Understanding the process of evolution is important for making informed decisions about the use of antibiotics and vaccinations to combat pathogens. Unfortunately, discussing the intersection of evolution and infectious diseases can be difficult due to preexisting religious views and/or political beliefs. We sought to explore whether gamification techniques like trial-and-error gameplay could overcome this problem by teaching the process of evolution without explicitly defining the theory. To do so, we created the freely available virtual reality game Zombie Ants VR: Definitive Edition, where players take on the role of the zombie fungus Ophiocordyceps with the goal of infecting and behaviorally manipulating ant hosts. The player’s in-game decisions determined whether they succeeded and reproduced or if they died and needed to try again as a new fungal spore. By emphasizing that each new attempt took place with a new individual, we aimed to intuitively teach how natural selection acts at the population level and dispel common evolutionary misconceptions. To test if the gameplay mechanics would have this effect, we performed a small-sample exploratory study in which we compared participant responses on pre- and post-game questionnaires. Our results demonstrated that playing Zombie Ants VR: Definitive Edition increased players’ understanding of evolution, independent of preexisting beliefs

System specifications for head-mounted displays (HMDs) do not guarantee effective human performance, particularly during locomotion, which places greater demands on gaze stabilization. We examined how video passthrough and mixed reality (MR) affect visual performance during standing, walking, and jogging. Eighteen participants completed a Landolt-C orientation task under natural viewing, passthrough, and MR on a Varjo XR-3. We used hierarchical Bayesian modeling to analyze detection, discrimination, and response time. Both HMD viewing modes degraded visual performance relative to natural viewing, with decrements amplifying during movement. Passthrough required stimuli up to 2.6× larger for reliable detection and 3.5× larger for accurate discrimination, and slowed responses by up to 83%. MR produced larger deficits, requiring stimuli up to 6.0× larger for detection and 4.1× larger for discrimination, and slowing responses by up to 128%. HMDs must therefore be evaluated under intended use conditions, as static benchmarks do not capture movement-dependent costs.

Introduction:Returning to work is a goal for many stroke survivors, with benefits for individuals and society. The ReTurn to work After stroKE (RETAKE) trial, which aimed to improve stroke survivors' work outcomes through early stroke-specific vocational rehabilitation (ESSVR), was ongoing during the COVID-19 pandemic. This study aimed to understand the impact of the pandemic on stroke survivors' work ability and return-to work support. Methods:Nine stroke survivors and five employers were interviewed. Thematic analysis informed by Normalisation Process Theory, found that biographical disruption experienced as a result of stroke was compounded by disruption on a global scale due to the pandemic. Results:Attempts to mobilise resources in response to disruption were hampered by pandemic-related issues. Although returning to work offered continuity in pre-stroke identity, businesses were also disrupted by the pandemic. Findings suggest that returning to work was easier for stroke survivors able to work from home and those receiving ESSVR. The opportunity to work from home helped stroke survivors adapt to new ways of working necessitated by the impact of stroke and social distancing rules during the pandemic. Discussion:Post-pandemic, remote working is more acceptable, which may benefit future stroke survivors aiming to return to work whilst managing post-stroke fatigue. This may mitigate disruption to lives and post-stroke identities.

Post COVID, teleconferencing systems such as Zoom, Teams, and Webex have become a part of our daily life. As many employees have returned to work part-time in person, hybrid teleconferencing has become the norm. However, current solutions are not well equipped to make remote participants part of the holistic conversation that may exist in the physical meeting room space. In this lightning contribution, we present the design of miVirtualSeat, a telepresence system for small hybrid meetings with an architectural vision in which remote and physical participants feel co-presence. We will discuss the architectural design constructs of miVirtualSeat for remote and physical participants, and the services and protocols that provide underlying support.

Mandatory human rights and environmental due diligence (HREDD) policies seem to represent a pathbreaking shift from voluntary measures to binding rules for global supply chains. Yet these policies endorse a "smart-mix" of voluntary and mandatory measures, and risk over-reliance on questionable private-sector assurances. In this paper, we ask how businesses framed these private/voluntary efforts in the face of looming regulation, focusing on the EU's new Corporate Sustainability Due Diligence Directive (CSDDD). Through a systematic coding of policy positions, we find businesses (1) using voluntary initiatives to delegitimize mandatory measures, (2) seeking to institutionalize voluntary norms, (3) pushing for private assurances to signify legal compliance, or (4) endorsing mandatory measures to protect the competitive advantage of sustainability leaders. While frames (1) and (4) shaped the debate, we argue that frames (2) and (3) are more fully reflected in the final text of the Directive. We explore both theoretical and practical implications.

Interactive Digital Narrative researchers have used a variety of methodologies to assess players' experiences with IDN processes, systems and artifacts. Interviewing and surveying have been the most prevalent methodology and, less frequently, recording in-process activities. Given the importance of interactivity and immersion, this paper considers how IDN research methods reveal player experience, player engagement, and/or player analysis. Drawing on related principles of IDN theory, sociocultural psychology and neuropsychological research, we present analyses of two phases of research in a real-time online IDN design learning workshop to compare contributions of in-process measures and interview measures of participant engagement. Analyses of data from each method reveal very different participant orientations in-process during an IDN design learning workshop and with an interview after the workshop. The analysis shows that in-process data align with neuropsychological definitions of flow: presence, relation, emotion, and conversational interaction. In contrast, the interview data align with definitions of metacognition: distance (past tense, individual focus), evaluation, analysis, and reflexive cognition. Based on those findings, we discuss howresearch methods affect definitions of fundamental concepts in IDNs, including interactivity and immersion. Implications include the need to clarify methodological labels and align chosen measures precisely with research questions and focal concepts, like interactivity. We also discuss how the complexity of IDN and the technologies embedded in digital systems allow integrating in-process and interview research protocols more centrally into IDN theory.

Social features are critical to contemporary virtual worlds or metaverses. We compare current platforms and motivate a new open-source platform to introduce high school students to authoring immersive media content. Many constraints around privacy, hardware, and licenses constrain the options for using these existing platforms and tools in informal education contexts. We propose that a federated model of servers could support innovation and communities.

In the aftermath of the pandemic, governments and organizations worldwide are proactively preparing for future challenges. The importance of communication and connection has been underscored in recent years, especially through applications like Skype, Discord, and Zoom, as they play a pivotal role in collaboration and innovation across the world. Virtual platforms have become integral for societies to connect and collaborate, emphasizing the need for the evolution of communication methods to ensure a resilient global future. This paper provides an implementation for an Extended Reality (XR) conferencing application. This required implementing an XR-capable application for the HoloLens 2 as well as creating a server application that acts as a hub for all connected users, with a focus on simplicity and modality to allow for future modification and experimentation. Once these applications were created, further testing was performed to evaluate network metrics, and user quality of experience through a user study. The user study evaluates the effects of latency on object movement and creates a starting point for further improvement on the created messaging system. The development and deployment of a basic conferencing application for the HoloLens 2 is an important step in building a more connected and resilient future.

Shifting from narrating in everyday life and culture to designing an IDN is a major challenge. It requires rethinking the goals and elements of narrating, with a focus on the player’s perspective. Yet, we know little about student designers’ IDN composing processes, such as how they use digital techniques (like branching) and develop narrative qualities, like character, to create multiple story trajectories for player engagement. Novices’ uptake of devices and narrative elements, such as character and choice poetics, is a process that can inform IDN theory and practice about the shift to this new genre. This paper presents a secondary analysis of interactive digital narrative (IDN) designs and player reflections created during a 2.5-h online workshop. Detailed analyses of narrative elements and digital devices in hundreds of design and reflection sequences trace uses and developments of novice authoring strategies. Four strands of analysis (narrative elements, choice poetics, player reflection, and Twine tree structure) offer a complementary picture of the IDN design learning process. Findings of our analysis show that, over time, student designers developed characters with increasing literary quality and with sophisticated choice options (socio-emotional and moral dilemmas) as pivots for narrative trajectories. Different character and choice development patterns related to player feedback suggest the importance of integrating these multiple dimensions into IDN research and pedagogy. Discussion highlights how the analysis captures the complexity of the IDN genre, provides a foundation for ongoing research into IDN designing as a developmental process, and offers a foundation for IDN pedagogy.

Large language models (LLMs) use statistical models to predict the next sequence of tokens and have capabilities previously considered unattainable outside of human intelligence. Communication design can benefit from a close examination of the ongoing conversations around the adoption and use of LLMs, both the public discourse and the specific language and rhetoric used in the initial set of application interfaces and prompts. Through a survey of existing practices and a case study of how AI is used within the interactive fiction community, where procedural content generation has played with expectations and personas, this paper offers a foundation for future critique of these models as they are embedded in the digital tools we rely upon for daily communication and work.

Objectives This mixed-method process evaluation underpinned by normalisation process theory aims to measure fidelity to the intervention, understand the social and structural context in which the intervention is delivered and identify barriers and facilitators to intervention implementation. Setting RETurn to work After stroKE (RETAKE) is a multicentre individual patient randomised controlled trial to determine whether Early Stroke Specialist Vocational Rehabilitation (ESSVR) plus usual care is a clinically and cost-effective therapy to facilitate return to work after stroke, compared with usual care alone. This protocol paper describes the embedded process evaluation. Participants and outcome measures Intervention training for therapists will be observed and use of remote mentor support reviewed through documentary analysis. Fidelity will be assessed through participant questionnaires and analysis of therapy records, examining frequency, duration and content of ESSVR sessions. To understand the influence of social and structural contexts, the process evaluation will explore therapists’ attitudes towards evidence-based practice, competency to deliver the intervention and evaluate potential sources of contamination. Longitudinal case studies incorporating non-participant observations will be conducted with a proportion of intervention and usual care participants. Semistructured interviews with stroke survivors, carers, occupational therapists, mentors, service managers and employers will explore their experiences as RETAKE participants. Analysis of qualitative data will draw on thematic and framework approaches. Quantitative data analysis will include regression models and descriptive statistics. Qualitative and quantitative data will be independently analysed by process evaluation and Clinical Trials Research Unit teams, respectively. Linked data, for example, fidelity and describing usual care will be synthesised by comparing and integrating quantitative descriptive data with the qualitative findings. Ethics and dissemination Approval obtained through the East Midlands—Nottingham 2 Research Ethics Committee (Ref: 18/EM/0019) and the National Health ServiceResearch Authority. Dissemination via journal publications, stroke conferences, social media and meetings with national Stroke clinical leads. Trial registration number ISRCTN12464275.

The complexity of interactive narratives inspired a variety of visual aids and graphical interfaces that support authoring tasks. This chapter analyzes the visual interface of popular IDN authoring tools that include an explicit visual interface for creating content, including Twine, Storyspace 3, inklewriter, Inform 7, and Adventure Game Studio. We employ a simple proto-IDN consisting of a set of passages that represent locations spatially linked together to compare the interactive and non-interactive visual aids across the five tools. We also identify several organizing metaphors that underly the visual logic, including Spatial Mapping, Scene-driven Structure, Nodal Mapping, and Traversal Mapping. Authors use the graphical interfaces in each of these tools to predict and manage the set of possible traversals that players may take. There identify key features in the interfaces by their function as a visual aid to specific authoring tasks. The interface techniques represented have evolved with these shared features, though they also represent the current limits of a paradigm of interactive narrative authoring where an author has explicit control over the structure and paths of the work.

Immersive Authoring remains primarily driven by user-generated content on social VR applications. This paper introduces and motivates an open-source tool, RealityFlow, implemented on top of the Unity engine, and which supports studying immersive authoring paradigms through visual programming languages. This paper describes the context of visual programming environments as well as the requirements, technical implementation, and overall motivations and goals for future iterations.

Interactions between players and designers during IDN authoring are an undervalued source of information about the authoring process. This paper analyzes a corpus of player-author interactions from an online workshop. We classified feedback types and IDN design features, showing player reflections during authoring influenced the peer designer’s work. Some types of feedback correlated positively with the overall growth of a design partner’s IDN, while other feedback types correlated with story content. When players suggested authoring techniques or other subjective experiences playing through the emerging IDN, their partner’s designs expanded structurally (nodes and branches). When players shared negative evaluations, the partner’s design did not grow. In comparison, player reflections that were cognitively oriented led to increases in story settings, while player affective expressions led to more character dialogue. Effects include increases in both IDN narrative elements and structure. Some effects correlate with participant gender and native language, although not with race/ethnicity. The study results offer insights about intersubjectivity - what is on novice player-designers’ minds as they wrestle with interactive digital narrative authoring. IDN pedagogy can, thus, benefit from designer-player collaboration as students experiment with technical authoring tools, develop and employ relevant vocabulary, and interpret a player’s feedback. Additionally, the Authoring-Other Exchange System employed in this study provides a framework and novel measures for future research and pedagogy.

Selection methods in VR are typically pointer-based, with gestural methods including joystick and translation. Rapid selection involves choosing among a small number of options. We propose a novel rotation-based rapid-selection gesture where the angle of the controller is used and present a virtual environment, ColorBound, that compares selection tasks using different control schemes in VR using two scenarios: data visualization and weapon selection. We plan to compare methods through timing and preference. The new scheme, controller rotation shows promise as an alternative with potential applications in tool selection, changing continuous and discrete options, and modifying settings for visualizations.

Despite advances in the technology that support augmented, virtual and mixed reality, there remains a substantial divide between who the current generation of tools consider as users and the potential creators that can use these emerging platforms. This chapter builds on the tools provided by platform studies to investigate how current authoring tools support the needs of potential authors, and what current barriers there are to greater participation in the new set of emerging media. While Unity has achieved a significant market share, it primarily addresses professional developers in the game, advertising and entertainment industries. Many use cases that have been captured by “amateurs” or creators outside these areas are beginning to be addressed by more content-focused and beginner-friendly creative authoring tools. Despite these advances, the tools remain out of reach for a wide population of non-computer scientists who wish to create innovative XR experiences relevant to their subject matter expertise. This chapter uses a set of case studies drawn from one author’s experience working in an academic context to manage the constantly evolving editor platforms and students with varying technical skills required to create VR, AR and XR projects and experiences. The specific expertise required to create, iterate, and maintain XR content acts to limit the scope and success of these projects. The case studies described here detail specific challenges and workarounds undertaken by one of the authors to create interdisciplinary XR experiences in collaboration with computer science undergraduate students. While successful in creating meaningful learning experiences for the students developing the games and simulations, these projects exemplify the extra layer of difficulties that those without computer science expertise must overcome to create meaningful XR experiences for their subject matter. This approach and perspective reveals that not only are “better” tools needed, but different assumptions about the end goals of creators and developers are necessary. XR creation does not need to be strongly tied to a pathway into a computer science career, just as creating and sharing content through the web has enabled a variety of different roles and expressions without every creator needing to know the technical details of how browsers or servers operate.

Augmented reality (AR) has the unique ability to situate an activity within a physical context, making it valuable for training and education. The affordances of AR include multimodal visualizations and auditory support. The disciplines of phonetics and phonology in applied linguistics concern how sounds are produced and articulated. We have designed and developed a pronunciation training app for the novice second language student learning Mandarin pinyin by applying linguistic theory while adhering to usability principles. This paper describes the requirements that drove the development of the app and the planned online experiment design that compares the same training under two conditions: AR and non-AR. The design features peer assessment, drills, in-app assessment, surveys, and a posttest, and is designed for a remote study without having participants come to the lab.

Virtual reality offers immense potential for subversive interactions to be the focus of stories. We argue that narrative framing is just as important as selecting meaningful user interactions in VR, and offer the portmanteau "transfordance" to describe how mechanics can decenter the normative embodied experience through narrative framing, and "transfordant design" to capture how they can be applied to expressive ends. We demonstrate the technique through a new virtual reality experience, The Hollow Reach, that centers traumatic recovery through experiences of mechanical and virtual prosthesis. In this demo, we use transfordant design in three meaning creation interactions: unreliable direct manipulation, gaze tendency, and voice (rather than speech).

Background: Identification of hospitalized patients with enteric multidrug-resistant organism (MDRO) carriage, combined with implementation of targeted infection control interventions, may help reduce MDRO transmission. However, the optimal surveillance approach has not been defined. We sought to determine whether daily serial rectal surveillance for MDROs detects more incident cases (acquisition) of MDRO colonization in medical intensive care unit (MICU) patients than admission and discharge surveillance alone. Methods: Prospective longitudinal observational single-center study from January 11, 2017, to January 11, 2018. Inclusion criteria were ≥3 consecutive MICU days and ≥2 rectal or stool swabs per MICU admission. Daily rectal or stool swabs were collected from patients and cultured for MDROs, including vancomycin-resistant Enterococcus (VRE), carbapenem-resistant Enterobacterales (CRE), third-generation cephalosporin-resistant Enterobacterales (3GCR), and extended-spectrum β-lactamase–producing Enterobacterales (ESBL-E) (as a subset of 3GCR). MDRO detection at any time during the MICU stay was used to calculate prevalent colonization. Incident colonization (acquisition) was defined as new detection of an MDRO after at least 1 prior negative swab. We then determined the proportion of prevalent and incident cases detected by daily testing that were also detected when only first swabs (admission) and last swabs (discharge) were tested. Data were analyzed using SAS version 9.4 software. Results: In total, 939 MICU stays of 842 patients were analyzed. Patient characteristics were median age 64 years (interquartile range [IQR], 51–74), median MICU length of stay 5 days (IQR, 3–8), median number of samples per admission 3 (IQR, 2–5), and median Charlson index 4 (IQR, 2–7). Prevalent colonization with any MDRO was detected by daily swabbing in 401 stays (42.7%). Compared to daily serial swabbing, an admission- and discharge-only approach detected ≥86% of MDRO cases (ie, overall prevalent MDRO colonization). Detection of incident MDRO colonization by an admission- or discharge-only approach would have detected fewer cases than daily swabbing (Figure 1); ≥34% of total MDRO acquisitions would have been missed. Conclusions: Testing patients upon admission and discharge to an MICU may fail to detect MDRO acquisition in more than one-third of patients, thereby reducing the effectiveness of MDRO control programs that are targeted against known MDRO carriers. The poor performance of a single discharge swab may be due to intermittent or low-level MDRO shedding, inadequate sampling, or transient MDRO colonization. Additional research is needed to determine the optimal surveillance approach of enteric MDRO carriage.Funding: NoDisclosures: None