What is XR? Towards a Framework for Augmented and Virtual Reality

Five canonical findings from 30 years of psychological experimentation in virtual reality

Virtual reality (VR) is an emerging medium used in work, play and learning. We review experimental research in VR spanning three decades of scholarship. Instead of exhaustively representing the landscape, our unique contribution is providing in-depth reviews of canonical psychological findings balanced across various domains within psychology. We focus on five findings: the benefit of being there depends on the activity; self-avatars influence behaviour; procedural training works better than abstract learning; body tracking makes VR unique; and people underestimate distance in VR. These findings are particularly useful to social scientists who are new to VR as a medium, or those who have studied VR but have focused on specific psychological subfields (for example, social, cognitive or perceptual psychology). We discuss the relevance for researchers and media consumers and suggest future areas for human behaviour research.

Resuscitation education science meets virtual and augmented reality: Evolution from potential concept to recommendations

Aim of the study

This study aims to examine the evolution of recommendations for integrating Virtual Reality (VR) and Augmented Reality (AR) into adult Basic Life Support (BLS) education over time.

Data sources

In December 2024, we conducted a two-phase search. First, we identified and reviewed publications available on the International Liaison Committee on Resuscitation (ILCOR) webpage, focusing on resuscitation education science, specifically addressing VR and/or AR in adult BLS education. In the second phase, we reviewed the references and citations of the included publication to identify relevant publications from the American Heart Association (AHA), European Resuscitation Council (ERC), and ILCOR.

Results

Across both phases, we included 29 AHA, ERC, and ILCOR publications on resuscitation education. These comprised 16 ILCOR CoSTRs, seven AHA/ERC guidelines (four ERC, three AHA), three ILCOR scientific statements, two AHA scientific statements, and one ILCOR review. The first mention of VR appeared in 2003, but the first recommendation was provided in 2020 AHA guidelines, suggesting its use for adult BLS training based on very low-quality evidence. In 2024, the ILCOR CoSTRs issued a weak recommendation supporting AR and a weak recommendation against VR for adult BLS training, both based on very low-quality evidence.

Conclusion

While VR/AR is gaining traction in resuscitation training, its effectiveness remains debated. Initially focused on professionals, it now extends to laypersons and schoolchildren. However, strong evidence is lacking. Future research should assess learning outcomes, guideline adherence, and patient impact to support stronger ILCOR recommendations.

Extended reality technologies in adult basic life support education: A scoping review

Aim

In recent years, virtual and augmented reality (VR/AR) technologies have gained increasing attention as innovative tools for education, including in the field of adult Basic Life Support (BLS). While existing reviews on this topic primarily focus on comparing VR/AR with other educational approaches, our research aimed to identify the VR/AR hardware and software applications assessed in published studies and their alignment with learning objectives in adult BLS education.

Methods

We conducted a scoping literature review using the Population, Exposure, and Outcome (PEO) framework to analyse publications from 2018 to 2024. The review focused on the impact of VR/AR (exposure) on affective, behavioral, and cognitive learning outcomes (outcome) in adult BLS education among laypersons, healthcare professionals, pre-licensure students, and duty-to-respond laypersons (population).

Results

From 1,282 database records and 54 alternative sources, 31 articles were selected for comprehensive analysis. Many of the studies (11/31; 36%) targeted pre-licensure students, such as nursing students, and laypersons (9/31; 20%), primarily high school students. Only one study focused on duty-to-respond laypersons (1/31; 3%). VR studies (24/31; 77%) were more common than AR studies (6/31; 19%), featuring a broad spectrum of ten VR headsets compared to just two types of AR headsets. Among the assessed software applications, twenty-one commercial programs were examined-sixteen designed for VR and five for AR. Most studies investigated affective outcomes (25/31; 81%), while behavioural outcomes were also commonly examined (22/31; 71%). In contrast, cognitive outcomes were explored in fewer studies (9/31; 29%).

Conclusion

Our review identified several challenges in existing studies, including variability in software and hardware, diverse learning outcomes, and accessibility issues with extended reality (XR) technology. To maximize its effectiveness, XR should be aligned with specific learning objectives rather than adopted for its novelty. Prioritizing educational efficacy ensures that XR enhances learning by addressing precise gaps, ultimately improving the understanding and retention of resuscitation skills among both laypersons and healthcare professionals.

Community-Based Virtual Reality Interventions in Older Adults with Dementia and/or Cognitive Impairment: A Systematic Review

INTRODUCTION

Virtual reality devices have been widely used for the rehabilitation among older people with cognitive impairments. They enable the user to navigate in three-dimensional environments, which are constructed by a computer. Recent studies have been focused on the cognitive benefits of virtual reality for people with cognitive deficits. The current study aimed to investigate the overall impact of community-based virtual reality interventions in older adults with dementia and/or cognitive impairment.

METHODS

A systematic review of the literature was conducted according to the PRISMA guidelines. Google Scholar, PubMed, Science Direct and Scopus databases were searched for the years 2010-2022.

RESULTS

Of the 245 articles 20 met the inclusion criteria. The results of the current systematic review indicated that virtual reality improved older adults' cognitive and motor skills and increased their positive emotions while minimizing less positive ones. However, there is insufficient data of its impact on their overall quality of life.

CONCLUSION

There is a need to implement and evaluate interventions that examine its impact not only on cognitive functioning, but also on other aspects of older people with cognitive deficits.

Comparison of augmented reality with other teaching methods in learning anatomy: A systematic review

Augmented reality (AR) has been investigated as an engaging educational tool that motivates undergraduate health science students to learn human anatomy. AR technology is developing rapidly, supporting medical education by presenting models of human anatomy as digital objects overlaid in the real world via mobile or head-mounted display (HMD). The purpose of this systematic review is to provide a post-pandemic analysis of AR compared with other methods for teaching anatomy and to determine the effects of AR on learning outcomes (LOs). Original research published between January 2020 and April 2024 was obtained from the WOS, Scopus, MEDLINE(Ovid), EMBASE, and PubMed databases, following PRISMA 2020 protocols. Articles included for analysis compared AR with alternative pedagogical methods of teaching undergraduate human anatomy. Studies that described AR as "mixed reality" (MR) were included, while those describing "virtual reality" (VR) were not considered. Risk of bias and limitations in individual studies were assessed using the Quality Assessment with Diverse Studies (QuADS) tool. Data were synthesized using a convergent integrated approach with LOs tabulated for visual analysis. A total of 17 articles were eligible for review: nine studies comparing AR via HMD hardware, and eight comparing mobile AR. The LOs of 12 studies were overwhelmingly reported as non-significant. Insufficient data precluded an accurate meta-analysis of LOs, and critical analysis revealed a considerable risk of bias and lack of justified methodology. While AR holds potential for supporting undergraduate students in learning anatomy, definitive outcomes from the current literature are limited by the heterogeneous nature of the studies and inconsistent use of terminology. It is recommended that future research employs professional AR technologies and incorporates the perspectives of university educators to ensure reliable outcomes that can direct the further development of AR technology in medical education.

Augmented Reality Exergames for Upcoming Cognitive-Motor Rehabilitation: User-Centered Design Approach and User Experience of Healthy Children

BACKGROUND

Traditional rehabilitation programs for children with cerebral palsy and acquired brain injuries aim to enhance motor and cognitive abilities through repetitive exercises, which are often perceived as tedious and demotivating. Extended reality technologies, including augmented reality (AR) and virtual reality, offer more engaging methods through exergames. However, to date, no AR exergames simultaneously integrate cognitive and motor aspects within navigational tasks. Developing these exergames necessitates rigorous methodological steps, especially when using emerging technologies such as AR. The MIDE (Multidisciplinary Iterative Design of Exergames) framework advocates a participatory design approach, involving users from the outset, the objective being to optimize the interface and validate game mechanics through user experience (UX) assessment. Some researchers initially test these mechanisms on healthy children before applying them to clinical populations.

OBJECTIVE

This study aims to evaluate the UX of our AR exergames, consisting of two games (AR Corsi and AR Zoo), in typically developing children.

METHODS

Typically developing children participated in two 1.5-hour sessions. During each session, they played one of two AR games using the Microsoft HoloLens 2 headset: AR Corsi and AR Zoo, both of which are designed to engage executive functions and motor skills through navigational capabilities. UX was assessed after each session using the following measures: System Usability Scale scores for usability, AttrakDiff for attractiveness and game quality, MeCue for emotional experience, and Rating scale of Perceived Exertion for Children for pre- and postsession mental and physical fatigue.

RESULTS

A total of 27 participants (mean age 11.9, SD 1.2 years) were included in the study. Mean System Usability Scale scores were 79.9 (SD 11.4) for AR Corsi and 76.3 (SD 12.1) for AR Zoo, indicating good usability. The AttrakDiff questionnaire yielded favorable results, with scores between 1 and 3 for overall attractiveness, pragmatic quality, and stimulation for both AR games. However, the hedonic quality "identity" received neutral scores (mean 0.6, SD 0.5 for AR Corsi and mean 0.7, SD 0.8 for AR Zoo). The MeCue emotions module yielded average scores of 5.2 (SD 0.7) for AR Corsi and 5.3 (SD 0.8) for AR Zoo, significantly exceeding the theoretical mean of 4 (P<.001). We observed a significant effect of physical fatigue (P=.02) and mental fatigue (P=.002) after exposure to both games. A comparative analysis of UX between the two games showed no significant differences.

CONCLUSIONS

This study demonstrates that our exergame, comprising two AR games, is user-friendly and well-received by typically developing children, eliciting positive emotions and overall appeal. Although some children reported fatigue, favorable UX evaluation confirms the validity of the game's content and mechanisms, suggesting its suitability for use among children with cerebral palsy and acquired brain injuries.

A novel training session: mixed reality evisceration surgery webinar

BACKGROUND

Evisceration surgery is an important part of an ophthalmologist's skillset but is an uncommon procedure. Therefore, it is important for training ophthalmologists to have adequate knowledge and confidence in this procedure to maximise learning opportunities. Mixed reality involves the intertwining of real and virtual environments and has been used successfully in surgical training.

OBJECTIVES

To improve participants' knowledge of the relevant anatomy, steps and confidence in performing evisceration surgery using an extended reality online webinar coupled with conventional teaching.

METHODS

The teaching session comprised of a short lecture introducing evisceration and explaining mixed reality technology including the Microsoft HoloLens headset. This was followed by a 3D demonstration of the orbit and globe, then the live evisceration procedure on a porcine cadaver, with the surgeon's point of view via the headset. There was expert live running commentary during the procedure with the use of virtual signposts on relevant anatomy. Participants were encouraged to be interactive and given the ability to share their annotations on-screen.

RESULTS

Ten doctors ranging from Foundation year 1 to Ophthalmology specialist training year 3 attended the 90-min session and completed pre- and post- session questionnaires (5-point Likert scales). Results showed statistically significant improvements in the knowledge, steps and confidence in performing the evisceration surgery (paired two-sample T-tests, SPSS version 29).

CONCLUSIONS

This study has demonstrated that utilisation of mixed reality with conventional teaching methods can provide a useful initial learning experience which may facilitate effective further learning of the evisceration surgery in a wet-lab or patient setting.

Dental implant placement with immersive technologies: A preliminary clinical report of augmented and mixed reality applications

A preliminary clinical report of implant placements with 2 immersive reality technologies is described: augmented reality with head mounted display and mixed reality with a tablet PC. Both immersive realities are promising and could facilitate innovative dental applications. However, mixed reality requires further development for clinical optimization.

Video gaming and sleep in adults: A systematic review

Video games (VGs) are one of the most common forms of entertainment and their diffusion is constantly increasing. Although largely studied in the framework of their relationship with mental and physical health, the relationship of VGs with sleep are not yet fully understood. This review provides a systematic assessment of the studies that investigated the relationships between video gaming and sleep in adults. The review search included both online databases (PubMed, Scopus, and PsycInfo) and citation tracking. Twenty-six studies were included in the final qualitative analysis. Findings are described separately for subjective and objective sleep measures and then discussed considering exposure levels and VG typology. Observational studies showed an association between excessive video gaming, poor sleep quality, and delayed sleep timing, whereas habitual and/or casual use was not associated with poor sleep and some studies even showed a beneficial effect on daytime functioning. Experimental evidence shows that playing an arousing VG before sleep delays sleep onset with possible alteration of sleep structure, whereas non-arousing cognitively challenging video gaming resulted in improved sleep continuity, stability, and organization. Overall, these findings show that the effect of VGs on sleep depends on the level of arousal associated with gaming, gaming sessions' duration, and frequency of gaming.

Virtual worlds, real opportunities: A review of marketing in the metaverse

Metaverse, as an emerging phenomenon, presents businesses with new opportunities to create user-centered, interactive, and fully immersive products and services that transcend the boundaries of physical and digital reality. However, there is a lack of understanding among academics and business leaders regarding what the metaverse is and how it can transform the marketing landscape. By conducting a systematic literature review of 39 articles using 5W1H framework, the study enhances the comprehension of marketing in metaverse from both conceptual and managerial perspectives. The study delves into the intricacies of the metaverse, examining its components, such as 3D virtual world, avatars, interoperability, and persistency, while exploring its opportunities and challenges. Specifically, it highlights the evolution of the 4P's of marketing and their applications across diverse industries, ranging from tourism and education to retailing and beyond. The review provides a comprehensive understanding of the state-of-the-art literature. The findings of this study can guide future research on the potential of metaverse and aid managers in developing effective marketing strategies related to marketing in metaverse.

Immersive medical training: a comprehensive longitudinal study of extended reality in emergency scenarios for large student groups

Young healthcare professionals and medical graduates often fall short in the practical experience necessary for handling medical emergencies. This can not only lead to strained feelings of inadequacy and insecurity among future physicians and less experienced healthcare providers in general, but also to detrimental outcomes for patients as emergency medicine demands rapid decision-making with low tolerance for errors. New didactic modalities and approaches may be needed to effectively address this shortcoming. Immersive technologies are powerful novel educational tools with untapped potential in medical training, and may be particularly suitable for simulation trainings in the high-stakes field of emergency medicine.Herein, we systematically explored the educational potential of extended reality (XR) technology, particularly virtual reality (VR), in the management of patients presenting as medical emergencies, combining the use of the STEP-VR application with an untethered hardware setup.Importantly, we aimed at studying multiple, large cohorts of senior medical students involving a total of 529 participants and collecting data over a period of two years. We assessed students' acceptance of the training through a modified questionnaire measuring device handling, content complexity, degree of immersion, learning success, and seminar design.Our results show high, sustained acceptance and ease of use across different student cohorts and subgroups, with most students finding XR/VR engaging and beneficial for acquiring emergency medicine skills. Importantly, the prevalence of simulation sickness was minimal. Moreover, no major effect of the head-mounted displays (HMDs) price range was noted with regard to the learning experience. The results underscore the potential of XR/VR capabilities in effectively enhancing medical education, particularly in areas of high-stakes clinical scenarios and emergency care, by providing realistic and reproducible immersive training environments.In summary, our findings suggest that XR/VR-based training approaches could significantly contribute to preparing future physicians for the complexities of emergency medical care, encouraging the integration of such technologies into medical curricula. However, careful consideration must be given to its suitability for all students and the practical challenges of its implementation, highlighting the need for further research to harness its full potential for medical education.

Mixed Reality in Clinical Settings for Pediatric Patients and Their Families: A Literature Review

In the post-pandemic context, there has been an increasing demand for technology-based interventions in education and healthcare systems, such as augmented and mixed reality technologies. Despite the promising outcomes of applying mixed reality (MR), there is limited aggregated evidence focusing on child-patient interventions in hospital-based or clinical settings. This literature review aimed to identify and synthesize existing knowledge on MR technologies applied to pediatric patients in healthcare settings. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of the Scopus and Web of Science databases was conducted to identify articles published in the last 10 years that address the application of augmented and/or MR technologies in pediatric hospital settings or clinical environments to improve patient and family outcomes. A total of 45 articles were identified, and following a rigorous screening and eligibility process, 4 review articles were selected for qualitative synthesis. From these reviews, 10 studies with relevant interventions and measured effects were extracted. The extracted studies were analyzed based on eight key attributes: country of origin, study design, characteristics of the study population, primary clinical setting, type of MR device used, nature of the intervention, variables measured, and significant effects observed in the outcome variables. The analysis revealed diverse approaches across different clinical settings, with a common focus on improving both emotional well-being and learning outcomes in pediatric patients and their families. These findings suggest that MR-based pediatric interventions generally provide children and their parents with positive emotional experiences, enhancing both learning and treatment outcomes. However, the studies reviewed were heterogeneous and varied significantly in terms of clinical settings and MR applications. Future research should focus on developing more controlled study designs that specifically target the pediatric population to strengthen the evidence base for MR interventions in healthcare.

Exploring perceived learning effectiveness in virtual reality health communication through the lens of construal level theory

BACKGROUND

Virtual reality is increasingly being used for health communication. This study aimed to propose and test an integrated model of the determinants of perceived learning effectiveness in virtual reality (VR) within health communication. It proposes that psychological distance negatively affects immersion, flow, and presence, positively affecting perceived learning effectiveness.

METHODS

The Fuzzy Decision Making Trial and Evaluation Laboratory Method (F-DEMATEL) and structural equation modeling (SEM) were used to test the proposed model. Data for the F-DEMATEL study were collected from 20 participants, whereas data for the SEM study were collected from 1104 participants, with 775 included in the final analysis.

RESULTS

The results of the F-DEMATEL study revealed that the three dimensions of psychological distance, emotional distance, spatial distance, and social distance are causal factors. In contrast, temporal, technical, and hypothetical distance are effect factors. The SEM results confirmed the negative effects of psychological distance on flow and presence and the positive effects of immersion and presence on perceived learning effectiveness. In addition, the mediating role of presence was confirmed.

CONCLUSIONS

The results suggest that interrelationships among the factors can enhance the perceived learning effectiveness of health communication from VR. The crucial role of ensuring low psychological distance and high engagement in VR communication is also confirmed, providing crucial implications for VR communication practitioners.

Cyborg Children: A Systematic Literature Review on the Experience of Children Using Extended Reality

This literature review presents a comprehensive and systematic account of research on the experiences of children with extended reality (XR), including VR, AR, and other types of immersive technologies that enhance and augment children's activities. The search on Scopus and Web of Science produced 531 outputs. Content analysis with inter-rater reliability (Krippendorff's α) and Leximancer, a software for text mining, were used for analyzing the material. Four research strands were identified: (1) interventions, treatments, and medical procedures in clinical contexts; (2) teaching and learning enhanced by XR; (3) children's adoption and user experiences; (4) design and prototyping of XR hardware and software for children. The results showed the following findings: (a) studies on children's clinical interventions and treatments using HMD-supported immersive virtual reality comprise the most substantial strand of studies; (b) research in this area, and in teaching and learning studies, has grown dramatically since 2017, while the other areas have been stagnant over the years; (c) AR research is still limited and is mainly applied in educational contexts for design and prototyping; (d) few studies have considered children's perspectives on XR safety issues; (e) research on the use of XR for enhancing social and emotional skills development is underrepresented. Future research should focus on the potential of XR technologies for interventions to enhance children's psychosocial wellbeing and health more broadly. The further implications and study limitations for the fast-developing nature of this transdisciplinary research field are also discussed.

Bridging the digital and physical: The psychology of augmented reality

By blurring the boundaries between digital and physical realities, Augmented Reality (AR) is transforming consumers' perceptions of themselves and their environments. This review demonstrates AR's capacity to influence psychology and behavior in profound ways. We begin by providing a concise introduction to AR, considering its technical, practical, and theoretical properties. Next, we showcase a multi-disciplinary set of recent studies that explore AR's impact on psychological processes and behavioral outcomes. We conclude by offering a selection of potential future research directions designed to deepen our understanding of the psychological and behavioral implications of AR experiences.

Ego-depletion and motor skill performance under pressure-experimental effects of a short term virtual-reality based mindfulness breathing meditation with integrated biofeedback

Ego-depletion describes a state of mind, where the capacity for self-control is temporarily depleted after a primary self-control action. The aim of this study was to investigate whether a brief virtual reality-based mindfulness breathing meditation with integrated biofeedback can be considered an effective strategy to counteract the detrimental effects of ego depletion on motor skill performance under pressure. The study included two experiments, each of them designed as counterbalanced cross-over trials and based on an a priori sample-size calculation. Within each experiment, participants completed two appointments in a randomly assigned order, during which they were asked to perform 20 basketball free throws (N = 18; Experiment 1) or 20 penalty kicks at a football goal in four target squares (N = 16; Experiment 2) under pressure pre and post the following conditions: Stroop-test-induced ego depletion followed by a 15 min resting break, Stroop-test-induced ego depletion followed by a 15 min virtual reality-based mindfulness breathing meditation with integrated biofeedback. Results indicate that, in comparison to a resting break, a brief virtual reality-based mindfulness meditation with integrated biofeedback can counteract the detrimental effects of ego-depletion (Experiment 2) and enhance motor skill performance under pressure (Experiment 1, 2) Implications for researchers and practitioners are derived in light of the identified methodological limitations.

Users' willingness to adopt metaverse drawing on flow theory: An empirical study using PLS-SEM and FsQCA

As a rapidly developing information technology in recent years, the metaverse has significantly transformed how we live, learn, and work. In order to accelerate the use of metaverse technology and promote users' acceptance of the metaverse, this study constructs an integrated model based on flow theory and use and satisfaction theory, to further explore the factors affecting users' acceptance of the metaverse. A total of 265 valid questionnaires were obtained through a situational questionnaire survey. Considering the limitations of a single analysis technique, we use two methods to analyze the data. Among them, the symmetric PLS-SEM method is mainly used to analyze the effects of single variables, while the asymmetric fsQCA method is used to analyze the combined effects of variables. The PLS-SEM results manifest that flow experience, perceived risk, and personal innovation directly influence users' acceptance of the metaverse, while perceived cost has no effect. Simultaneously, interactivity, presence, and social presence indirectly affect users' acceptance of the metaverse, while informativeness and enjoyment have no indirect effect. Significantly, fsQCA unveiled five configurations resulting in a high user acceptance of the metaverse, as well as six configurations leading to a negative acceptance. The complementary findings from PLS-SEM and fsQCA offer valuable insights for both theoretical understanding and practical implementation.

Understanding the knowledge structure and the value creation process of the metaverse

The metaverse is a digital space that empowers users to interact socially, using new and specific technologies, to generate value and co-create experiences. This paper provides a framework for organising the themes discussed in pioneering literature. An adaptation of the PRISMA process was used to explain the methodology applied. The results showed that more than 84 % of studies on the metaverse have been published since 2020. Technologies such as augmented reality and artificial intelligence are positioned as the basic themes, and decision-making and human-machine interface are emerging themes. This paper constitutes an original contribution as it also presents the highlights and structure of the main themes on metaverse. Additionally, it develops an analytical framework for understanding the metaverse value creation. Therefore, this paper represents a starting point for a reflection on the applications of the metaverse that can contribute to the achievement of productive and valuable progress in various fields of research.

Tourism marketing in the metaverse: A systematic literature review, building blocks, and future research directions

The aim of this research is to investigate tourist marketing within the embryonic context of the metaverse in order to comprehend the building blocks and the primary technologies employed in the sector. A systematic literature review (SLR) was conducted on 386 articles, with an overall qualitative approach that included 86 references, all of which dealt with the topic of the metaverse and had direct or potential implications for the tourism sector (hotels, restaurants, means of transport, leisure activities and destination itself). The articles are taken from: Science Direct, Taylor & Francis, Emerald, Springer and Google Scholar. The SLR was carried out according to the PRISMA search protocol. The results indicate the technologies that have been most thoroughly studied at the confluence of marketing, tourism, and the metaverse (AI, virtual reality, augmented reality, mixed reality, blockchain, tokens (NFTs) and digital twins). Moreover, they establish the foundational components of tourism marketing in the metaverse for the first time (tourism products, the metaverse as a distribution and branding channel for tourism and, tourist customer as protagonist). Finally, the study exposes research gaps and recommends future directions for exploration (monetization of products in the metaverse, promotion and marketing strategies in the metaverse, new profiles for marketing professionals, policy development that regulates commercial activity in the metaverse).

Water monitoring with an automated smart sensor supported with solar power for real-time and long range detection of ferrous iron

Low-power and smart sensing systems for iron detection are necessary for in situ monitoring of water quality. Here, a potentiometric Fe2+-selective electrode (ISE) was fabricated based on cyanomethyl N-methyl-N-phenyl dithiocarbamate for the first time as an ionophore. Under optimal conditions, the ISE showed a Nernstian slope of 29.76 ± 0.6 mV per decade for Fe2+ ions over a wide concentration range from 1.0 × 10-1 to 1.0 × 10-5 M with a lower detection limit (LOD) of 1.0 × 10-6 M. The ISE interference of various cations on the potentiometric response was also investigated. The ISE had a response time less than 3 s and the lifetime was two months. Also, an automated, long-range (LoRa), wireless enabled sampling microfluidic device powered with a solar panel as an autonomous power source was developed for a continuous sampling and sensing process. The sensing platform was employed in the determination of Fe2+ in acid mine drainage and spiked water samples with an average recovery of 100.7%. This simple, inexpensive (below $350), portable sensing platform will allow for rapid real-time monitoring of ground-, drinking-, and industrial waters contaminated with iron.

XR and mental wellbeing: state of the art and future research directions for the Metaverse

Introduction

The purpose of this study is to provide an overview of extant research regarding XR technology and its effect on consumer wellbeing. With the hopes of informing marketing practitioners on XR consumer psychology, in preparation for the Metaverse.

Methods

To achieve the above aim, two types of analysis took place. Firstly, a bibliometric analysis was conducted which was then followed by a framework-based structured literature review. The latter entailed an analysis of 81 articles evaluated from a positive psychological approach.

Findings

Following the TCCM framework, the analysis revealed the most common psychological theories demonstrating potential avenues for XR to impact consumer wellbeing. Moreover, researchers found preliminary links between, theory, characteristics, and contexts. Giving a preliminary description of how theory manifests into reality. Finally, the overview of extant literature was used to propose new avenues for future research pertaining to marketing, the Metaverse, and consumer effects.

Conclusion

In conclusion, the paper provides stakeholder insights which can ensure minimal consumer risk and sustainable use of the XR technology and Metaverse. While addressing the need for more research that uncovers the psychological effects of emerging technologies, so to prepare for the Metaverse. This is especially important when considering the current upsurge of these technologies and the uncertainties associated with their novelty and the idea of an 'always on' consumer.

Virtual reality is effective in the management of chronic low back ache in adults: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Chronic low back ache (CLBA) is a common condition that is conventionally managed with physical therapy and analgesics. Recently, virtual reality-based interventions have been tried out in the management of CLBA. Their effectiveness, however has not been established. This meta-analysis aims to find out if the application of VR will lead to better pain relief, as compared to conventional techniques in adults with CLBA.

METHODS

The literature search was carried out in three online databases for potential randomized controlled trials that compared VR-based interventions with conventional treatment in CLBA. Data on outcome parameters were recorded. Meta-analysis was carried out with the help of appropriate software.

RESULTS

Seven studies having data on 507 subjects were included in the meta-analysis. Their mean ages were 48.4 years. There were 252 subjects in the VR group and 255 in the control group. VR-based interventions were found to have a statistically significant improvement in the pain intensity compared with conventional techniques (p - 0.005).

CONCLUSION

VR-based interventions are effective in the management of CLBA in the short term. Further research with longer follow-up is required to evaluate if these improvements are persistent in the long term.

Augmented reality for supporting the interaction between pedestrians and automated vehicles: an experimental outdoor study

Introduction: Communication from automated vehicles (AVs) to pedestrians using augmented reality (AR) could positively contribute to traffic safety. However, previous AR research for pedestrians was mainly conducted through online questionnaires or experiments in virtual environments instead of real ones. Methods: In this study, 28 participants conducted trials outdoors with an approaching AV and were supported by four different AR interfaces. The AR experience was created by having participants wear a Varjo XR-3 headset with see-through functionality, with the AV and AR elements virtually overlaid onto the real environment. The AR interfaces were vehicle-locked (Planes on vehicle), world-locked (Fixed pedestrian lights, Virtual fence), or head-locked (Pedestrian lights HUD). Participants had to hold down a button when they felt it was safe to cross, and their opinions were obtained through rating scales, interviews, and a questionnaire. Results: The results showed that participants had a subjective preference for AR interfaces over no AR interface. Furthermore, the Pedestrian lights HUD was more effective than no AR interface in a statistically significant manner, as it led to participants more frequently keeping the button pressed. The Fixed pedestrian lights scored lower than the other interfaces, presumably due to low saliency and the fact that participants had to visually identify both this AR interface and the AV. Discussion: In conclusion, while users favour AR in AV-pedestrian interactions over no AR, its effectiveness depends on design factors like location, visibility, and visual attention demands. In conclusion, this work provides important insights into the use of AR outdoors. The findings illustrate that, in these circumstances, a clear and easily interpretable AR interface is of key importance.

Mixed Reality for a collective and adaptive mental health metaverse

This research paper explores the significant transformative potential of Mixed Reality (MR) technology as enabler of the metaverse, specifically aimed at enhancing mental health therapies. The emerging world of the metaverse, a multiuser, adaptive, three-dimensional digital space, paired with the interactive and immersive benefits of MR technology, promises a paradigm shift in how mental health support is delivered. Unlike traditional platforms, MR allows for therapy within the comfort of the user's familiar surroundings, while incorporating the benefits of social collaboration and interactions. The metaverse environment fosters heightened personalization and deeper user engagement, thereby offering a more tailored approach to computerized therapy. Beyond its immersive capabilities, MR offers potential for real-time, smart adaptations to the users' psycho-physiological state, targeting unique patients' needs on a diverse spectrum of therapeutic techniques, thus broadening the scope of mental health support. Furthermore, it opens avenues for continuous emotional support in everyday life situations. This research discusses the benefits and potentials of integrating MR within a mental health metaverse, highlighting how this innovative approach could significantly complement traditional therapeutic methods, fostering improved treatment efficacy, focusing on social and collective experiences, and increasing patient engagement.

Psychological and physiological health outcomes of virtual reality-based mindfulness interventions: A systematic review and evidence mapping of empirical studies

Objective

In the past two decades, mindfulness, rooted in Buddhist traditions, has gained considerable scientific interest. Virtual reality (VR) technology, in particular head-mounted displays, offers immersive experiences and is examined in this systematic review in terms of VR-based mindfulness interventions and their effects on psychological and physiological health outcomes.

Methods

Using the Preferred Reporting Items for Systematic Review and Meta Analyses guidelines, a systematic search was conducted with the following search terms: [(mindful* OR "meditat*") AND ("virtual reality" OR "VR") AND (health OR physio* OR psycho* OR mental OR physical)]. Considering critiques of methodological quality in existing systematic reviews, this study adopts Boell and Cecez-Kecmanovic's hermeneutic approach, critically evaluating research outcomes.

Results

Psychological benefits include improved anxiety, mindfulness, emotions, disease patterns, affect, stress, (presleep) arousal, meditation and others. Physiological effects focus on neurobiological markers, heart rate/heart rate variability, pain, blood pressure, cortisol and galvanic skin resistance. Evidence mapping shows that more research has been conducted in the last 6 years, particularly by North American and South Korean authors, and points to gaps in study methodology. In addition, attention regulation is identified as a primary mindfulness mechanism in VR scenarios, often in nature-based virtual environments, with mainly single-session studies lasting 5 or 10 minutes.

Discussion

Critical mapping reveals the need for additional studies to support and extend initial findings in this emerging research field. Methodologically, there is a call for more true-experimental studies to enhance rigor. From a content perspective, VR protocols are currently still strongly characterized by single-session interventions, which makes it especially difficult to make a dose-response statement regarding long-term effects.

Conclusion

In summary, the studies provide important initial findings on psychological and physiological effects of VR-based mindfulness interventions on health. In addition, the need for more methodologically rigorous studies was emphasized, along with other methodological adjustments that must be carefully considered in the planning of future studies.

Optimizing Digital Tools for the Field of Substance Use and Substance Use Disorders: Backcasting Exercise

BACKGROUND

Substance use trends are complex; they often rapidly evolve and necessitate an intersectional approach in research, service, and policy making. Current and emerging digital tools related to substance use are promising but also create a range of challenges and opportunities.

OBJECTIVE

This paper reports on a backcasting exercise aimed at the development of a roadmap that identifies values, challenges, facilitators, and milestones to achieve optimal use of digital tools in the substance use field by 2030.

METHODS

A backcasting exercise method was adopted, wherein the core elements are identifying key values, challenges, facilitators, milestones, cornerstones and a current, desired, and future scenario. A structured approach was used by means of (1) an Open Science Framework page as a web-based collaborative working space and (2) key stakeholders' collaborative engagement during the 2022 Lisbon Addiction Conference.

RESULTS

The identified key values were digital rights, evidence-based tools, user-friendliness, accessibility and availability, and person-centeredness. The key challenges identified were ethical funding, regulations, commercialization, best practice models, digital literacy, and access or reach. The key facilitators identified were scientific research, interoperable infrastructure and a culture of innovation, expertise, ethical funding, user-friendly designs, and digital rights and regulations. A range of milestones were identified. The overarching identified cornerstones consisted of creating ethical frameworks, increasing access to digital tools, and continuous trend analysis.

CONCLUSIONS

The use of digital tools in the field of substance use is linked to a range of risks and opportunities that need to be managed. The current trajectories of the use of such tools are heavily influenced by large multinational for-profit companies with relatively little involvement of key stakeholders such as people who use drugs, service providers, and researchers. The current funding models are problematic and lack the necessary flexibility associated with best practice business approaches such as lean and agile principles to design and execute customer discovery methods. Accessibility and availability, digital rights, user-friendly design, and person-focused approaches should be at the forefront in the further development of digital tools. Global legislative and technical infrastructures by means of a global action plan and strategy are necessary and should include ethical frameworks, accessibility of digital tools for substance use, and continuous trend analysis as cornerstones.

Use of extended reality in sleep health, medicine, and research: a scoping review

STUDY OBJECTIVES

This scoping review explores the use of extended reality (virtual, augmented, and mixed reality) within sleep health, sleep medicine, and sleep research. It aims to provide insight into current uses and implementation considerations whilst highlighting directions for future research.

METHODS

A systematic scoping review was undertaken informed by the preferred reporting items for systematic reviews and meta-analyses for scoping reviews and Johanna Briggs Institute.

RESULTS

The use of virtual reality (VR) as a research tool in the investigation of areas such as dreaming and memory reactivation is growing. Thirty-one articles were identified in total with 20 utilizing VR to improve sleep as a clinical intervention.

CONCLUSIONS

Research exploring the utility of VR as a clinical intervention in various patient populations and clinical settings is therefore warranted. Researchers and clinicians should ensure that extended reality interventions are developed based on clinical reasoning and informed by evidence of both sleep medicine and the effects of virtual and augmented reality. Where possible future research should utilize up-to-date technology and reporting frameworks to assist in the translation of research into clinical practice.

Virtual emotions and Criminal Law

This article examines the role that Criminal Law should play in regulating the non-therapeutic use of immersive Virtual Reality (VR), specifically its massive use by consumers. The starting point has been to consider VR as an intermediate risk scenario, for the purposes of Criminal Law, between the criminality entirely generated in the physical world and that developed in the 2D digital environments [cybercrimes and criminality linked to social networks and persuasive Artificial Intelligence (AI)]. Firstly, specialize literature has been analyzed to establish the nature of virtual reality. From a technical standpoint, virtual reality is a neurotechnology infused with high-risk artificial intelligence; an inseparable synthesis of non-invasive neurotechnology and a set of AI systems, considered high-risk for the fundamental rights of citizens. From the perspective of its functioning, VR is a "transformative" neurotechnology capable of altering what people perceive as reality. This is possible, because its realism lies in the emotional immersion of the user in the virtual experience, similarly to how our brain functions. Therefore, the key idea in the immersive functioning of virtual reality is its capacity to evoke and modify human emotions, which results its greater harmful potential compared to the 2D environment. From there, three central and specific areas of (legally unaddressed) risk arise: (1) the special comprehensive nature of the data collected and stored during its use; (2) its ability to mentally reproduce the "physical" experience of the avatar in the user; and (3) its significant capacity to manipulate individuals. Secondly, the paper examines both the reported cases and the foreseeable criminality in virtual worlds or "proto-metaverse," focusing on the three risk areas, and exemplifying them with attacks on mental privacy, sexual freedom, and consumer manipulation. Finally, it is proposed that Criminal Law should also intervene (as soon as possible) to define the "red lines" of massive virtual reality use by citizens. With a democratic and human-centered approach, a basic legal framework is outlined for the criminalization of specific harms and risks associated with virtual reality, adapting the existing legal framework as necessary.

Advancements in combining electronic animal identification and augmented reality technologies in digital livestock farming

Modern livestock farm technologies allow operators to have access to a multitude of data thanks to the high number of mobile and fixed sensors available on both the livestock farming machinery and the animals. These data can be consulted via PC, tablet, and smartphone, which must be handheld by the operators, leading to an increase in the time needed for on-field activities. In this scenario, the use of augmented reality smart glasses could allow the visualization of data directly in the field, providing for a hands-free environment for the operator to work. Nevertheless, to visualize specific animal information, a connection between the augmented reality smart glasses and electronic animal identification is needed. Therefore, the main objective of this study was to develop and test a wearable framework, called SmartGlove that is able to link RFID animal tags and augmented reality smart glasses via a Bluetooth connection, allowing the visualization of specific animal data directly in the field. Moreover, another objective of the study was to compare different levels of augmented reality technologies (assisted reality vs. mixed reality) to assess the most suitable solution for livestock management scenarios. For this reason, the developed framework and the related augmented reality smart glasses applications were tested in the laboratory and in the field. Furthermore, the stakeholders' point of view was analyzed using two standard questionnaires, the NASA-Task Load Index and the IBM-Post Study System Usability Questionnaire. The outcomes of the laboratory tests underlined promising results regarding the operating performances of the developed framework, showing no significant differences if compared to a commercial RFID reader. During the on-field trial, all the tested systems were capable of performing the task in a short time frame. Furthermore, the operators underlined the advantages of using the SmartGlove system coupled with the augmented reality smart glasses for the direct on-field visualization of animal data.

Implications of immersive technologies in healthcare sector and its built environment

Objectives

This research focuses on how built environment experts can contribute to the MXR-enabled digital innovation as part of the multidisciplinary team effort to ensure post-pandemic resilience in healthcare built environment. The goal of this research is to help healthcare providers, built environment experts, and policy makers respectively: (1) Advocate the benefits of MXR for innovating health and social care; (2) Spark debate across networks of expertise to create health-promoting environment; and (3) Understand the overriding priorities in making effective pathways to the implementation of MXR.

Methods

To highlight the novelty of this research, the study relies on two qualitative methodologies: exploratory literature review and semi-structured interviews. Based on the evaluation of prior works and cross-national case studies, hypotheses are formulated from three arenas: (1) Cross-sectional Initiatives for Post-pandemic Resilience; (2) Interoperability and Usability of Next-gen Medicines; and (3) Metaverse and New Forms of Value in Future Healthcare Ecosystems. To verify those hypotheses, empirical findings are derived from in-depth interviews with nine key informants.

Results

The main findings are summarized under the following three themes: (1) Synergism between Architecture and Technology; (2) Patient Empowerment and Staff Support; and (3) Scalable Health and Wellbeing in Non-hospital and Therapeutic Settings. Firstly, both built environment and healthcare sectors can benefit from the various capabilities of MXR through cross-sectional initiatives, evidence-based practices, and participatory approaches. Secondly, a confluence of knowledge and methods of HCI and HBI can increase the interoperability and usability of MXR for the patient-centered and value-based healthcare models. Thirdly, the MXR-enabled technological regime will largely affect the new forms of value in healthcare premises by fostering more decentralized, preventive, and therapeutic characteristics in the future healthcare ecosystems.

Conclusion

Whether it's virtual or physical, our healthcare systems have placed great emphasis on the rigor of evidence-based approach linking health outcome to a clinical environment. Henceforth, built environment experts should seek closer ties with the MXR ecosystems for the co-production of scalable health and wellbeing in non-hospital and therapeutic settings. Ultimately, this is to improve resource efficiency in the healthcare sector while considering the transition of health resources towards in silico status by increasing the implementation of MXR.

Methodological innovations to strengthen evidence-based serious illness communication

BACKGROUND/OBJECTIVE

A growing population of those affected by serious illness, prognostic uncertainty, patient diversity, and healthcare digitalization pose challenges for the future of serious illness communication. Yet, there is paucity of evidence to support serious illness communication behaviors among clinicians. Herein, we propose three methodological innovations to advance the basic science of serious illness communication.

RESULTS

First, advanced computation techniques - e.g. machine-learning techniques and natural language processing - offer the possibility to measure the characteristics and complex patterns of audible serious illness communication in large datasets. Second, immersive technologies - e.g., virtual- and augmented reality - allow for experimentally manipulating and testing the effects of specific communication strategies, and interactional and environmental aspects of serious illness communication. Third, digital-health technologies - e.g., shared notes and videoconferences - can be used to unobtrusively observe and manipulate communication, and compare in-person to digitally-mediated communication elements and effects. Immersive and digital health technologies allow integration of physiological measurement (e.g. synchrony or gaze) that may advance our understanding of patient experience.

CONCLUSION/PRACTICE IMPLICATIONS

New technologies and measurement approaches, while imperfect, will help advance our understanding of the epidemiology and quality of serious illness communication in an evolving healthcare environment.

Subjective Quality Assessment of V-PCC-Compressed Dynamic Point Clouds Degraded by Packet Losses

This article describes an empirical exploration on the effect of information loss affecting compressed representations of dynamic point clouds on the subjective quality of the reconstructed point clouds. The study involved compressing a set of test dynamic point clouds using the MPEG V-PCC (Video-based Point Cloud Compression) codec at 5 different levels of compression and applying simulated packet losses with three packet loss rates (0.5%, 1% and 2%) to the V-PCC sub-bitstreams prior to decoding and reconstructing the dynamic point clouds. The recovered dynamic point clouds qualities were then assessed by human observers in experiments conducted at two research laboratories in Croatia and Portugal, to collect MOS (Mean Opinion Score) values. These scores were subject to a set of statistical analyses to measure the degree of correlation of the data from the two laboratories, as well as the degree of correlation between the MOS values and a selection of objective quality measures, while taking into account compression level and packet loss rates. The subjective quality measures considered, all of the full-reference type, included point cloud specific measures, as well as others adapted from image and video quality measures. In the case of image-based quality measures, FSIM (Feature Similarity index), MSE (Mean Squared Error), and SSIM (Structural Similarity index) yielded the highest correlation with subjective scores in both laboratories, while PCQM (Point Cloud Quality Metric) showed the highest correlation among all point cloud-specific objective measures. The study showed that even 0.5% packet loss rates reduce the decoded point clouds subjective quality by more than 1 to 1.5 MOS scale units, pointing out the need to adequately protect the bitstreams against losses. The results also showed that the degradations in V-PCC occupancy and geometry sub-bitstreams have significantly higher (negative) impact on decoded point cloud subjective quality than degradations of the attribute sub-bitstream.

Exploring the Darkverse: A Multi-Perspective Analysis of the Negative Societal Impacts of the Metaverse

The Metaverse has the potential to form the next pervasive computing archetype that can transform many aspects of work and life at a societal level. Despite the many forecasted benefits from the metaverse, its negative outcomes have remained relatively unexplored with the majority of views grounded on logical thoughts derived from prior data points linked with similar technologies, somewhat lacking academic and expert perspective. This study responds to the dark side perspectives through informed and multifaceted narratives provided by invited leading academics and experts from diverse disciplinary backgrounds. The metaverse dark side perspectives covered include: technological and consumer vulnerability, privacy, and diminished reality, human-computer interface, identity theft, invasive advertising, misinformation, propaganda, phishing, financial crimes, terrorist activities, abuse, pornography, social inclusion, mental health, sexual harassment and metaverse-triggered unintended consequences. The paper concludes with a synthesis of common themes, formulating propositions, and presenting implications for practice and policy.

Degree of Acceptance of Virtual Reality by Health Sciences Students

Virtual Reality (VR) is an emerging technology with educational benefits demonstrated in numerous studies. Its integration into the curriculum implies the use of cognitive resources by students and the training of digital skills by teachers. The objective of this study is to determine the degree of acceptance of students with learning objects produced in VR and in 360°, as well as to analyze their evaluation and the established relationships. A sample of 136 medical students who completed questionnaires on the Technology Acceptance Model (TAM) and the quality of the training activity was used. The results show high levels of acceptance, both in VR and 360° objects. The students perceived the usefulness of the training activity as high, with significant correlations between the different dimensions. This study demonstrates the potential of VR as an educational technology and offers new perspectives for future research.

An immersive virtual reality learning environment with CFD simulations: Unveiling the Virtual Garage concept

Virtual reality has become a significant asset to diversify the existing toolkit supporting engineering education and training. The cognitive and behavioral advantages of virtual reality (VR) can help lecturers reduce entry barriers to concepts that students struggle with. Computational fluid dynamics (CFD) simulations are imperative tools intensively utilized in the design and analysis of chemical engineering problems. Although CFD simulation tools can be directly applied in engineering education, they bring several challenges in the implementation and operation for both students and lecturers. In this study, we develop the "Virtual Garage" as a task-centered educational VR application with CFD simulations to tackle these challenges. The Virtual Garage is composed of a holistic immersive virtual reality experience to educate students with a real-life engineering problem solved by CFD simulation data. The prototype is tested by graduate students (n = 24) assessing usability, user experience, task load and simulator sickness via standardized questionnaires together with self-reported metrics and a semi-structured interview. Results show that the Virtual Garage is well-received by participants. We identify features that can further leverage the quality of the VR experience with CFD simulations. Implications are incorporated throughout the study to provide practical guidance for developers and practitioners.

"Standing Up for Earth Rights": Awe-Inspiring Virtual Nature for Promoting Pro-Environmental Behaviors

Virtual nature exposure has emerged as an effective method for promoting pro-environmental attitudes and behaviors, also due to the increased emotional connection with nature itself. However, the role played by complex emotions elicited by virtual nature, such as awe, needs to be fully elucidated. Awe is an emotion stemming from vast stimuli, including nature, and virtual reality (VR) emerged as an effective medium to elicit it. One hundred nineteen participants were exposed to either one of four VR environments: (a) an awe-inspiring virtual nature, (b) a non-natural awe-inspiring virtual scenario, (c) a non-awe-inspiring virtual nature, (d) a non-natural non-awe-inspiring scenario. Pro-environmental attitudes, intentions, discrete emotions, and affect were measured and compared across the different conditions. Two ad hoc tasks were developed to measure two pro-environmental behaviors after each VR exposure. Participants were invited to sign a real petition against plastic production, consumption, and in favor of plastic recycling (a personally engaging behavior), and to take flyers to spread the word on the petition to friends and acquaintances (a socially engaging behavior). Awe-inspiring virtual nature resulted in a significantly increased number of flyers taken by participants (vs. control). Disposition toward the protection of the environment, positive emotional affect, and condition significantly correlated with the number of flyers taken. These results indicated that awe-inspiring virtual nature can influence socially engaging pro-environmental attitudes and behaviors but not personally engaging ones.

Developing a Virtual World for an Open-House Event: A Metaverse Approach

The concept of a metaverse, a virtual world that offers immersive experiences, has gained widespread interest in recent years. Despite the hype, there is still a gap in its practical application, especially in the realm of education. This study presents the design and implementation of a metaverse tailored to the needs of education. The goal of this paper is to demonstrate the feasibility of such a system and evaluate its effectiveness. It is crucial to understand the architecture and implementation of a metaverse to effectively customise it for educational purposes. To assess user experience, a field study was conducted, collecting data through questionnaires and qualitative feedback. The results show that users were pleased with the features, player experience, and ease of use.

Design and evaluation of a remote synchronous gamified mathematics teaching activity that integrates multi-representational scaffolding and a mind tool for gamified learning

Gamified learning is an instructional strategy that motivates students to learn, and the use of multiple representations assists learning by promoting students' thinking and advanced mathematical problem-solving skills. In particular, emergency distance learning caused by the COVID-19 pandemic may result in a lack of motivation and effectiveness in learning. This study designed an online gamified learning activity incorporating multi-representational scaffolding and compared the differences in the learning achievement and motivation for the gamified activity and general synchronous distance learning. In addition, for the group that conducted the gamified learning activity, we measured the participants' flow, anxiety, and emotion during the activity. A total of 36 high school students participated in the experiment. The results indicated that the gamified learning activity was not significantly effective in terms of enhancing learning achievement. In terms of learning motivation, a significant decrease in motivation was found for the group using general synchronous learning, while a significant increase in motivation was found for the group using synchronous gamified learning. This indicates that despite the negative impact of the pandemic on learning, gamified learning still enhances students' learning motivation. The results of flow, anxiety, and emotion showed that the participants had a positive and engaged experience. Participants provided feedback that the multi-representational scaffolding facilitates learning.

User Experience during an Immersive Virtual Reality-Based Cognitive Task: A Comparison between Estonian and Italian Older Adults with MCI

Mild cognitive impairment (MCI) is an early stage of cognitive abilities loss and puts older adults at higher risk of developing dementia. Virtual reality (VR) could represent a tool for the early assessment of this pathological condition and for administering cognitive training. This work presents a study evaluating the acceptance and the user experience of an immersive VR application representing a supermarket. As the same application had already been assessed in Italy, we aimed to perform the same study in Estonia in order to compare the outcomes in the two populations. Fifteen older adults with MCI were enrolled in one Rehabilitation Center of Estonia and tried the supermarket once. Afterwards, they were administered questionnaires aimed at evaluating their technology acceptance, sense of presence, and cybersickness. Estonian participants reported low side effects and discrete enjoyment, and a sense of presence. Nonetheless, their intention to use the technology decreased after the experience. The comparison between Italian and Estonian older adults showed that cybersickness was comparable, but technology acceptance and sense of presence were significantly lower in the Estonian group. Thus, we argue that: (i) cultural and social backgrounds influence technology acceptance; (ii) technology acceptance was rather mediated by the absence of positive feelings rather than cybersickness.

A Systematic Literature Review of Handheld Augmented Reality Solutions for People with Disabilities

Mobile applications on smartphones and tablets have become part of our everyday lives. The number of augmented reality (AR) technology applications is also increasing. Augmented reality has proven to be effective in various areas of human life, from education, marketing, and training to navigation. All people have the right to access information and use available technologies, but not everyone has the same opportunities. To contribute to the digital inclusion of people who are often disadvantaged in this regard, we should think about the accessibility of digital technologies, including mobile augmented reality (MAR). The specificity of MAR is a new way of human-computer interaction compared to traditional mobile solutions. The objective of this review paper is to analyze the handheld AR solutions developed for people with different disabilities to identify accessibility challenges related to interaction when performing different tasks in AR. It also explores and presents accessibility features and other accessibility best practices, as well as potential future research directions related to the personalization and customization of such solutions for individuals. The results of this literature review can contribute to the creation of accessibility guidelines in the field of handheld AR and encourage the development of accessible AR solutions that can benefit not only people with disabilities but also people without disabilities.

Mitigating negative emotions through virtual reality and embodiment

Oncological treatments are responsible for many of the physical changes (aesthetic and functional) associated with cancer. Because of this, cancer patients are at high risk of developing mental health problems. The aim of this study is to propose an innovative Virtual Reality (VR) training that uses a somatic technique (i.e., embodiment) to create a bridge with the bodily dimension of cancer. After undergoing a psycho-educational procedure, a combination of exposure, out-of-body experience, and body swapping will gradually train the patient to cope with cancer-related difficulties, increasing stress tolerance, and patient empowerment. The most engaging step of this advanced form of Stress Inoculation Training is the body swapping experience, which will guide the patient in embodying a resilient cancer patient who is facing similar difficulties. Through the VR ability to simulate the human brain functioning, and the potential of embodiment to hook to the somatic dimension of illness, we expect that once the concepts endured through the patient’s experience of resilience are triggered, the patient will be more prone to implement functional coping strategies in real life, reaching empowerment and adjusting to the post-treatment difficulties. When the scenarios are built and the training tested, our intervention could be used to support patients with different oncological diseases and who are treated in different cancer hospitals, as well as patients with other non-oncological problems (e.g., social anxiety). Future research should focus on using our paradigm for other clinical populations, and supporting cancer patients in coping with different distressing situations.

Virtual Reality Game for Physical and Emotional Rehabilitation of Landmine Victims

Landmine victims require an engaging and immersive rehabilitation process to maintain motivation and therapeutic adherence, such as virtual reality games. This paper proposes a virtual reality exercise game called Exogames, which works with Nukawa, a lower limb rehabilitation robot (LLRR). Together, they constitute the general Kina system. The design and development process of Exogames is reported, as well as the evaluation of its potential for physical and emotional rehabilitation. In an initial survey designed ad-hoc, 13 health professionals evaluated compliance with various requirements. They agreed that Exogames would help the user focus on rehabilitation by providing motivation; 92.3% said that the user will feel safe in the virtual world, 66.7% of them agreed or totally agreed that it presents characteristics that may enhance the physical rehabilitation of lower limbs for amputees, 83.3% stated that it would promote the welfare of landmine victims, and 76.9% responded that the graphical interface and data report are useful for real-time assessment, and would be helpful for four interventional areas in all rehabilitation stages. In a second evaluation, using standardized surveys, five physical therapists and one lower limb amputee tried the Kina system as users. They filled out the System Usability Scale (SUS), the Physical Activity Enjoyment Scale (PACES), and the Game Experience Questionnaire (GEQ). The usability of the Kina system overall score was 69 (66, 79) out of 100, suggesting an acceptable though improvable usability. The overall PACES score of 110 (108, 112) out of 126 suggests that users enjoyed the game well. Finally, users indicated a positive effect with a good sense of immersion and smooth of gameplay during the tests, as indicated by the GEQ results. In summary, the evaluations showed that Exogames has the potential to be used as a virtual reality game for the physical and emotional rehabilitation of landmine victims.

Energy Oriented Concepts and Other SMART WORLD Trends as Game Changers of Co-Production—Reality or Future?

The aim of the study is to identify, map and assess the maturity and impact level of the specific energy-oriented economy and other SMART management concepts and social, technological, finance (economical), environmental, and communication (S.T.F.E.C.) trends which arose from the dynamic development and spread of the Industry 4.0 revolution on processes of effective competitiveness and the creation of modern enterprises. The article presents data and information obtained thanks to an in-depth review of the literature (extensive desk research), as well as that obtained as part of the conducted CAWI pilot study. The authors aim to search for answers to three specific research questions, concluding that recently, special attention is paid to such issues as co-creation and co-production, energy-oriented and circular economy, eco-energy, and sustainability. The findings of this study clearly show that in the SMART WORLD era, there is a growing interest in cooperation, co-creation, co-production issues, and usage of modern technologies and SMART management concepts typical of the Industry 4.0 era. The main reason for this is that enterprises strive to optimize and maximize their efficiency in the processes of competitiveness creation. Researched data allows us to conclude that openness to social, environmental, and technological trends and issues, with an approach based on sustainable and eco-energy-oriented development, play an increasingly important role. However, the level of their importance, implementation level, and maturity differ depending on the type of organization or industry. For example, service and trade companies more often than production companies use and rate the usefulness of social trends higher (reality = mainstream orientation for S&T companies and a future orientation for production companies), while production companies apply a more balanced approach, showing greater commitment to economic technological, environmental and financial trends (reality = mainstream orientation for production companies and a future orientation for trade and services companies). Given that the study shows and describes preliminary research results (pilot studies), the authors plan to undertake further efforts in the in-depth scientific exploration of the issues concerned, including, which is particularly important, conducting full-scale research.

Extended Reality in Marketing—A Multiple Case Study on Internet of Things Platforms

This research highlights how cloud platform as a service technologies host extended reality technologies and convergent technologies in integrated solutions. It was only around 2019 that scholarly literature conceptualized the role of extended reality, that is, augmented reality, virtual reality, and mixed reality, in the marketing function. This article is a multiple case study on the leading eleven platform as a service vendors. They provide the programming technology required to host software as a service in the cloud, making the software available from everywhere. Of the eleven cases, 10% integrate technologies in solutions. Research results show that extended reality technologies reinvent digital marketing; as part of this, they shape the customer delivery model in terms of customer value proposition; favor the choice of customer channel (the omnichannel); possibly lead to new customer relationships, such as cocreation; and reach global mass customers. Extended reality in the delivery model is complemented by other technologies in the operating model. These combinations provide the foundations of the business models, which are either network or platform business models. This study identifies a number of solutions enabled by extended reality, which have an integrated goal in the form of customer value contribution and are to be studied in further articles.

Extended Reality for Smart Building Operation and Maintenance: A Review

The operation and maintenance (O&M) of buildings and infrastructure represent a strategic activity to ensure they perform as expected over time and to reduce energy consumption and maintenance costs at the urban and building scale. With the increasing diffusion of BIM, IoT devices, and AI, the future of O&M is represented by digital twin technology. To effectively take advantage of this digital revolution, thus enabling data-driven energy control, proactive maintenance, and predictive daily operations, it is vital that smart building management exploits the opportunities offered by the extended reality (XR) technologies. Nevertheless, in consideration of the novelty of XR in the AECO sector and its rapid and ongoing evolution, knowledge of the specific possibilities and the methods of integration into the building process workflow is still piecemeal and sparse. With the goal to bridge this gap, the article presents a thorough review of virtual reality (VR), augmented reality (AR), and mixed reality (MR) technologies and applications for smart building operation and maintenance. After defining VR, AR, and MR, the article provides a detailed review that analyzes, categorizes, and summarizes state-of-the-art XR technologies and their possible applications for building O&M along with their relative advantages and disadvantages. The article concludes that the application of XR in building and city management is showing promising results in enhancing human performance in technical O&M tasks, in understanding and controlling the energy efficiency, comfort, and safety of building and infrastructures, and in supporting strategic decision making for the future smart city.