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virtual reality for Preoperative Planning and Education in Pediatric Surgery: Preliminary Results for the Treatment of Congenital Malformations and Tumors

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WORLD JOURNAL OF SURGERY 2025年第6期49卷 1497-1507页

作者： Pelizzo, Gloria Pierucci, Ugo Maria Marinaro, Michela Costanzo, Sara Durante, Eleonora Ardenghi, Carlotta Musitelli, Alessia Milani, Paolo Rizzetto, Francesco Vertemati, Maurizio Campari, Alessandro Barisella, Marta Santaniello, Tommaso Gallotta, Cristina Camporesi, Anna Paraboschi, Irene Varrica, Alessandro Alberti, Daniele Calcaterra, Valeria Zuccotti, Gianvincenzo V Buzzi Childrens Hosp Dept Pediat Surg Milan Italy Univ Milan Dept Biomed & Clin Sci Milan Italy Univ Milan Interdisciplinary Ctr Nanostruct Mat & Interfaces CIMaINa Milan Italy Univ Milan Dept Phys Aldo Pontremoli Milan Italy ASST Grande Osped Metropolitano Niguarda Dept Radiol Milan Italy Univ Milan Postgrad Sch Diagnost & Intervent Radiol Milan Italy V Buzzi Childrens Hosp Dept Pediat Radiol Milan Italy Sacco Hosp Pathol Unit Milan Italy V Buzzi Childrens Hosp Dept Pediat Anesthesia & Intens Care Milan Italy IRCCS Policlin San Donato Dept Congenital Cardiac Surg San Donato Milanese Italy Univ Brescia ASST Spedali Civili Children Hosp Dept Pediat Surg Brescia Italy Univ Brescia Dept Clin & Expt Sci Brescia Italy V Buzzi Childrens Hosp Pediat Dept Milan Italy Univ Pavia Dept Internal Med Pediat & Adolescentol Unit Pavia Italy

Purposevirtual reality (VR) has emerged as a valuable tool in surgical planning, offering detailed anatomical spatial orientation and three-dimensional (3D) navigation. This study explores using virtual reality head-mounted display (VR-HMD) technology in preoperative planning for pediatric surgery, aiming to improve outcomes in treating congenital malformations and tumors while advancing surgical *** retrospective analysis was performed on pediatric patients diagnosed with congenital malformations and tumors who received treatment between 2021 and 2024 at the "V. Buzzi" Children's Hospital in Milan, Italy. Patient-specific 3D VR models were generated from reconstructed computed tomography/magnetic resonance imaging (CT/MRI) images and analyzed preoperatively to optimize surgical planning and strategy development. The advantages of preoperative VR compared to traditional imaging techniques were *** VR models were included in the study (n = 35: congenital malformations and n = 15 tumors). The VR-HMD setup facilitated interactive anatomical exploration, enabling precise surgical navigation and planning. Compared to conventional imaging, preoperative VR simulations modified the surgical approach in 75.0% of cases, enabling minimally invasive strategies in complex congenital malformations and guiding the decision for open surgery in anatomically challenging tumors such as adrenal and hepatic masses. VR images demonstrated superior anatomical resolution and identified potential intraoperative complications in 92.0% of cases compared to conventional imaging. Remarkably, examining the vascular hilum in pulmonary, hepatic, and renal structures provided enhanced guidance for determining the surgical approach, ensuring a safer and more precise respect for the anatomy in complex cases. As a result, preoperative VR navigation demonstrated the feasibility of minimally invasive procedures in 45.6% of complex cases whereas recommending an open surgi

关键词： congenital malformations education pediatric surgery preoperative simulation tumors virtual reality

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virtual reality to Support Inpatient Addiction Treatment: Patients Are Ready, What About Therapists? A Feasibility Study

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INTERNATIONAL JOURNAL OF MENTAL HEALTH AND ADDICTION 2023年第6期21卷 4085-4107页

作者： Arissen, Clemence van der Helm, Laura Dijkstra, Boukje Markus, Wiebren IrisZorg Inst Addict Care Sheltered Housing & Soc POB 351 NL-6800 AJ Arnhem Netherlands Radboud Univ Nijmegen NISPA Nijmegen Inst Scientist Practitioners Addic POB 9104 NL-6500 HE Nijmegen Netherlands

This study aimed to identify facilitators and barriers for implementation of virtual reality therapy (VRT), used to train communication and problem-solving skills aiding relapse prevention, when integrated with addiction treatment (Treatment as Usual;TAU). Mixed methods were used in an observational, partly prospective, design. A total of 21 therapists and 113 patients from three inpatient addiction clinics were assessed. Therapists filled in questionnaires to gauge expectancies and experiences regarding facilitators and barriers at baseline, after a try-out period, halfway, and at the end of the pilot lasting 6-12 months. They also participated in focus-group interviews. Patients filled in similar questionnaires before an initial, and after they finished a third, VRT session. In addition, nine patients were interviewed. All VRT sessions were logged, with patients answering additional questions. Acceptability of VRT was high in both groups. It was feasible to integrate VRT with TAU and integration showed potential effectiveness. Barriers included incidental motion sickness, technical difficulties, costs, and device setup time. Both therapists and patients advocated VRT use to augment addiction treatment. Findings suggest a clinical effectiveness study is warranted.

关键词： Feasibility virtual reality Addiction care

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virtual reality as a path to self-knowledge

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SYNTHESE 2023年第3期202卷 1-21页

作者： Schwengerer, Lukas Univ Duisburg Essen Inst Philosophie Fak Geisteswissenschaften Univ Str 12 D-45141 Essen Germany

I discuss how virtual reality can be used to acquire self-knowledge. Lawlor (Philos Phenomenol Res 79(1):47-75, 2009) and Cassam (Vices of the mind: from the intellectual to the political. OUP, Oxford, 2014) develop inferential accounts of self-knowledge in which one can use imagination to acquire self-knowledge. This is done by actively prompting imaginary scenarios and observing one's reactions to those scenarios. These reactions are then used as the inferential basis for acquiring self-knowledge. I suggest that the imaginary scenarios can be in principle replaced with scenarios in virtual reality in a way that still provides an inferential basis for self-knowledge. Instead of internal prompting in imagination, I call this external prompting in virtual reality. I discuss the advantages and disadvantages of external prompting. On one hand, external prompting avoids some of the common biases that can intervene with internal prompting in imagination. On the other hand, external prompting comes with some challenges of its own. External prompting might be more time-consuming and might be open to a game-like approach of the agent leading to a different sort of distortion that gets in the way of self-knowledge. I suggest that these are practical challenges, but nevertheless, external prompting seems worthwhile for self-knowledge that is otherwise especially difficult to acquire.

关键词： Self-knowledge Self-belief Introspection virtual reality

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virtual reality technology in neuropsychological testing: A systematic review

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JOURNAL OF NEUROPSYCHOLOGY 2023年第2期17卷 382-399页

作者： Pieri, Luca Tosi, Giorgia Romano, Daniele Univ Milano Bicocca Psychol Dept Milan Italy Univ Milano Bicocca Mind & Behav Technol Ctr MIBTEC Milan Italy Univ Salento Dipartimento Sci Umane & Sociali Lecce Italy NeuroMi Milan Ctr Neurosci Milan Italy Univ Milano Bicocca Psychol Dept Piazza Ateneo Nuovo 1 I-20126 Milan Italy

Neuropsychological testing aims to measure individuals' cognitive abilities (e.g. memory, attention), analysing their performance on specific behavioural tasks. Most neuropsychological tests are administered in the so-called 'paper-and-pencil' modality or via computerised protocols. The adequacy of these procedures has been recently questioned, with more specific concerns about their ecological validity, i.e. the relation between test scores observed in the laboratory setting and the actual everyday cognitive functioning. In developing more ecological tasks, researchers started to implement virtual reality (VR) technology as an administration technique focused on exposing individuals to simulated but realistic stimuli and environments, maintaining at the same time a controlled laboratory setting and collecting advanced measures of cognitive functioning. This systematic review aims to present how VR procedures for neuropsychological testing have been implemented in the last years. We initially explain the rationale for supporting VR as an advanced assessment tool, but we also discuss the challenges and risks that can limit the widespread implementation of this technology. Then, we systematised the large body of studies adopting VR for neuropsychological testing, describing the VR tools' distribution amongst different cognitive functions through a PRISMA-guided systematic review. The systematic review highlighted that only very few instruments are ready for clinical use, reporting psychometric proprieties (e.g. validity) and providing normative data. Most of the tools still need to be standardised on large cohorts of participants, having published only limited data on small samples up to now. Finally, we discussed the possible future directions of the VR neuropsychological test development linked to technological advances.

关键词： cognitive assessment neuropsychology PRISMA test virtual reality VR

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virtual reality Respiratory Biofeedback in an Outpatient Pediatric Pain Rehabilitation Program: Mixed Methods Pilot Study

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JMIR REHABILITATION AND ASSISTIVE TECHNOLOGIES 2025年 12卷 e66352页

作者： Recker, Kristin Silliman, Julia Gifford, Karolina Patel, Parth Santana, Lisgelia Hildenbrand, Aimee K. Palit, Shreela Wasserman, Rachel Univ Cent Florida Coll Med Orlando FL USA Nemours Childrens Hlth Syst Dept Grad Med Educ Orlando FL USA Nemours Childrens Hlth Dept Anesthesiol 6535 Nemours Parkway Orlando FL 32827 USA Thomas Jefferson Univ Sidney Kimmel Med Coll Dept Pediat Philadelphia PA USA Ctr Healthcare Delivery Sci Nemours Childrens Hlth Jacksonville FL USA

Background: Chronic pain in adolescents is a significant and growing concern, as it can have negative implications on physical and psychosocial development. Management can be complicated by the increasing risks associated with opioid misuse, highlighting the need for effective nonpharmacological interventions. Biofeedback is an empirically supported behavioral intervention for chronic pain that targets the self-regulation of physiological responses. virtual reality (VR) is a novel delivery method for biofeedback that could serve as an engaging and effective platform for adolescents. Objective: The goal of this study was to assess the feasibility, acceptability, and preliminary effectiveness of integrating a VR-delivered respiratory biofeedback intervention into an outpatient pediatric pain rehabilitation program (PPRP) for adolescents with chronic pain. Methods: In this pilot study, we recruited 9 participants from those enrolled in the PPRP at Nemours Children's Hospital. Participants underwent 2 VR respiratory biofeedback sessions per week over a 4-week period using AppliedVR's "RelieVRx" program. Feasibility was defined as >60% of eligible patients enrolling with at least 80% of VR sessions completed. Acceptability was assessed via validated acceptability questionnaires, with high acceptability defined as an average acceptability rating score >3 on a 5-point Likert scale. Open-ended responses were analyzed via qualitative analysis. Preliminary effectiveness was assessed with questionnaires measuring the quality of life (Pediatric Quality of Life Inventory [PedsQL]) and level of pain interference in daily activities (Functional Disability Inventory) before and after participation in the pain program. Finally, heart rate (HR) and blood pressure (BP) were measured before and after each VR session. Results: Of 14 eligible PPRP patients, 9 (64%) enrolled in the VR respiratory biofeedback study, and 7 (77% of study participants) completed at least 80% of biofeedback se

关键词： chronic pain adolescents feasibility respiratory biofeedback virtual reality VR applied VR respiratory biofeedback acceptability

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virtual reality in business management education: Evaluating through the TPACK (technological pedagogical content knowledge) lens

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COMPUTERS IN HUMAN BEHAVIOR REPORTS 2025年 18卷

作者： Escandon-Barbosa, Diana Salas-Paramo, Jairo Pontificia Univ Javeriana Cali Fac Econ Sci & Adm Cali Colombia

Modern technologies in education are essential for advancing learning processes and improving students' engagement with innovative tools. This research analyzes gamification through immersive virtual reality and traditional platform games to support cognitive development, creative problem-solving, interaction, understanding, and expected performance. The study explores how these approaches impact students in professional programs, such as SMART and related disciplines. Data from 210 undergraduate students across diverse university professional programs were analyzed using a structural equation model. As higher education institutions strive to enhance their curricula by incorporating gamification technologies, it is crucial to understand both the potential benefits and risks. Misapplication these technologies can negatively affect learning outcomes, emphasizing the need for informed implementation of pedagogical strategies. This study demonstrates that characteristics associated with the virtual environment, such as interaction and immersion, significantly enhance students' creativity and comprehension. Ensuring robust interaction and immersion within virtual learning environments correlates with heightened performance expectancy, fostering a more effective and engaging educational experience. By focusing on these aspects, this research contributes to the growing body of knowledge on the effective use of digital technologies in education, offering insights into optimizing learning environments to maximize student engagement and learning outcomes.

关键词： Digital technologies Cognitive processes Creative thinking virtual reality Gamification Higher education Structural equation model Performance expectancy Interaction And total immersion

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virtual reality and museum tourism in the anchoring paradigm

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CURRENT ISSUES IN TOURISM 2025年第11期28卷 1768-1786页

作者： Huang, Zhuowei (Joy) Lv, Chaoran Gu, Jiang Long, Lingfei Sun Yat Sen Univ Sch Tourism Management Zhuhai Peoples R China Nanjing Univ Business Sch Nanjing Peoples R China Univ Hong Kong Business Sch Hong Kong Peoples R China

The present research designed a series of two studies and examined the impacts of the additional VR tour on museum tourist behaviour, learning and satisfaction, considering tourists' belief of technology in the anchoring paradigm. It finds that museum tourists with an additional VR tour of cultural exhibitions spend less time and show a targeted temporal-spatial pattern in the on-site visit than those without VR. The findings indicated that participants who read the poster about VR are advanced and helpful in museum visits and reported higher learning and satisfaction compared with those who did not read the poster, no matter whether they took the additional VR tour or not. This finding suggests that external anchors significantly influence and even bias people's judgements in visitor learning and satisfaction with their visit to cultural exhibitions. This study is among the first to look into the human-technology relationship, particularly the sentiment of 'technological optimism' in the tourism context. Using the anchoring theory, this study investigates museum tourists' cognitive mechanism involving their belief in technology. It is also innovative in employing interdisciplinary methods, such as spatial-temporal analysis, in-depth interviews, observations and experiments.

关键词： Anchoring effect virtual reality museum tourism technological optimism museum learning outcome

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virtual reality supported trainings for lean education: conceptualization, design and evaluation of competency-oriented teaching-learning environments

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INTERNATIONAL JOURNAL OF LEAN SIX SIGMA 2023年第6期14卷 1102-1120页

作者： Riemann, Thomas Metternich, Joachim Tech Univ Darmstadt Inst Prod Management Technol & Machine Tools Darmstadt Germany

Purpose The purpose of this approach is to structure and facilitate the development of competency-oriented virtual training scenarios. This approach should help to develop reproducible results. Design/methodology/approach This publication presents a procedure for the structured, competency-oriented design of virtual teaching-learning environments. The procedure is based on the competency-oriented design of learning factories according to Tisch and consists of a total of three phases with various substeps. The different steps of the method are presented by means of an application example and the generated scenario is evaluated by means of a competency measurement according to Glass regarding its suitability for teaching competencies. Findings In addition to an application example that introduces the approach, this publication presents concrete results from the research project. In addition to a review of the opportunities and limitations of virtual reality (VR) in continuing education, these also refer to possible, realizable requirements for the use of VR. In addition, results on the suitability of VR learning environments for competency development in the context of value streaming mapping training are presented. Originality/value This approach represents a substantial extension of existing concepts for the design of physical learning factory training for lean topics. It can help learning factory operators and other training providers to design competency- and user-oriented virtual training. VR offers a multitude of potentials in this context, but these can only be exploited through conscientious use of the technology.

关键词： virtual reality Learning factory Learning environment Education Lean Digitization

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virtual reality for geospatial education: immersive technologies enhance sense of embodiment

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CARTOGRAPHY AND GEOGRAPHIC INFORMATION SCIENCE 2023年第3期50卷 233-248页

作者： Bagher, Mahda M. Sajjadi, Pejman Wallgrun, Jan Oliver LaFemina, Peter Klippel, Alexander Penn State Univ Ctr Immers Experiences Dept Geog University Pk PA 16802 USA Penn State Univ Ctr Immers Experiences University Pk PA 16802 USA Penn State Univ Dept Geosci University Pk PA 16802 USA Wageningen Univ & Res Lab Geoinformat Sci & Remote Sensing Wageningen Netherlands

This article focuses on the role of embodiment in learning spatial phenomena in virtual reality in the context of geospatial education. We conducted an empirical study on the geovisualization of global earthquake locations in immersive VR and desktop VR. We asked students to visualize cross-sections of the geometry of earthquake locations in subduction zones and answer pre- and post-experience questions. The degree of the sense of embodiment in immersive VR versus desktop VR was researched. We defined the sense of embodiment based on two embodied affordances: (1) embodied relative reference frame and (2) bodily engagement. We found that immersive VR has a significantly higher sense of embodiment than desktop VR. Additionally, students showed a significantly higher level of reflective thinking in immersive VR. In terms of learning performance, students significantly gained knowledge in both conditions when comparing their pre- and post-knowledge. However, we could not find any significant difference between immersive and desktop VR. The lower level of embodiment in desktop VR seemed sufficient to improve students' grades. These results encourage more research studies on the effect of the sense of embodiment on learning in the geospatial and earth sciences.

关键词： virtual reality penetrative thinking 3D visualization embodiment user experience human computer interaction (HCI) geospatial learning

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virtual reality and Neurofeedback for Management of Cancer Symptoms: A Feasibility Pilot

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AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE 2023年第3期40卷 291-298页

作者： Rolbiecki, Abigail J. Craig, Kevin Polniak, Megan Smith, Jamie Ghosh, Parijat Mehr, David R. Univ Missouri Dept Family & Community Med MA306 Med Sci BldgDC032-00 Columbia MO 65212 USA

Background: Evidence suggests the usefulness of complementary and alternative medicine approaches, like neurofeedback and virtual reality, for the management of cancer-related pain and mood. It is not well-understood whether neurofeedback delivered through virtual reality is feasible and acceptable to patients actively undergoing cancer treatment. Objective: The purpose of this study was to explore the feasibility and acceptability of a nature-based virtual reality combined with neurofeedback as a non-pharmacologic strategy for managing cancer-related pain and anxiety. Methods: This study utilized a mixed-methods approach. Participants included 15 cancer patients undergoing treatment. Patients engaged in a 22-minute nature-based virtual reality experience, wearing a virtual reality headset with a Brainlink headband measuring EEG activity. Participants were asked to complete the Edmonton Symptom Assessment System revised version (ESAS-r) before (T1) and after (T3) the experience to measure pain and anxiety. They were asked their level of pain midway through the experience (T2) and completed a follow-up interview afterward. Results: This study revealed feasible delivery of a virtual reality intervention combined with neurofeedback for patients seeking cancer treatment. All participants (100%) completed the intervention experience. Patients report this is an acceptable approach to managing cancer-related pain and anxiety. Comparisons between patients' pain scores at T1, T2, and T3 reveal statistically significant reductions in pain (p .001). Patients also report decreased depression and anxiety. Conclusion: This is the first study examining virtual reality combined with neurofeedback as a non-pharmacologic intervention for managing cancer symptoms during treatment. The study reveals it is a promising for managing cancer-symptoms.

关键词： complementary and alternative medicine neurofeedback electroencephalogram virtual reality cancer treatment pain anxiety

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