To relieve perceived pain in patients undergoing colonoscopy, we developed an endoscopist-patient co-participative VR tool (EPC-VR) based on A Neurocognitive Model of Attention to Pain. It allows the patient to play a VR game actively and supports the endoscopist in triggering a distraction mechanism to divert the patient's attention away from the medical procedure. We performed a comparative clinical study with 40 patients. Patients' perception of pain and affective responses were evaluated, and the results support the effectiveness of EPC-VR: active VR playing with endoscopists' participation can help relieve the perceived pain and scare of patients undergoing colonoscopy. Finally, 87.5% of patients opt to use the VR application in the next colonoscopy.

Human cognition and behavior can be unconsciously affected by personal avatars in the virtual world, a phenomenon known as the Proteus Effect. When using first-person non-human avatars, the characteristics of virtual hands may also induce relevant cognitive and even behavioral patterns in real human hands. Therefore, evaluating human-avatar gesture consistency may be a potentially effective method for objectively assessing the Proteus Effect when using non-human avatars. To explore this question, we first created human and non-human avatars, including three animals. Then, we constructed a dataset of hand gestures and trained a model to dynamically recognize real-hand gestures that were consistent with corresponding avatar hands. Next, we designed a virtual reality experimental task involving grasping objects with intuitive gestures and performed a 2 (avatar type: human/non-human) $* 2$ (virtual hand: presence/absence of spontaneous movement) within-subject experiment to examine the effects of avatar characteristics on self-illusion and human-avatar gesture consistency. The results showed that participants performed a significantly larger percentage of gestures that were consistent with their currently used avatars. Additionally, participants did experience self-illusion when using non-human avatars, although the levels were significantly lower than those when using human avatars. Therefore, self-illusion may serve as a perceptual antecedent of the Proteus Effect, even with non-human avatars, inadvertently altering the behavioral gestures of their real hands. In conclusion, detecting human-avatar gesture consistency can help evaluate the Proteus Effect.