The rapid advancement of technology has revolutionized language learning, introducing innovative methods that depart from traditional instructional approaches. This study employs a mixed-methods research design to examine the impact of chatbot-based language learning support, adaptive learning algorithms, and virtual reality language immersion on the language learning proficiency and self-regulated learning skills of English as a Foreign Language (EFL) learners. The research design includes quantitative analysis of language proficiency scores and qualitative exploration of learner experiences with the technological interventions. The theoretical implications of this study are rooted in constructivist and socio-cultural learning theories, which underpin the design and implementation of the technological interventions. The triangulation of qualitative and quantitative data revealed that the participants' positive perceptions of the effectiveness of chatbot-based language learning support were supported by the quantitative results, with the variable "chat-bot based support" demonstrating a substantial mean difference compared to other groups. This convergence of findings reinforces the positive influence of chatbot-based support on language learning outcomes and highlights the importance of integrating theoretical perspectives with empirical evidence to gain a comprehensive understanding of the impact of technological interventions on language learning outcomes for EFL learners. The study's findings provide insights into the potential of these technological interventions to optimize language learning outcomes for EFL learners and promote autonomous learning behaviors.

Background: This study explored the effects of a virtual reality exercise program on overweight middle-aged women. Methods: This randomized controlled trial included women 4065 years of age with a body mass index (BMI) of 23 kg/m2 or more living in D city. The virtual reality environment was set up by attaching an IoT sensor to an indoor bicycle and linking it with a smartphone, enabling exercise in an immersive virtual reality through a head-mounted display. Results: In the virtual reality exercise group, the BMI was significantly decreased after the 8-week intervention compared with the baseline value (F=100.806, p<.001). The depression scores were significantly different among the three groups, with the intervention effect being more significant in the virtual reality exercise group than in the indoor bicycle exercise and con-trol groups (F=3.462, p<.001). Furthermore, the levels of exercise fun (F=12.373, p<.001) and exer-cise immersion (F=14.629, p<.001) were significantly higher in the virtual reality exercise group than in the indoor bicycle exercise and control groups. Conclusions: The virtual reality exercise program positively affected the BMI and the levels of depression, exercise fun, and exercise im-mersion in overweight middle-aged women. It is an effective home exercise program for obesity management in this population.

Background: Given that VR is applied in multiple domains, understanding the effects of cybersickness on human cognition and motor skills and the factors contributing to cybersickness gains urgency. This study aimed to explore the predictors of cybersickness and its interplay with cognitive and motor skills. Methods: 30 participants, 20-45 years old, completed the MSSQ and the CSQ-VR, and were immersed in VR. During immersion, they were exposed to a roller coaster ride. Before and after the ride, participants responded to CSQ-VR and performed VR-based cognitive and psychomotor tasks. Post VR session, participants completed the CSQ-VR again. Results: Motion sickness susceptibility, during adulthood, was the most prominent predictor of cybersickness. Pupil dilation emerged as a significant predictor of cybersickness. Experience in videogaming was a significant predictor of both cybersickness and cognitive/motor functions. Cybersickness negatively affected visuospatial working memory and psychomotor skills. Overall cybersickness’, nausea and vestibular symptoms’ intensities significantly decreased after removing the VR headset. Conclusions: In order of importance, motion sickness susceptibility and gaming experience are significant predictors of cybersickness. Pupil dilation appears as a cybersickness’ biomarker. Cybersickness negatively affects visuospatial working memory and psychomotor skills. Cybersickness and its effects on performance should be examined during and not after immersion.

With the widespread Application of Virtual Reality (VR) in education, optimizing foreign language learning in VR has become a focal point of research. This paper introduces a comprehensive theoretical framework (VR-CCL) based on constructivism and cognitive load theory to enhance foreign language learning in VR. Through a literature review, we explore the applications of VR in education, foreign language learning theories, and prior works on technology-assisted language learning. We further detail the three main components of the VR-CCL framework and validate its effectiveness through two case studies: Duolingo VR and Rosetta Stone VR. Finally, we discuss the strengths and limitations of the framework and its implications for educators and developers.

Background: Since the advent of virtual reality (VR), it has been used in medical education for surgical training and anatomy teaching. Recently, other modalities of extended reality (XR) such as augmented reality (AR) and mixed reality (MR) has also made its way into medical education. Although there has been research validating XR’s use in medical education, there have been few studies on the research trends of the different XR modalities. The paper aims to compare the research trends of the XR modalities in general and in terms of the medical fields studied and outcomes measured. Methods: Web of Science was searched, and preliminary data was extracted to analyze the general trend. Inclusion and exclusion criteria were then applied, and finalized articles were analyzed and grouped based on the medical field studied and outcomes measured. Results: 31 articles on VR, eight on AR and one on MR were included in the final analysis. We found that there is increasing research in VR since 1990 and AR since 2008. The research in MR is constant. Most of the papers on VR studied endoscopic surgery and anatomy whereas AR studied mostly anatomy and endovascular procedures. Using Miller’s prism of clinical competence, the competency measured most for VR and AR is “show”. Discussion and conclusion: Advancement in computing, communication and display technologies since 1990 may contribute to the increase in research on VR whereas the ubiquity of smartphone since 2008 may explain the increase in research on AR. Although both VR and AR are used in surgical training and anatomy teaching, we found possible strengths of VR in counseling and AR in practical skills. The competency "show" was measured most as most of the papers were on surgery, and the XR simulators used can capture surgical parameters

This study explores the integration of Building Information Modelling (BIM) and Virtual Tours in the Architecture Engineering and Construction (AEC) industry, focusing on Facility Management (FM) and Computerized Maintenance Management Systems (CMMS). The research addresses the need for different levels of detail in BIMs across various building phases and the potential of Virtual Tours as a complement to BIMs in IoT-based FM. The study’s methodology includes a literature review, a pilot-demonstrator case study, installation of monitoring and IoT control devices, execution of BIMs and Virtual Tour models, and development of links between system elements. The case study is based on the Controlled Environments for Living Lab Studies (CELLS), a unique facility designed for flexible monitoring and remote-control processes. The findings of this research could provide valuable insights into the potential of Virtual Tours to complement and connect to BIMs within a life cycle perspective, enhancing the usability of digital twins for nontrained users and contributing to the evolution of the AEC industry.

With the emergence of new VR/AR technologies, the question arises of how they can be used in human-swarm interaction. Where are the limitations and boundaries of conventional interfaces, and how can VR/AR overcome them? To find out, a user study was conducted. The subjects were able to interact with an autonomously acting swarm of drones using both a conventional desktop interface (Desktop-HSI) and a newly developed VR interface (VR-HSI).The resulting assessments are used as a basis for determining the extent to which this new technology can be applied in human-swarm interaction. The technical basis was an already tested simulation software that was expanded with a network interface to allow interacting with a drone swarm using connected HSIs (Human-Swarm Interfaces). Standardized communication was emphasized to enable the development of HSIs with different requirements. Specifically for this work, a VR-HSI was developed with Unity and a desktop-HSI with Java and their performance regarding human-swarm interaction was evaluated.

Technology can be seen everywhere and has been integrated into our lives.We are always using technology and enjoying the convenience brought by technology. However, physical retailers and e-commerce companies are also gradually adopting advanced technologies. Technology improves the purchasing environment and purchasing experience. Virtual reality and augmented reality have been hotly discussed in recent years. Technology, although virtual reality and augmented reality technology have not yet matured, it can be said that they will in the future It has great development potential. Virtual reality and augmented reality are also beginning to sprout in the retail industry. However, research on the acceptance of the use of virtual reality and augmented reality in the apparel shopping process is still lacking because This study explores how usefulness, ease of use, hedonicity, customer experience, customer engagement and satisfaction. To influence customer loyalty, this study adopted questionnaire survey and convenience sampling methods, and collected a total of 308 valid questionnaires. The analysis method used confirmatory factor analysis and structural equation model to verify the research hypothesis relationship. The results of this study found. Hedonic has a significant impact on customer loyalty, while usefulness, ease of use, customer experience, customer engagement and satisfaction Satisfaction does not have a significant impact on customer loyalty. This study explains the academic contribution of the research results. The practical implications in marketing are put forward, and specific suggestions and directions for future research are given.

This paper explores benefits of using VR technologies in higher education. Theoretical part investigates classical education system and its features in order to compare advantages of using VR systems in education. VR technologies and its current state in industry and in education were explored as well as which branches of higher education uses these systems. Survey was conducted through online questionnaire where respondents (N = 55) gave their opinion on VR and the implementation of VR technologies in education. Three hypotheses related to the use of VR technology, student interest, and learning outcomes as well as the effectiveness, immersiveness and the effect of VR systems on the users were tested through 27 questions.

Simulation-based education is a part of Intelligent Transportation Systems (ITS) education. The paper discusses the experimental success of using Virtual Reality (VR) technology in simulation-based ITS education to improve the quality of education while increasing immersion and motivation. The study documents the application of VR technology to a microscopic simulation model and the methodology to capture and evaluate student experiences. The study discusses findings and ways to improve the planned VR technology implementation in the ITS laboratory.

Internationalization and alternative ways for strategic management have been an objective for stakeholders in cultural industry, especially after COVID-19 pandemic crisis. During the past years “internationalization” has been almost exclusively related with promoting creation or content to larger audiences. Such a strategy seemed sufficient, even if empirical data did not always support such a belief. Technological progress and costs reduction in developing Virtual Reality (VR) and Augmented Reality (AR) applications, provides to cultural industry the opportunity to reach global audiences and to enrich their experience. Current research provides evidence about developing VR and AR tools that can act as internationalization facilitators when it comes to cultural industry. Research conducted during “VARSOCUL” project funded by the European Regional Development Fund (ERDF) as part of the Greek National Scope Action entitled "RESEARCH-CREATE-INNOVATE". The project’s main result, alongside with VR and AR tools developed are presented.

Multidisciplinary neurotechnology holds the promise of understanding and non-invasively treating neurodegenerative diseases. In this preclinical trial on Parkinson's disease (PD), we combined neuroscience together with the nascent field of medical virtual reality and generated several important observations. First, we established the Oculus Rift virtual reality system as a potent measurement device for parkinsonian involuntary hand tremors (IHT). Interestingly, we determined changes in rotation were the most sensitive marker of PD IHT. Secondly, we determined parkinsonian tremors can be abolished in VR with algorithms that remove tremors from patients' digital hands. We also found that PD patients were interested in and were readily able to use VR hardware and software. Together these data suggest PD patients can enter VR and be asymptotic of PD IHT. Importantly, VR is an open-medium where patients can perform actions, activities, and functions that positively impact their real lives - for instance, one can sign tax return documents in VR and have them printed on real paper or directly e-sign via internet to government tax agencies. Lastly, we generated a technical framework wherein movements in the real world can be measured side-by-side with those in virtual reality. With this framework, we observed anecdotal evidence of parkinsonian tremors being reduced in real life when our algorithms abolished digital hand tremors in VR.

Technological advances made Virtual and Mixed Reality (VMR) accessible at our fingertips. However, only recently VMR has been explored for the teaching of biology. Here, we highlight how VMR applications can be useful in biology education, discuss about caveats related to VMR use that can interfere with learning, and look into the future of VMR applications in the field. We then propose that the combination of VMR with Machine Learning and Artificial Intelligence can provide unprecedented ways to visualise how species evolve in self-sustained immersive virtual worlds, thereby transforming VMR from an educational tool to the centre of biological interest.

As virtual reality (VR) games appeal to increasingly large audiences, many newcomers need convenient and flexible onboarding sessions. Traditional methods of creating tutorial levels can be time-consuming and require additional effort from the development team. In this paper, we present a toolkit for computer-assisted tutorial generation in VR. We conducted an interview with developers and a between-subjects user study to evaluate our toolkit compared to a manually designed onboarding experience by measuring user performance in actual gameplay. The results indicate that our toolkit performs equivalently to manual tutorials in terms of user success. Most users subjectively prefer a manually designed tutorial primarily for its aesthetic value. These results are encouraging, as they prove the feasibility of semi-automated onboarding.

Appropriate techniques for promoting reading fluency are difficult to implement in the classroom. There is little time to provide students with individualized feedback on reading aloud or to moti-vate them to do so. In this context, VR can be beneficial for learning, to provide individualized feedback and for increasing learners' engagement. Studies analyzing established methods of lan-guage learning in school in VR seem to be lacking so far. Therefore, this study project was the first to analyze the acceptance of students towards the implementation of a concept of reading fluency training with students at a secondary school in VR. The study method was developed based on the Technology Acceptance Model. The VR environment developed is web-based and provides indi-vidual and collaborative opportunities for training reading fluency, giving, and receiving feed-back, and deepening content understanding of the reading texts. To analyze the acceptance of the VR environment, 5 guided interviews were conducted. The results show that despite technical challenges with the VR environment, students accepted and appreciated the reading fluency training in VR. The integration of established concepts of reading fluency training in foreign lan-guage classrooms has great potential as additional added value can be created to address the challenges of face-to-face instruction.

While digital libraries offer essential benefits for the digital age such as constant availability and accessibility, they often fail in providing a similarly enjoyable browsing experience that benefits engagement and serendipitous exploration inherent to traditional library experiences. In this paper, we propose a virtual reality (VR) library environment that emulates a traditional library promoting an engaging browsing experience that benefits browsing enjoyment and serendipity. The implemented system uses procedural content generation to dynamically generate a library-like environment, wherein each room corresponds to a specific category of the digital library. To assess the usability of the implemented system, we conducted an A/B study comparing the VR environment with the web interface of Project Gutenberg. The results of the study suggest that while the physical demand for using the VR environment is higher, the system can significantly benefit the browsing experience and entice users’ curiosity. Furthermore, the study suggests that the system can increase user engagement and users generally felt that using the system was rewarding.

Visualization techniques are a powerful communication tool between construction stakeholders. The advancement of technology from 2D drawings to 3D models, Virtual Reality (VR), and Augmented Reality (AR) has emphasized the crucial role of efficient communication of ideas, designs, and concepts in preventing project delays and other issues in the Architecture, Engineering, and Construction (AEC) industry. Contemporary innovations such as web-based virtual reality cloud platforms that facilitate collaborative AEC projects and Head-mounted Displays that enable the viewing of VR environments are some of the latest technological developments that are emerging in the construction industry. These technological advances have the potential to improve communication, increase project efficiency, and enhance the quality of construction work. The purpose of this research is to identify existing trends and potential future directions by appropriating the state of the art of the intellectual growth of Virtual reality and Augmented Reality. The study used scientometric analysis in reviewing existing publications to scientifically map the evolution of VR and AR in the AEC sector. The study observed an emerging but little amount of publications on VR and AR in construction. While Africa contributes little significance, advancement in VR and AR research is led by United States and America. The study expresses concern over the dearth of research and the low amount of collaborations amongst institutions in diverse countries. The study concludes that VR and AR research in the AEC sector must be afforded the needed focus and attention. In recent times, the global Coronavirus pandemic has shown that technology such as VR and AR is inevitable in the success of a project.

Low Back Pain (LBP) is one of the most common problems among adults. The usual physiotherapy treatment is to perform physical exercises. However, some LBP patients have false beliefs regarding their pain and they tend to avoid physical movements which might increase their pain and disability. Virtual Reality (VR) has shown to be an effective intervention in improving motor functions and reducing pain perception. Existing VR interventions for LBP rehabilitation were based on a non-immersive VR, whereas to effectively reduce the pain intensity, we need an immersive VR. In this paper, we introduce the development and evaluation of a serious game called RabbitRun with an immersive experience to engage the patients in a virtual environment and distract them from the pain while performing LBP exercises. The initial usability evaluation results suggest that RabbitRun game is enjoyable and acceptable. The game is easy to play and learn and most of the participants are willing to play the game at home. This solution will enhance the rehabilitation outcome since the patients who are suffering from LBP can use the system at their home and train more for long period of time using a smartphone and low-cost virtual reality device such as Google Cardboard.

This research presents the creation of a Virtual Reality experience for the Balzi Rossi museum, commemorating the centenary of Prince Albert I Grimaldi's archaeological work at the site. The project, a collaboration between the University of Genoa's 3D Lab Factory, Eurodrone, and the Balzi Rossi archaeological museum, aims to preserve and convey the site's heritage through advanced VR technology. Initially employing Unreal Engine 4, the team used photogrammetry for 3D reconstruction of the "Caviglione" and "Florestano" caves, notable for their ancient rock engravings. This first VR model, despite hardware limitations, provided an interactive exploration of the site. The subsequent development phase utilized Unreal Engine 5, incorporating Nanite technology for enhanced visual fidelity. This advancement resulted in a more detailed and immersive VR experience, presenting the Balzi Rossi cliff across different historical periods, including the Würm glaciation. Key to this phase was optimizing the VR experience for performance, focusing on stable frame rates and minimizing motion sickness, and integrating a multi-lingual interface for broader accessibility. Since November 2023, the VR setup at the Balzi Rossi Museum has been an educational and interactive feature, enabling visitors to explore the site's history virtually. This research demonstrates the potential of VR in cultural heritage preservation and education, providing a foundation for future technological improvements in the field.

With advances in Building Information Modeling (BIM), Virtual Reality (VR) and Augmented Reality (AR) technologies have many potential applications in the Architecture, Engineering, and Construction (AEC) industry. However, the AEC industry, relative to other industries, has been slow in adopting AR/VR technologies, partly due to lack of feasibility studies examining the actual cost of implementation versus an increase in profit. The main objectives of this paper are to understand the industry trends in adopting AR/VR technologies and identifying gaps within the industry. The identified gaps can lead to opportunities for developing new tools and finding new use cases. To achieve these goals, two rounds of a survey at two different time periods (a year apart) were conducted. Responses from 158 industry experts and researchers were analyzed to assess the current state, growth, and saving opportunities for AR/VR technologies for the AEC industry. The findings demonstrate that older generations are significantly more confident about the future of AR/VR technologies and they see more benefits in AR/VR utilization. Furthermore, the research results indicate that Residential and commercial sectors have adopted these tools the most, compared to other sectors and institutional and transportation sectors had the highest growth from 2017 to 2018. Industry experts anticipated a solid growth in the use of AR/VR technologies in 5 to 10 years, with the highest expectations towards healthcare. Ultimately, the findings show a significant increase in AR/VR utilization in the AEC industry from 2017 to 2018.

The commercial popularity of Virtual Reality attracted educators’ interest and brought new opportunities to the educational landscape. At the same time, Learning Analytics emerged with the promise to revolutionise the traditional practices by introducing ways to systematically assess and improve the effectiveness of instruction. However, the collection of ‘big’ educational data is mostly associated with web-based platforms as they offer direct access to learners’ activities with minimal effort. On the antipode, the nature of VR limits the opportunities for such data collection. Hence, in the context of this work, we present a four-dimensional theoretical framework, that accounts the information that can be gathered from VR-supported instruction, and propose a set of structural elements which can be utilised for the development of a Learning Analytics prototype system. The outcomes of this work are expected to support practitioners to maximise the potential of their interventions and provide inspiration for new ones.

Background: This work presents Com@Rehab, a technological patient-centred activity for individuals needing a physical rehabilitation approach and with a specific loss of functionality. Within this scope, this paper focuses on the description of the activity in virtual reality (VR), its components, design and user profile, and its versatility and future adaptability regarding different ages, pathologies and rehabilitation contexts. Methods: The VR activity has been customised according to the patient's clinical needs while replicating an activity of daily living, namely showering. In addition, to validate and get feedback on the developed system, a validation questionnaire was applied to a group of healthy individuals to test the efficiency of the technology that supports the VR activity. Results: Preliminary results show that 94% of the participants recommended the experience, the performance of the various components of the system was successfully implemented, participants quickly adhered to the VR technology, and the UI assistant’s functionality should be improved. Conclusion: This solution creates a more effective, interactive, humanised rehabilitation approach based on a Virtual Reality (VR) activity. The Com@Rehab Communication Module improves human-human and human-machine communication while contributing to health literacy.

Virtual Reality (VR) can be useful in efforts that aim to improve wellbeing of older members of the society. Within this context, the work presented in this paper aims to provide to elderly a user-friendly and enjoyable Virtual Reality (VR) application incorporating memory recalling and storytelling activities that can promote mental awareness, so that negative side effects related to brain inactivity are prevented. An important aspect of the proposed VR application is the presence of a virtual audience that listens to the stories presented by elderly users, and interacts with the user. In an effort to maximize the impact of the VR application, research was conducted to study whether the elderly are willing to use the VR application and whether they believe it can help to improve well-being and reduce the effects of loneliness and social isolation. The results show that elderly users are positive towards the use of such an application in everyday life, as a means of improving their overall well-being.

The intricate nature of congenital heart disease requires understanding of complex, patient-specific three-dimensional dynamic anatomy of the heart, from imaging data such as three-dimensional echocardiography for successful outcomes from surgical and interventional procedures. Conventional clinical systems use flat screens and therefore display remains two-dimensional, which undermines the full understanding of the three-dimensional dynamic data. Additionally, control of three-dimensional visualisation with two-dimensional tools is often difficult, so used only by imaging specialists. In this paper we describe a virtual reality system for immersive surgery planning using dynamic three-dimensional echocardiography, which enables fast prototyping for visualisation such as volume rendering, multi-planar reformatting, flow visualisation, and advanced interaction such as three-dimensional cropping, windowing, measurement, haptic feedback, automatic image orientation, and multi-user interactions. The available features were evaluated by imaging and non-imaging clinicians, showing that the virtual reality system can help improve understanding and communication of the three-dimensional echocardiography imaging and potentially benefit congenital heart disease treatment.

This study explores consumer perceptions of virtual reality (VR) in marketing, aiming to understand how immersive technology impacts engagement and brand perception. As VR continues to evolve and integrate into various marketing strategies, it becomes crucial to examine its effectiveness and the factors influencing consumer attitudes. Through a detailed thematic analysis, this research identifies key themes such as familiarity with VR technology, immersion and engagement, technical quality, accessibility, personalization, storytelling, social interaction, purchase intentions, and brand perception. The findings reveal that familiarity with VR enhances enthusiasm and comfort, leading to more positive attitudes towards VR marketing. The immersive and multi-sensory nature of VR provides a significant advantage over traditional advertising methods, fostering stronger emotional connections and increasing memorability. However, the quality of the VR experience is critical; high-quality graphics and seamless interactions are essential for maintaining positive consumer perceptions. Technical issues, such as lag and motion sickness, can negatively impact the experience, especially for those less acquainted with VR technology. Accessibility remains a challenge, with limited access to VR headsets restricting the reach of VR marketing campaigns. Personalization of VR content is highly valued, though it must be balanced with ethical considerations related to data privacy. The power of storytelling in VR enhances engagement by allowing consumers to actively participate in narratives. Social interaction within VR experiences adds an extra layer of enjoyment. The study also highlights the practical applications of VR marketing in high-involvement sectors and underscores the need for continuous innovation and consumer feedback to maximize the technology's impact. Overall, VR holds significant potential to transform marketing practices by offering immersive, engaging, and memorable experiences that deepen consumer connections and drive positive outcomes.

Purpose: People with Williams syndrome (WS, n = 20, CA = 12.5, MA = 8.9) have strong verbal short-term memory but challenged verbal long-term memory. This study aimed to evaluate the memory abilities of people with WS and examine the possibility of improving their memory performance. Methods: Twelve navigations completed the study. Fourteen indexes were used for each navigation. Controls matched in chronological age (CA, n = 20, mean age = 12.5), mental age (MA, n = 20, mean age = 8.8), 5th graders (n = 20, mean age = 10.3), and college students (CS, n = 20, mean age = 20.2) were recruited. Results: The WS group was slowest and erred more in completing tasks than the CA and MA groups. The error patterns revealed group differences in the number of extra items purchased and missed correct items. The 5th graders erred more than the CS on extra items purchased; the CA group erred more than the CS and the 5th graders on missed correct items. The WS group erred more than the CA and MA groups for incorrect items purchased, extra items purchased, missed correct items, and incorrect types purchased. The error patterns yielded replacements and confusion. Semantic features attributed to atypical processing during navigation have emerged in people with WS. Conclusion: These findings suggest that people with WS have developmental disorders in verbal long-term memory. The current study serves as a foundation for future interventions in people with WS.

This research paper explores the transformative potential of immersive media, specifically virtual reality (VR), in enhancing empathy among users. Empathy is vital in fostering understanding, compassion, and social cohesion. Immersive media, with its ability to transport individuals into simulated environments and perspectives, offers unique opportunities to bridge the empathy gap. This paper examines how VR can boost empathy, including perspective-taking, emotional connection, experiential learning, breaking down barriers, and empathy-building simulations. It discusses existing studies and empirical evidence supporting the effectiveness of VR in promoting empathy. The paper acknowledges the ethical considerations and challenges associated with using VR for empathy enhancement, such as avoiding stereotype reinforcement and ensuring inclusive design. By highlighting the potential of immersive media in cultivating empathy, this research paper contributes to the growing field of empathy research and provides insights for the development and application of VR experiences aimed at fostering empathy and understanding in diverse contexts.

Virtual reality (VR) describes a family of technologies which immerse users in sensorily-stimulating virtual environments. Such technologies have increasingly found applications in the treatment of neurological and mental health disorders. Depression, anxiety, and other mood abnormalities are of concern in the growing elderly population – especially those who reside in long-term care facilities (LTCFs). The transition from the familiar home environment to the foreign LTCF introduces a number of stressors that can precipitate depression. However, recent studies reveal that VR therapy (VRT) can promote positive emotionality and improve cognitive abilities in the elderly, both at home and in LTCFs. VR thus holds potential in allowing elderly individuals to gradually adapt to their new environments – thereby mitigating the detrimental effects of place attachment and social exclusion. Nevertheless, while the current psychological literature is promising, the implementation of VR in LTCFs faces many challenges. LTCF residents must gain trust in VR technologies, care providers require training to maximize the positive effects of VRT, and decision makers must evaluate both the opportunities and obstacles in adopting VR. Here, we concisely review the implications of depression related to place attachment in LTCFs, and explore the potential therapeutic applications of VR.

Choosing a career path is an important decision in a person’s life and forms the basis for their future direction. It impacts the future career and influences financial stability as well as the person’s well-being. Many people struggle to find out what they are interested in and talented in, making it difficult to choose a fitting career path. Therefore, the decision-making process requires careful consideration, self-reflection, and exploring numerous options. While virtual environments provide an effective way to explore different experiences, virtual reality (VR) offers users immersive interactions with simulated 3D environments. This allows the realistic exploration of different job fields in a virtual environment without being physically present. VR 360-degree videos have been shown to significantly increase job interest among students. The ability to review and refine performance makes VR an ideal tool for career skill development as well as career guidance. In this paper, we present a tool that offers young people virtual career guidance through an immersive VR experience. The study investigates the extent to which performing occupational tasks in a virtual environment influences the career perceptions of young adults and whether it enhances their understanding of professions. In total, 23 teenagers and 8 application experts were involved to assess the teenager’s expectations and the potential of the career guidance tool.

In this 2 x 2 between-subjects experimental study, a virtual reality (VR) laboratory simulation is paired with a VR molecular world intervention to teach chemistry concepts. The independent variables are the implementation timing of the molecular world intervention (Pre-lab vs. Integrated) and the level of embodiment (Traditional vs. VR). Eighty students (N = 80), ages 11-18 years old, from a community center in New York City participated, completing a pretest, the laboratory simulation, the molecular intervention, and a post-test. The pre- and post-test measures included multiple-choice, free-response, and drawing questions. A key finding was that integrating the intervention within the lab simulation, no matter which level of embodiment, led to significantly higher gains in learning. The combination of using physical manipulatives and integrating them within the lab exercise (Integrated Traditional condition) demonstrated the greatest gains overall. On drawing measures, the Integrated VR condition showed significant improvement in three out of the four drawing categories (i.e., molecule shape, atom quantity, and relative sizes). The implications are that even though using a VR molecular world intervention can lead to significant learning of abstract chemistry content, the use of physical manipulatives is still a more effective tool.

This review explores the integration of Virtual and Mixed Reality in medical training. The advent of immersive technologies has revolutionized traditional methodologies, offering immersive, interactive, and flexible learning environments. This study aims to assess the impact, efficacy, and potential of Extended Reality (XR) in medical education. Methods included a comprehensive analysis of current Metaverse’s applications in various medical fields, including surgery, diagnostics, and patient care. Results indicate a significant enhancement in learning outcomes, practical skills, and student engagement. Conclusions suggest that Virtual Reality is a valuable tool for medical training, providing realistic simulations and improving both theoretical knowledge and practical skills. The intersection of virtual reality and cognitive neuroscience presents an exciting frontier for understanding the human brain's response to immersive environments. This review explores how VR impacts learning, with a particular focus on the activation and engagement of the prefrontal cortex during immersive experiences. It delves into various studies that highlight the transformative potential of VR in educational settings and therapeutic applications, demonstrating how VR can facilitate deeper and more effective learning experiences. The review will present a dedicated section on the current methodologies used to analyze the brain's response while immersed in a virtual environment.

One of the most crucial aspects of the user experience in virtual reality (VR) is the sense of presence. To evaluate this, both subjective and objective methods can be employed. While subjective methods are easy to implement and interpret, they may not fully capture user feedback, and the results can sometimes lack consistency. In contrast, using objective methods, such as electroencephalography (EEG), can provide more reliable insights. To investigate the influence of realism on the sense of presence, we conducted an EEG study with 21 participants who experienced two VR environments—one realistic and one non-realistic. During the study, we continuously measured their brain activity using an EEG device. Our findings showed that alteration in the level of realism in an environment can be detected through changes in brain activity. Notably, we observed that users take longer to adapt to a non-realistic environment when transitioning from a realistic scene, compared to the reverse. Although our study has limitations, such as the total number of participants, we gained valuable initial insights into how realism may influence brain activity. These findings suggest that higher realism may lead to reduced cognitive load, increased attention, improved decision-making, and suppression of irrelevant information.

Point cloud acquisition systems now enable the capture of geometric models enriched with additional attribute data, providing a deeper semantic understanding of the measured environments. However, visualizing complex spatiotemporal point clouds remains computationally challenging. This paper presents a fusion methodology that aggregates points from different instants into unified clouds with reduced redundancy while preserving time-varying information. The static 3D structure is condensed using a voxel approach, while temporal attributes are propagated across the merged data. The resulting point cloud is optimized and rendered interactively in a virtual reality (VR) application. This platform allows for intuitive exploration, visualization, and analysis of the merged clouds. Users can examine thermographic properties using color maps and study graphical temperature trends. The potential of VR for insightful interrogation of point clouds enriched with multiple properties is highlighted by the system.

Virtual reality (VR) can play a key role in automotive marketing research, lowering costs and shortening the time it takes to bring a new product to market. However, there are still few VR applications that support automotive customers' experiences during the early stages of product development. Through a systematic review of literature and patents, this study aims to identify the challenges and opportunities for the application of virtual reality in car clinics, and to categorize them into attributes. We searched through the knowledge databases of PatentScout, ScienceDirect, Springer, and IEEEXplore. We found 72 patents with a high concentration in a few inventors. The United States of America presented the greatest number of records and the most common applications related to the apparatus for automatically reading respondents' reactions in a virtual environment. In terms of articles, we found 19 research papers that discussed sixteen categories identified as challenges and opportunities for automotive marketing research: 1) cost, 2) location to customers, 3) flexibility in interactions, 4) model transportation, 5) depth perception, 6) haptic perception, 7) motion, 8) movement perception/ physical collision, 9) color and texture, 10) sound feedback, 11) product interaction/manipulation, 12) visual-spatial, 13) graphic quality, 14) intuitiveness, 15) cybersecurity and 16) cybersickness. We conclude that the automotive industry can employ virtual reality for marketing research, but relevant elements such as hardware and software definition, stimulus quality, and research objectives, among others, must be considered.

The rising popularity of virtual reality has seen a recent push in applications, such as, social media, educational tools, medical simulations, entertainment and training systems. With virtual realitythe ability to engage users for specific purposes, provides opportunities to entertain, develop cognitive abilities and technical skills outside of the standard mediums (e.g., the television or theclassroom) thereby optimizing exposure with realistic (live) opportunities. However, before these applications of virtual reality become more widespread, there are a number of open questions andissues that must be addressed including limitations, challenges, relationships between fidelity, multi-modal cue interaction, immersion, and knowledge transfer and retention. In this article, we begin with a brief overview of virtual reality methods, followed by a discussion of virtual reality and its applications (both historically, currently and in the future). We review virtual reality trends both from the early artistic days through to current day state of the art technological advancements. We explore emerging and futuristic breakthroughs - and their applications in virtual reality - showing how virtual reality will go way beyond anything we could envision. Infact, after reading this article, we hope the reader will agree, that virtual reality, is possibly one of the most powerful mediums of our time. While the earliest mechanistic virtual reality prototypes (e.g., Sensorama) allowed us to view stereoscopic 3D images accompanied by stereosound, smells, as well as wind effect - set the foundation and direction for future pioneers - there have been spearheaded developments which have continually pushed the concept of virtual reality to new domains. As virtual reality evolves, many new and yet-to-be-imagined applications will arise, but we must have understanding and patience as we wait for science, research andtechnology to mature and improve. The article ends with a short overview of future directions based upon recent breakthroughs in research and what this will mean for virtual reality in the coming years.

In this study, 6 residents of a long-term care facility were asked to try on Virtual Reality glasses and report their first experiences with Virtual Reality. The results show that Virtual Reality is of great interest to elderly residents of in-patient long-term care facilities. The wearing period was longer than expected and no symptoms of cyber sickness occurred. For the residents it was exciting to explore the virtual environments. Austrian destinations, nature scenes in the mountains and forests but also trips to the zoo, the museum, in churches or even densely populated areas like shopping streets or train stations would be places for the residents, they would like to explore virtually. Far-off destinations such as Rio de Janeiro or the Caribbean are more of an exception. Biographically relevant places such as the parental home or the location of their wedding were not named. Concerning the usability, an adjustment of the VR glasses is necessary for a longer-term use in any case.

This study presents virtual reality (VR) videos as an effective technique for delivering extension educational materials on manure and mortality management. Virtual reality is a technology that can enable immersive distance learning. Using VR tours can enable the public to learn manure and mortality management technologies without in-person farm visits, thus saving traveling time and money and avoiding exposure to pathogens and noxious odors in farms. As the first part of this project, 360° VR tours were created on multiple aspects of manure management, including composting, anaerobic digestion, and preliminary wastewater treatment. These videos were presented to a diverse audience of agricultural producers, extension specialists, and researchers through in-person and online extension events and the Texas Manure YouTube channel. The effectiveness of videos was evaluated using surveys, which measured the audience's awareness of the topics before and after watching VR videos. Statistical analysis revealed that the increase in awareness after watching the videos was statistically significant, with a p-value of less than 0.0001. Statistical analysis also revealed that job classification and professional experience significantly impacted the change in awareness. Researchers, extension specialists/agents, and participants with less experience in manure and mortality management experienced a greater change in awareness than agricultural producers and participants with more experience. Interest and impression of the audience on the VR videos was also evaluated. According to survey data, the majority of the audience rated these videos as an effective technique for educating the public about manure and mortality management, found the VR videos interesting, were willing to learn more content through VR videos, and were likely to recommend them to their colleagues. A statistically significant correlation could be observed between the awareness change and the effectiveness rating given to the videos by the participant.

In this paper, we introduce a specialized, fully automated experimental arrangement designed for assessing the effectiveness of augmented and virtual reality technologies in healthcare setting and explore its design principles focusing on depth sensor characterization. The main goal of this project is to establish a robust benchtop platform for the quantitative evaluation of extended reality technologies in a controlled environment, emphasizing the practical assessment of augmented reality head-mounted devices. We outline a design concept and considerations for an experimental configuration aimed at creating a realistic testing environment. This apparatus comprises an observation platform mounted on a three-degree-of-freedom motorized system and a test phantom stage. Focusing on real-case scenarios, we utilized a range of sensors, including readily available range-sensing cameras and commercial augmented reality headsets, such as the Intel RealSense L515 LiDAR camera, mounted on the motion control system. The setup enabled automated data collection and facilitates controlled assessments and validation of various facets of augmented reality technologies, including object, hand, and head tracking, as well as static and dynamic image registration. This paper describes the system architecture, the process of automated data collection, and presents several evaluation studies conducted with this setup, providing insights into the quality and temporal noise associated with static or moving objects or observers in augmented reality applications.

This research hypothesised that the use of Virtual Reality (VR) applications can be used to train people in the ability to acquire targets faster, with greater accuracy when using motion controllers than compared with a traditional pointing device (mouse) on a 2D display. User performance was defined and measured using Reaction Time and Accuracy. The research findings suggests that the use of motion controllers in VR improved Reaction Time but not Accuracy when compared against the traditional pointing device and 2D display. This suggests that VR can be used specifically in training scenarios where Reaction Times are more important than Accuracy. It is recommended that further research is conducted using a wider range of hardware and software configurations with a stratified sample that takes into account age and gender to expand the collective understanding of factors that impact on VR aiming and target acquisition in VR.

Previous research has explored different models of synchronous remote learning environments supported by videoconferencing and virtual reality platforms. However, few studies have evaluated the preference and acceptance of synchronous remote learning in a course streamed in an immersive or augmented reality platform. This case study uses ANOVA analysis to examine the engineering students´ preferences for receiving instruction during the COVID19 pandemic in three classroom types: face-to-face, conventional virtual (mediated by videoconferencing) and an immersive virtual classroom (IVC). Likewise, structural equation modeling, was used to analyze the acceptance of the IVC perceived by students, this includes four latent factors: ease of receiving a class, perceived usefulness, attitude towards IVC and IVC use. The findings showed that the IVC used in synchronous remote learning has a similar level of preference to the face-to-face classroom, and higher than the conventional virtual one. Despite the high preference for receiving remote instruction in IVC, aspects such as audio delays that affect interaction still need to be resolved. On the other hand, a key aspect for a good performance of these environments is the dynamics associated with the teaching-learning processes and the instructor´ qualities.

INTRODUCTION: With an increase in the aging population, the application of evidence-based practice in geriatric education can strengthen knowledge, skills, and clinical experience for healthcare students caring for older adults. Age Friendly Health Systems (AFHS) is one of the frameworks founded on providing evidence-based and low-risk care centered on what matters most to older adults, their families, and caregivers. Virtual Reality (VR) platforms are gaining popularity due to their ability to provide an immersive, hands-on learning experience resembling an actual medical practice or care setting. Immersive learning enhances students’ sensory perceptions, promoting an innovative and engaging way of acquiring concepts that are difficult to teach in real life. This study aimed to design, develop, implement, and evaluate a case-based training module highlighting AFHS and educating medical students on the 4Ms approach in geriatric care (What Matters, Medication, Mentation, and Mobility). METHODOLOGY: The project was a feasibility study completed in two phases. Phase one included planning and development of a case-based scenario incorporating 4Ms of AFHS. Phase two included implementing and evaluating the VR training module into the geriatric curriculum for medical students. RESULTS: The final VR case displays a hospital and post-acute setting where an elderly patient is admitted for a hip fracture. Students learn how to triage and treat patients from admission to discharge while demonstrating their knowledge of AFHS. Approximately 10% of students completed the evaluation survey, and preliminary results indicate significant knowledge change in pre-post scenario-based training on AFHS. CONCLUSION: The VR education platform and embedded scenario promise an innovative adaptation of technology in learning the concepts of the 4Ms of AFHS. However, future studies should explore VR education with clinical assessment evaluation to ensure competence in providing Age-Friendly care.

In recent years, the need to contain healthcare costs due to the growing public debt of many countries, combined with the need to reduce costly travel by patients unable to move autonomously, have captured the attention of public administrators towards tele-rehabilitation. This trend has been consolidated overwhelmingly following the Covid-19 pandemic, which has made it precarious, difficult and even dangerous for patients to access hospital facilities. We present a platform devoted to the rapid prototyping of Virtual Reality based, cognitive tele-rehabilitation exercises. Patients who experienced injury or pathology need to practice a continuous training in order to recover functional abilities, and the therapist need to monitor the outcomes of such practices. The Virtual Reality exercises are designed on Unity 3D to empower the therapist to set up personalised exercises in a easy way, enabling the patient to receive personalized stimuli, which are crucial for a positive outcome of the practice. Furthermore, the reaction speed of the system is of fundamental importance, as the temporal evolution of the scene must proceed parallel to the patient’s movements, to ensure an effective and efficient therapeutic response. So, we optimized the Virtual Reality application in order to make the loading phase and the startup phase as fast as possible and we have tested the results obtained with many devices: in particular computers and smartphones with different operating systems and hardware. The implemented platform integrates in Nu!Reha system®, a tele-rehabilitation set of services that helps patients to recover cognitive and functional capabilities.

Despite recent developments in monitoring and visualizing construction progress, the data exchange between construction jobsite and office lacks automation and real-time recording. To address this issue, a near real-time construction work inspection system called iVR is proposed; this system integrates 3D scanning, extended reality, and visual programming to visualize interactive onsite inspection for indoor activities and provide numeric data. iVR comprises five modules: iVR-location finder (finding laser scanner located in the construction site) iVR-scan (capture point cloud data of jobsite indoor activity), iVR-prepare (processes and convert 3D scan data into a 3D model), iVR-inspect (conduct immersive visual reality inspection in construction office), and iVR-feedback (visualize inspection feedback from jobsite using augmented reality). An experimental lab test is conducted to validate the applicability of iVR process; it successfully exchanges required information between construction jobsite and office in a specific time. This system is expected to assist Engineers and workers in quality assessment, progress assessments, and decision-making which can realize a productive and practical communication platform, unlike conventional monitoring or data capturing, processing, and storage methods, which involve storage, compatibility, and time-consumption issues.

This research examines the effects of the implementation of an educational programme of mindfulness training using Virtual Reality (VR) with students in adapted vocational training. The aim of this programme is to instruct and strengthen attention and self-regulation skills in relation to the learning process, with the objective of reducing anxiety and impulsivity in students, contributing to promoting sustainability in education, as well as reducing inequalities. The development and implementation of this project was carried out in IES Teguise in Lanzarote (Spain) with 11 students with intellectual disabilities who used the Virtual Reality Mindfulness application called TRIPP for three months. The use of Virtual Reality offers immersive experiences, while mindfulness enables concentration, which directly contributes to higher academic performance. After the implementation of the programme, it is observed that the use of this emerging technology provides students with a sense of calm and well-being, which translates into improvements in their academic grades, promoting equal and quality education in line with the Sustainable Development Goals (SDGs).

This paper examines the use of multisensory virtual reality (VR) as a novel approach in psychological therapy for autobiographical memory retrieval with benefits for cognitive enhancement, stress reduction etc. The research in this paper was done under Romanian Arut Research Grant no. 27/09/10/2023 ”Intelligent VR system for treating autobiographical/episodic memory deficits".  By simulating realistic multisensory experiences, VR technology offers an immersive environment that surpasses traditional therapeutic methods in effectiveness. Previous studies demonstrate improved outcomes in treating various psychological conditions (affective disorders and PTSD, specific phobias and age-related cognitive decline). Technological advancements in VR, such as olfactory integration cand contribute to the realism and therapeutic potential of these environments, the integration of various physical stimuli with VR holds promising potential psychological therapies and highlighting the need for further interdisciplinary research. In this pilot study we tested the efficacy of a new system for triggering autobiographical memory retrieval. For this we used images combined with odors in a congruent manner and offering participants the chance to interact with the VR environment by using 2 virtual hands. We evaluated the efficacy of this system using qualitative methods with emphasis on the evaluation of the emotions associated with memory recollection and the ease of triggering memories. All participants in our pilot study experienced intense emotions related to childhood or adolescence and the pleasant feelings they had during the experiment persisted even after it ended. This is an advancement to what exists currently and original research elements for our paper.

A real-time flight simulation tool is proposed using a Virtual Reality Head-Mounted Display (VR-HMD) for airships operating in beyond the line-of-sight (BLOS) conditions. Particularly, the VR-HMD is developed for stratospheric airships flying at low/high altitudes. The proposed flight simulation tool uses the corresponding aerodynamics characteristics of the airship, the buoyancy effect, mass balance, added mass, propulsion contributions and ground reactions in the FlightGear Fight Simulator (FGFS). The VR headset has been connected to the FGFS along with the radio controller containing the real-time orientation/state of each button that is also simulated to provide better situational awareness and a Head-Up Display (HUD) that has been developed to provide the required flight data. In this work, a system was developed to connect the FGFS and the VR-capable graphics engine, Unity, to a PC and a wireless VR-HMD in real-time with minimal lag between data transmission. A balance was found for FGFS to write to a CSV file at a period of 0.01s. For Unity, the file was read every frame which translates to around 0.0167s (60 Hz). A test procedure was also conducted with a similar rating technique based on the NASA TLX questionnaire that identifies the pilot’s spare mental capacity when completing an assigned task to assure the comfortability of the proposed VR-HMD. Accordingly, a comparison has been made for the aircraft control using the desktop simulator and the VR-HMD tool. Results, showed that the current iteration of the system is ideal to train pilots on using similar systems in a safe and immersive environment. Furthermore, such an advanced portable system may even increase the situational awareness of pilots and allow them to complete a sizeable portion of actual flight tests with the same data transmission procedures in simulation. The resulting VR-HMD flight simulator is also conceived to express the ground control station (GCS) concept and transmit flight information as well as the point of view (POV) visuals in real-time using the real environment broadcasted using an onboard camera.

Mild cognitive impairment (MCI) is when brain function declines. It is a transition stage between normal aging and Alzheimer's disease (AD) and may be an underlying symptom of AD. Improper use of test instruments or imperfect test methods in clinical practice often leads to variations in test results. In addition, there may be resistance from the subject if he/she has to undergo multiple screening tests simultaneously. Therefore, the objective of this study was to use virtual reality to create an image testing scenario that integrates Mini-Cog, Short Portable Mental Status Questionnaire (SPMSQ), Mini-mental Status Examination (MMSE), Saint Louis University Mental Status Examination (SLUMS), Clinical Dementia Rating (CDR), and Cognitive Abilities Screening Instrument (CASI), and combine fuzzy logic control (FLC) technology to develop an MCI forecasting system. There were 24 middle-aged to older adults aged 50 to 65 years who participated in the evaluation experiment. The results showed that the MCI forecasting system developed in this study is highly correlated with the traditional screening tests, including Mini-Cog, SPMSQ, MMSE, SLUMS, and CASI. The forecasting system can provide an integrated reference score for testers in making judgments. In addition, the distribution of the System Usability Scale (SUS) evaluation scores for the MCI forecasting system revealed that 87.5% were grade C (good to use) or above, and 29.2% were grade B (extremely good to use) or above. The forecasting system receives positive feedback from the subjects.

Nurses and paramedics play a pivotal role when Mass Casualty Incidents (MCI) occur, yet they often feel unprepared for such events. Implementation strategies for training activities, including Virtual Reality (VR) and Augmented Reality (AR) simulations, offer realistic and immersive learning experiences, enhancing skills and competencies for nursing students. The aim of this work was to investigate the adopted tools in studies on VR&amp;AR simulations for training nursing and paramedic students in managing MCI. A scoping review was performed following the PRISMA-ScR statement, and the search strategy was conducted through five electronic databases from December 2022 to March 2023. Of 162 records identified, 27 full-text were screened and, six studies were included in this review. These studies involved students who were assigned to different training methods, including immersive VR simulation, written instruction, and traditional lecture. VR&amp;AR and immersive simulation generally show promising evidences in enhancing practical skills and knowledge in MCI management. VR&amp;AR showed to be promising in disaster education and preparedness training, offering different levels of immersiveness and engagement, encouraging active and experential learning. Further research is needed to determine their long-term effectiveness. The choice of training method should consider program goals, target population, and available resources.

Vein blood sampling is one of the methods of mass blood sampling, and is an act of drawing blood from a vein for blood type discrimination, confirmation of various physiological indicators, disease diagnosis, and the like, and is the most commonly used blood sampling method. An important point in vein blood sampling is to search for the exact location of the vein and insert the blood sampling. This is influenced by the patient's obesity, skin and blood vessel conditions, and the experience of the clinical technologist, nurse, and resident who performs the blood sampling. It is required to perform blood sampling technique practice. However, due to many limitations of the practice room or laboratory, there is a problem of using only a limited environment and model for clinical practice. As a result, many medical educational institutions have situations in which only fragmentary clinical practices are performed, and it is difficult to per-form a large number of blood sampling skills practices, so they do not provide enough experience to understand the actual skill field. In this paper, we propose a method for developing a virtual reality-based vein blood sampling simulator to practice a large number of blood sampling techniques without restrictions. The proposed vein blood sampling simulator can operate a 3D model related to vein blood sampling using HMD Controller and Haptic in a virtual space for vein blood sampling practice by wearing an HMD (Head mounted display), and can perform vein blood sampling practice through interaction with the patient 3D model. there is. In addition, the effectiveness of the simulator developed for dental students was verified, and as a result of the verification, the potential of the proposed vein blood sampling simulator was confirmed.

Virtual reality experiences are frequently created using game engines, yet they are not simple for novices and unskilled professionals who don’t have programming and 3D modeling skills. Concurrently, there is a knowledge gap in software project design for intuitive virtual reality authoring tools, which were supposed to be easier to use. This work compiles design guidelines derived from a systematic literature review to contribute in the development of more intuitive virtual reality authoring tools. We searched the Scopus and Web of Science databases for works published between 2018 and 2021 and discovered 14 papers. We compiled 14 requirement and feature design guidelines, such as Visual Programming, Immersive Authoring, Reutilization, Sharing and Collaboration, Metaphors, and Movement Freedom, among others. The collected guidelines have the potential to either guide the development of new authoring tools or to evaluate the intuitiveness of existing tools. Furthermore, they can also support the development of the metaverse, since virtual content creation is one of its bases.

The aim of the study is to assess enjoyment and intensity of physical exercise while practicing physical activity (PA) in immersive virtual reality (IVR) using innovative training devices (omni-directional Omni treadmill and Icaros Pro flight simulator). The study also contains the results of subjective research on the usefulness of such a form of PA in the opinion of users. In total, 61 adults (10 women and 50 men) took part in the study. To assess the enjoyment level (EL) Interest/Enjoyment subscale of Intrinsic Motivation Inventory (IMI) was used. Exercise intensity was assessed during 10-minute sessions of active video games (AVGs) in IVR based on heart rate (HR). The average enjoyment level during physical exercise in IVR on the tested training devices was relatively high (Omni 5.74 points, Icaros 5.60 points). In the opinion of the majority of participants, AVGs on IVR training devices constitute a sufficiently useful form of movement to meet the needs of PA practiced in free time, and they can even replace some of the classic forms of movement. Intensity of PA during games on training devices was at the level recommended for health benefits for 92% (Omni) and 84% (Icaros Pro) of its duration. Based on the conducted research, it can be assumed that AVGs in IVR using a multi-directional treadmill and a flight simulator can be an effective tool for increasing participation in health-oriented PA.

Virtual Reality (VR) technology in education has the potential to revolutionize the Indian school education system. This research study investigates the present state of VR adoption, perceived benefits, concerns, and future expectations among both students and educators. The survey-based approach collected responses from 45,000 students and 2,000 educators across a diverse range of schools in India. The findings highlight a mixed current landscape with significant room for expansion in VR utilization. Both students and educators express optimism regarding the benefits of VR, recognizing its capacity to enhance engagement, comprehension, and motivation in the learning process. However, challenges, including budget constraints, the need for training and support, and concerns about student safety, must be addressed to effectively integrate VR into education. Expectations for the future emphasize inclusivity, accessibility, and customized learning experiences. The research underscores the transformative potential of VR in Indian education while emphasizing the necessity of addressing practical challenges for its successful implementation.

Background Augmented reality (AR) in surgery can offer an enhanced view of reality through the superimposition of computer-generated digital images on the real environment. It allows surgeons to integrate image visualisation, improving operative efficiency, surgical outcomes, surgical training and patient education. This review aims to evaluate the current status of augmented reality in surgery, surgical training and potential future applications. Methods We performed a non-systematic review of available literature from January 2005 to August 2021 by searching PubMed, EMBASE and the Cochrane library using a combination of terms “augmented reality”, “virtual reality”, “surgery”, “simulation” and “training”. Articles considered for this review were identified by relevant search criteria including title, keywords, abstract, and full-text. Conclusions AR technologies present an exciting new trend with multiple potential applications in surgery. Intraoperative AR systems have shown promise in specialties involving fine movement of organs during surgical procedures, including Neurosurgery, Ears, Nose and Throat and Orthopaedic Surgery. AR has also exhibited the potential to enhance surgical training and improve knowledge acquisition; it can foster international collaborations via telesurgery and telepresence. In the near future, AR will likely work in symbiosis with surgeons, serving as a complex computer-human coalition which can improve patient outcomes, patient education and surgical training.

Sensory integration is an essential function of human life, and its decline causes difficulties in the quality of life, especially in older adults. In this study, we proposed an arm-reaching task based on a virtual reality head-mounted display (VR-HMD) system to assess sensory integration in daily life, and examined whether reaching task performance was associated with age and resting-state functional connectivity (rsFC) between the brain regions of interest involved in sensory integration. We hypothesized that performance during a reaching task with multiple cognitive loadings would be affected by aging. The gap angle between the reaching hand and target positions was compared between older and middle-aged adults as a measure of sensory integration function. In addition, rsFC, which was significantly correlated with the gap angles of individual participants in the older adult group, was identified using resting-state functional magnetic resonance imaging data. The mean gap angle was significantly larger in the older adults than in the middle-aged group and was also significantly correlated with connections between the left primary motor area and the left inferior temporal gyrus, temporo-occipital part. Because the connectivity between the areas is known to be related to visuomotor integration, the results suggest the involvement of visuomotor integration in the decline of sensory integration function in old age and the validity of the gap angle during the proposed VR-HMD task as an index for the decline in function.

ABSTRACT: Background: Virtual Reality (VR) emerges as a promising non-pharmacological intervention for managing symptoms and providing distraction during chemotherapy. This study aims to assess VR's effectiveness on cancer-related symptoms, vital signs, and patients' perception of the chemotherapy in lung cancer patients. Methods: A quasi-experimental study was conducted on 100 patients. Participants were allocated into an intervention group (n = 55), which experienced immersive VR, and a comparison group (n = 45), which received usual care. Data were collected through questionnaires and checklists, including feedback on the VR experience, pain, vital signs, and common cancer symptoms, assessed through the Edmonton Symptom Assessment Scale. Results: VR had a significant impact on reducing the perception of the chemotherapy length. Patients reported high levels of satisfaction and tolerability. No adverse events were observed. VR did not have significant influence on pain intensity and vital signs. The only exceptions were oxygen saturation, where a significant difference (p = 0.02) was reported, and perception of chemotherapy duration. Conclusions: As a non-pharmacological intervention, VR proves beneficial in minimizing the perceived length of chemotherapy session for lung cancer patients, enhancing their overall treatment experience. The intervention showed to be a safe, feasible, and well-accepted distraction technique. Future research should explore VR's potential effects on a wider range of symptoms and evaluate its impact on long-term outcomes.

Introduction: The aim is to investigate the possibility of altering the delusional perceptions of psychotic patients by exposing them to a cognitively flexible virtual environment. A flexible vir-tual reality (VR) environment could challenge and enhance the ability to adapt to changing situa-tions and generate novel solutions to core psychotic symptoms. Materials and methods: A systematic review was conducted using different combinations of keywords in different databases. This study was conducted using the PRISMA statement. Results: There is a growing literature on the use of VR to manipulate and normalise perceptual distortions in psychosis. Over the last decade, the number of published studies on VR in mental health has increased 14-fold. Conclusions: A cognitive flexibility virtual environment can alter delusional perception by ex-posing the person to different scenarios that require them to question their assumptions, test their hypotheses, and revise their beliefs. Commonly used biosensors measure heart rate, skin con-ductance and body temperature in relation to different emotional states. Recently, there has been a major shift towards the use of neuroimaging techniques to better understand the pathophysiology of mental disorders. This is where the new wave of biosensor-integrated virtual reality (VR) sys-tems comes in.

Background: 3D virtual reality (VR) Motionless Imagery Exercise through Avatar (MIEA) was developed to improve elderly’s psychological (cognitive and emotional) and physical health. This study observed the impact of this program on the cognitive functions and emotional well-being and the electrophysiological changes in older adults. Methods: This study was conducted using a randomized controlled trial design. The participants included 38 adults, 65 to 84 years of age, who were physically mobile and neurologically healthy. Among them, 19 participants were assigned to the experimental group, who underwent exercises using elderly avatars in a VR virtual exercise program. The other 19 participants were assigned to the control group who underwent the VR program. Both groups engaged in the VR intervention for 20 minutes three times a week, over six weeks. Results: The cognitive functions, including attention restraint, working memory, and phonemic fluency, of the experimental group showed significant improvements compared to the control group. Regarding emotional well-being, the experimental group showed greater self-efficacy. The electrophysiological changes revealed similar patterns to exercise-induced reactions in electromyography of the experimental group after intervention. Conclusions: These findings confirm that participation in 3D VR MIEA enhances cognitive functions and physical self-efficacy among the elderly. Therefore, 3D VR MIEA can be utilized in the rehabilitation therapy of patients or elderly with limited physical activity.

Background: Virtual Reality (VR) is an emerging tool in the management of anxiety, one of the most disturbing symptoms of Alcohol Use Disorder (AUD), which often leads to relapse. Still, patients with Alcohol Use Disorder frequently have a history of Acute Symptomatic Seizures, and they are subsequently excluded from studies using VR because of the hypothesized fear of inducing photosensitive seizures. The first part of this narrative review explores the pathophysiological mechanisms of seizures associated with AUD, specifically acute symptomatic seizures. In contrast, the second part explores virtual reality’s safe use in seizure-prone individuals, highlighting that the current state-of-the-art is based on a biased per-ception and old epidemiological data from studies conducted on photosensitive seizures in the late 90s. VR exposure has yet to be reported as triggering seizures within known pharmacovigilance databases. Significance: The implications weigh heavily on VR research currently associated with this significant adverse event. Further studies are necessary to address the risk of seizures triggered by VR in patients predisposed to developing seizures, like alcohol use disorder patients with a history of acute symptomatic seizures. Such research is essential to ensure that the potential benefits of Virtual Reality as a tool for managing anxiety in individuals with alcohol use disorder and acute symptomatic seizures are not unduly restricted. Furthermore, AUD can also serve as an intervention model feasible to de-bias attitudes toward the current lack of evidence base concerning the significant adverse events of VR-induced seizures, therefore facilitating the clinical implementation of this unharnessed digital treatment interface.

This study investigated the effectiveness of virtual reality (VR) technology in table tennis education compared to traditional training methods. A 12-week randomized controlled trial was conducted with 120 participants divided equally between VR and traditional training groups. Performance metrics, learning motivation, and satisfaction were assessed at regular intervals. Results demonstrated significant advantages of VR training, with the VR group showing superior improvements in serve accuracy (23.5% vs. 15.8%, p < 0.001), rally endurance (increase of 8.2 vs. 5.7 shots, p < 0.01), and overall skill scores (18.7 vs. 13.2 points improvement, p < 0.001). The VR group also exhibited higher increases in learning motivation (23.5% vs. 12.8%, p < 0.001) and satisfaction (31.5% vs. 18.7%, p < 0.001). Subgroup analysis revealed particular benefits for novice players and younger participants. These findings suggest that VR technology offers a promising approach to enhance table tennis education, potentially revolutionizing sports training methodologies. Future research should focus on long-term skill retention and the optimization of VR training protocols.

Existing methods for simulating missile dynamics and training often rely on three degrees of freedom (3DOF) motions, limiting their ability to represent the complex maneuvers and targeting strategies of modern missiles. This paper proposes integrating virtual reality (VR) technology with six degrees of freedom (6DOF) dynamics to enhance the accuracy and efficiency of missile simulation and training. By incorporating 6DOF dynamics, simulations can capture the full range of missile motion, providing a comprehensive understanding of their capabilities and limitations. Through VR, users can immerse themselves in realistic missile scenarios, interact with dynamic behaviors in real-time, and refine their targeting and interception skills. The integration of VR with 6DOF dynamics also facilitates real-time feedback and evaluation, enhancing training efficiency and proficiency in missile operations. This approach aims to revolutionize missile training by bridging the gap between traditional simulation methods and real-world dynamics.

The concept of using eye-tracking in virtual reality for education has been researched in various fields over the past years. With this review, we aim to discuss the recent advancements and applications in this area, explain the technological aspects, highlight the advantages of this approach and inspire interest in the field. Eye-tracking has already been used in science for many decades and now has been substantially reinforced by the addition of virtual and augmented reality technologies. The first part of the review is a general overview of eye-tracking concepts and its applications. In the second part, the focus shifted towards application of eye-tracking in virtual reality. The third part is the description of the recently emerged concept of eye-tracking in virtual reality when applied to education and studying, which has not been thoroughly described before. We describe the main findings, technological aspects and advantages of this approach.

The use of active video games or exergames has been booming recently, as they are motivating and promote exercise and healthy lifestyle habits for their users, and these immersive virtual reality (IVR) exercise programs could be compared to traditional physical exercise programs. A starting point for this would be to explore the physiological responses that can be generated by its use. Therefore, the main objective of this study was to evaluate the response across certain physiological parameters (heart rate, blood pressure and stress) after an IVR exergame exposure in a sample of healthy adults, and secondarily to explore its feasibility and usefulness as a tool to facilitate physical exercise. 37 healthy adults (22-54 years, 54.1% women) participated in the study. They carried out one exergaming session with the HTC Vive ProTM hardware. The primary outcome was evaluated using the concentration of cortisol, heart rate and blood pressure. Secondary outcomes were evaluated with safety using the Simulator Sickness Questionnaire (SSQ); usability evaluated with the System Usability Scale (SUS); personal experiences evaluated with Game Experience Questionnaire (GEQ) and perceived exertion through the Borg perceived effort scale. All participants completed the IVR session without significant adverse effects, and all physiological parameters analysed increased significantly in relation to pre-intervention levels. Perceived exertion corresponded to a moderate to intense exercise (6.30±0.50/10 on the modified Borg scale). All the sample considered the experience as good or very good and would recommend it. These findings support that our IVR session can be compared to a moderate to intense physical activity, as it involved similar perceived exertion with significant increases in heart rate, blood pressure and salivary cortisol levels.

Children and adolescents with severe burns require dressing changes, associated with pain. As immersive virtual reality (VR) gained prominence as non-pharmacological adjuvant analgesia, we conducted a systematic review and meta-analysis on the efficacy of full immersive VR on pain experienced during dressing changes in hospitalized children and adolescents with severe burns. This exercise included quality and risk of bias assessment. The systematic reviewsearch resulted in eight studies and 142 patients. This exercise included quality and risk of bias assessment. Due to missing data, four studies were excluded from the meta-analysis. Fixed effects meta-analysis of the four included studies (n = 104) revealed a large effect size (ES) (SMD=0.94; 95% CI=0.62, 1.27; Z=5.70; p&lt;0.00001) for adjuvant full immersive VR compared to standard care. In conclusion, adjuvant full immersive VR significantly reduces pain experienced during dressing changes in children and adolescents with burns. We therefore recommend implementing full immersive VR as an adjuvant in this specific setting and population. However, this requires further research into the hygienic use of VR appliances in health institutions. Furthermore, due to the high cost of the hardware, a cost-benefit analysis is required. Finally, research should also verify the long term physical and psychological benefits of VR.

Falls are considered a significant cause of disability, pain, and premature deaths in older adults, often due to sedentary lifestyles and various risk factors. Combining immersive virtual reality (IVR) with physical exercise, or exergames, enhances motivation and personalizes training, effectively preventing falls by improving strength and balance in older people. IVR technology may increase the ecological validity of the assessments. The main goal of our study was to assess the feasibility of using a KAVE-based VR platform combining simulations of Levadas and a Cable Car to perform a balanced assessment and profiling of the older adult population for high risk-of-falls and the related user experience. A VR-based platform using a Wii balance board and a CAVE was developed to assess balance and physical fitness. Validated by the Biodex Balance System (BBS), 25 older adults participated in this study. The usability and presence were measured through the System Usability Scale and ITC-SOPI questionnaires, respectively. The IVR system showed a high presence and a good usability score of 75. Significant effects were found in the maximum excursion of the Centre of Pressure (COP) on the anterior-posterior axis during the Cable Car Simulation (CCS), correlating with BBS metrics. Multiple discriminative analysis models and the support vector machine classified fall risk with moderate to high accuracy, precision, and recall. The system accurately identified all high-risk participants using the Leave-One-Out method. This study suggests that an IVR-based platform based on simulations with high ecological validity can be used to assess physical fitness and identify individuals at a higher risk of falls.

Virtual reality (VR) technology gains theoretical support from rehabilitation and pedagogical theories and offers a variety of capabilities in educational and interventional contexts with affordable products. VR is attracting increasing attention in the medical and healthcare industry as it provides fully interactive three-dimensional simulations of real-world settings and social situations, which are particularly suitable for cognitive and performance training including social and interaction skills. The worldwide rising trend in the prevalence of autism spectrum disorder calls for innovative and efficacious techniques for assessment and treatment. The article offers a summary of current perspectives and evidence-based applications of VR technology as an educational and intervention tool for individuals with autism spectrum disorder, with a primary focus on social communication including social functioning, emotion recognition, and speech and language. Technology- and design-related limitations as well as the disputes over the application of virtual reality to autism research and therapy are discussed and future directions of this emerging field are highlighted with regards to application expansion and improvement, technology enhancement, and the development of brain-based research and theoretical models.

Spina bifida, a congenital neural tube defect, presents a complex set of challenges, particularly in motor function, for individuals across the lifespan. The condition is characterized by incomplete closure of the spinal column during embryonic development, leading to a spectrum of motor impairments such as gait abnormalities, muscle weakness, and compromised functional mobility. The prevalence of spina bifida remains a global concern, affecting approximately 1 in 1000 live births. This research investigates the potential impact of virtual reality (VR) rehabilitation on motor function in individuals with spina bifida in Tanzania. A randomized controlled trial involving 120 participants is designed, with one group undergoing traditional rehabilitation and another engaging in a six-week VR rehabilitation program. Motor function assessments, including gait analysis, muscle strength measurements, and functional mobility tests, were conducted at baseline, midpoint, and post-intervention. Preliminary analysis suggests that VR rehabilitation may offer unique benefits, leading to improvements in motor function. The study aims to contribute valuable insights into the efficacy of VR-based interventions for enhancing the motor capabilities of individuals with spina bifida, providing a foundation for future rehabilitation strategies in this population.

The last decade has witnessed rapid development of immersive virtual reality (IVR) and its application in various contexts. However, its application in supporting real-time virtual collaboration has been quite rare due to technical barriers and the lack of validated design principles. To address this research gap, this study designed and developed an IVR space to enable multi-user synchronous co-located collaboration. An evaluation study (N = 95) was conducted to explore its useful design considerations and the influencing factors for collaboration experience. The IVR space was enabled by the simultaneous localization and mapping (SLAM)-based inside-out tracking technique and was informed by four essential design considerations for promoting effective collaboration in IVR, namely, the role script, learning task, collaboration mechanism, and communication design. The study results revealed that students in general were satisfied with their collaboration experience in IVR, with social presence and collaboration competency as significant predictors of collective efficacy and social experience. Based on both quantitative and qualitative results, this study proposes four validated principles for designing effective IVR spaces to support synchronous co-located collaboration.

Virtual reality software might be challenging to utilize for beginners and unskilled professionals who do not have a programming or 3D modeling background. Concurrently, there is a knowledge gap in software project design for intuitive virtual reality authoring tools, which were supposed to be easier to use. These tools are frequently insufficient due to a lack of support and standard operating procedures. Adopting the Design Science Research paradigm, this study aims to evaluate the validity of fourteen design guidelines for the development of intuitive virtual reality authoring tools as an artifact. While a previous study completed the first steps of the Design Science Research, by identifying problems, defining solution objectives, and developing and demonstrating the design guidelines, this work seeks to qualitatively evaluate their application in a practical experiment. A group of engineering students with no prior experience in creating virtual worlds were tasked with examining the design guidelines while using the NVIDIA Omniverse Enterprise as an exemplary use case and responding to a questionnaire and a focus group interview about how they perceived these guidelines. A correlation analysis confirmed that most guidelines scores behaved as expected and were ranked according to the use-case functionality. The participants understood the guidelines' definition and could decide if they agreed or disagreed with their presence during the experiment. We conclude that, in accordance with the Design Science Research, the proposed artifact is useful, i.e., the design guidelines for virtual reality authoring tools perform what they are designed to do and are operationally reliable in accomplishing their goals.

This paper investigates the physical/virtual dynamics when constructing an immersive environ-ment for medieval courtyard houses in Historic Cairo. Using a VR Lab at a university campus, the paper analyzes a courtyard that symbolizes social resilience and community bonding at the newly rehabilitated Bayt Yakan. The courtyard is reconstructed as a Mixed Object through 3D documentation and scanning the space to develop a photogrammetry and VR experience. The results show that the sense of presence is perceived through a combination of factors and juxta-positions of the real and the virtual including: 1) architectural aesthetics, 2) intangible elements and 3) socio-cultural activities in space. Based on the pilot case study, the paper concludes with proposing a “Geospatial Framework for Immersive Environments and Social Sustainability” that is transdisciplinary, pluralistic and expansive in nature to encompass the multiple narratives of the contested past, and overlay the material and immaterial sustainable features embedded in historical contexts, where the Mixed Reality paradigm becomes an enabler for multiple voices, tools and mediums.

The following systematic and bibliographic review investigates the intersection between the treatment of cognitive impairments and virtual and augmented reality-based game-oriented applications. The review provides a view into the last 12 years of research. The PubMed Database served as the main source for the review. We defined a comprehensive set of investigation variables and classified three main topics: bibliography, medical, and technical. Of a total of 61 identified articles, 19 were included. The findings from these studies indicate the positive effects of using virtual and augmented reality applications to improve cognitive function and depression. There is also a gap in high-quality evidence since clinical trials have been conducted only with a few patients. Preliminary results indicate positive cognitive and physical well-being effects, but the field demands further investigation to determine the effectiveness. Future research needs to focus on larger studies and the quality of the developed applications. Further, it is important to look at scores like Quality of Living and Satisfaction in Daily Activities to create a functioning environment for the patient.

Background and Objectives: Botulinum toxin injections are commonly used for the treatment of spasticity. However, injection procedures are associated with pain and procedural anxiety. While pharmacological approaches are commonly used to reduce these, inno-vative technology might be considered as a potential non-pharmacological alternative. Given this context, immersive virtual reality (VR) has shown effectiveness in the man-agement of procedural pain[1]. Our retrospective pilot study aimed to assess the potential added value of virtual reality in the management of pain and anxiety during intra-muscular injections of botulinum toxin. Materials and Methods: Twenty-one adult patients receiving botulinum toxin injections were included. A numerical rating scale was used to assess pain and anxiety during the injection procedure. The patient reported the pain experienced during previous injections without VR before injection and the pain expe-rienced in the current procedure with VR after the end of the procedure. Level of satis-faction of VR experience, if they agreed to reuse VR for the subsequent toxin botulinum injection, and if they would recommend VR to other patients were assessed. Results: The use of virtual reality showed a decrease of 1.8 pain-related points compared to without technology. No significant improvement in the level of anxiety was reported. Patients were very satisfied by their VR experience (7.9 out of 10) and would agree to reuse VR in their next injection procedure (88%) and to recommend the use of VR in other patients (100%). Conclusion: VR was useful for managing procedural pain related to botulinum toxin injection in adults, with a high level of satisfaction reported by the patient. VR should be considered as a valuable alternative to pharmacological approach to manage procedural pain during Botulinum toxin injection in adults.

Immersive virtual reality has the potential to motivate and challenge patients that need and want to relearn movements in the process of (neuro-)rehabilitation. The aims of this study were to evaluate the feasibility and users’ acceptance of an innovative immersive virtual reality system (head-mounted display) used in combination with robot assisted gait training in subjects suffering from neurological diseases. Fifteen participants tested a single session of immersive virtual reality by means of head-mounted display during a Lokomat gait session. Training parameters and safety indicators were collected and the acceptance was investigated among the participants and the therapists. The results suggest that the immersive virtual reality system is feasible with respect to safety and tolerance. Furthermore, the very positive overall acceptance of the system suggests that it has potential to be included in a robot assisted gait training session by means of Lokomat. Taken together, this study demonstrates the feasibility and acceptance of an innovative immersive virtual reality system in combination with a robot assisted gait training in subjects suffering from stroke and spinal cord injury, as well as their therapists.

In recent years information and communication technologies (ICT) play a significant role in all aspects of modern society and impact socioeconomic development in sectors as education, administration, business, medical care and agriculture. The benefits of such technologies in agriculture can be appreciated only if farmers use them. In order to predict and evaluate the adoption of these new technological tools, the technology acceptance model (TAM) can be a valid aid. The paper measures the potential acceptance of an e-learning tool designed for EU farmers and agricultural entrepreneurs. Starting from a literature review of the technology acceptance model, by analyzing the most commonly used external variables in the fields of e-learning, Agriculture, and Virtual reality, the analysis shows that computer self-efficacy, individual innovativeness, computer anxiety, perceived enjoyment, social norm, content and system quality, experience and facilitating conditions are the most common determinants addressing technology acceptance. Furthermore, findings evidenced that the external variables have a different impact on the two main beliefs of the TAM Model, Perceived Usefulness (PU) and Perceived Ease of Use (PEOU). This study is expected to bring theoretical support for academics when determining the variables to be included in TAM extensions.

Human-Computer Interaction, including technology-aided instruction, is beginning to focus on virtual reality (VR) technology due to its ability to support immersive learning, teaching through simulation, and gamification of learning. These systems can deliver high-level multisensory learning experiences that are important in the teaching of many subjects, especially those involving abstract concepts or requiring spatial skills, such as organic chemistry. Haptic experiences with VR, however, remain a challenge. In addition, development have focused on general entertainment/gaming; VR systems in chemistry implement simulations of the chemistry laboratory and other advanced systems whereas those that support safe, game-like, immersive and multisensory learning of organic chemistry with haptics at pre-university education levels are scarce. We developed the VR Multisensory Classroom (VRMC) as an immersive learning environment within a VR head-mounted display, where learners employ hand movements to build hydrocarbon molecules and experience haptic feedback through gloves with built-in sensors and hand-tracking with the Leap Motion system. We report here the evaluation of the first prototype by learners from diverse backgrounds who reported on the ability of the VRMC to support high engagement, motivation, interest and organic chemistry learning as well as diverse learning styles. The VRMC is a novel VR classroom that supports immersive learning in molecular organic chemistry with haptics for multisensory learning.

Although proposition of “Virtual Reality” (VR) and “Augment Reality” (AR) can be traced back to the 60s, both areas are actually blooming in recent decades. Thanks to the latest deep learning techniques, an enormous advance in computer vision research community has taken place. Since VR and AR are highly related to computer vision tasks, these areas have enjoyed the benefits as well. Yet there is no sufficient survey on such impact and new research areas arising from it. This paper mainly focuses on the latest research progress in ACM Symposium on Eye Tracking Research & Applications (ETRA) 2019, as well as several recent representative paper works. It aims to figure out the influence of deep learning techniques on latest VR/AR research. Meanwhile, new issues have popped up with the development of VR and AR technology, such as privacy and computation efficiency. This paper draws attention to such newly produced topics as well. In addition, this paper also investigates on the effect of latest VR and AR techniques on people, such as level of teamwork in collaborative tasks, assistance and treatment to patients and the disabled, etc.

The visual perception of leisure spaces between residences in cold regions is important for public health. To compensate for the existing researches` lack of ignoring the cold snow season`s influence, this study selected two types of outdoor leisure space environments in non-snow and snow seasons as research objects. An eye tracker combined with a Semantic Difference (SD) questionnaire was used to verify the feasibility of the application of virtual reality technology, screen out leisure gaze characteristics, and reveal the environmental factors related to leisure visual perception. In snow season, spatial aspect ratio (SAR), building elevation saturation (BS), and grass proportion in the field of view (GP) showed strong correlation to the leisure visual perception scores (W). In non-snow season, apart from the above three factors, roof height difference (RHD), tall tree height (TTH) and color contrast (HC) also influenced W obviously. The effects of factors on W were revealed in immersive virtual en-vironment (IVE) orthogonal experiments and genetic algorithm (GA) and k-nearest neighbor algorithm (KNN) were combined to optimized the environmental factors. The optimized threshold ranges in the non-snow season environment were SAR: 1.82‒2.15, RHD: 10.81 m‒20.09 m, BS: 48.53‒61.01, TTH: 14.18 m‒18.29 m, GP: 0.12‒0.15, and HC: 18.64‒26.83. In the snow season environment, the optimized threshold ranges were SAR: 2.22‒2.54, BS: 68.47‒82.34, and GP: 0.1‒0.14.

Visualization has always been a crucial part of the educational process. Implementing computer algorithms and virtual reality tools into it is vital for the new generation engineers, scientists and researchers. In the field of chemistry education, various software that allow dynamic molecular building and viewing are currently available. These software are now used to enhance the learning process and ensure better understanding of the chemical processes from the visual perspective. The present short communication provides a summary of these applications based on the NarupaXR program, which is a great educational tool that combines the functionality and simple design necessary for an educational tool. NarupaXR is used with a companion application “Narupa Builder'' which requires a different file format, therefore a converter that allows a simple transition between the two extensions has been developed. The converter sufficiently increases the efficiency of the educational process. The automatic converter is freely available on GitLab (https://gitlab.com/teamSCAMT/converter_mol2_to_xml). The current communication provides detailed written instructions that can simplify the installation process of the converter and facilitate the use of both the software and the hardware of the VR set.

Background/Objectives: Informed consent for anesthesia poses both legal challenges and problems of understandable communication. Fulfilling all requirements through anesthesiologists directly interacting with patients is a time- and staff-consuming strategy. Given today's smart technologies, notably including virtual reality (VR), we explored in a prospective randomized study whether 'VR-assisted informed consent' could improve this situation. Methods: Fifty patients scheduled for orthopedic surgery were randomized. In the control group, informed consent was obtained via patient-specialist dialogs only. The patients in the study group, wearing a head-mount display, watched an 8-minute immersive 3D movie with standard explanations of general anesthesia, followed by a patient-specialist dialog to address open question. The time spent on the dialogs in both groups was evaluated as primary outcome variable. As secondary variables, we analyzed both a three-item Likert scale on patient satisfaction with the VR experience and cost differences between both groups. Results: Patient-specialist dialogs were carried on for median (IQR) durations of 93 (20–182) seconds in the study group versus 665 (261–829) seconds in the control group (P&lt;0.001). All patients exposed to VR rated this experience as favorable (87.5%) or neutral (12.5%). Based on anesthesiologists' incomes in the US and UK, our approach would reduce the staff expenditure for each patient-specialist dialog by median amounts of ≈40 or ≈11 US dollars, respectively (2× P&lt;0.001). Conclusions: 'VR-assisted informed consent' for anesthesia is well accepted by patients and reduces the time requirements for patient-specialist dialogs, thus pointing out a potential avenue towards increasing the work-time efficiency of anesthesiologists.

Several medical graduates, avoid surgical specialties especially those with complex and delicate anatomy due to their doubt in their visual spatial abilities. Many patients are deemed inoperable, particularly in the field of pediatric cardiology, due to the complexity of the anatomy. On a similar note, stratification of risk of cardiac interventions, and decision making, is a room of significant person-based and center-based bias. Two inter-related technologies, namely immersive virtual reality (VR) and artificial intelligence have made impossible things possible and can help to standardize decision making strategies. This review aimed at reviewing the main anatomical and lesion-based scopes of these advancements in the field of cardiac care, with a special focus on pediatric cardiology.

Hand tracking enables controller-free interaction with virtual environments, which can, compared to traditional handheld controllers, make virtual reality (VR) experiences more natural and immersive. As naturalness hinges on both technological and user-based features, fine-tuning the former while assessing the latter can be used to increase usability. For a grab-and-place use case in immersive VR, we compared a prototype of a camera-based hand tracking interface (Leap Motion) with customized design elements to the standard Leap Motion application programming interface (API) and a traditional controller solution (Oculus Touch). Usability was tested in 32 young healthy participants, whose performance was analyzed in terms of accuracy, speed and errors as well as subjective experience. We found higher performance and overall usability as well as overall preference for the handheld controller compared to both controller-free solutions. While most measures did not differ between the two controller-free solutions, the modifications made to the Leap API to form our prototype led to a significant decrease in accidental drops. Our results do not support the assumption of higher naturalness for hand tracking but suggest design elements to improve the robustness of controller-free object interaction in a grab-and-place scenario.

This article argues that despite a citation review is a rarely used research tool, this can be very useful to assess the impact of new research topics, both from the future research direction and the bibliometric perspectives. An explorative study is presented around the research area marked as Industry 4.0 with the conference paper mentioned in the title of this citation review. Even though the given reference paper is relatively recent, there are already twenty-seven citations listed among three different scholar databases. These are Google Scholar, ResearchGate and Semantic Scholar. In light of this, the article provides a bibliometric confirmation and analysis for the progression of the line of research adopted by de Giorgio et al. in the exploration of non-traditional methods using virtual reality technology and human-robot collaboration for adaptive applications in Industry 4.0. Furthermore, it represents a model for the authors’ self-development and an example of an unconventional approach to scientific work that may help improve related bibliometric research and scholar database strategies to index new articles and topics in the future.

This review article explores the convergence of virtual reality (VR) and architectural design from an inclusive lens. It underscores the crucial role of virtual reality (VR) in serving as a catalyst for the incorporation of social and cultural sustainability principles in architectural projects. The exploration is guided by inclusive design principles, which encompass several aspects such as accessibility, cultural sensitivity, diversity and inclusivity, user-centered design, and empathy. These concepts serve as the basis for further investigation into the potential of virtual reality (VR) technology to enhance and heighten these features within architectural design, therefore promoting the progress of social and cultural sustainability. The review article highlights the profound impact that virtual reality (VR) may have, going beyond mere visualisation to generate architectural experiences that are immersive, interactive, and empathetic. These experiences are designed to take into account diverse perspectives and needs.

Horse riding therapy, also known as hippotherapy, is a popular treatment for children with cerebral palsy (CP). However, the need for trained therapists, massive land use, and expensive maintenance of the horse ranch makes hippotherapy not affordable or even available for most patients in Indonesia. This problem motivates us to consider mechanical horse riding simulator machines to replace actual horse hippotherapy. However, most patients are children and are easily bored when asked to do monotonous activities for an extended period. The room setting also does not give the patient visual inputs that usually help motivates the children in real-horse hippotherapy activities. To solve this problem, we designed an exercise game (exergaming) software which we named \textit{Sirkus Apel}, providing the patients with fun activities while doing the therapy. We also design an inertial sensor-based controller that lets the patients control the in-game horse by their back movements, which also benefits CP patients. To make the visual input enjoyable to the user while also considering the user's safety, we built a convex mirror-based dome virtual reality to provide an immersive 3-D experience. We then project the game content to the dome to provide an immersive experience to the patients making it as if they are riding a real horse inside the game.

The efficiency of performance in various sports has the development of certain specific skills at its core. In ice hockey, both the technical aspects (techniques, stance) and the cognitive ones (keeping attention on the puck, game strategy, etc.) are highly important. This study is aimed at the identification of specific features that determine the performance efficiency of professional hockey players. We used virtual reality (VR) to study the differences between professional ice hockey players and novices in terms of motor responses to the puck’s presentation on different levels of difficulty. The study involved 22 participants, 13 of them being professional ice hockey players (M_age=20±2.9; mean age of training experience М=14.18±3.8) and 9 being not experienced participants (M_age=20±1.4). The study showed that the stick response time of professional hockey players is significantly higher (0.98 ms vs 1.5 ms, p≤0.05) in more difficult situations close to a real game. Moreover, professionals proved to have more stable movement patterns of the knee and hip joints. They also make fewer head movements as a response to stimuli during all runs (0.66 vs 1.25, p≤0.05). Therefore, the results indicate specific spatial-temporal, technical and tactical, and energetic determinants, that ensure higher performance efficiency in hockey players

Understanding visual engagement in marketing is crucial for optimizing user experience and enhancing campaign effectiveness. This study introduces the Visual Interaction Analysis (VIA) methodology, utilizing advanced eye-tracking technology within immersive virtual reality (VR) environments to examine generational and gender differences in visual engagement after exposure to advertising materials. Using the Cognitive 3D platform for precise data capture, this research analyzed fixation patterns—total fixations, duration of fixations, and average duration per fixation—across Millennial and Generation Z cohorts. The analysis involved 44 participants, who were exposed to three posters in controlled VR settings. Results revealed significant generational differences: Generation Z demonstrated more focused attention, with higher fixation counts and longer total fixation durations compared to Millennials, suggesting that differences in media consumption and technological adaptation influence engagement strategies. However, both generations showed a similar depth of engagement, as indicated by the average duration per fixation. Gender analysis within Generation Z further revealed that female participants engaged for longer periods per fixation, indicating deeper processing of visual information. This methodology offers a robust framework for quantifying visual engagement, providing actionable insights that can help marketers tailor strategies and optimize campaign designs before launch.

The efficacy of the product development process is measured by the ability to launch a project with product and production process specifications that could guarantee that the manufacturing can produce it with the least impact. If a problem is detected late, they bring consequences beyond the high cost of the solution, if related to physical ergonomics, which will influence the well-being of operators, productivity, and quality. Virtual Reality (VR) and Digital Human Modeling (DHM) are ones of the enabling technologies of Industry 4.0 and has already been applied on a large scale in industries such as automotive, construction, and aeronautics. However, even though the huge applications, these technologies are not yet applied by these industries for the analysis of physical ergonomics during product development phases. This study aims to characterize the state of the art and technology about the application of Virtual Reality and Digital Human Modeling for the physical ergonomics analysis in the during product development phases in the industry through a systematic review of the literature and patents. In patent documents recovery, we used Derwent Innovation database. The research is based on searching the selected terms in the title, summary, and claims of the documents through a search strategy containing IPC code and keywords. In articles recovery, we searched ScienceDirect, Springer, and IEEExplore databases for scientific publications. The search resulted in 311 patents documents and 16 articles in the scientific database. This study analyzed the patents to map out the technological progress in this area, where we found in the charts and data an increasing number of publications per year and a spread application with a considerable number of new technologies presented in these recent patents. The literature review indicated that Virtual Reality technology complements the Digital Human Modeling during physical ergonomics analysis for manufacturing process already designed. The majority of research on the use of VR and DHM technologies for physical ergonomics analysis focus on the automotive industry and the ergonomic assessment of workstations and current processes. Further research is needed to investigate how Virtual Reality and Digital Human Modeling might assist in the understanding of physical ergonomics in certain tasks throughout the product development process, such as the simulation of worker posture or effort when assembling parts.

The growing dependence on large language models (LLM)s highlights the urgent need to deepen trust in these technologies. Regular, rigorous validation of their expertise, especially in nuanced and intricate scenarios, is essential to ensure their readiness for clinical applications. Our study pioneers the exploration of LLM utility in the field of cardiology. We stand at the cusp of a transformative era where mature AI and LLMs, notably ChatGPT, GPT-4, and Google Bard, are poised to influence healthcare significantly. Recently, we put three available LLMs, OpenAI's ChatGPT-3.5, GPT-4.0, and Google's Bard, to the test against a significant Polish medical special-ization licensing exam (PES). The exams cover the scope of completed specialist training, focusing on diagnostic and therapeutic procedures, excluding invasive medical procedures and interven-tions. In our analysis, GPT-4 consistently outperformed the others, ranking first, with and Google Bard and ChatGPT- 3.5 following, respectively. The performance metrics underscore GPT-4's no-table potential in medical applications. Given a score improvement of over 23.5 % between two AI models released just four months apart, clinicians must stay informed and up-to-date about these rapidly evolving tools and their potential applications to clinical practice. Our results provide a snapshot of the current capabilities of these models, highlighting the nuanced performance dif-ferences when confronted with identical questions

Selection is a fundamental interaction element in Virtual Reality (VR) and 3D user interfaces (UIs). Raycasting, one of the most common object selection techniques, has been known to have difficulties in selecting small or distant objects. Meanwhile, recent advancements in computer vision technology have enabled seamless vision-based hand tracking in consumer VR headsets, enhancing accessibility to freehand mid-air interaction and highlighting the need for further research in this area. This study proposed a new technique called TouchView which utilizes a virtual panel with a modern adaptation of the Through-the-lens metaphor to improve freehand selection for VR UI. TouchView enables faster and less demanding target selection by allowing direct touch interaction with the magnified object proxies reflected on the panel view. Repeated-measures ANOVA on the results of a follow-up user experiment on multitarget selection with 23 participants showed that TouchView outperformed the current market-dominating freehand raycasting technique, Hybrid Ray in terms of task performance, perceived workload, and preference. The user behavior was also analyzed to understand the underlying reasons for these improvements. The proposed technique can be used in VR UI applications to enhance the selection of distant objects, especially for cases with frequent view shifts.

It is important that both static and dynamic information is efficiently used to create a suitable tourism plan. However, collecting, accumulating and managing dynamic information can cost tourists time, money and energy. The present study developed an original tourism support system was designed and developed with the purpose of reducing the burden of tourists who are unfamiliar with the tourist destinations in particular. An original tourism planning support system and web-geographic information systems (Web-GIS) were integrated into a single system, and two original functions were implemented. The system was operated targeting Osaka City, Japan for a period of one month. The information concerning 529 sightseeing spots was collected from tourism-related web media and then saved to the database of the system beforehand. During the operation period, a cumulative total of 160 users accessed the system. Based on the questionnaire survey results, most of the main functions were highly rated regardless of users’ travel experiences to the operation target area. Additionally, based on the access log analysis results, it was clear that the use of the system was in line with the purpose of the present study, as the number of visits to the page for the main functions were high.

Background. The role of exercise programs during Substance Use Disorder (SUD) treatment is considered particularly supportive in fostering positive psychological and behavioral changes. The aim of this feasibility study was to explore the acute effects of cycling exercise in an immersive virtual reality (IVR) environment on attentional control and self-efficacy expectations of indi-viduals undergoing SUD treatment. Methods. A total of 20 individuals (mean age of 37.75 years) enrolled in a SUD treatment program participated in the study. They were instructed to complete a single session of cycling with a self-selected duration within the IVR system. Results. Following the cycling session, pre-post measures indicated a statistically significant im-provement in self-efficacy expectations and attentional control measured with the Stroop test. The results revealed that participants expressed high levels of intention for future use, inter-est/enjoyment, and positive attitudes toward the IVR exercise system. Qualitative data indicated that participants found the IVR exercise system enjoyable, expressed a strong intention to use it, and did not encounter technical difficulties or negative emotions. Conclusions: In conclusion, it seems that engaging in a brief period of self-selected exercise within a virtual environment can result in temporary activation of cognitive changes, heightened self-efficacy expectations, and a motivating approach to increasing physical activity participation among individuals with SUD, thus suggesting the feasibility of this approach.

Abstract: This research aims at developing a virtual reality destination experience (VRDE) model as a moderating variable between sustainable tourist behavior (STB) and tourist visit intention (TVI). The portability variable strengthens VRDE, and the content quality variable supports VRDE. The research method used was purposive convenience sampling covering 204 respondents who visited the vicinity of Kebon batik village in Klaten, Central Java, Indonesia. The research findings were H1: STB has a significant effect on VRDE, H2: VDRE has an impact on TRVI, H3: portability has a significant effect on VRDE, and H4: content quality did not have an impact on VRDE. The novelty of this research is the VRDE application applied to Community Sustainable Tourist Behavior in developing countries.

Binge-eating disorder (BED) and bulimia nervosa (BN) have adverse psychological and medical consequences. Novel interventions, like the integration of virtual reality (VR) with cue-exposure therapy (VR-CET), enhance outcomes for refractory patients compared to cognitive behavior therapy (CBT). Little is known about the feasibility and acceptability of translating VR-CET into real-world settings. To investigate this question, adults previously treated for BED or BN with at least one objective or subjective binge episode/week were recruited from an outpatient University eating disorder clinic to receive up to eight weekly one-hour VR-CET sessions. Eleven of 16 (68.8%) eligible patients enrolled; nine (82%) completed treatment; 82% (9/11) provided follow-up data 7.1 (SD=2.12) months post-treatment. Overall, participant and therapist acceptability of VR-CET was high. Intent-to-treat objective binge episodes (OBEs) decreased significantly from 3.3 to 0.9/week (p &lt; .001). Post-treatment OBE 7-day abstinence rate for completers was 56%, with 22% abstinent for 28 days at follow-up. Among participants purging at baseline, episodes decreased from a mean of one to zero/week, with 100% abstinence maintained at follow-up. The adoption of VR-CET into real-world clinic settings appears feasible and acceptable, with a preliminary signal of efficacy. Findings, including some loss of treatment gains during follow-up may inform future treatment development.

Background Robotic-assisted thoracic surgery (RATS) has become the standard procedure for treating lung malignancy, offering numerous advantages over traditional methods. However, the minimally invasive nature of RATS presents unique challenges, notably a limited field of view and reduced tactile feedback for the surgeon. These limitations can significantly impact the surgeon's ability to navigate complex anatomical structures during surgery. To address these challenges, we recognized the need for enhanced preoperative familiarization with each patient’s specific anatomy. In response, we developed an innovative virtual reality (VR) surgical navigation system, utilizing head-mounted displays (HMDs), designed to provide surgeons with a more comprehensive and interactive understanding of the patient's anatomy before the actual surgery. This VR system aims to extend the surgeon's capabilities in both preoperative sumilation and intraoperative navigation, potentially mitigating the inherent limitations of RATS. Methods Three-dimensional (3D) volumized data, meticulously extracted from preoperative computed tomography (CT) scans, were seamlessly integrated into the Perspectus VR Education software. These data were then displayed on an HMD, facilitating an interactive 3D reconstruction of pulmonary structures. This reconstruction allowed for each structure to be visualized individually, enabling detailed preoperative resection simulations tailored to each patient's unique anatomy. During RATS, these specific 3D reconstructed images were made accessible within the surgeon's console through the TilePro™ multi-display input, providing real-time, intraoperative guidance. Results During the preoperative simulations, the 3D anatomic structure of the pulmonary vessels, as well as the spatial relationship between the lesion and adjacent tissues, were successfully visualized. This enhanced visualization enabled surgeons to thoroughly evaluate a patient's anatomy, significantly improving the safety and accuracy of the subsequent procedure. The integration of VR software with the HMD provided surgeons with a true 3D interaction with real patient data. This setup not only offered a unique perspective through the surgical console but also allowed for easy manipulation of the data on a mobile laptop, thereby enhancing the overall surgical planning process. Conclusions VR simulation using HMDs offers a viewing experience akin to that of a robotic 3D viewer, potentially providing an innovative avenue for surgeons to develop specific robotic surgical skills without the need for practicing on live patients. This technology, when integrated with routine imaging modalities, can significantly enhance preoperative planning. Such integration not only contributes to the safety but also improves the accuracy of anatomical resections. Our findings suggest that VR simulation with HMDs is particularly effective in assisting surgeons to accurately identify lesion locations in RATS, thereby optimizing surgical outcomes.

Virtual assistants (VAs) have gained widespread popularity across a wide range of applications, and the integration of Large Language Models (LLMs) such as ChatGPT has opened up new possibilities for developing even more sophisticated VAs. However, this integration poses new ethical issues and challenges that must be carefully considered, particularly as these systems are increasingly used in public services: transfer of personal data, decision-making transparency, potential biases, and privacy risks. This paper, an extension of the work presented at IberSPEECH 2022, analyzes the current regulatory framework for AI-based VAs in Europe and delves into ethical issues in depth, examining potential benefits and drawbacks of integrating LLMs with VAs. Based on the analysis, this paper argues that the development and use of VAs powered by LLMs should be guided by a set of ethical principles that prioritize transparency, fairness, and harm prevention. The paper presents specific guidelines for the ethical use and development of this technology, including recommendations for data privacy, bias mitigation, and user control. By implementing these guidelines, the potential benefits of VAs powered by LLMs can be fully realized while minimizing the risks of harm and ensuring that ethical considerations are at the forefront of the development process.

BACKGROUNDRestrictive practices are defined by measures linked to physical and chemical restraints to reduce the movement or control behaviours during any emergency. Seclusion is an equal part of restrictive practices intended to isolate and reduce the sensory stimulation to safeguard the patient and those within the vicinity. Using interventions by way of virtual reality (VR) could assist with reducing the need for restrictive practices as it could help reduce anxiety or agitation by way of placing users into realistic and immersive environments. This could also aid staff to and change current restrictive practices.AIMTo assess the feasibility and effectiveness of using a VR platform to provide reduction in restrictive practice (RRP) training. METHODSThe study received ethics approval was obtained prior to starting the study from the Health Research Authority in United Kingdom (22/HRA/3030 REFERENCE). A randomised controlled feasibility study was conducted alongside of an evaluation at at 1 month and 6 within inpatient psychiatric wards at Southern Health NHS Foundation Trust, UK. Virti Virtual Reality scenarios will be used on VR headsets to provide training on reducing restrictive practices in 3 inpatient psychiatric wards. Outcome measures included General Self-Efficacy (GSE) scale, Generalised Anxiety Disorder Assessment 7 (GAD-7), Burnout Assessment Tool (BAT-12), The Everyday Discrimination (EDS) Scale, and the Compassionate Engagement and Action (CEA) Scale. RESULTSThe statistical significance of most variables is high, with the exception of the BAT12 score, compassionate engagement to others score, compassionate to others total score, compassionate engagement from others score, and compassionate from others total score, which exhibit lower statistical power in two-sample t-tests. To assess the acceptability, preference, and adherence of users to the Virti VR technology for RRP training, we calculated the System Usability Scale (SUS) scores and visualized the program's completion using pie charts. The majority of respondents reported SUS scores exceeding 70, with a mean SUS score of 71.79. In accordance with the insights provided by Bangor et al. (38), the VR platform demonstrated superior usability compared to approximately 62% of other products. we utilized the GAD7 score to assess the confidence levels within the two groups. We compared the data for the VR group and the control group after one month, as well as the baseline and one-month data for both the VR group and the control group. Given that the p-values are below 0.05 and the statistical power is high, it can be concluded that there are no statistically significant differences in confidence levels between the VR and control groups at baseline and day-30. CONCLUSIONSOur study has revealed the challenges associated with implementing such a program, even though the staff has given it high usability ratings. With the ongoing advancement of VR technology, we have the capability to create scenarios and simulations tailored to various healthcare environments. This empowers staff to receive more comprehensive and effective training for handling a wide range of situations.

Background: Osteoarthritis (OA) is a common health condition that often requires procedures like total hip arthroplasty (THA). Rehabilitation plays a crucial role in managing OA, especially in supporting recovery and improving outcomes following THA. Given the rising demand for THA and the significant impact of OA on mobility and quality of life, effective rehabilitation strategies are essential. This study investigates the impact of virtual reality (VR) therapy on the psychological and functional outcomes of female patients undergoing rehabilitation post-THA. Methods: This pilot randomized controlled trial was conducted with 24 female patients aged 60 and older. Participants were randomized into two groups: a control group receiving 4-week standard rehabilitation and an experimental group receiving standard rehabilitation plus VR therapy. Psychological and functional statuses were assessed using the Hospital Anxiety and Depression Scale (HADS), Perception of Stress Questionnaire (PSQ), and various functional tests before and after the intervention. Results: The experimental group showed significant improvements in psychological outcomes, with a 53% reduction in overall HADS scores and a 43% reduction in PSQ scores. Functional improvements were also observed, with significant increases in Tinetti Test, Barthel Index, and Rivermead Motor Assessment scores. In contrast, the control group showed no significant changes in psychological parameters and less pronounced functional improvements. Conclusions: VR therapy effectively enhances psychological well-being and functional recovery in women undergoing rehabilitation post-THA. These findings suggest that integrating VR therapy into standard rehabilitation protocols could improve outcomes and should be considered in future rehabilitation strategies.

Avatar therapy (AT) is a novel virtual reality-based psychotherapy that has been developed to treat auditory verbal hallucinations (AVH) in treatment-resistant schizophrenia patients. Various psychotherapeutic components, such as emotions and sense of presence, could contribute to clinical outcomes. However, the interplay between sense of presence, emotions and clinical response has seldom been investigated. This study aimed to explore the relations between sense of presence, emotions, and clinical outcomes in AT. To conduct this investigation, data from previous and ongoing AT trials were used. Sense of presence and emotions were assessed using standardized questionnaires. AVH were evaluated using the Psychotic Symptom Rating Scales. While sense of presence was positively associated with positive emotions such as control and serenity, no significant associations were found for negative emotions. Moreover, a higher level of sense of presence was associated with a bigger decrease in AVH. Overall, positive emotions seem to be associated with sense of presence in AT. Sense of presence also seems to be involved in the therapeutic outcome, thereby suggesting that this could be an important component related to clinical response. More studies are needed to confirm these trends, which could be generalized to other virtual reality-based psychotherapies.

Some of the barriers preventing Virtual Reality (VR) from being widely adopted are the cost and unfamiliarity of VR systems. Here we propose that in many cases the specialized controllers shipped with most VR head-mounted displays can be replaced by a regular smartphone, cutting the cost of the system, and allowing users to interact in VR using a device they are already familiar with. To achieve this, we developed SmartVR Pointer, an approach that uses smartphones as a replacement for the specialized controllers for two essential operations in VR: selection and navigation by teleporting. In SmartVR Pointer a camera mounted on the head-mounted display (HMD) is tilted downwards so that it points to where the user will naturally be holding their phone in front of them. SmartVR Pointer supports three selection modalities: tracker-based,gaze-based, and combined/hybrid. In the tracker-based SmartVR pointer selection we use image-based tracking to track a QR code displayed on the phone screen and them map the phone’s position to a pointer shown within the field of view of the camera in the Virtual Environment. In the gaze-based selection modality the user places the pointer using their gaze and taps on the phone for selection. The combined technique is a hybrid between head-gaze-based interaction in VR and smartphone-based Augmented Reality. It allows the user to control a VR pointer that behaves like a mouse pointer by moving their smartphone to select objects within the virtual environment, and to interact with the selected objects using the smartphone’s touch screen. The touchscreen is used for selection and dragging. SmartVR Pointer is simple and requires no calibration and no complex hardware assembly or disassembly. We demonstrate successful interactive applications of SmartVR Pointer in a VR environment with a demo where the user navigates in the virtual environment using teleportation points on the floor and then solves a Tetris-style key-and-lock challenge.

Background: Virtual Reality (VR) is transforming neuropsychological assessment by providing immersive environments that closely replicate real-world conditions. This study presents the Virtual Reality Trail Making Test (TMT-VR), a novel adaptation of the traditional Trail Making Test, aimed at evaluating cognitive functions in individuals with Attention Deficit Hyperactivity Disorder (ADHD). We examined the ecological validity, convergent validity, usability, and user experience of the TMT-VR compared to the traditional version. Methods: Fifty-three participants, including 25 with ADHD and 28 neurotypical controls, completed both the traditional and VR versions of the TMT. Participants also provided feedback on the VR experience via standardized questionnaires. Results: Statistical analyses demonstrated a significant positive correlation between TMT-VR scores and both the traditional TMT and ADHD symptomatology as measured by the Adult Self-Report Scale (ASRS), confirming the TMT-VR’s ecological and convergent validity. High usability and positive user experience ratings indicated strong acceptability of the VR platform. Notably, the ADHD group exhibited greater performance differences in the VR environment, suggesting that VR may more effectively capture real-world cognitive challenges. Conclusions: These findings suggest that TMT-VR is a valid, engaging, and ecologically valid tool for cognitive assessment in ADHD, and other clinical populations, offering enhanced insights over traditional methods.

Background: Regular moderate-vigorous intensity exercise is recommended for adults as it can improve longevity and reduce health risks associated with a sedentary lifestyle. However, there are barriers to achieving intense exercise that may be addressed using virtual reality (VR) as a tool to promote exercise intensity and adherence, particularly through visual feedback and competition. The purpose of this work is to compare visual feedback and competition within fully-immersive VR to enhance exercise intensity and user experience of exercise for young adults; and to describe and compare visual attention during each of the conditions. Methods: Young adults (21- 34 years old) bicycled in three 5-minute VR conditions (visual feedback, self-competition and competition against others). Exercise intensity (cycling cadence and % of maximum heart rate) and visual attention (derived from a wearable eye tracking sensor) were measured continuously. User experience was measured by an intrinsic motivation questionnaire, perceived effort and participant preference. A repeated measures ANOVA with paired t-test post-hoc tests was conducted to detect differences between conditions. Results: Participants exercised at a higher intensity and had higher intrinsic motivation in the two competitive conditions compared to visual feedback. Further, participants preferred the competitive conditions and only reached a vigorous exercise intensity during self-competition. Visual exploration was higher in visual feedback compared to self-competition. Conclusion: For young adults bicycling in VR, competition promoted higher exercise intensity and motivation compared to visual feedback.