Search Results (460)

Background/Objectives: Western Canadian and U.S. communities outside urban centres remain underserved by primary, specialist, emergency, mental health, and chronic-disease services. These access problems reflect distance, weather, workforce shortages, specialist maldistribution, primary care attachment gaps, broadband limitations, and the governance realities of Indigenous and Tribal communities. This scoping review with narrative synthesis examined how telehealth and virtual-care models affect rural access in western Canada and the western/frontier United States. Methods: Searches were completed on 21 May 2026 in PubMed/MEDLINE, Embase, CINAHL, Scopus, the Cochrane Library, and PubMed Central. Supplementary searches included Google Scholar, publisher platforms, reference-list checking, and official Canadian and U.S. health-system sources. Peer-reviewed evidence published from 1 January 2016 to 21 May 2026 was eligible when it addressed rural, remote, frontier, Indigenous, underserved, western, or northern healthcare settings and reported access, implementation, safety, continuity, equity, or service-use outcomes. Results: The search identified 112 records; 27 duplicates were removed, 85 records were screened, 37 full texts were assessed, and 28 peer-reviewed records were included. Seven official sources were retained separately. Evidence was mainly observational, qualitative, mixed-methods, implementation-focused, or review-level. Moderate confidence supported telehealth for travel reduction and specialist input, especially through eConsultation, provider-to-provider consultation, telementoring, and real-time emergency support. Confidence was low to moderate for hybrid primary care and telemental health, and low for durable reductions in emergency department use. Conclusions: Telehealth may be most appropriately implemented as a hybrid, locally anchored, culturally safe access model, not as a stand-alone substitute for rural primary care, specialist capacity, or emergency services. Implementation should include broadband support, local physical assessment capacity, documentation, continuity, patient education, and clear escalation pathways. Full article

This article presents an integrated approach that combines Virtual Reality (VR), Augmented Reality (AR), and an Intelligent Virtual Assistant (IVA) to support training, on-the-job assistance, and maintenance in a textile manufacturing environment. The solution spans three systems: RioRV, a Unity-based VR platform for immersive, step-by-step procedure rehearsal, instructional videos, and simplified 3D animations; RiAR, a mobile AR application for assisted maintenance and access to real-time and historical machine data using marker-based (VuMark) identification; and Ria, a web-based IVA that delivers document-grounded answers, operational queries over a secure plant API, short-horizon forecasting, and a narrow set of guarded remote actions. The architecture prioritizes human-centered Industry 5.0 principles—safety, usability, and resilience—by enabling operators to learn procedures in VR, execute tasks with AR overlays and maintenance media at the workstation, and obtain concise, source-cited guidance via the IVA without leaving immersion. In the case study with a spinning section at RIOPELE, the convergence of VR, AR, and IVA reduced reliance on bulky manuals, shortened time-to-information for machine status, and established a feedback loop in which training and operational experience continuously enrich the knowledge base. Full article

Everyday heritage objects are often overlooked despite their cultural significance and vulnerability to surface degradation caused by environmental exposure, material ageing, and human interaction. This review examines how surface characterization, digital documentation, additive manufacturing, and extended reality (XR) technologies can be integrated to support the conservation, replication, and inclusive dissemination of such assets. The study synthesizes recent advances in non-destructive surface analysis methods, including spectroscopic and imaging techniques, alongside 3D scanning approaches capable of capturing both geometry and surface condition. These data are linked to additive manufacturing workflows for producing accurate and durable replicas, with particular attention to surface fidelity and material selection. The review further explores how tactile replicas and multimodal interpretation strategies can enhance accessibility for visually impaired users, addressing limitations of visually dominant heritage practices. XR technologies are discussed as complementary tools for interpretation and remote access. The findings highlight that combining surface-focused conservation with digital and fabrication technologies enables more resilient, accessible, and sustainable heritage management. Future research should focus on standardizing inclusive design approaches and improving the integration of surface data into digital and physical reproduction pipelines. Full article

Rural and remote health systems continue to face persistent workforce challenges that affect the delivery of chronic disease care, including diabetes management. Mentorship is widely recognised as a valuable strategy for supporting health professionals, with demonstrated benefits for practice development and workforce sustainability. However, many mentorship approaches are developed in well-resourced settings and assume stable infrastructure, protected time, and workforce capacity. These assumptions may not align with the realities of rural and remote practice, where service pressures and resource constraints shape everyday care. This commentary examines how mentorship can be designed for constrained health systems. It proposes a systems-oriented perspective that positions mentorship as part of routine practice rather than as a separate professional development activity. Emphasis is placed on flexibility, co-design, and cultural safety, with attention to how mentorship can be integrated within workforce development pathways. This reframing has implications for strengthening rural health services by supporting continuous, context-responsive learning within routine practice. More broadly, this approach offers a scalable pathway to workforce strengthening in geographically dispersed and resource-variable health systems. Full article

This paper presents a Digital Twin (DT)-based framework for the control, monitoring, and intelligent optimization of an Assembly/Disassembly/Repair Mechatronic Production Line (A/D/R MPL), developed as a laboratory platform aligned with Industry/Education 4.0/5.0 paradigms. The A/D/R MPL is assisted by two complementary cyber–physical robotic systems: an Assembly/Disassembly/Replacement Cyber–Physical Robotic System (A/D/R CPRS), and a Mobile Cyber–Physical Robotic System (MCPRS), enabling both fixed and mobile intelligent operations. The CPRS is equipped with an industrial robotic manipulator (IRM) responsible for A/D/R tasks, while the A/D Mechatronic Line (A/D ML) consists of seven interconnected workstations (WS1–WS7) dedicated to storage, transport, quality control, and final product handling. MCPRS includes a wheeled mobile robot (WMR), carrying a robotic manipulator (RM) and Mobile Visual Servoing System (MVSS). Each workstation is connected to a local slave programmable logic controller (PLC), which communicates via PROFIBUS with a master PLC located at the CPRS level. Additional communication infrastructures include LAN PROFINET and LAN Ethernet for local integration, and WAN Ethernet connectivity enabled through open platform Communication-Unified Architecture (OPC-UA), ensuring interoperability, scalability, and remote accessibility. Also, MODBUS TCP as serial industrial communication is used between the master PLC and the MCPRS. Virtual environment supports task planning through Augmented Reality (AR) and real-time monitoring through Virtual Reality (VR). The system behaviour is modelled with synchronized hybrid Petri Nets (SHPNs) which describe the discrete and hybrid dynamics of A/D/R processes. Artificial intelligence (AI) techniques are integrated into the DT framework for optimal task scheduling and adaptive decision-making. As a laboratory-scale implementation, the proposed system provides a comprehensive platform for experimentation, validation, and education. It supports Education 4.0/5.0 objectives by facilitating hands-on learning, human–machine interaction, and the integration of emerging technologies such as AI, Digital Twins, AR/VR, and cyber–physical systems. At the same time, it embodies Industry 4.0/5.0 principles, including interoperability, decentralization, sustainability, robustness, and human-centric design. Full article

Robot-assisted telerehabilitation (RAT) combines rehabilitation robotics with digital health workflows to extend access to upper-limb (UL) therapy after stroke. Mixed reality (MR) may support therapist–patient interaction and task visualization; however, early-stage systems require rigorous evaluation of safety and usability before deployment in the home. In a formative, mixed-methods usability study conducted in a controlled setting using a telerehabilitation workflow, six individuals post-stroke (≥3 months) and six occupational therapists (OTs) completed a single supervised session with a desktop-mounted end-effector type therapeutic robot (iTbot) integrated with Microsoft HoloLens 2. Participants performed structured passive and active UL exercises while therapists supervised and interacted with the system via the MR control interfaces. Safety was evaluated by documenting observed adverse events and safety-stop activations. Usability and user experience were assessed using the System Usability Scale (SUS), study-specific satisfaction questionnaires (reported with scale ranges), and semi-structured follow-up interviews analyzed using thematic analysis. All participants completed the session without observed adverse events or safety-stop activations. Overall usability was favorable, with a mean (SD) SUS total score of 78.3 (15.9) out of 100 (stroke: 74.2 [18.1]; occupational therapists: 82.5 [13.5]). Qualitative feedback indicated that MR was perceived as engaging and intuitive by many users, while also identifying implementation needs relevant to real-world telerehabilitation, including clearer onboarding, simplification of certain MR interactions, and improved physical interfaces (e.g., handle options). Therapists highlighted workflow considerations for remote supervision and patient independence. Together, these findings support progression to multi-session, in-home studies to quantify remote assistance needs, technical reliability, adherence, and clinical outcomes. Full article

Background: Low-cost virtual reality exergames may help maintain and improve postural control in children with spastic hemiplegia cerebral palsy (CP). This study aimed to evaluate the comparative effectiveness of the same six-week, low-cost exergame programme delivered via telerehabilitation (TR) and face-to-face (FF) in CP children. Methods: In this randomised controlled trial, 15 CP patients completed 18 sessions over 6 weeks. The TR group received remotely delivered sessions, whereas the FF control group completed in-person sessions with a physiotherapist. Outcomes were assessed at baseline; weeks 2, 4, and 6; and follow-ups at weeks 8 and 10. Postural control (centre-of-pressure sway area; CoP_sway) was measured during eyes open (EO), eyes closed (EC), voluntary mediolateral sway to a 30 bpm auditory cue (EO/EC), and during exergames targeting mediolateral (ML-WS) and anteroposterior (AP-WS) weight-shifting. Timed Up and Go (TUG) and Modified Modified Ashworth Scale (MMAS) were also assessed. Results: At week 6, both TR and FF significantly reduced CoP_sway (TR: p = 0.001, EC; FF: p = 0.01, EO). TR also improved dynamic postural control (p < 0.05) and TUG scores (p = 0.03), with functional gains sustained until week 10. Between-group comparisons revealed that TR achieved significantly greater reductions in AP weight-shifting (SD_ML, p = 0.001; V_ML, p = 0.004) and TUG (p = 0.009) than FF, with these advantages persisting throughout follow-up as revealed by post hoc analysis. Conversely, only FF significantly reduced ankle muscle tone (MMAS, p = 0.05). TR demonstrated broader improvements in secondary CoP metrics and superior long-term retention of functional mobility gains. Conclusions: Both six-week exergame interventions led to improvements in postural control. This trial demonstrated that telerehabilitation is a viable, comparable alternative to face-to-face delivery. Long-term retention suggests both modalities are complementary, offering flexible solutions to enhance routine physiotherapy service pathways. These findings provide a basis for validating these models across larger clinical cohorts. Full article

The COVID-19 pandemic highlighted the need for effective disinfection strategies in order to minimize human exposure and reduce the risk of contagion in indoor environments. Ultraviolet-C (UV-C) irradiation has proven to be an effective solution for inactivating a wide range of pathogens. However, traditional fixed UV-C systems suffer from limited coverage and lack operational flexibility. To address these limitations, this paper proposes an augmented reality (AR)-based teleoperation framework for an omnidirectional mobile robot equipped with a UV-C disinfection light. Unlike traditional toolchain integrations, our framework synergizes immersive spatial visualization of a reconstructed environment, operator-guided waypoint-based remote navigation, and real-time interaction with the disinfection payload in a single operational workflow. The system is implemented using a ROSMASTER X3 Plus robotic platform, which generates a three-dimensional representation of the environment through visual simultaneous localization and mapping using RTAB-Map. The result is a 3D map that is imported into the Unity game engine and deployed to a Meta Quest 3 head-mounted display, enabling immersive visualization and interaction. Communication between the AR interface and the robotic system is achieved via the ROS-TCP-Connection, allowing real-time data exchange and remote robot control. Through the AR interface, the operator can navigate the robot within the scanned environment and activate the UV-C light. Experimental validation conducted in a classroom demonstrates the feasibility of the proposed approach and shows measurable reductions in surface microbial load. These results indicate that our system-level integration of AR-assisted teleoperation with mobile UV-C robotics represents a feasible proof-of-concept for flexible, operator-guided disinfection of indoor spaces. Full article

Archaeological sites present critical issues related to fragmented documentation systems, the difficulty of integrating stratigraphic analyses with three-dimensional survey data, and the lack of digital tools capable of connecting scientific documentation, conservation needs, and public dissemination. This study proposes an integrated digital workflow for the archaeological park of Aeclanum, in which reality-based multi-scale survey data are transformed into an HBIM model structured through stratigraphic interpretation, material analysis, and semantically organised information. The resulting three-dimensional dataset supports the subsequent Scan-to-BIM process, ensuring consistency between the digital representation and the existing remains. Within this framework, the HBIM model is conceived not only as a geometric representation of the current state, but also as an information environment incorporating data on construction techniques, materials, and decay conditions, thus providing a basis for conservation-oriented assessment and future intervention priorities. At the same time, the model supports digital reconstruction hypotheses consistent with archaeological evidence, later developed within an immersive environment that allows visitors to compare the present condition of the site with its reconstructed historical configuration. The workflow highlights the potential of HBIM as an interface between survey, knowledge organisation, conservation support, and digital enhancement. Full article

The construction industry remains among the most hazardous, with workers in horizontal transportation infrastructure facing additional risks from dynamic work zones, live traffic exposure, and variable environmental conditions. Immersive technologies such as Virtual Reality (VR) and Augmented Reality (AR) offer new approaches to accident analysis and prevention, yet their applications toward improving occupational safety in transportation construction have not been comprehensively reviewed. This paper presents a systematic review of 54 studies published between 2016 and 2025 collected from two online databases (Transportation Research International Documentation and Web of Science). This review synthesizes how immersive technologies contribute to occupational risk assessment, safety training, and real-time hazard monitoring in the construction of roads, bridges, tunnels, and work zones. Each study is classified across two dimensions: the immersive medium (VR, AR, etc.) and the operational context within the construction lifecycle (onsite tools, offsite monitoring and planning, simulation-based analysis, and workforce education). This dual classification is the first to systematically map immersive technology applications for occupational safety, specifically within horizontal transportation infrastructure. The findings of this review demonstrate the unique use cases of each immersive medium, revealing that VR is primarily used for controlled experimentation and full-immersion remote analysis, whereas AR and handheld devices are preferred for field-deployed applications. Despite these promising capabilities, widespread adoption remains limited by hardware constraints, challenging field conditions, and organizational resistance. This suggests that future work should focus on safety systems tested in real-world settings and rigorously evaluated by domain experts to enable their integration into standard workplace risk management practices. Full article

Virtual reality (VR) interfaces increasingly rely on interaction within peripersonal space. However, the conditions under which interaction performance in virtual environments can approximate those of comparable real-world tasks remain underexplored, particularly for hierarchical menus requiring precise sequential input. This study investigated how the presence or absence of tactile feedback influences movement time and selection accuracy during hierarchical menu interaction in peripersonal space across different task difficulty levels. Twelve participants performed a three-level hierarchical selection task on a 4 × 3 menu in two controlled experiments with a stereoscopic 3D TV. Two interaction conditions were tested: a surface-based condition, with the menu attached to the physical screen, and a mid-air condition, with the menu positioned 35 cm and 45 cm in front of participants. Selections were confirmed using a handheld remote. Results showed no statistically significant difference in movement time and selection accuracy between the virtual and real environments when screen-surface targets provided tactile feedback, but performance declined for mid-air targets without tactile references, particularly under higher task difficulty levels. These findings suggest that tactile feedback, coordinated visual target placement, and users’ familiarity with touchscreen-like interaction jointly act as key factors for designing effective, immersive, and user-friendly VR menu systems in peripersonal space. Full article

Social Virtual Reality (VR) is emerging as a powerful medium for remote social interaction and collaboration, enabling multiple users to share experiences together while apart. Likewise, recent advances in multimedia technologies have proposed strategically combining diverse content formats and introducing interaction techniques for recreating virtual environments and engaging with them, respectively. This study pioneers the joint exploration of Social VR enhanced with holographic communication, multimodal content integration, and advanced interaction methods to deliver realistic and interactive group visits to reconstructed cultural heritage sites, specifically an existing restaurant–museum. The reconstructed space is further augmented with Points of Interest (PoIs), which can be freely visited and dynamically activated to provide rich contextual and historical information about the venue. The proposed technology and scenario have been evaluated objectively and subjectively. Results from objective tests offer relevant insights into the technical requirements, performance metrics (including bandwidth usage and latency), and overall system stability. Results from subjective tests with 22 participant pairs reveal high levels of user satisfaction, particularly in terms of immersion, presence, togetherness, and interaction quality regardless of whether participants acted as Guides (interacting with the VR environment) or Followers (observing and following the Guide’s actions). Beyond demonstrating feasibility, the findings from this study prove, for the first time, how strategically combining multi-user holoportation with multimodal content and role-based interactions can enable guided, collaborative cultural or touristic visits that preserve social presence while supporting rich exploration and contextual learning. Full article

Extended Reality (XR) and Artificial Intelligence (AI) are increasingly converging within cyber–physical infrastructures, including digital twins, the Spatial Web, and smart-city systems. These environments require new frameworks for understanding how human performance emerges through sustained interaction with immersive interfaces and adaptive computational agents. This paper introduces the TAXI–XI-CAP framework, a two-layer model that links psychobiological mechanisms of XR–AI interaction to higher-level, experimentally testable capability constructs. The TAXI layer defines 42 mechanisms spanning perception, cognition, physiology, sensorimotor control, and social coordination, while XI-CAP organizes these into capability patterns such as remote dexterity, distributed cognition, and adaptive workload regulation. Derived through a theory-guided synthesis across XR, neuroscience, and human–automation interaction, the framework models performance as emerging from interacting mechanisms under real-world constraints. A validation-oriented research agenda is proposed, emphasizing mechanism-level measurement, capability-level evaluation, and longitudinal testing. The TAXI–XI-CAP framework provides a structured basis for hypothesis generation, comparative analysis, and empirical validation of XR–AI systems, supporting the development of reliable, scalable, and human-centered Extended Intelligence infrastructures. Full article

Complex psychosis (CP) remains one of the most challenging conditions in mental health, characterized by persistent symptoms, cognitive impairment, functional disability, and reduced autonomy. Traditional rehabilitation approaches, although essential, are often insufficient to address the multidimensional needs of these individuals. Over the past decade, rapid advances in digital health have opened new opportunities to enhance psychosocial rehabilitation, improve engagement, and personalize treatment pathways. This narrative review synthesizes current evidence on the use of digital and immersive technologies in the rehabilitation of people with CP, including virtual reality (VR), augmented reality (AR), telerehabilitation platforms, mobile health (m-Health) applications, digital phenotyping, and AI-assisted cognitive remediation. We examine clinical trials, feasibility studies, and real-world implementations published between 2015 and 2025, highlighting the efficacy of VR-based social cognition training, remote cognitive remediation, ecological momentary interventions, and hybrid digital–in-person rehabilitation models. Mechanisms of action, transfer to real-world functioning, and predictors of engagement are described. Barriers such as digital literacy, access disparities, privacy concerns, and clinical integration are critically discussed. We also outline future directions, including adaptive algorithms, biosensor integration, and the development of multimodal digital ecosystems tailored to individual recovery trajectories. By integrating technological innovation with recovery-oriented care, digital rehabilitation tools have the potential to transform the treatment landscape for people with CP. This review offers a roadmap for clinicians, researchers, and policymakers seeking to incorporate evidence-based digital solutions into modern psychiatric rehabilitation. Full article

Background: Μetabolic syndrome (MetS)—comprises central adiposity, elevated blood pressure, dyslipidaemia, and dysglycaemia, increasing the risk of type 2 diabetes and cardiovascular disease. Exercise training improves cardiorespiratory fitness and several MetS components, but real-world effectiveness is limited by poor adherence, restricted supervision, and insufficient personalisation. Objective: This scoping review mapped the clinical intervention evidence on technology-enhanced exercise and structured physical activity relevant to MetS, while distinguishing direct MetS evidence from translational evidence. Methods: In accordance with PRISMA-ScR, we searched PubMed and extended the search to Scopus and Web of Science; a supplementary IEEE Xplore search and a post hoc Embase check were also conducted. Eligible studies were interventions using web-based delivery, wearables, telemonitoring/mobile health (mHealth), artificial intelligence (AI) coaching, virtual reality (VR)/exergaming, or continuous glucose monitoring (CGM) alongside exercise training or structured physical activity. Results: Nineteen studies met the eligibility criteria. The evidence base was weighted toward wearable/app-based feedback and telemonitoring/mHealth/web-based approaches, with fewer studies on VR/exergaming, CGM-enabled exercise, and AI coaching. Most studies were randomised or cluster-randomised, but interventions were usually short term. Across categories, technology most consistently supported adherence, self-monitoring, accountability, remote supervision, and, in selected cases, physiology-informed personalisation. Direct MetS evidence was strongest for wearables with structured feedback, telemonitoring, mHealth, and web-based delivery, whereas AI coaching and CGM were supported by adjacent translational evidence. Conclusions: Technology-enhanced exercise and structured physical activity show promising but heterogeneous and still preliminary potential for MetS management. Key limitations include short follow-up, uneven representation across categories, inconsistent reporting of exercise dose/intensity fidelity and adverse events, and limited equity and implementation outcomes. Full article