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Search Results (13,380)

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29 pages, 4477 KB  
Article
The Effectiveness of an Augmented Reality-Based Early Intervention Program Using Interactive Games to Enhance Eye Contact as a Nonverbal Communication Skill in Children with Autism: A Single-Case Experimental Design
by Shoeb Saleh and Rommel AlAli
J. Intell. 2026, 14(4), 64; https://doi.org/10.3390/jintelligence14040064 - 10 Apr 2026
Abstract
Children with Autism Spectrum Disorder (ASD) frequently exhibit marked impairments in nonverbal communication, particularly in eye contact, which serves as a foundational element for social interaction and relational development. This study evaluated the effectiveness of an early intervention program utilizing interactive games supported [...] Read more.
Children with Autism Spectrum Disorder (ASD) frequently exhibit marked impairments in nonverbal communication, particularly in eye contact, which serves as a foundational element for social interaction and relational development. This study evaluated the effectiveness of an early intervention program utilizing interactive games supported by Augmented Reality (AR) technology to enhance eye contact behaviors, specifically initiation and maintenance, in children with autism. Using a multiple baseline across participants single-case experimental design, four boys (aged 5–7 years) diagnosed with ASD participated in an 8-week intervention at a specialized center in Saudi Arabia. The intervention featured tablet-based, gamified AR tasks incorporating real-time visual feedback, graduated difficulty levels, and reinforcement mechanisms designed to elicit social gaze and sustained eye contact. Eye contact duration and frequency were measured during structured social interactions via systematic direct observation. The results demonstrated significant improvements across all participants, with the mean duration of eye contact increasing from a baseline of 2.0 s to 5.8 s post-intervention. Visual analysis revealed robust treatment effects, further supported by substantial Tau-U effect sizes (range = 0.89–0.96; M = 0.93). Follow-up data collected three weeks post-intervention confirmed the maintenance of gains for three of the four participants. These findings suggest that AR-based interventions provide an effective and culturally responsive approach for enhancing specific nonverbal communication behaviors among children with autism in Middle Eastern contexts. Implications for clinical practice and directions for future research are discussed. Full article
30 pages, 2772 KB  
Article
The Haptic Fidelity Paradox in VR: Cognitive Load and User Satisfaction
by Yoona Jeong and Tack Woo
Appl. Sci. 2026, 16(8), 3722; https://doi.org/10.3390/app16083722 - 10 Apr 2026
Abstract
High-fidelity haptic interfaces are widely assumed to enhance virtual reality (VR) training; however, they can trigger a “fidelity paradox” where hardware complexity paradoxically degrades usability. Grounded in Task-Technology Fit (TTF) theory and Hassenzahl’s pragmatic-hedonic quality framework, this study investigates the mechanisms underlying this [...] Read more.
High-fidelity haptic interfaces are widely assumed to enhance virtual reality (VR) training; however, they can trigger a “fidelity paradox” where hardware complexity paradoxically degrades usability. Grounded in Task-Technology Fit (TTF) theory and Hassenzahl’s pragmatic-hedonic quality framework, this study investigates the mechanisms underlying this paradox through a within-subject experiment (N=70) in a VR cooking simulation comparing three interface paradigms: VR controllers (VRC), hand tracking (HT), and haptic gloves (HG). Results confirmed that HG’s low task-technology fit—manifested as tracking errors, physical resistance, and increased operational overhead—generated significantly higher extraneous cognitive load (H1) and degraded interaction satisfaction (H2) despite its superior intended sensory resolution. Critically, in the HG condition, pragmatic quality (technical reliability) was identified as the dominant driver of satisfaction, while hedonic quality additions (thermal feedback) did not show a significant independent contribution to satisfaction in the HG condition. Perceived training effectiveness remained above the neutral threshold across all conditions (H3), indicating that content-level TTF is preserved independently of interface-level TTF mismatch. These findings suggest that VR interface design should prioritize “functional sufficiency”—ensuring tools serve as transparent, seamless extensions of the user—over the blind pursuit of sensory maximization. Full article
37 pages, 1305 KB  
Entry
Human-Centric, Sustainable and Resilient Smart Cities in Industry 5.0
by Athanasios Tsipis, Vasileios Komianos and Georgios Tsoumanis
Encyclopedia 2026, 6(4), 87; https://doi.org/10.3390/encyclopedia6040087 - 10 Apr 2026
Definition
The concept of “human-centric, sustainable and resilient smart cities” in Industry 5.0 (I5.0) refers to urban socio-technical ecosystems in which digital infrastructures and services are explicitly oriented toward human well-being, ecological stewardship, and systemic resilience rather than purely technological optimization or automation. Grounded [...] Read more.
The concept of “human-centric, sustainable and resilient smart cities” in Industry 5.0 (I5.0) refers to urban socio-technical ecosystems in which digital infrastructures and services are explicitly oriented toward human well-being, ecological stewardship, and systemic resilience rather than purely technological optimization or automation. Grounded in the I5.0 framework, which promotes human-centricity, sustainability, and resilience as equally important pillars, this paradigm repositions smart cities as value-driven environments that integrate enabling technologies such as Artificial Intelligence (AI), the Internet of Things (IoT), Extended Reality (XR), and related digital infrastructures within participatory, transparent, ethical, and accountable governance structures. From this perspective, technologies function as means through which cities develop higher-order capabilities for sensing, decision support, coordination, interaction, and adaptive service delivery. At the same time, they address digital divides and include measures that promote and protect inclusion, trust, and long-term socio-environmental viability. This entry synthesizes the conceptual foundations, technological enablers, capability-oriented architecture, governance implications, and emerging challenges that influence the transformation of smart cities into human-centric, sustainable, and resilient innovation systems in the I5.0 era. Full article
(This article belongs to the Collection Encyclopedia of Digital Society, Industry 5.0 and Smart City)
14 pages, 2318 KB  
Article
A Flexible Wearable Data Glove Based on Hybrid Fiber-Optic Sensing for Hand Motion Monitoring
by Jing Li, Xiangting Hou, Ke Du, Huiying Piao and Cheng Li
Materials 2026, 19(8), 1525; https://doi.org/10.3390/ma19081525 - 10 Apr 2026
Abstract
Wearable data gloves often suffer from electromagnetic interference, insufficient substrate stability, and limited capability for multi-degree-of-freedom motion measurement. To address these limitations, a flexible glove incorporating a hybrid POF-FBG sensing scheme was designed and fabricated. Plastic optical fibers (POFs) were side-polished and patterned [...] Read more.
Wearable data gloves often suffer from electromagnetic interference, insufficient substrate stability, and limited capability for multi-degree-of-freedom motion measurement. To address these limitations, a flexible glove incorporating a hybrid POF-FBG sensing scheme was designed and fabricated. Plastic optical fibers (POFs) were side-polished and patterned with long-period gratings to improve sensitivity to wrist flexion-extension and abduction-adduction. Then fiber Bragg gratings (FBGs) were embedded in a polydimethylsiloxane substrate and encapsulated using thermoplastic polyurethane fixtures to reduce the influence of skin stretching and improve measurement accuracy of finger-joint angle. Moreover, a thermoplastic polyurethane skeleton with an adaptive sliding-rail structure was 3D printed to maintain the stability of the sensor placement at the joints. Experimental results demonstrated the mean absolute errors of 4.06°, 1.38° and 1.70° for wrist flexion-extension, abduction-adduction and finger-joint bending, respectively, along with excellent gesture classification using a support vector machine algorithm, which indicates great potential in virtual reality interaction and hand rehabilitation applications. Full article
(This article belongs to the Special Issue Advances in Optical Fiber Materials and Their Applications)
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26 pages, 442 KB  
Article
Spinal Cord Injury as a Socially Lived Disability: A Phenomenological Study of Rehabilitation and Everyday Life Among Community-Dwelling Individuals
by Dimitra Karadimitri, Christina-Anastasia Rapidi, Stelios Parissopoulos, Dimitrios Skempes, Savvas Spanos, Maria Tsekoura and Vasiliki Sakellari
J. Clin. Med. 2026, 15(8), 2878; https://doi.org/10.3390/jcm15082878 - 10 Apr 2026
Abstract
Background/Objectives: Spinal cord injury (SCI) leads to long-term changes in mobility, bodily function, and everyday participation, extending beyond physical impairment to affect autonomy, identity, and social inclusion. In Greece, limited community-based rehabilitation services, environmental inaccessibility, and fragmented follow-up care further shape the lived [...] Read more.
Background/Objectives: Spinal cord injury (SCI) leads to long-term changes in mobility, bodily function, and everyday participation, extending beyond physical impairment to affect autonomy, identity, and social inclusion. In Greece, limited community-based rehabilitation services, environmental inaccessibility, and fragmented follow-up care further shape the lived experience of individuals with SCI. This study aimed to explore the lived experiences and perceived rehabilitation needs of people with paraplegia living in the community, adopting a phenomenological approach to understand rehabilitation as an ongoing process of reclaiming autonomy, dignity, and participation. Methods: A qualitative phenomenological design was employed. In-depth semi-structured interviews were conducted with fourteen individuals with paraplegia following SCI. Data were analyzed using Braun and Clarke’s reflexive thematic analysis, supported by ATLAS.ti software. Results: Participants described living with SCI as a ‘Socially lived disability: a daily confrontation with an inadequate system and the ongoing struggle for accessibility, autonomy, and dignity’ (Overarching Theme). Participants’ experiences were organized into six themes: (A) facing the new reality, (B) barriers and facilitators of independent living, (C) role and importance of rehabilitation, (D) me and others around me, my difference, (E) the need for adequately trained and informed health professionals and caregivers, (F) ageing as an additional challenge. Conclusions: Living with SCI is experienced as an ongoing process of embodied and social reorientation, in which autonomy, participation, and dignity are continuously negotiated rather than restored once and for all. Rehabilitation emerges as a lifelong, person-centered process that extends beyond functional recovery to support bodily confidence, accessibility, social inclusion, and quality of life across the life course. These findings highlight the need for coordinated, community-based rehabilitation systems, accessible environments, and adequately trained health professionals capable of addressing the evolving functional, social, and existential realities of individuals living with SCI. Full article
(This article belongs to the Special Issue Neuromuscular Diseases and Musculoskeletal Disorders)
38 pages, 6596 KB  
Review
Beyond Soil Health: Soil Security Underpinning a National Framework for Sustainable Australian Agriculture
by Alex McBratney, Sandra Evangelista, Nicolas Francos, Anilkumar Hunakunti, Ho Jun Jang, Wartini Ng, Thomas O’Donoghue, Julio Cesar Pachón Maldonado, Minhyung Park, Amin Sharififar, Quentin Styc and Yijia Tang
Earth 2026, 7(2), 62; https://doi.org/10.3390/earth7020062 - 10 Apr 2026
Abstract
The long-term sustainability of Australian agriculture is fundamentally constrained by the capacity, condition, availability, and governance of soil resources. Australian soils are among the oldest and most weathered globally, highly heterogeneous, and often slow or effectively irreversible to recover once degraded. Traditional approaches [...] Read more.
The long-term sustainability of Australian agriculture is fundamentally constrained by the capacity, condition, availability, and governance of soil resources. Australian soils are among the oldest and most weathered globally, highly heterogeneous, and often slow or effectively irreversible to recover once degraded. Traditional approaches centred on soil health, while valuable at paddock scale, are insufficient to address national-scale challenges related to spatial variability, data continuity, economic valuation, and policy integration. This paper examines soil security as a policy-relevant framework for supporting more sustainable Australian agriculture. Building on the dimensions of soil security (capacity, condition, capital, connectivity, and codification), we synthesise recent Australian case studies to show how soil security extends beyond soil health to integrate biophysical properties, digital soil infrastructure, socio-economic value, and governance mechanisms. Drawing on recent Australian case studies, this review identifies advances in digital soil mapping, national soil assessments, economic valuation of soil capital, stakeholder connectivity, and emerging policy frameworks, while also identifying persistent gaps in regulation, data standardisation, and institutional coordination. The paper argues that soil security can help operationalise 3-N agriculture—Net-Zero, Nature-Positive, and Nutrient-Balanced systems—by translating sustainability goals into spatially explicit, place-based decisions grounded in soil realities. By explicitly accounting for soil capacity limits, condition trajectories, capital value, information flows, and codified rules, soil security can support more realistic climate mitigation strategies, targeted nature-positive interventions, and durable nutrient security outcomes. We conclude that embedding soil security more explicitly within Australian agricultural research, policy, and governance would strengthen efforts to deliver productive, resilient, and socially legitimate food and fibre systems. Without soil security, sustainability frameworks may remain difficult to operationalise consistently; with soil security, they can be translated more effectively into measurable, place-based, and durable decisions. Full article
24 pages, 2681 KB  
Article
The Informational Economy Functional: A Variational Principle for Decoherence and Classical Emergence
by Wan Zheng
Quantum Rep. 2026, 8(2), 32; https://doi.org/10.3390/quantum8020032 - 10 Apr 2026
Abstract
The emergence of classicality through quantum decoherence is commonly described from complementary perspectives emphasizing stability (environment-induced superselection), objectivity (Quantum Darwinism), or physical feasibility (information thermodynamics). In realistic open quantum systems, however, these aspects coexist and compete under finite physical resources. In this work [...] Read more.
The emergence of classicality through quantum decoherence is commonly described from complementary perspectives emphasizing stability (environment-induced superselection), objectivity (Quantum Darwinism), or physical feasibility (information thermodynamics). In realistic open quantum systems, however, these aspects coexist and compete under finite physical resources. In this work we argue that classical structure selection is most naturally understood as a resource-constrained, multi-objective process. We introduce the Informational Economy Functional (IEF), an effective accounting framework that places loss of distinguishability, energetic dissipation, and the generation of redundantly accessible records on equal footing. The associated Principle of Informational Economy characterizes emergent classical structures as those achieving an optimal compromise among stability, objectivity, and energetic feasibility. Classicality is thus neither maximally stable, nor maximally redundant, nor maximally energy-efficient, but instead reflects a Pareto-optimal balance shaped by environmental constraints. The IEF yields falsifiable predictions concerning pointer-structure variability, redundancy deformation, and resource-sensitive trade-offs, and suggests concrete experimental tests in continuously monitored quantum platforms. Classical reality is thereby reinterpreted as the most economical configuration in which information can stably form, propagate, and persist. Full article
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24 pages, 396 KB  
Review
Adaptive Architectures for Gamified Learning in Software Engineering: A Systematic Review
by Aurora Annamaria Quartulli, Giovanni Mignogna, Vera Zizzo and Marina Mongiello
Computers 2026, 15(4), 235; https://doi.org/10.3390/computers15040235 - 9 Apr 2026
Abstract
Effective software engineering education today requires tools that adapt to individual learner proficiency and progress, while ensuring positive student engagement. Gamified platforms represent an effective approach to learning and maintaining motivation, but their efficacy depends on a robust underlying architecture. This systematic literature [...] Read more.
Effective software engineering education today requires tools that adapt to individual learner proficiency and progress, while ensuring positive student engagement. Gamified platforms represent an effective approach to learning and maintaining motivation, but their efficacy depends on a robust underlying architecture. This systematic literature review analyzes state-of-the-art artificial intelligence (AI)-based adaptive architectures designed to support gamified learning tools, highlighting their architectural models (such as intelligent tutoring systems, multi-agent systems, and immersive virtual reality/augmented reality environments), adaptation mechanisms (including Generative AI and chatbots), and personalization strategies. A significant focus is placed on Process Mining and Learning Analytics as methodological approaches to organize learning paths and guide dynamic adaptation based on student behavior. The results of the selected studies demonstrate advantages such as increased engagement, longer-term participation, and personalized learning pace. However, challenges remain, such as common assessment criteria, integrating different technologies, and system scalability. The findings offer concrete insights for designing the next generation of effective gamified learning tools, based on data and software engineering processes. Full article
25 pages, 3226 KB  
Article
Quality of the Amazon Açaí Waste Stored Under Different Conditions over Time for Pyrolysis and Combustion Aimed at Bioenergy Recovery Systems
by Thayane Duarte Costa, Fernanda Yukari de Souza Sakuma, Juliana Livian Lima de Abreu dos Santos, Thiago de Paula Protásio, Michael Douglas Roque Lima, Mario Vanoli Scatolino, Lourival Marin Mendes, Eunice Gonçalves Macedo, Tiago Marcolino de Souza, Breno Marques da Silva e Silva and Lina Bufalino
Sustainability 2026, 18(8), 3730; https://doi.org/10.3390/su18083730 - 9 Apr 2026
Abstract
The Amazonian açaí waste is promising for producing charcoal through pyrolysis and bioenergy through combustion, but the property losses from its poor disposal in the environment remain unknown. Therefore, this work aimed to analyze how different storage conditions of the açaí waste over [...] Read more.
The Amazonian açaí waste is promising for producing charcoal through pyrolysis and bioenergy through combustion, but the property losses from its poor disposal in the environment remain unknown. Therefore, this work aimed to analyze how different storage conditions of the açaí waste over time, which mimic the reality throughout the Amazon, modify its bioenergetic properties. The samples were stored in a covered greenhouse for nine months in the following conditions: immersed in water, on the soil, and in open plastic bags. The biomass was analyzed by Fourier-transformed near-infrared spectroscopy, physical properties, stereomicroscopy, proximate composition, and thermogravimetry. The degraded waste showed endocarp attack and fungi proliferation. The chemical groups of primary cell wall components were concentrated, unlike water-soluble materials, raising the fixed carbon from 22% to 25% after 30 days. Consequently, higher heating values were kept (≈19 MJ/kg). However, water immersion storage sharply decreased the waste basic density from 0.81 g/cm3 to 0.56 g/cm3, dropping the energy density from 12 GJ/m3 to 8 GJ/m3. Moreover, storage raised ash content from 1.1% up to 1.9%. The storage hindered the start of the main phases of combustion and pyrolysis, which were later intensified, especially for soil-stored waste. Therefore, more stable combustion and pyrolysis require fresh waste. Besides natural drying, plastic bag storage over time kept the waste quality closer to that of the fresh waste. Full article
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38 pages, 2857 KB  
Review
BIM-Based Digital Twin and Extended Reality for Electrical Maintenance in Smart Buildings: A Structured Review with Implementation Evidence
by Paolo Di Leo, Michele Zucco and Matteo Del Giudice
Appl. Sci. 2026, 16(8), 3685; https://doi.org/10.3390/app16083685 - 9 Apr 2026
Abstract
The current literature on electrical system maintenance highlights three technology domains—Building Information Modeling (BIM), Digital Twin (DT), and extended reality (XR)—that have independently demonstrated strong potential for improving lifecycle information management, predictive analytics, and operational support. However, their convergence remains largely underexplored, particularly [...] Read more.
The current literature on electrical system maintenance highlights three technology domains—Building Information Modeling (BIM), Digital Twin (DT), and extended reality (XR)—that have independently demonstrated strong potential for improving lifecycle information management, predictive analytics, and operational support. However, their convergence remains largely underexplored, particularly in electrical system maintenance. This paper provides a structured review of BIM–DT–XR convergence in electrical system lifecycle management, examining their roles across lifecycle phases and their integration through literature synthesis and cross-domain implementation evidence. BIM is analyzed as a basis for modeling and integrating facility management with electrical asset lifecycles; DT as a framework for dynamic system representation and applications in electrical and power systems; and XR as a means of visualizing and interacting with BIM-DT environments. Cross-domain implementation evidence from an industrial electrical facility and a tertiary smart-building pilot shows that BIM–DT–XR integration is technically feasible at pilot scale. However, the analysis identifies five structural integration gaps: semantic misalignment between building-oriented IFC and grid-oriented CIM ontologies; fragmented standard adoption; inconsistent data governance and naming practices; validation approaches focused on syntactic rather than dynamic model fidelity; and the separation of XR visualization from predictive DT capabilities. The implementation evidence further indicates that real-world deployment remains constrained by data quality limitations, integration complexity, cost factors, and interoperability with legacy systems. The review concludes that, despite the maturity of individual technologies, their effective application depends on advances in semantic alignment, lifecycle data governance, validation of dynamic models, and scalable integration frameworks, enabling the transition toward integrated, interoperable, and lifecycle-aware infrastructures for electrical system maintenance. Full article
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31 pages, 1986 KB  
Article
SiteSync: A Remote Real-Time Collaborative System for Early-Stage Site Analysis in Architecture, Engineering, and Construction
by Yining Liu and Ding He
Appl. Sci. 2026, 16(8), 3684; https://doi.org/10.3390/app16083684 - 9 Apr 2026
Abstract
Early-stage remote site analysis is often hindered by fragmented media that fail to convey sufficient spatial context to off-site collaborators. To address this challenge, we propose SiteSync, a real-time remote collaborative system that combines live video, coarse mesh streaming, georeferenced pose tracking, and [...] Read more.
Early-stage remote site analysis is often hindered by fragmented media that fail to convey sufficient spatial context to off-site collaborators. To address this challenge, we propose SiteSync, a real-time remote collaborative system that combines live video, coarse mesh streaming, georeferenced pose tracking, and 3D spatial annotations to establish a shared spatial understanding between on-site and remote collaborators. The system was evaluated through a counterbalanced within-subject study with 24 participants, comparing the synchronous SiteSync workflow against a traditional asynchronous baseline. The results showed that SiteSync significantly improved task performance by reducing completion time and rework while increasing overall accuracy (all p < 0.001). Participants also reported lower cognitive workload and higher usability. Remote users benefited most significantly. These findings show that the synchronous workflow can improve collaboration efficiency and user experience in early-stage site analysis. Full article
20 pages, 1074 KB  
Article
Ecological and Ethological Assessment of Captive Testudo graeca in an Urban Bazaar: A Case of High-Constraint Wildlife Tourism in Kastamonu, Northern Anatolia
by Murat Afsar, Çetin Çelik, Mahsun Cağlar, Pınar Durmuş and Birgül Afsar
Animals 2026, 16(8), 1141; https://doi.org/10.3390/ani16081141 - 9 Apr 2026
Abstract
The Spur-thighed tortoise (Testudo graeca) is a long-lived terrestrial reptile listed as ‘Vulnerable’ on the IUCN Red List and protected under CITES Appendix II. As an ecosystem engineer, it plays a vital role in Mediterranean landscapes, yet it frequently faces anthropogenic [...] Read more.
The Spur-thighed tortoise (Testudo graeca) is a long-lived terrestrial reptile listed as ‘Vulnerable’ on the IUCN Red List and protected under CITES Appendix II. As an ecosystem engineer, it plays a vital role in Mediterranean landscapes, yet it frequently faces anthropogenic pressures in urban environments. This study provides an ecological and ethological assessment of a captive T. graeca population (n = 42) in the historical Münire Madrasa Handicrafts Bazaar in Kastamonu, Türkiye. The methodology integrated spatial carrying capacity modeling (Boullon model), systematic ethogram-based observations (120 h), and ethnozoological surveys (n = 200). Spatial analysis revealed that the population exceeds the corrected Real Carrying Capacity (RCC ≈ 10) by four times (Overcapacity Index: 4.2) within the 70 m2 area. Ethological findings documented chronic stress, with stereotypic pacing (H1) occupying 32% of the time budget, alongside a significant loss of anti-predator mechanisms due to anthropogenic habituation (İ1). While stakeholders (100%, 95% CI: 98.1–100%) perceive the tortoises as cultural symbols of abundance, the biological reality indicates severe welfare risks, including potential metabolic bone disease from a monotonous anthropogenic diet and a disrupted Ca:P ratio. The site is categorized as a ‘High-Constraint Interaction Zone’. We propose a management transition toward a monitored ‘Urban Wildlife Education Station’ to align local cultural values with international animal welfare and conservation standards. Full article
(This article belongs to the Section Human-Animal Interactions, Animal Behaviour and Emotion)
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26 pages, 4370 KB  
Article
Enabling Inclusive Access to Restricted Sacred Spaces: A Real-World Comparison of VR360 and AI-Driven Virtual Reality
by Phimphakan Thongthip, Darin Poollapalin, Songpon Khanchai, Pakinee Ariya and Phichete Julrode
Informatics 2026, 13(4), 59; https://doi.org/10.3390/informatics13040059 - 9 Apr 2026
Abstract
This study investigates how virtual reality systems can support inclusive access to culturally restricted sacred heritage sites. Two extended reality (XR) approaches were developed and deployed in a real-world setting: a VR360 virtual tour and an AI-driven immersive virtual reality prototype with conversational [...] Read more.
This study investigates how virtual reality systems can support inclusive access to culturally restricted sacred heritage sites. Two extended reality (XR) approaches were developed and deployed in a real-world setting: a VR360 virtual tour and an AI-driven immersive virtual reality prototype with conversational interaction. A research-in-the-wild, between-subjects study was conducted with 136 participants using mixed methods, including standardized questionnaires (System Usability Scale, User Engagement Scale, and Igroup Presence Questionnaire), retrospective interviews, and exhibition staff observations. The results reveal clear trade-offs between the two systems. The VR360 system demonstrated higher usability and operational reliability, requiring minimal supervision and technical resources, whereas the AI-driven immersive VR system supported embodied exploration and conversational inquiry, which was associated with higher spatial presence and helped visitors address questions during exploration. Qualitative findings further indicate that conversational interaction enhanced user experience but also introduced greater technical complexity and staffing requirements. Overall, the study provides empirical insights for designing and deploying XR systems in heritage contexts and highlights how different levels of immersion and interaction influence usability, presence, and operational feasibility when supporting inclusive access to culturally restricted sites. Full article
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18 pages, 1634 KB  
Article
3D Virtual Reality Performance Metrics as a Future Fatigue Biomarker in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
by Anja-Maria Ladek, Leonie Priebe, Thomas Harrer, Ellen Harrer, Georg Michelson, Thomas S. Knauer, Diogo X. Dias-Nunes, Christian Y. Mardin, Antonio Bergua and Bettina Hohberger
Biomedicines 2026, 14(4), 855; https://doi.org/10.3390/biomedicines14040855 - 9 Apr 2026
Abstract
Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disorder, characterized by symptoms such as post-exertional malaise (PEM) and cognitive impairments. This study assessed reaction time (RT) metrics in three-dimensional (3D) visual tasks with the aim of objectively quantifying the cognitive impairments in [...] Read more.
Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disorder, characterized by symptoms such as post-exertional malaise (PEM) and cognitive impairments. This study assessed reaction time (RT) metrics in three-dimensional (3D) visual tasks with the aim of objectively quantifying the cognitive impairments in ME/CFS patients compared to controls. Methods: A total of 120 participants (60 ME/CFS patients and 60 controls) were recruited at the Department of Ophthalmology, Universität of Erlangen-Nürnberg. RT was assessed using a virtual reality–oculomotor test system, presenting 3D stimuli at three disparity levels (275″, 550″, and 1100″) within three gaming repetitions (R1, R2, and R3). Mixed-effects models were used to evaluate group differences, with age and gender as covariates. Pairwise contrasts were calculated to assess changes across repetitions. Fatigue self-assessments were recorded by validated questionnaires, (FACIT Fatigue Scale, Chalder Fatigue Scale, Bell Score and Health Assessment Questionnaire), and their correlation with RT metrics was portrayed using a Spearman correlation matrix. Results: Estimated means (EM-means) for RT were significantly prolonged in ME/CFS patients compared to controls at disparity 275″ (1969 ms vs. 1384 ms; p = 0.0001), 550″ (1409 vs. 1071 ms; p = 0.0012) and 1100″ (1126 ms vs. 891 ms; p = 0.00223). Age was a significant covariate (p < 0.001), while gender showed no effect. Both groups demonstrated improvements in RT over repetitions; however, ME/CFS patients showed a significantly lower improvement compared to controls, reaching significance in R3 (p = 0.0042). RT metrics did not correlate with patients’ self-assessment scores. Conclusions: ME/CFS patients showed consistently slower RTs compared to controls, particularly in later, easier gaming repetitions, potentially reflecting the impact of fatigue. Full article
(This article belongs to the Section Molecular and Translational Medicine)
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17 pages, 570 KB  
Perspective
Towards a Closed-Loop Bioengineering Framework for Immersive VR-Based Telerehabilitation Integrating Wearable Biosensing and Adaptive Feedback
by Gaia Roccaforte, Arianna Sinardi, Sofia Ruello, Carmela Lipari, Flavio Corpina, Antonio Epifanio, Anna Isgrò, Francesco Davide Russo, Alfio Puglisi, Giovanni Pioggia and Flavia Marino
Bioengineering 2026, 13(4), 439; https://doi.org/10.3390/bioengineering13040439 - 9 Apr 2026
Abstract
Telerehabilitation—the remote delivery of rehabilitation services—is undergoing a paradigm shift with the convergence of immersive virtual reality (VR) and wearable biosensor technologies. This perspective article outlines a vision for home-based motor and cognitive rehabilitation that is engaging, personalized, and data-driven. We describe how [...] Read more.
Telerehabilitation—the remote delivery of rehabilitation services—is undergoing a paradigm shift with the convergence of immersive virtual reality (VR) and wearable biosensor technologies. This perspective article outlines a vision for home-based motor and cognitive rehabilitation that is engaging, personalized, and data-driven. We describe how immersive VR environments (for example, simulations of home settings or supermarkets) coupled with wearable sensors can address current challenges in rehabilitation by increasing patient motivation, enabling real-time biofeedback, and supporting remote clinician supervision. Gamification mechanisms and rich sensory feedback in VR are highlighted as key strategies to enhance user engagement and adherence to therapy. We discuss conceptual innovations such as multi-sensor data integration, dynamic difficulty adaptation, and AI-driven personalization of exercises, derived from recent research and our development experience, and consider their potential benefits for patients with neuro-cognitive-motor impairments (e.g., stroke, Parkinson’s disease, and multiple sclerosis). Implementation scenarios for home-based therapy are presented, emphasizing scalability, standardized digital metrics for monitoring progress, and seamless involvement of clinicians via telehealth platforms. We also critically examine the current limitations of VR and telehealth rehabilitation and how an integrative model could overcome these barriers. More specifically, this perspective defines the engineering requirements of a closed-loop VR-based telerehabilitation framework, including multimodal data synchronization, calibration, signal-quality management, interpretable adaptive control, digital biomarker validation, and practical strategies to improve accessibility, privacy, and scalability in home-based neurological rehabilitation. Full article
(This article belongs to the Special Issue Physical Therapy and Rehabilitation)
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