Open Rails: free train simulator that supports the world's largest range of digital content. The project provides a train simulator for the largest collection of digital content in the world - routes, rolling stock and activities - initially developed for Microsoft's Train Simulator product.
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Microsoft Game Studios announced Fable III, along with a release date of 2010. Also, Microsoft announced their intention to release Fable II on the Xbox Live Marketplace in five episodes, the first of which will be free to download.
Of the 46 studies, 22 (48%) used nonimmersive VR simulators, of which computer-based programs and the LapSim, AnthroSim, and MIST-VR simulators were the most commonly used [6,8,9,14,41,56,58-61,64,65,70,73,75,78,80,81,85-88]; 12 (26%) used fully immersive VR, with the most common headsets used being the Oculus Rift and HTC Vive [16,17,20,23,57,62,69,71,74,76,77,79]; and 2 (4%) used the stereographic CrystalEyes shutter glasses, which enabled 3D visualization when connected to an immersive workbench, for partially immersive VR [68,84]. Of the 46 studies, 6 (13%) used AR, with the Microsoft HoloLens glasses being the most commonly used device [7,22,66,82,83,89]. Other devices included smartphone apps, the ODG R-7 Smartglasses, and the Brother AiRScouter WD-200B headset. Of the 46 studies, 3 (7%) combined AR with VR [63,67,72]. For example, Luciano et al [63] used the ImmersiveTouch VR system in addition to high-resolution AR stereoscopic glasses. Qin et al [67] included nonimmersive VR, fully immersive VR, and AR in a comprehensive multimodal simulation training program. The study by Wang et al [24] did not clearly state the level of immersion.
The second condition relates to when fully immersive VR (with and without haptics) or AR with a manikin immersed learners in the training environment [16,20,22,23,57,62,71,74,76,77,79]. This triggered perceptions of deep immersion, whereby learners were transported into their training environments and a safe learning environment, free from patient harm. Bhowmick et al [23] explained that isolation from the outside world and use of realistic scenarios (eg, environments, characters, and tasks) promoted feelings of deep immersion. This resulted in improved learning, knowledge, and comfort with knowledge and skill performance.
The last training-related context relates to when VR (nonimmersive and fully immersive, with and without haptics) or AR were used to train novices (learners with little or no experience). The programs were expected to trigger various resources and mechanisms, including feedback and objective measurement of skills or knowledge; independent and self-directed learning; a safe, static, and risk-free learning environment; repeated practice; and exposure to experience [6,8,9,14,17,41,58-62,65,70-72,76,79,81]. This may result in technical proficiency, skill acquisition and improved performance (including operative performance), learner satisfaction, and the most improvement in novices.
In medicine, the nascent influence of extended reality is prevalent. Virtual reality platforms have been designed to teach foundational subjects, such as human anatomy [6,7], and train surgeons in complex surgical procedures [8-11]. Augmented and mixed reality offer methods of visualizing intraoperative procedures and diagnostic images with devices, such as Google Glass (Google Inc) or Microsoft HoloLens (Microsoft Inc), that have the potential to improve procedure safety and success [12-14]. The ability of virtual reality to distract patients from the physical environment also offers therapeutic approaches for rehabilitation and for treating pain or psychiatric disorders [15-17]. Likewise, ophthalmology has seen a growing influence of extended reality. Ophthalmic graduate medical education in the United States has seen an increase in the use of virtual eye surgery simulators, from 23% in 2010 to 73% in 2018 [18,19]. Extended reality technologies have also been explored as a method of therapy in ophthalmic diseases such as amblyopia and visual field defects [20,21]. Although the versatility of extended reality platforms can influence the practice of ophthalmology, health care providers should be well informed of the benefits and limitations of such technologies. This will allow evidence-based decision making when adopting nascent methods of ophthalmic education, diagnosis, and treatment. The focus of this review was to systematically evaluate current evidence of the efficacy, validity, and utility of the application of extended reality in ophthalmic education, diagnostics, and therapeutics. 2ff7e9595c
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