Virtual Worlds, Volume 4, Issue 4 (December 2025) – 11 articles

Modern myoelectric prostheses remain difficult to control, particularly during rehabilitation, leading to high abandonment rates in favor of static devices. This highlights the need for advanced controllers that can automate some motions. This study presents an end-to-end framework coupling deep reinforcement learning with augmented reality (AR) for prosthetic actuation. A 14-degree-of-freedom hand was modeled in Blender and deployed in Unity. Two reinforcement learning agents were trained with distinct reward functions for a grasping task: (i) a discrete, Booleann reward with contact penalties and (ii) a continuous distance-based reward between joints and the target object. Each agent trained for 3 × 10⁷ timesteps at 50 Hz. The Booleann reward function performed poorly by entropy and convergence metrics, while the continuous reward function achieved success. The trained agent using the continuous reward was integrated into a dynamic AR scene, where a user controlled the prosthesis via a myoelectric armband while the grasping motion was actuated automatically. This framework demonstrates potential for assisting patients by automating certain movements to reduce initial control difficulty and improve rehabilitation outcomes. Full article

With origins in video gaming, 3D virtual worlds (VWs) are digital environments where people engage and interact synchronously using digital characters called avatars. VWs may have future potential for delivering youth mental health (YMH) services. Despite progress in developing VW-based YMH interventions, limited consultation with young people may be contributing to mixed uptake and engagement. This study aimed to understand how young people with experiences accessing YMH services view the potential (i.e., hypothetical) use of VWs for YMH service delivery to understand qualitative factors influencing uptake. Eleven 18–25-year-old consumers (M = 22.91 years; five women, five men, and one non-binary person) took part in one-on-one, semi-structured interviews via videoconferencing. Interviews explored anticipated ease of use, helpfulness, and perceived intention to use VW-based YMH interventions if they were made available. Interviews were analysed using reflexive thematic analysis. Four themes were produced: (1) VWs as unique therapeutic spaces; (2) creative engagement for therapy; (3) VW communication promoting both connection and distance; (4) flexible access. All participants expressed a level of openness towards the potential use of VWs for YMH interventions. Features such as creative world-building and avatar customisation, increased anonymity, and remote accessibility were seen as ways to improve access to convenient, personalised, and engaging mental healthcare. Concerns included technology misuse, privacy risks, and reduced physical and emotional presence. Future research and service development should test real-world outcomes to ensure clinical benefit and employ codesign approaches that leverage servicer-users’ expectations to ensure accessible and acceptable delivery. Full article

Introduction: The integration of Immersive Virtual Reality (IVR) into teacher education is a significant innovation that can enhance the learning and practical training of future teachers. IVR enables highly interactive, immersive experiences in simulated educational environments where student teachers confront realistic classroom challenges. The objective was to synthesize how IVR is implemented in the training of future teachers and its level of effectiveness, in order to develop recommendations for practice and identify potential barriers to implementation. Method: A systematic review was carried out following the PRISMA model. A total of 1677 articles published in the Web of Science, Scopus, and SciELO databases were reviewed between 2021 and 2025, with 13 articles selected for analysis. Results: The reviewed articles highlight Immersive Virtual Reality (IVR) as a virtual tool that facilitates the training of future teachers. Among its most common applications are the use of virtual and augmented reality for conflict resolution, classroom management, and teacher adaptation. However, its implementation is limited by access to equipment, scenario development, and integration into university institutions. Conclusions: There is converging evidence that supports the strengths of using IVR as an emerging technology in teacher training, offering facilitating elements for the development of pedagogical competencies through the simulation of practical situations in a safe environment. Thus, this review summarizes recommendations for practice and warnings about implementation barriers, identifying the most potential uses and proposing actionable steps for its phased adoption in initial teacher training. Full article

Digital twins are increasingly utilized across all lifecycle stages of physical entities. Augmented reality (AR) offers real-time immersion into three-dimensional (3D) data, which provides an immersive experience with dynamic, high-quality, and multi-dimensional digital twins. A robust and customizable data platform is essential to create scalable 3D digital twins; Universal Scene Description (USD) provides these necessary qualities. Given the potential for integrating immersive AR and 3D digital twins, we developed a software application to bridge the gap between multi-modal AR immersion and USD-based digital twins. Our application provides real-time, multi-user AR immersion into USD-based digital twins, making it suitable for time-critical tasks and workflows. AR digital twin software is currently being tested and evaluated in an application we are developing to train astronauts. Our work demonstrates the feasibility of integrating immersive AR with dynamic 3D digital twins. AR-enabled digital twins have the potential to be adopted in various real-time, time-critical, multi-user, and multi-modal workflows. Full article

The Gaia System is a tabletop projection mapping system for museum exhibitions, now in its third iteration and installed at the Sortland Museum (Norway). It presents socio-economic, environmental, and historical topics through an interactive spatial display. The system supports both multi-user interaction—allowing many visitors to engage simultaneously—and a tour guide mode for staff-led presentations. It combines scientific, data-driven visualizations with popular-science, story-driven content and integrates both real-time and locally stored data streams. Its design and development processes are thoroughly described. A field study with 32 participants yielded a System Usability Scale (SUS) score of 84.14 and a mean User Experience Questionnaire (UEQ-S) overall score of 1.93, indicating high usability and a positive user experience. The participants found the projection technology impressive and the content informative while noting challenges such as information overload, unclear temporal structuring of the content, and minor technical issues. Planned developments focus on restructuring the content for shorter sessions, implementing a new content management system, and refining the technical stability. Finally, this work reframes projection mapping as operational infrastructure rather than a fixed display, offering practical guidance for researchers advancing PM methodologies and museum practitioners deploying innovative, technology-driven exhibitions. Full article

Pediatric diffuse midline gliomas in the brainstem (bDMGs) are malignant primary brain neoplasms with poor prognosis. Conventional dogma cites that biopsy procedures have risks of devastating injury to the eloquent brainstem and have no direct benefit to affected patients. In recent years, the use of augmented reality (AR) adjuncts has demonstrated potential in providing excellent intraoperative three-dimensional (3D) visualization of intracranial structures. Put together, we hypothesize that the application of AR will be useful as a training tool for brainstem biopsy procedures. Anatomical models of bDMG tumors are created and uploaded to an AR application. The processed data is transferred into designated AR head-mounted devices. Briefly, individual 3D-rendered bDMG images are overlaid with an age-matched, life-sized child mannequin in prone position. A virtual stereotactic brain biopsy needle is deployed by the user into the lesion. At the end of the exercise, each user evaluates their trajectory of choice to assess its accuracy. Overall, the participants reported that the AR platform was useful in reviewing technical nuances for brainstem biopsy in a safe environment. This focused, proof-of-concept study adds to the growing body of literature that AR platforms demonstrate feasibility for neurosurgeons in the understanding of challenging operative neuroanatomy. Full article

This feasibility study explored the integration of physiological monitoring into a virtual reality (VR) intervention for pediatric pain management. The goal of this study is to identify a feasible strategy for collecting physiologic data in the context of a VR intervention currently being developed for youth with chronic pain. We assess the potential of Cognitive Load (CL)—derived from heart rate and pupillometry/eye-tracking data—as a marker of arousal and user engagement in a VR simulation to promote school functioning in youth with chronic pain. The HP Reverb G2 Omnicept headset and Polar H10 heart-rate sensor were utilized. The Child Presence Questionnaire (CPQ) assessed participants’ self-reported immersion and engagement. Data collection focused on feasibility and utility of physiologic data in assessing arousal and correlations with self-reported experience. Nine participants engaged in the simulation, with eight yielding complete data. The simulation and headset were well tolerated. CPQ Transportation subscale showed trend-level correlation with mean CL. Due to small sample and feasibility focus, individual-level results were examined. Combining multiple physiologic markers into a construct like CL is intriguing, but data interpretability was limited. Pupillometry and related metrics show promise as feasible markers of engagement and arousal for VR-based intervention but require appropriate expertise to fully interpret. The study found that integration of physiologic monitoring is feasible, but further work is needed to standardize metrics and identify the most useful and user-friendly markers. Full article

Emerging virtual reality (VR) technologies provide objective and immersive methods for assessing cognitive–motor function, particularly in elite sport. This study evaluated the reliability and validity of VR-based cognitive–motor assessments in a large sample of elite male athletes (n = 829). Ten cognitive–motor tests, delivered via Oculus Quest 2 headsets, were used, covering four domains: Balance and Gait (BG), Decision-Making (DM), Manual Dexterity (MD), and Memory (ME). A Confirmatory Factor Analysis (CFA) was conducted to establish a four-factor model and generate data-driven weights for domain-specific composite scores. The results demonstrated that the composite scores for BG, MD, ME, and a Global Cognitive–Motor (CM) score were all normally distributed. However, the DM score significantly deviated from normality, exhibiting a pronounced ceiling effect. Test–retest reliability was high across all cognitive–motor domains. In summary, VR assessments offer ecologically valid and precise measurements of cognitive–motor abilities by capitalising on high-fidelity motion tracking and standardised test delivery. In particular, the Global CM Score offers a robust metric for parametric analyses. While future work should address the DM ceiling effect and validate these tools in diverse populations, this approach holds significant potential for enhancing the precision and sensitivity of psychological and clinical assessment. Full article

Colour is a fundamental determinant of affective experience in immersive virtual reality (VR), yet the emotional and physiological impact of individual hues remains poorly characterised. This study investigated how fifteen calibrated Munsell hues influence subjective and autonomic responses when presented in immersive VR. Thirty-six adults (18–45 years) viewed each hue in a within-subject design while pupil diameter and skin conductance were recorded continuously, and self-reported emotions were assessed using the Self-Assessment Manikin across pleasure, arousal, and dominance. Repeated-measures ANOVAs revealed robust hue effects on all three self-report dimensions and on pupil dilation, with medium-to-large effect sizes. Reds and red–purple hues elicited the highest arousal and dominance, whereas blue–green hues were rated most pleasurable. Pupil dilation closely tracked arousal ratings, while skin conductance showed no reliable hue differentiation, likely due to the brief exposure times (30 s). Individual differences in cognitive style and personality modulated overall reactivity but did not alter the relative ranking of hues. Taken together, these findings provide the first systematic hue-by-hue mapping of affective and physiological responses in immersive VR. They demonstrate that calibrated colour shapes both experience and ocular physiology, while also offering practical guidance for educational, clinical, and interface design in virtual environments. Full article

Background: Young children have experienced increased emotional difficulties, including anxiety, emotion dysregulation, and tantrums. Limited access to mental health services has created an urgent need for accessible interventions to equip professionals with effective strategies for managing children’s strong emotions. This study piloted an innovative virtual reality (VR) simulation designed to teach professionals emotion management techniques. Methods: Participants included 107 early childhood professionals (e.g., educational, healthcare, and allied health) working with children aged 3–6 years from the southeastern United States. The multilingual VR simulation taught professionals emotion management strategies. Participants self-selected whether to complete a temper tantrum management simulation (n = 71) or a separation anxiety simulation (n = 36). Participants’ responses to children’s strong emotions were assessed at baseline, post-intervention, and at one-month follow-up, along with a satisfaction survey. Results: Participants reported a significant increase in intent to use effective emotion regulation strategies immediately following VR completion. However, actual use of effective strategies showed no significant change at one-month follow-up. Being a Spanish-speaking professional was associated with significantly greater improvements in both intent and actual use of effective strategies at follow-up. Participants reported high satisfaction ratings with the VR simulations. Conclusions: VR simulations show promise as an innovative tool for teaching emotion management strategies, particularly benefiting Spanish-speaking early childhood professionals. While effective for immediate motivation, additional support mechanisms (e.g., repeated practice, workplace supports) may be needed to sustain long-term behavior change in professional practice. Full article

Background: Virtual reality has been shown to reduce pain during labour. We aimed to determine whether virtual reality reduces analgesia use and shortens labour duration. Methods: A non-randomised pilot study was conducted, using a matched case–control design (1:2 ratio). Cases were women who voluntarily used virtual reality alongside standard intrapartum pain management, including non-pharmacological methods and/or epidural analgesia. Controls received standard intrapartum pain management. Results: A total of 108 women were included for analysis (36 cases vs. 72 controls). Perceived pain scores before and after virtual reality use did not differ significantly (p = 0.43, p = 0.73), suggesting a limited immediate analgesic effect under current conditions. Epidural analgesia rates and cervical dilation at initiation of analgesia did not show significant differences between cases and controls (p = 0.13, p = 0.42). After adjusting for induction of labour and cervical dilation at admission, there were no significant differences for duration of epidural analgesia (p = 0.86, p = 0.56), duration of labour (p = 0.64, p = 0.55), or vaginal birth (p = 0.23). Adjusted models indicated a non-significant trend toward shorter durations of labour, birth, and epidural exposure for cases. Conclusions: Our pilot study did not reveal a decrease in perceived pain or epidural analgesia use or an effect on duration of labour and vaginal birth. Full article