JMIR XR and spatial computing最新文献

{"title":"Perceived Usability, User Experience, and Technology Acceptance of Role-Specific Augmented Reality Decision Support Tools for Cardiac Arrest Resuscitation: Prospective Observational Pilot Study.","authors":"Ryan Kang, Adam Cheng, Yiqun Lin, Hyeongil Nam, Jennifer Davidson, Donovan Curtis Duncan, Johan N Siebert, Sergio Manzano, Alexandre De Masi, Ana Rajic, Sharleen Kayne Olanka, Frederic Ehrler, Kangsoo Kim","doi":"10.2196/72013","DOIUrl":"10.2196/72013","url":null,"abstract":"<p><strong>Background: </strong>Cardiac arrest is a critical medical emergency that requires strict adherence to clinical guidelines to achieve optimal outcomes. Deviations from these guidelines, often due to task complexity, can adversely affect patient outcomes. Augmented reality (AR) offers a way to deliver role-specific, in-view guidance, but evidence on its perceived usability, user experience, and acceptability in cardiac arrest resuscitation remains limited.</p><p><strong>Objective: </strong>This study aimed to design, develop, and evaluate a role-specific AR decision support system for resuscitation team leaders and medication nurses. In this observational study, we assessed clinicians' perceived usability, user experience, and technology acceptance of the new AR system in a high-fidelity simulated cardiac arrest scenario.</p><p><strong>Methods: </strong>We conducted a prospective observational pilot study using a high-fidelity simulated pediatric cardiac arrest scenario. A total of 10 clinicians were recruited from Alberta Children's Hospital, including 5 (50%) of 10 pediatric emergency physicians serving as team leaders (men: 3/5, 60%, and women: 2/5, 40%; median age 41, IQR: 40-42 y) and 5 (50%) of 10 emergency nurses serving as medication nurses (men: 1/5, 20%, and women: 4/5, 80%; median age 45, IQR: 42-46 y). Participants used role-specific AR decision support interfaces deployed on HoloLens 2 head-mounted displays. Following the simulation, perceived usability, user experience, and technology acceptance were assessed using validated questionnaires: the System Usability Scale, User Experience Questionnaire, and Technology Acceptance Model. Data were collected via postsimulation surveys and analyzed descriptively.</p><p><strong>Results: </strong>Descriptive analyses were performed without inferential statistical testing. The mean System Usability Scale scores were 75.5 (SD 9.25, 95% CI 64.0-87.0) for team leaders and 82.0 (SD 11.20, 95% CI 68.0-96.0) for medication nurses. User experience was positive across roles, with mean User Experience Questionnaire scores indicating favorable attractiveness (team leaders: 1.87, SD 1.14, 95% CI 0.45-3.28; medication nurses: 2.43, SD 0.52, 95% CI 1.79-3.08), pragmatic quality (team leaders: 1.88, SD 0.87, 95% CI 0.80-2.97; medication nurses: 1.80, SD 0.69, 95% CI 0.94-2.66), and hedonic quality (team leaders: 2.40, SD 0.89, 95% CI 1.30-3.50; medication nurses: 2.28, SD 0.69, 95% CI 1.42-3.13). Technology acceptance was high, with mean combined Technology Acceptance Model scores of 5.92 (SD 0.46, 95% CI 5.35-6.49) for team leaders and 6.02 (SD 0.56, 95% CI 5.32-6.71) for medication nurses.</p><p><strong>Conclusions: </strong>This study introduces a novel role-specific AR decision support system that delivers tailored, in-view guidance to resuscitation team leaders and medication nurses during cardiac arrest. Unlike prior cognitive aids that present uniform or device-agnostic information, this syst","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"3 ","pages":"e72013"},"PeriodicalIF":1.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Youth and Young Adults' Perspectives on Augmented Reality-Driven Vaping Cessation Interventions: Interpretive Description Study.","authors":"Karlee Fonteyne, Elizabeth Keys, Mohammad Khalad Hasan, Laura Struik","doi":"10.2196/79674","DOIUrl":"10.2196/79674","url":null,"abstract":"<p><strong>Background: </strong>Vaping among youth and young adults has become a significant public health issue, with increasing prevalence and associated health risks. Despite awareness of these risks, many youth and young adults struggle to quit due to complex social pressures, stress, and a lack of tailored interventions. Digital tools, including augmented reality (AR), offer an opportunity to address these challenges by creating engaging and personalized support systems.</p><p><strong>Objective: </strong>The aim of this study was to determine what can be learned from youth and young adult vapers who are motivated to quit vaping to inform the design of mobile app-based AR intervention strategies.</p><p><strong>Methods: </strong>This qualitative study applied an interpretive description (ID) approach to explore youth and young adults' perspectives on vaping cessation and their preferences for digital intervention features. Semistructured interviews were conducted with participants (N=12) who shared their experiences with vaping, quitting attempts, and ideas for app-based AR support. Reflexive thematic analysis and ID were used to code the data and identify patterns, resulting in the generation of themes that reflected the individualized and contextual nature of vaping cessation.</p><p><strong>Results: </strong>The findings collectively yielded four major themes: (1) social and cultural context play a role in youth and young adults' experiences of cessation, (2) quitting vaping is an individual endeavor that does not always mean success, (3) digital support as a bridge between individual and social needs, and (4) AR as a catalyst for personalized support. These themes address the motivations, challenges, and opportunities identified by participants in their cessation journeys, as well as their perspectives on integrating AR technology as a supportive tool. Our findings reveal that vaping cessation is a deeply personal process influenced by internal motivations (eg, health improvement and personal milestones) and external factors (eg, social context). Participants identified AR as a promising app-based tool for cessation support, with interest in potential AR-integrated features such as gamified rewards, health visualizations, and anonymous support. Youth and young adults emphasized the need for sensitive design to avoid negative or punitive content.</p><p><strong>Conclusions: </strong>This study provides actionable insights for designing youth and young adult-centered digital health tools that leverage app-based AR to support vaping cessation. By addressing the unique sociocultural and behavioral needs of youth and young adults, app-based AR interventions can bridge gaps in traditional cessation strategies. These findings contribute to the development of innovative public health approaches aimed at reducing vaping prevalence in vulnerable populations.</p>","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"2 ","pages":"e79674"},"PeriodicalIF":1.8,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Potential of Metaverse to Elicit Therapy-Related Emotions Among Individuals With Depression: Controlled Pilot Study of Cognitive and Emotional Responses.","authors":"Fabiha Islam, Purushothaman Muthukanagaraj, Mei-Hsiu Chen, Liang Zhan, Alex Leow, Chao Shi","doi":"10.2196/82422","DOIUrl":"10.2196/82422","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Depression, a prevalent mental health condition, affects millions worldwide. Many face significant barriers to accessing effective therapy. Metaverse has become a promising platform for addressing these challenges. Its 3D virtual environments allow users to engage through customizable avatars, supporting the elicitation of therapy-related emotions, an essential component of therapeutic interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This pilot study investigates the potential of the Metaverse to elicit therapy-related emotional responses in individuals experiencing depression. The objectives are to assess emotional arousal, mental workload (MWL), and affective engagement during an emotional elicitation task in a Metaverse environment and compare them with those observed in a similar real-world setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a between-subjects experiment involving 28 participants: 14 had self-reported depression symptoms; 14 had minimal or no depression. Participants were assigned to a real-world environment or a Metaverse environment. Second Life (SL), a persistent 3D virtual world that utilizes human-like avatars for navigation, was the Metaverse environment. A desktop computer represented the real-world setting. Participants watched emotion-eliciting video clips to evoke amusement, anger, disgust, fear, and sadness. They reported their emotional arousal using the 16-item self-report inventory, MWL using the NASA Task Load Index, and emotional engagement using the Positive and Negative Affect Schedule.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Regardless of the environment, participants with self-reported depression symptoms reported significantly higher amusement (&lt;i&gt;F&lt;/i&gt; &lt;sub&gt;1,24&lt;/sub&gt;=4.882, &lt;i&gt;P&lt;/i&gt;=.04; self-reported depression: mean 5.00, SD 2.481; minimal or no depression: mean 3.07, SD 1.940), anger (&lt;i&gt;F&lt;/i&gt; &lt;sub&gt;1,24&lt;/sub&gt;=7.067, &lt;i&gt;P&lt;/i&gt;=.01; self-reported depression: mean 4.79, SD 2.190; minimal or no depression: mean 2.71, SD 1.899), sadness (&lt;i&gt;F&lt;/i&gt; &lt;sub&gt;1,24&lt;/sub&gt;=4.353, &lt;i&gt;P&lt;/i&gt;=.048; self-reported depression: mean 5.21, SD 2.293; minimal or no depression: mean 3.50, SD 1.912), and perceived performance (&lt;i&gt;F&lt;/i&gt; &lt;sub&gt;1,24&lt;/sub&gt;=4.939, &lt;i&gt;P&lt;/i&gt;=.04; self-reported depression: mean 91.07, SD 90.302; minimal or no depression: mean 31.07, SD 36.278) than those with minimal or no depression. Participants with minimal or no depression reported lower perceived effort in the SL environment than in the real-world setting (SL: mean 40.71, SD 38.016; real world: mean 158.571, SD 120.411; &lt;i&gt;P&lt;/i&gt;=.02), indicating Metaverse's potential to alleviate cognitive stress during emotionally eliciting tasks. There were no significant differences in perceived MWL or emotional engagement between the real-world and Metaverse settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Individuals with self-reported depression symptoms exhibited heightened emotional responses across environmental settings, indicating th","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"2 ","pages":"e82422"},"PeriodicalIF":1.8,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Reality Application for Teaching Complex Congenital Heart Defect Anatomy: Design and Development Study.","authors":"Kevin Muneton, David Buyck, Carlos-Eduardo Guerrero-Chalela, Shanti Narasimhan, Paul A Iaizzo","doi":"10.2196/74429","DOIUrl":"10.2196/74429","url":null,"abstract":"<p><strong>Background: </strong>Medical education still faces challenges in teaching complex human cardiac anatomy to a wide range of learners, especially in the subject of congenital heart defects. Traditional educational methods such as cadaver dissection and the use of textbooks still face some limitations, for example, specimen availability and student comfort. The objective of this research is to use newer technologies, like virtual reality (VR), to teach the anatomy of congenital heart defects (CHDs) of 3D heart models from real computed tomography (CT)-scan images, to offer a more profound learning experience for learners and mentors.</p><p><strong>Objective: </strong>The objective of this study is to propose and implement an innovative pipeline for a VR-based educational application for CHDs, and to assess its acceptance and suitability for medical education by evaluating potential future users.</p><p><strong>Methods: </strong>Heart images of anonymized CT scans were used to create high-fidelity 3D cardiac models, using Materialise Mimics Core and 3-matic Medical. These models were next integrated into a Unity-powered VR application. A heterogeneous group of cardiologists, biomedical engineers, and medical trainees visiting the Visible Heart Laboratories was invited to this pilot study to assess perceived effectiveness and satisfaction of this VR app for CHD education.</p><p><strong>Results: </strong>A total of 9 participants were included in the study, comprising 4 (44%) cardiologists, 2 (22%) biomedical engineers, and 2 (22%) medical trainees. Mean perception based on potential for CHD education of this VR-app (4.56, SD 0.53), was higher than traditional methods (3.22, SD 0.026<i>; P</i>=.008). Participants rated this application more suitable for medical students (mean=3.22, SD 0.83; <i>P</i>=.02) and patient education (mean=4.11, SD 1.05; <i>P</i>=.03).</p><p><strong>Conclusions: </strong>Our developed VR application offers an innovative approach to teaching the complex cardiac anatomy of CHDs using models from CT scans. This research shows how newer technologies can be optimized for medical education with the advantage of 3D visualization and a teaching environment without geographical limitations. Future work should focus on Extended Reality (XR) integration, adding more heart and organ models, as well as performing long-term efficacy studies.</p>","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"2 ","pages":"e74429"},"PeriodicalIF":1.8,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual, Augmented, and Mixed Reality for Motor Neurorehabilitation: Scoping Review Focused on the Role of Body Representation.","authors":"Massimo Magrini, Olivia Curzio, Cristina Dolciotti, Gabriele Donzelli, Maria Cristina Imiotti, Fabrizio Minichilli, Davide Moroni, Paolo Bongioanni","doi":"10.2196/63487","DOIUrl":"10.2196/63487","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Extended reality (XR), encompassing virtual reality, augmented reality (AR), and mixed reality, is increasingly being used in neurorehabilitation to provide multisensory feedback and promote neural plasticity in sensorimotor networks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This scoping review aimed to (1) examine how XR technologies are applied in motor neurorehabilitation, (2) explore how body representation and somatic embodiment are addressed, and (3) analyze the methodological designs of XR-based interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, with a comprehensive search across PubMed, Embase, Scopus, and Web of Science from inception to December 2023. Eligible studies included original research involving XR-based interventions explicitly targeting neurorehabilitation. Studies related to somatic embodiment and reporting data on implementation and user outcomes were considered without date restriction. Three independent reviewers conducted screening in Covidence. The following variables were extracted: study design, participant characteristics, XR devices and software, experimentation details, treatment approaches, and evaluation methods. Methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale and the Murad Scale. Findings have been presented in tabular and narrative formats.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty-six studies met the inclusion criteria, and these were mainly clinical trials involving patients with neurological conditions, particularly poststroke status (n=6) and spinal cord injury (n=2). Several studies provided physiological data, including electroencephalography (n=12), electromyography (n=2), magnetic resonance imaging (n=1), galvanic skin response (n=1), electrodermal activity (n=1), and motor-evoked potential data (n=1). Two studies used noninvasive brain stimulation, and another two used eye tracking. Most studies (n=17) used built-in motion sensors; however, some (n=8) analyzed the data quantitatively. Unity 3D was the most frequently used development platform (n=8). First-person (n=20) and third-person (n=2) perspectives were used, and 4 studies combined both perspectives. Interventions mainly targeted sensorimotor deficits, with improvements in motor and cognitive performance. Sixteen studies addressed body perception, focusing on limb embodiment. Questionnaires were the most frequently used evaluation tools (n=18), and 3 studies used standardized tests. Some studies (n=7) investigated body ownership under visuomotor inconsistencies with or without visuotactile stimulation. XR was primarily applied to enhance sensorimotor recovery and assess device feasibility. Few studies directly measured embodiment (n=4), ownership (n=2), or self-location (n=2). The ability of XR platforms to deliver m","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"2 ","pages":"e63487"},"PeriodicalIF":1.8,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Extended Reality Into Primary Care Chronic Pain Programs: A Real-World Feasibility Study of the REDOCVR Intervention.","authors":"Jose Ferrer Costa, Alexandra Fernandez Brusco, Christian Torrecillas Camacho, Elena Villabona Lopez, Melanie Rodriguez Belloso, Laura Villares Urgell, Pablo Serrano Barrena, Nuria Moran Bueno","doi":"10.2196/82858","DOIUrl":"10.2196/82858","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic pain management in public health services often struggles with limited engagement, emotional burden, and medication use. XR shows promise in specialized settings, but evidence for codesign and integration into primary care remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to examine the feasibility, usability, and real-world implementation of REDOCVR, an XR-supported psychoeducational program, and to explore preliminary clinical outcomes during its integration into chronic pain groups in public primary care centers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a nonrandomized, hybrid type 2 phased implementation study conducted in 3 primary care centers in Catalonia, Spain. The intervention built on existing multidisciplinary psychoeducational chronic pain groups led by psychologists and physiotherapists. In collaboration with patients, XR modules were codesigned and incorporated to enhance mindfulness, cognitive reframing, and motor activation activities already established in routine care. Eight weekly sessions included 15-20 minutes of this content, with a supervised medication tapering protocol included in later groups. Primary outcomes were implementation measures (adherence, tolerability, System Usability Scale, and satisfaction). Secondary outcomes included patient-reported clinical measures (Warwick-Edinburgh Mental Well-being Scale [WEMWBS], Hospital Anxiety and Depression Scale [HADS], Central Sensitization Inventory, and EQ-5D-5L) and medication changes, assessed at baseline, post-intervention, and 5-month follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 42 participants were enrolled, and 36 (85.7%) completed the intervention and all assessments. Adherence was high, and no serious adverse events occurred, with minimal cybersickness reported (5.6%). Patient usability was strong (mean 81.4, 95% CI 75.6-87.1), and overall satisfaction was high (mean 82.4, 95% CI 78.5-86.4). Professional usability was moderate (mean 59.1, 95% CI 51.6-66.5). Statistically significant improvements were observed in emotional well-being (Warwick-Edinburgh Mental Well-being Scale mean change 4.8, 95% CI 2.9-6.7; Cohen &lt;i&gt;d&lt;/i&gt;=0.86), anxiety (HADS-A -2.5, 95% CI -3.8 to -1.2; Cohen &lt;i&gt;d&lt;/i&gt;=0.66), and depression (HADS-D -1.6, 95% CI -2.5 to -0.7; Cohen &lt;i&gt;d&lt;/i&gt;=0.62) (all &lt;i&gt;P&lt;/i&gt;&lt;.001). Mobility improved significantly (median change -1.0, 95% CI -1.0 to 0.0, &lt;i&gt;P&lt;/i&gt;=.09), while Pain/Discomfort showed a nonsignificant trend (&lt;i&gt;P&lt;/i&gt;=.08). Among tapering participants (n=22), mean use of benzodiazepines decreased by 71.7% and opioids by 41.8% at 5 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study suggests that an XR-enhanced psychoeducational program can be incorporated into group-based chronic pain care within the public primary health care system. Exploratory improvements in emotional well-being, anxiety, depression, and reduced use of high-risk medications during supervised tapering indicate pote","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"2 ","pages":"e82858"},"PeriodicalIF":1.8,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Sensation Seeking and Fear Response: Interventional Study of Personality and Behavior Using a Virtual Reality Heights Simulation.","authors":"Rebecca C Daugherty, Christina S Jacksack, Becca J Daye, Brandon G Oberlin","doi":"10.2196/73785","DOIUrl":"10.2196/73785","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Immersive virtual reality (VR) technology presents digital simulations that create the sense of an actual experience. VR simulations are persuasive enough to elicit physiological reactions that mirror real-world responses. Prior research suggests that fear responses and sensation seeking are inversely correlated, but that work largely relies on self-reported outcomes and hypothetical scenarios.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To more closely model real-world phenomena, we tested for inverse associations using an experiential height exposure simulation and a behavioral task for sensation seeking. We tested these associations comprehensively by using multiple methods for convergent evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 57 healthy undergraduates participated in an interventional study that included an anxiety-inducing VR simulation, behavioral tasks, and personality inventories. The VR paradigm (Richie's Plank) prompted users to walk across and step off a plank at the top of a skyscraper. This simulation of extreme height exposure and falling was intended to evoke fear. Physiological recordings and self-reported state anxiety were collected prior to and during the experience. Behavioral sensation seeking was quantified using an olfactory choice task offering a \"boring\" or \"exciting\" (risky) option varying in intensity and pleasantness. Evoked fear was calculated as the difference between the calm (pre-plank) and provoked fear state (standing on the plank), with correlations performed between evoked fear and personality and behavioral measures. The false discovery rate was set to &lt;i&gt;q&lt;/i&gt;&lt;.05, with analyses conducted in SPSS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The VR experience evoked self-reported fear (&lt;i&gt;P&lt;/i&gt;&lt;.001) and physiological arousal (&lt;i&gt;P&lt;/i&gt;&lt;.006 for heart rate and &lt;i&gt;P&lt;/i&gt;&lt;.017 for respiration). Acrophobia correlated with self-reported fear in men and women (&lt;i&gt;P&lt;&lt;/i&gt;.01). Behavioral sensation seeking negatively correlated with both self-reported fear (&lt;i&gt;P&lt;/i&gt;=.02) and increased heart rate in men (&lt;i&gt;P&lt;/i&gt;=.02). Behavioral and self-reported sensation seeking were uncorrelated (&lt;i&gt;P&lt;/i&gt;=.89). Self-reported fear was uncorrelated with physiological fear responses (&lt;i&gt;P&lt;/i&gt;&gt;.46).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;VR simulations can produce lifelike responses to scenarios that are impractical to test in reality. Our demonstration of an experiential manipulation negatively correlating with sensation seeking behavior in men increases confidence in other findings from studies using more traditional methods. Our use of VR along with objective measures, for example, behavioral tasks, and subjective measures, for example, self-report, confirm the effectiveness of these tools to investigate behavioral health topics. Our findings further suggest that sex is an important intervening factor for fear and sensation seeking and that additional study is warranted. This study highlights the potential of VR t","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"2 ","pages":"e73785"},"PeriodicalIF":1.8,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmented Reality Framework to Measure and Analyze Eye-Hand Coordination in Stroke Patients with Unilateral Neglect: Proof-of-Concept Study.","authors":"Jonathan Becker, Sophokles Ktistakis, Mirko Meboldt, Thomas Nyffeler, Dario Cazzoli, Quentin Lohmeyer","doi":"10.2196/70985","DOIUrl":"10.2196/70985","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Stroke is a leading cause of disability, often accompanied by unilateral spatial neglect (USN), which severely impairs recovery. Traditional assessments like paper-pencil tests provide limited insights into behaviors and eye-hand coordination during real-world tasks. Advances in hand pose estimation and eye tracking in combination with augmented reality (AR) offer potential for data-driven assessments of naturalistic interactions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This proof-of-concept study presents and evaluates a multimodal behavioral tracking system that captures gaze, body, and hand movements during interactions within an AR environment. Our primary goals are to (1) validate that this system can achieve robust and accurate interaction data capture in clinical settings, (2) show that the system can reliably detect known USN behavioral patterns, and (3) explore how comprehensive data can provide new understanding of eye-hand coordination deficits in USN.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We developed an AR-based assessment system using Microsoft HoloLens 2 and an external body-tracking camera to capture real-time gaze, hand, and body movements in an interactive environment. Multimodal data streams were temporally synchronized, fused, and filtered to enhance spatial accuracy and availability. Tracking performance was benchmarked against a traditional optical motion-capture system to validate reliability. In a study, 7 patients with right-brain lesions with mild to moderate USN and 8 healthy controls participated. Each performed a designed reaching task, stamping virtual sheets of paper that appeared randomly on a table. We analyzed participants' search behavior patterns to assess attentional biases and examined gaze anchoring timing during targeted reaching motions to explore potential eye-hand coordination deficits.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The fusion of hand-tracking data from the HoloLens 2 and external system reduced tracking loss from 25.7% to 2.4%, with an absolute trajectory error of 3.27 cm. The system demonstrated high usability and was well accepted by patients. Data from the control group confirmed the absence of intrinsic lateral biases in the system and task design. The USN group displayed typical search behavior through ipsilesional biases in gaze direction during visual exploration (median deviation 7.46 [1.61-9.48] deg, &lt;i&gt;P&lt;/i&gt;&lt;.05) and longer times to find contralesional targets (median difference 1.08 [0.20-1.80] s, &lt;i&gt;P&lt;/i&gt;=.02). Additionally, the eye-hand coordination analysis revealed lateral differences in gaze anchoring during targeted reaching motions in the USN group, with earlier fixation on contralesional targets (median difference 112 [71-146] ms, &lt;i&gt;P&lt;/i&gt;=.02).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The proposed AR framework provides a novel, comprehensive data-driven method for capturing interaction behavior in a controlled, yet naturalistic environment. Our results demonstrated t","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"2 ","pages":"e70985"},"PeriodicalIF":1.8,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Humans in Virtual Reality Mental Health Research: Systematic Review.","authors":"Shu Wei, Daniel Freeman, Aitor Rovira","doi":"10.2196/75087","DOIUrl":"10.2196/75087","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) is showing increasing promise for assessing, understanding, and treating mental health difficulties. Virtual humans (VHs) represent a key aspect within many VR mental health applications. While VHs can play diverse roles and display varied characteristics, their design and influence have rarely been the primary focus of mental health research.</p><p><strong>Objective: </strong>We aimed to carry out a systematic review of how VHs in immersive VR have been used in applications for mental health, focusing on their roles and interaction types, and the human characteristics being tested.</p><p><strong>Methods: </strong>Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched PubMed, MEDLINE, PsycINFO, Scopus, and Web of Science, using defined keyword combinations involving VR, VHs, and mental health. Eligible studies included peer-reviewed research using immersive VR with VHs in a mental health context, without restrictions on study design or population. We excluded nonimmersive VR, nonmental health applications, and papers without empirical data. Data were synthesized narratively, and a taxonomy to categorize VHs that we developed was used.</p><p><strong>Results: </strong>A total of 79 studies met all eligibility criteria. VHs were most frequently applied in studies on social anxiety (n=18), eating disorders (n=18), and psychosis (n=15). They were primarily used as active social interaction partners (n=40), as part of virtual crowds (n=16), and as virtual bodies for participants (n=23). Explicit interactions dominated active partner studies, while implicit and passive or no interactions were prevalent in crowd and body studies. Over half of the studies (n=44) varied the VH characteristics, with body size and gender being the most common variables, and personality was explored in fewer studies (n=5). Only a limited number of studies provided detailed descriptions of VH appearance and behavior, with some including still images and videos.</p><p><strong>Conclusions: </strong>VHs are versatile tools to be used within VR mental health applications, but their design features are inconsistently reported and insufficiently examined in relation to intervention outcomes. Evidence is limited by heterogeneity in study aims, designs, and populations, and by incomplete reporting of VH characteristics, which constrains replication and cross-study comparison. Standardized reporting and systematic investigations of VH design are needed to optimize their roles in evidence-based mental health applications.</p>","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"2 ","pages":"e75087"},"PeriodicalIF":1.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Feasibility and Acceptability of a Stand-Alone Virtual Reality Headset on Perceived Pain and Anxiety During Bone Marrow Biopsies: Mixed Methods Pilot Study.","authors":"Ajay Mittal, Suhaiba Huq, Jonathan Wakim, Kevin Kapadia, Tung Wynn","doi":"10.2196/65324","DOIUrl":"10.2196/65324","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) is an emerging technology that provides an immersive user experience and has the ability to distract patients from the negative or painful experiences commonly associated with medical procedures. Bone marrow biopsies are medical procedures where a needle is inserted into the bone and a syringe is used to withdraw the liquid bone marrow. They are performed to diagnose and monitor disorders affecting the blood, often as part of care for hematology and patients with cancer.</p><p><strong>Objective: </strong>The purpose of this pilot study is to assess the feasibility of VR as an adjunctive therapy to alleviate the perception of pain and anxiety in patients receiving bone marrow biopsies.</p><p><strong>Methods: </strong>This pilot study enrolled 60 adult participants receiving a bone marrow biopsy to assess the acceptability and feasibility of VR to impact reported pain and anxiety levels compared to the participants' baseline measurements preoperatively. They were randomly assigned to \"control\"/non-VR intervention (n=30) and \"experimental\"/VR groups (n=30). The \"experimental\"/VR group used the Meta Quest 2 headset (Meta) with original VR content developed for this study. Participants completed a survey adapted from a standardized verbal numerical rating scale to rate their pain and anxiety levels before and after the bone marrow biopsy. Measurements such as procedure length, patient vitals, and experience were also gathered from both study groups.</p><p><strong>Results: </strong>Results indicated that participants had no significant differences in their heart rate, respiration rate, and blood oxygen saturation levels between the 2 groups. Participants in the VR group (n=30) had a significantly shorter procedure length than the control group (n=30) with a 25% time reduction (<i>P</i>=.02). Participants in the VR group (mean 4.29, SD 1.19) were significantly more likely to rate the distraction as effective (<i>P</i><.001) and report they would repeat the procedure (mean 4.32, SD 1.05; <i>P</i><.001). Finally, participants in the VR group (mean 2.13, SD 1.26) had significantly lower levels of anxiety during the procedure (<i>P</i><.001) and felt significantly more comfortable after the procedure (mean 4.45, SD 1.12; <i>P</i><.001).</p><p><strong>Conclusions: </strong>This investigation encourages the acceptability of using VR intervention for patients undergoing bone marrow biopsies. Further, the length of procedures was found to be shorter when compared to the control group, supporting the feasibility of the technology for clinical management. These novel interventions can provide distraction-based therapy that is noninferior to the standard of care and provide enjoyable user experiences that reduce the perceived pain and anxiety of nonsedated medical procedures.</p>","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"2 ","pages":"e65324"},"PeriodicalIF":1.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}