JMIR Serious Games最新文献

{"title":"Haptic-Driven Serious Card Games for Older Adults: User Preferences Study.","authors":"Xin Huang, Nazlena Mohamad Ali, Shafrida Sahrani","doi":"10.2196/73135","DOIUrl":"https://doi.org/10.2196/73135","url":null,"abstract":"<p><strong>Background: </strong>Haptic feedback technology is widely used, including in serious games. It is an additional sensory method that supplements audio and vision, provides a novel user experience through a physical control layer, and enhances the immersion of virtual reality, thereby improving the user's cognitive state while alleviating dependence on visual information. However, there is limited research on haptic feedback preferences for mobile serious card games designed for older adults.</p><p><strong>Objective: </strong>The study aims to investigate older adults' preferences for haptic feedback in mobile serious card games.</p><p><strong>Methods: </strong>This study recruited a total of 250 participants from Dangtu County, Anhui Province, China, with an average age of 64.78 (SD 4.23) years. A descriptive survey was conducted among older adults, structured questionnaires were distributed, and data were collected via the Wenjuanxing (Changsha Ranxing Information Technology Co Ltd) mobile app. Reliability and validity analyses were performed using SPSS (IBM Corp) software. The questionnaire investigated older adults' basic understanding of card games and serious games, the integration of card games with mobile devices, the potential impact of combining card games with haptic feedback technology, as well as suggestions and opinions.</p><p><strong>Results: </strong>The results showed that 63.2% (158/250) of the older adults liked the slight haptic feedback mode, and 78.4% (196/250) of the participants believed that combining haptic feedback technology with mobile card games would help improve cognitive abilities. The study found that 73.6% (184/250) of the older adults believed that this technology could reduce their reliance on visual information. This confirms that the combination of serious card games and haptic feedback can alleviate sensory impairments in older adults. Qualitative analysis revealed the potential of haptic feedback to reduce visual fatigue and provide an engaging cognitive training experience.</p><p><strong>Conclusions: </strong>Older adults have shown great interest in incorporating haptic feedback into mobile serious card games, believing that this could enhance their cognitive abilities while reducing their reliance on visual information. However, limitations include sample size and geographic restrictions, differences in digital literacy, self-reported data, and lack of longitudinal assessment. Longitudinal studies are recommended to evaluate the long-term effects of mobile serious card games with haptic feedback on cognitive abilities. Such investigations could provide valuable insights for game developers, rehabilitation institutions, and the development of cognitive training tools for older adults.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e73135"},"PeriodicalIF":3.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Active Video Games Training for Older Adults: Comparative Study of User Experience, Workload, Pleasure, and Intensity.","authors":"Néva Béraud-Peigné, Alexandra Perrot, Pauline Maillot","doi":"10.2196/67314","DOIUrl":"https://doi.org/10.2196/67314","url":null,"abstract":"<p><strong>Background: </strong>Given the appeal of active video games (AVG), many tools are now being used for combined training in older adults. However, there is a lack of comparative data to determine which type of AVG is better suited to older adults.</p><p><strong>Objective: </strong>The purpose of this study was to compare user experience (UX), workload, pleasure, and intensity of three different experiences: (1) an Immersive and Interactive Wall Exergame (I2WE), (2) a consumer device (SWITCH), and (3) a combination of video games and physical stimulation (biking and videogaming, BIKE-VG) for older adults. I2WE and SWITCH are categorized as Moving While Thinking training, meaning that the cognitive task is integrated into the motor or physical task. In contrast, BIKE-VG is categorized as Thinking While Moving training, where the cognitive and motor or physical tasks are not interconnected. The nature of the cognitive, physical, and motor combinations also differentiates them. I2WE is multi-domain training, while BIKE-VG is physical-cognitive training, and SWITCH is motor-cognitive training.</p><p><strong>Methods: </strong>A total of 90 older adults (mean [SD] 69.49 [5.78]) were divided into 3 groups (I2WE, SWITCH, and BIKE-VG). Each participant completed a 45-minute group session and then filled out questionnaires to evaluate UX, workload, pleasure, and intensity.</p><p><strong>Results: </strong>The UX was positive for I2WE and SWITCH, and neutral for BIKE-VG. It was higher for I2WE than for BIKE-VG (t87=2.83; P=.02; d=0.70; 95% CI 0.15-1.69). The workload was moderate across all 3 groups. The intensity was moderate for all groups, ranging between 50% and 70% of the maximum heart rate, and approached high intensity for the I2WE and SWITCH groups. It was significantly higher for I2WE than for BIKE-VG (t66= 2.86; P=.01; d=0.70; 95% CI 1.04-11.43). The perceived pleasure was significantly higher for I2WE (t87=3.63; P=.001; d=0.9;95% CI 2.74-13.23) and SWITCH (t87=3.11; P=.01; d=0.87; 95% CI 1.82-13.69) compared with BIKE-VG.</p><p><strong>Conclusions: </strong>The UX and perceived enjoyment are higher for the Moving While Thinking training compared with the Thinking While Moving training. This indicates that the I2WE and SWITCH training approaches are promising and motivating options for combined training for older adults.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e67314"},"PeriodicalIF":3.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Virtual Reality as a Distraction Tool for Venipuncture in Children: Observational Pilot Feasibility Study.","authors":"Chris Worth, Leyi Yang, Catherine Fullwood, Indraneel Banerjee","doi":"10.2196/66656","DOIUrl":"https://doi.org/10.2196/66656","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) is increasingly used as a distraction tool for painful procedures in children. Studies have shown variable benefit but have not identified factors to maximize utility.</p><p><strong>Objective: </strong>This study aimed to undertake a feasibility study to investigate factors influencing virtual reality headset (VRH) utility for venipuncture and cannulation.</p><p><strong>Methods: </strong>Children admitted as inpatients were recruited and given a VRH during anticipated venipuncture or cannulation. Feedback from participants, parents, and operators was obtained through questionnaires and the Wong-Baker Faces Scale (WBFS).</p><p><strong>Results: </strong>Thirteen children of a target 32 (41%), aged a median of 7 (range 5-12) years, were recruited to the study; 9 (69%) parents and 7 (54%) participants reported a positive VR experience, found VRH comfortable, and wanted repeat application for future venisection or cannulation. However, patient recruitment was suboptimal at 41% (binomial 95% CI 24%-59%) of the target, as busy operators undertaking venisection or cannulation on eligible patients were unable to spare time for VRH use during the COVID-19 pandemic. The preprocedure time spent with VRH was associated with participants' positive experience of VR distraction (median 15, IQR 2.5-50 vs 180, IQR 120-450) seconds (P=.02). Five (38.4%) participants removed the VRH prior to procedure; these were relatively young compared to those who continued VRH (median 6, IQR 5.00-7.00 vs 10, IQR 6.75-12.00 years), suggesting better acceptance of VR in older children. There was no significant difference in WBFS pain ratings before (median 0, IQR 0-10) or after the procedure (median 0, IQR 0-6), with many children choosing 0 (\"no hurt\") at initial assessment. By contrast, parent and doctor or phlebotomist responses indicated that VR reduced pain and anxiety (n=9, 69%), in agreement with participant perception (n=7, 54%; Cohen κ=0.68).</p><p><strong>Conclusions: </strong>VR as a distraction tool in children is influenced by age and preprocedure familiarity, suggesting that the optimal use is in older children with greater cognitive and emotional maturity. Multidimensional feedback from participants, parents, and investigators should be obtained to test the true efficacy of VR in future studies.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e66656"},"PeriodicalIF":3.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Domain-Specific Evaluation of Exergame Metrics Among Older Adults With Mild Neurocognitive Disorder: Secondary Analysis of 2 Randomized Controlled Trials.","authors":"Wanda Kaiser, Eling D de Bruin, Patrick Manser","doi":"10.2196/65878","DOIUrl":"https://doi.org/10.2196/65878","url":null,"abstract":"<p><strong>Background: </strong>Exergame-based training enhances physical and cognitive performance in older adults, including those with mild neurocognitive disorder (mNCD). In-game metrics generated from user interactions with exergames enable individualized adjustments. However, there is a need to systematically investigate how well such game metrics capture true cognitive and motor-cognitive performance to provide a more robust basis for personalized training.</p><p><strong>Objective: </strong>The primary objective was to identify valid game metrics as indicators for in-game domain-specific cognitive performance during exergaming in individuals with mNCD. We also aimed to explore game metric performance changes over time during exergame-based training.</p><p><strong>Methods: </strong>Data were analyzed from individuals with mNCD who completed a 12-week home-based, exergame-based intervention following the Brain-IT training concept. A cross-sectional analysis was conducted by correlating game metrics with standardized neurocognitive reference assessments. To confirm the alternative hypothesis, we predetermined the following criteria: (1) statistically significant correlation (P≤.05; uncorrected; 1-sided) with (2) a correlation coefficient (Pearson r or Spearman ρ) of ≥0.4. Visual and curve-fitting longitudinal analyses were conducted to explore game performance changes over time.</p><p><strong>Results: </strong>Data were available from 31 participants (mean age 76.4, SD 7.5 y; n=9, 29% female). In total, 33% (6/18) of the game metrics were identified as valid indicators for in-game cognitive performance during exergaming. In the neurocognitive domain of learning and memory, these metrics included the mean reaction time (ρ=-0.747), the number of collected items (ρ=0.691), and the precision score (r=-0.607) for the game Shopping Tour (P<.001 in all cases), as well as the point rate (P=.008; r=0.471) for the game Simon. In addition, point rate was a valid indicator for executive function (P=.006; r=0.455) and visuospatial skills (P=.02; r=0.474) for the games Targets and Gears, respectively. The exploratory longitudinal analysis revealed high interindividual variability, with a general trend of the expected typical curvilinear curves of rapid initial improvements followed by a plateau in performance.</p><p><strong>Conclusions: </strong>This study demonstrated that metrics reflecting the precision of responses generally performed better than metrics reflecting the speed of responses. These observations highlight the importance of selecting valid game metrics for implementation in exergame designs. Further research is needed to explore the potential of game metrics and identify factors contributing to individual variability in in-game performance and performance progression, as well as identifying and adopting strategies that facilitate individual learning success and thus promote effectiveness in improving health outcomes.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e65878"},"PeriodicalIF":3.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discriminative Power of the Serious Game Attention Slackline in Children and Adolescents With and Without Attention-Deficit/Hyperactivity Disorder: Validation Study.","authors":"Nicolás Ruiz-Robledillo, Ignacio Lucas, Rosario Ferrer-Cascales, Natalia Albaladejo-Blázquez, Javier Sanchis, Juan Trujillo","doi":"10.2196/65170","DOIUrl":"10.2196/65170","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity, significantly impacting the psychological, social, and academic well-being of affected children and adolescents. Traditional ADHD diagnostic methods often rely on subjective reports, which can be biased. Recent advancements in serious games offer the potential for objective assessment tools.</p><p><strong>Objective: </strong>This study aimed to evaluate the discriminative power and concurrent validity of the serious game Attention Slackline in distinguishing children and adolescents with ADHD from those without the condition and in correlating game performance with standardized ADHD assessment scales.</p><p><strong>Methods: </strong>A sample of 32 children and adolescents diagnosed with ADHD and 39 healthy controls participated in the study. Participants were divided into 2 age groups: children (aged 6-11 years) and adolescents (aged 12-17 years). The serious game Attention Slackline was administered alongside established ADHD assessment scales, including the Child and Adolescent Assessment System and the ADHD Rating Scale IV. Group differences were analyzed using multivariate analysis of covariance, and effect sizes were reported using Cohen d. Correlations between game performance and ADHD symptoms were calculated using Pearson r.</p><p><strong>Results: </strong>Children with ADHD demonstrated significantly worse performance in Attention Slackline than the controls (t65=-2.26; P=.03; |d|=0.901), whereas no significant differences were observed in adolescents (t65=0.75; P=.73; |d|=0.191). Task performance was negatively correlated with family-reported hyperactivity/impulsivity symptoms in children across both tests (r=-0.43 and r=-0.51), but no significant correlations were observed in adolescents.</p><p><strong>Conclusions: </strong>The findings support the validity of Attention Slackline for assessing hyperactivity/impulsivity symptoms in children with ADHD. However, its efficacy decreases in adolescents, potentially due to developmental factors, such as compensatory strategies and ceiling effects in task performance. The gamified nature of the tool enhances engagement, which is crucial for young populations, while maintaining its diagnostic utility in measuring impulsivity. The age-dependent validity aligns with previous research indicating that continuous performance test paradigms are less effective in older populations due to developmental maturation. Attention Slackline shows potential as a complementary tool for ADHD diagnosis in children, offering an engaging and objective assessment of hyperactivity/impulsivity. Future research should aim to establish clinical cutoff points and refine the task's complexity to align with individual characteristics.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e65170"},"PeriodicalIF":3.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions Toward an Attentional Bias Modification Mobile Game Among Individuals With Low Socioeconomic Status Who Smoke: Qualitative Study.","authors":"Michael Wakeman, Lydia Tesfaye, Gunnar Baskin, Tim Gregory, Greg Gruse, Erin Leahy, Brandon Kendrick, Sherine El-Toukhy","doi":"10.2196/59515","DOIUrl":"10.2196/59515","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Attentional bias modification (ABM) can help address implicit attention from individuals who smoke toward smoking cues, which trigger cravings and lapses that impede smoking cessation. We developed an ABM mobile game, Fruit Squish, to support individuals who smoke and are quitting as part of a multicomponent smoking cessation mobile app, Quit Journey. Users advance in the game by tapping on neutral (ie, fruit) rather than smoking-related (eg, cigarette pack) imagery that they are presented with, essentially training them to avoid focusing on smoking cues.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to gauge acceptance of an ABM smoking cues mobile game among young adults who smoked and were socioeconomically disadvantaged.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We recruited 38 individuals who smoked cigarettes, aged 18-29 years, who were neither 4-year college graduates nor enrollees in 4-year colleges to participate in 12 semistructured digital focus groups. Sessions were audio recorded and transcribed verbatim. We used ATLAS.ti software to code the transcripts for salient themes based on the Second Unified Theory of Acceptance and Use of Technology constructs (ie, effort expectancy, facilitating conditions, hedonic motivation, performance expectancy, and social influence) and sentiment (ie, negative, neutral, and positive).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Performance expectancy of the mobile game was the dominant technology acceptance construct discussed (34/110, 30.90%). Perceived usefulness of the game was mixed in sentiment owing to perceptions that the game aimed to distract individuals who smoke during cravings and concerns that cue imagery in the game could trigger cravings. Hedonic motivation was the second most discussed technology acceptance construct (17/110, 15.45%), with participants describing the game as neither fun nor engaging. Participants referenced their past experiences with mobile games and mobile device characteristics as facilitating conditions for using the game (10/110, 9.09%). Although effort expectancy was minimally discussed (6/110, 5.45%), the game was characterized as easy to use. To improve the game, participants suggested adding new levels with increasing difficulty (eg, increase stimuli speed and limit session time) and new game elements (eg, leaderboard). Other suggestions included improving game graphics and renaming the game to capture its relation to smoking cessation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Young adults with low socioeconomic status who smoke had mixed reactions to a mobile smoking cues ABM game. Results suggest the need to communicate the rationale underlying ABM games to users and their potential positive effects on smoking cessation. To promote the uptake and sustained use of ABM mobile games, they need to be on par with commercially available entertainment mobile apps. Research is needed to explore the efficacy of gamified ABM on cognitive biases in real-life","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e59515"},"PeriodicalIF":3.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Virtual Reality-Based Interventions on Cognitive Function in Patients With Neuropsychiatric Disorders: Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Qiujing Du, Yuhan Wei, Yuexuan Ma, Changqing Liu, Shanshan Du, Qi Zhang, Xiaotong Gong, Jiaju Yang, Qijie Li, Ka Li","doi":"10.2196/67501","DOIUrl":"10.2196/67501","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) technology has emerged as a promising tool for cognitive rehabilitation in patients with neuropsychiatric disorders. These patients often endure significant cognitive impairments, which are associated with decreased quality of life and increased disease burden. Traditional treatments are limited in improving cognitive functions, making VR-based interventions an area of growing interest.</p><p><strong>Objective: </strong>This meta-analysis aims to evaluate the efficacy of VR-based interventions on cognitive function in patients with neuropsychiatric disorders by synthesizing data from randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>Following PRISMA guidelines, we conducted a comprehensive search across PubMed, Web of Science, MEDLINE, EMBASE, and Cochrane Library for RCTs from January 2010 to December 2024. Studies were included if they evaluated the impact of VR-based interventions on cognitive outcomes in patients with neuropsychiatric disorders. Data extraction and risk of bias assessment were performed independently by 2 researchers. Meta-analyses were conducted using random-effects models, and standardized mean differences (SMDs) as effect size.</p><p><strong>Results: </strong>A total of 21 RCTs involving 1051 participants were included. Overall, VR-based interventions significantly improved cognitive functions of patients with neuropsychiatric disorders (SMD 0.67, 95% CI 0.33-1.01, z=3.85; P<.001). Subgroup analyses revealed significant benefits for cognitive rehabilitation training (SMD 0.75, 95% CI 0.33-1.17, z=3.53; P<.001), exergame-based training (SMD 1.09, 95% CI 0.26-1.91, z=2.57; P=.01), and telerehabilitation and social functioning training (SMD 2.21, 95% CI 1.11-3.32, z=3.92; P<.001). Conversely, immersive cognitive training, music attention training, and vocational and problem-solving skills training did not yield significant improvements (z=1.86, P=.06; z=0.35, P=.72; z=0.88, P=.38; respectively). Disease-type subgroup analyses indicated significant improvements in schizophrenia (SMD 0.92, 95% CI 0.22-1.62, z=2.58; P=.01), and mild cognitive impairment (SMD 0.75, 95% CI 0.16-1.35, z=2.47; P=.01), but not in brain injuries, Parkinson disease, or stroke (z=0.34, P=.73; z=1.26, P=.21; z=1.16, P=.24; respectively).</p><p><strong>Conclusions: </strong>This meta-analysis revealed that VR-based interventions can improve cognitive functions among individuals with neuropsychiatric disorders, with notable improvements observed in cognitive rehabilitation training, exergame-based training, and tele-rehabilitation and social functioning training. These results offer valuable evidence supporting the use of VR technology in rehabilitation for neuropsychiatric conditions and inform the optimization of future intervention approaches.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e67501"},"PeriodicalIF":3.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring Stress and Perceptions for a Virtual Reality-Based Pericardiocentesis Procedure Simulation for Medical Training: Usability Study.","authors":"Alberto Rubio-López, Rodrigo García Carmona, Laura Zarandieta Román, Alejandro Rubio Navas, Angel González-Pinto, Pablo Cardinal-Fernández","doi":"10.2196/68515","DOIUrl":"https://doi.org/10.2196/68515","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Virtual reality (VR) is increasingly used in medical education, providing immersive environments for training in high-risk procedures such as pericardiocentesis. This lifesaving procedure requires technical precision and induces cognitive and physiological stress. Evaluating both usability and stress responses in a VR-based pericardiocentesis simulation is essential. Heart rate variability (HRV) serves as an objective stress marker, while prior VR experience may influence usability and stress perception.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to assess the usability of a VR-based pericardiocentesis simulation, examine the relationship between usability perceptions and physiological stress (HRV), and determine the impact of prior VR experience on usability scores and stress responses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 119 final-year medical students participated in a VR pericardiocentesis simulation. Usability was evaluated using the System Usability Scale (SUS), the Post-Study System Usability Questionnaire, the Presence Questionnaire, and the Simulator Sickness Questionnaire. Physiological stress was assessed through HRV parameters, including the root-mean-square of successive differences (rMSSDs), percentage of differences greater than 50 ms (PNN50), low-frequency to high-frequency ratio, and nonlinear HRV indices (SD1/SD2 ratio, Poincaré area). Statistical analyses included descriptive statistics, Spearman correlations, and Mann-Whitney U tests to explore relationships between usability, stress, and prior VR experience.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The VR simulation received a mean SUS score of 75.00 (SD 6.41; 95% CI 73.42-76.58), exceeding the general usability threshold of 68 (P=.002). The mean Post-Study System Usability Questionnaire score of 2.92 (SD 1.83; 95% CI 2.55-3.29) indicated moderate satisfaction, while the mean Presence Questionnaire score of 109.46 (SD 9.12; 95% CI 107.88-111.04) reflected strong immersion. Simulator sickness symptoms were mild (mean Simulator Sickness Questionnaire score 12.43, SD 15.41; 95% CI 9.28-15.58), although novice users reported significantly higher nausea levels (P=.02). Physiological stress analysis revealed a mean rMSSD of 281.27 (SD 98.99; 95% CI 259.45-303.09) ms and PNN50 of 56.85% (SD 19.70%; 95% CI 52.23%-61.47%), indicating moderate autonomic balance. A significant negative correlation was observed between HRV parameters (rMSSD and PNN50) and simulator sickness (P=.04; Spearman ρ=-0.23), suggesting that higher physiological stress was associated with increased simulator sickness symptoms. Prior VR experience was linked to higher usability scores (SUS +5.2; 95% CI 3.12-7.28; P=.03) and lower simulator sickness symptoms (P=.02) but did not significantly affect HRV markers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;VR-based simulations for high-risk medical procedures are effective training tools with high usability (SUS=75) and strong immersion","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e68515"},"PeriodicalIF":3.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Integrated Model for Circular Waste Management Using the Internet of Things, Semantic Web, and Gamification (Circonomy): Case Study in Indonesia.","authors":"Vitri Tundjungsari, Bambang Purnomosidi Dwi Putranto, Muhamad Bahrul Ulum, Nizirwan Anwar","doi":"10.2196/66781","DOIUrl":"10.2196/66781","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The problem of how to deal with waste is a global issue all countries face. Like many developing countries, Indonesia has inadequate infrastructure to process the extremely high volume of waste produced throughout the country and minimal public participation in proper waste management. Although the Indonesian government regulates waste banks as a community-based waste management solution, there is a lack of integrated technological innovations to support waste banks. This study fills the gap by developing Circonomy, a model combining Internet of Things, gamification, and semantic web technologies to advance community-based circular waste management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this study is to develop Circonomy as a circular waste model that integrates an Internet of Things-based smart bin, semantic web, and gamification as an innovative technological solution.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We identified the problem by observing Indonesian waste banks at 3 locations in Jakarta and Yogyakarta to define and design Circonomy. The Circonomy prototype was developed using the Design Science Research Methodology and evaluated based on technical performance and user experience. The technical performance has three indicators: bin capacity accuracy with a minimum of 80% precision, bin lid response time &lt;5 seconds for a minimum of 80% of trials, and data transmission success rate of at least 80%. The user experience metric has two indicators: a minimum of 80% reporting high usability and ease of use, and at least 80% of users reporting that they feel more motivated using the prototype than the traditional waste bank. We selected 10 random participants aged 18-60 years to perform a user experience evaluation of our prototype.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The Circonomy prototype demonstrated sound and stable performances related to technical performance and user experience. Circonomy achieved at least 80% technical performance accuracy, comparable to industry standards. The accuracy problem lies in the placement of the ultrasonic sensor. The waste should be placed directly under the ultrasonic sensor to ensure the bin's capacity measurement accuracy. The user experience testing results from 10 participants indicated that Circonomy has excellent user engagement, and 100% felt motivated by gamification and 80% found the mobile app easy to use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The testing results showed that Circonomy has acceptable performances for early-stage prototyping, with at least an 80% accuracy rate in technical performance and user experience. This ensures that Circonomy operates effectively in real-world conditions while remaining cost-efficient and scalable. For future development, Circonomy will prioritize enhancing the accuracy and reliability of sensor-based occupancy detection through improved sensor placement, the integration of multiple sensors, and an exploration of alternative technolog","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e66781"},"PeriodicalIF":3.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Serious Games as Digital Therapeutics for Enhancing the Abilities of Children With Attention-Deficit/Hyperactivity Disorder (ADHD): Systematic Literature Review.","authors":"Jing Lin, Woo-Rin Chang","doi":"10.2196/60937","DOIUrl":"10.2196/60937","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often begins in childhood and requires long-term treatment and management. Given the potential adverse effects of pharmacological interventions in children, interest in alternative treatments has increased. Among alternative therapies, serious games have emerged as a promising digital therapeutic approach and are increasingly recognized as an important intervention for children with ADHD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This systematic review aims to evaluate the effectiveness of serious games as digital therapeutics for children with ADHD. It focuses on assessing therapeutic outcomes, including improvements in attention, hyperactivity-impulsivity, social skills, motor skills, executive functions, and enjoyment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive literature search was performed across 5 databases: PubMed, Web of Science, Scopus, IEEE Xplore, and ACM Digital Library, covering English studies published from January 2010 to January 2024. Eligibility criteria were established based on the PICOS (Participants, Intervention, Comparison, Outcomes, Study design) framework, with digital therapeutics guidelines pragmatically applied to inform inclusion criteria, exclusion criteria, and quality assessment. Standardized tools including the Cochrane Risk of Bias Tool for randomized controlled trials, the Cochrane Risk of Bias Tool for Non-Randomized Studies of Interventions (ROBINS-I) for nonrandomized controlled trial studies, and the Critical Appraisal Skills Program checklists were used to evaluate risk of bias. Data on study design, targeted abilities, game software and hardware, and intervention parameters (duration, frequency, and length) were extracted and synthesized descriptively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 35 studies identified (1408 participants), gender data were available for 22 studies (888 participants), comprising 660 male and 228 female participants. Analysis revealed multiple abilities focused across many studies: 80% (28/35) assessed attention, 29% (10/35) addressed hyperactivity-impulsivity, 17% (6/35) explored improvements in social skills, 20% (7/35) evaluated motor skills, and 43% (15/35) investigated executive functions. Furthermore, in 89% (31/35) of the trials, children exhibited a positive attitude toward game interventions. Evidence suggests that serious games may contribute to improvements in attention, hyperactivity-impulsivity, social skills, and executive functions in children with ADHD. Although findings on motor skills were inconclusive, interventions incorporating somatosensory inputs demonstrated benefits for hand-eye coordination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The findings support the potential of serious games as a digital therapeutic modality for child","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e60937"},"PeriodicalIF":3.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}