      <p>The patient: Patients have access to a variety of apps from the Smartphone,
including those based in the use of immersive VR and AR technologies. In these
last cases, the patient needs to slip the smartphone into a Head Mounted Display
(HMD) to be immersed within 3D virtual worlds.</p>
      <p>The practitioner: The health professional accesses to the platform from a
mobile device or a desktop computer and is able to register new patients, link
them to the apps contained in the platform, review each session or obtain
detailed information of the patients’ activity. In the case of VR and AR
applications, the interface allows the professional to see what the patients sees,
adapt in real time the content of the virtual worlds according to the patients’
needs, create graphs, take notes and other features.</p>
      <p>Practitioners can use the platform during face-to-face sessions but can also use it
remotely. Despite this, note that all applications need the direct supervision of a
practitioner. In a wider sense mSinaptiks allows for a regular and constant connection
between the practitioner and the patient.</p>
    </sec>
    <sec id="sec-5">
      <title>4. FIRST APPLICATIONS OF THE PLATFORM</title>
      <p>The first applications of mSinaptiks are mainly focused in mental health evaluation and
treatment:
•</p>
    </sec>
    <sec id="sec-6">
      <title>Fear of public speaking / oratory skills training. The application contains</title>
      <p>three VR environments that represent the most common situations related to
public speaking: an auditorium (figure 3), a meeting room and a classroom. The
users can practice oratory skills and confront their fears in a systematic and
controlled way.
•
ADHD assessment. A VR screening tool developed to evaluate the effects of
pharmacological and/or psychological interventions for ADHD (figure 4). The
app contains a virtual classroom and uses a HMD and a head tracking system.
Within the virtual scenario, children are assessed for performance in visual or
audio attention tasks while a series of typical classrooms distracters appear. As a
result of each session, the system provides information about the attention
performance and the behavior of the child.
Coping with anxiety and pain. Immersive VR experience designed as a
method for distracting patients during highly painful and/or stressful situations
(figure 4). The user will visit a pleasant tropical island that contains a variety of
captivating situations: a Japanese garden, a waterfall, a dam, an ancient tree, etc.
This tool can be used in a variety of contexts: dental clinics, pain and surgery
units, health centers or in patients with anxiety or stress.</p>
      <p>Behavioral self-reports. This application allows to design and manage
cognitive-behavioral self-reports that patients can fill out through the
Smartphone in their daily live (figure 5). Unlike traditional paper-and-pencil
self-reports, the practitioner can incorporate multimedia elements (such as
pictures or audio notes) and reminders.
Bradley, G. (2000). The information and communication society: how people will live
and work in the new millennium. Ergonomics, 43(7), 844-857.</p>
      <p>Botella, C. &amp; Bretón-López, J. (2014). The use of information and communication
technologies in clinical psychology. Revista de Psicopatología y Psicología Clínica,
19(3), 149-156.</p>
      <p>Garcia-Palacios, A., Herrero, R., Vizcaíno, Y., Belmonte, M.A., Castilla, D., Molinari,
G., Baños, R.M. &amp; Botella, C. (2015). Integrating virtual reality with activity
management for the treatment of fibromyalgia: Acceptability and preliminary efficacy.
The Clinical Journal of Pain, 31(6), 564-572.</p>
      <p>Gerardi, M., Cukor, J., Difede, J., Rizzo, A. &amp; Rothbaum, B. O. (2010). Virtual reality
exposure therapy for post-traumatic stress disorder and other anxiety disorders. Current
Psychiatry Reports, 12, 298–305.</p>
      <p>Hone-Blanchet, A.,Wensing, T. &amp; Fecteau, S. (2014). The use of virtual reality in
craving assessment and cue-exposure therapy in substance use disorders. Frontiers in
Human Neuroscience, 8:884.
Meyerbroker, K. &amp; Emmelkamp, P. M. (2010). Virtual reality exposure therapy in
anxiety disorders: A systematic review of process-and-outcome studies. Depression and
Anxiety, 27, 933–944.</p>
      <p>Opris, D., Pintea, S., García-Palacios, A., Botella, C., Szamosközi, S. &amp; David, D.
(2012). Virtual reality exposure therapy in anxiety disorders: a quantitative
metaanalysis. Depression and Anxiety, 29(2), 85-93.</p>
      <p>Parsons, T. D. &amp; Rizzo, A. A. (2008). Affective outcomes of virtual reality exposure
therapy for anxiety and specific phobias: A meta-analysis. Journal of Behavior Therapy
and Experimental Psychiatry, 39, 250 –261.
Riva, G., Bacchetta, M., Baruffi, M. &amp; Molinari, E. (2002). Virtual-reality-based
multidimensional therapy for the treatment of body image disturbances in binge eating
disorders: A preliminary controlled study. IEEE Transactions on Information
Technology in Biomedicine, 6, 224–234.</p>
      <p>Riva, G., Manzoni, M., Villani, D., Gaggioli, A. &amp; Molinari, E. (2008). Why you really
eat? Virtual reality in the treatment of obese emotional eaters. Studies in Health
Technology and Informatics, 132, 417–419.</p>
    </sec>
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