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The chapter provides an in-depth analysis of digital therapeutics (DTx) as a revolutionary approach to managing major depressive disorder (MDD). It discusses the evolution and definition of DTx, their application across various medical fields, regulatory considerations, and their benefits and limitations. This chapter extensively covers DTx for MDD, including smartphone applications, virtual reality interventions, cognitive-behavioral therapy (CBT) platforms, artificial intelligence (AI) and chatbot therapies, biofeedback, wearable technologies, and serious games. It evaluates the effectiveness of these digital interventions, comparing them with traditional treatments and examining patient perspectives, compliance, and engagement. The integration of DTx into clinical practice is also explored, along with the challenges and barriers to their adoption, such as technological limitations, data privacy concerns, ethical considerations, reimbursement issues, and the need for improved digital literacy. This chapter concludes by looking at the future direction of DTx in mental healthcare, emphasizing the need for personalized treatment plans, integration with emerging modalities, and the expansion of access to these innovative solutions globally.

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BACKGROUND: The practice of dental surgery requires a few different skills, including mental rotation of an object, precision of movement with good hand-eye coordination, and speed of technical movement. Learning these different skills begins during the preclinical phase of dental student training. Moreover, playing a musical instrument or video game seems to promote the early development of these skills. However, we found that studies specifically addressing this issue in the field of dental education are lacking. OBJECTIVE: The main aims of this study are to evaluate whether the ability to mentally represent a volume in 3D, the precision of gestures with their right and left hand, or the speed of gesture execution is better at baseline or progresses faster for players (video games or music or both). METHODS: A prospective monocentric controlled and longitudinal study will be conducted from September 2023 and will last until April 2025 in the Faculty of Dental Surgery of Nantes. Participants were students before starting their preclinical training. Different tests will be used such as Vandenberg and Kuse's mental rotation test, the modified Precision Manual Dexterity (PMD), and performing a pulpotomy on a permanent tooth. This protocol was approved by the Ethics, Deontology, and Scientific Integrity Committee of Nantes University (institutional review board approval number IORG0011023). RESULTS: A total of 86 second-year dental surgery students were enrolled to participate in the study in September 2023. They will take part in 4 iterations of the study, the last of which will take place in April 2025. CONCLUSIONS: Playing video games or a musical instrument or both could be a potential tool for initiating or facilitating the learning of certain technical skills in dental surgery. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55738.

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The neural network optimal control strategy based on a fuzzy differential game is proposed for the tripartite UAV confrontation systems consisting of the attackers, defenders, and targets. Firstly, the tripartite UAV mutual confrontation model is constructed and a nonlinear differential control system is established. Secondly, combining the fuzzy evaluation method and differential game theory, the tripartite UAV are divided into two parts of the confrontation game: attackers-defenders and attackers-targets. The optimal control strategies for the attackers, defenders and targets parties are derived separately. Then, the tripartite UAV game model is considered to be difficult to solve directly. The evaluation neural network is introduced to approximate the optimal value function using an adaptive dynamic programming method. The convergence of the evaluation neural network weights and the stability of the nonlinear differential control system are proved by using Lyapunov stability theory. Finally, the effectiveness of the tripartite UAV confrontation game control strategy designed in this paper is verified by simulation.

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Obesity management can effectively reduce the risks and complications associated with obesity and improve the quality of life of patients. After assessing the advantages and limitations of various obesity management approaches, self-management has been strongly recommended due to the advantages of minimal side effects and lower costs compared to treatment via drugs and surgery. However, successfully implementing lifestyle intervention strategies requires scientific guidance and strong determination. With the development of electronic and information technology, lifestyle intervention has transformed considerably. A new concept, called Gamified Digital Therapeutics (GDTx), represents a gaming format with Digital Therapeutics (DTx). It can effectively enhance patient compliance and accessibility to chronic disease management. Here, we review recent studies on the application of GDTx for the self-management of obesity and discuss three aspects surrounding its completion rates, satisfaction levels, and effectiveness. In contrast to traditional approaches to obesity self-management, implementing GDTx effectively corrects unhealthy dietary and lifestyle habits, markedly enhancing the dissemination of nutritional and exercise-related health knowledge. Of particular significance is the evident improvement in the adherence of obese patients to weight loss programs. Despite numerous studies indicating that GDTx may offer an effective solution for obesity self-management, there are still several limitations in the medicalization of GDTx for self-management of obesity. This review aimed to provide a reference for subsequent studies and promote the widespread application of GDTx in obesity self-management to help reduce the obesity rate and alleviate the burden on obese patients.

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BACKGROUND: Young people with intellectual developmental disabilities have a persistent delay in the development of executive functions. Virtual reality (VR) is increasingly being used as a cognitive intervention tool, with significant effectiveness demonstrated in different types of populations. METHODS: This pilot study aims to investigate the impact of a cognitive training program utilizing VR on young adults diagnosed with intellectual developmental disabilities (IDDs). The participants (N = 15) served as their own control group and were assessed three times: weeks 0, 8, and 16, with a rest period (0-8 weeks) and an intervention period (8-16 weeks). The assessments included measures of cognitive function provided by E-Prime® (Version 3). RESULTS: Overall, an improvement in working memory and inhibitory control was found after the intervention, but not in sustained attention. CONCLUSIONS: These findings suggest that VR-based cognitive training holds promise as an effective intervention for enhancing cognitive abilities in young adults with intellectual developmental disabilities. This study provides a foundation for future investigations into VR's role in cognitive rehabilitation and its potential to support daily living skills and overall quality of life for individuals with IDDs. Further research is needed to explore the long-term effects and broader applicability of VR interventions.

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Since game mechanics and their visual aspects have become more and more addictive, there is concern about the growing prevalence of Internet gaming disorder (IGD). In the current narrative review, we searched PubMed and Google Scholar databases for the keywords "igd biomarker gaming" and terms related to biomarker modalities. The biomarkers we found are grouped into several categories based on a measurement method and are discussed in the light of theoretical addiction models (tripartite neurocognitive model, I-PACE). Both theories point to gaming-related problems with salience and inhibition. The first dysfunction makes an individual more susceptible to game stimuli (raised reward seeking), and the second negatively impacts resistance to these stimuli (decreased cognitive control). The IGD patients' hypersensitivity to reward manifests mostly in ventral striatum (VS) measurements. However, there is also empirical support for a ventral-to-dorsal striatal shift and transition from goal-directed to habitual behaviors. The deficits in executive control are demonstrated in parameters related to the prefrontal cortex (PFC), especially the dorsolateral prefrontal cortex (DLPFC). In general, the connection of PFC with reward under cortex nuclei seems to be dysregulated. Other biomarkers include reduced P3 amplitudes, high-frequency heart rate variability (HRV), and the number of eye blinks and saccadic eye movements during the non-resting state. A few studies propose a diagnostic (multimodal) model of IGD. The current review also comments on inconsistencies in findings in the nucleus accumbens (NAcc), anterior cingulate cortex (ACC), and precuneus and makes suggestions for future IGD studies.

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More than half of all game players report experiencing some form of hate, harassment or abuse within gaming spaces. While prevalence assessments of these actions in digital gaming spaces are ongoing, little remains known about the more extreme forms of these behaviors. Specifically, experiences of extremism. This paper addresses the gap in research knowledge around the expression of extremist sentiment in games by evaluating their prevalence, location, and nature, and impact. Assessing experiences via an online survey, game players (n = 423) reported an alarmingly high rate of frequency for being the direct target of, as well as a witness to, all forms of extremist content. Most of these experiences were text-based, reported to be happening in-game. Most players endorsed statements relating to a normalization of extreme ideologies within gaming cultures. It is promising that reporting these behaviors was the primary action taken by players for most of the players; however, "ignoring" these actions was also a common strategy. It is possible that player inaction reflects the embeddedness and normalization of these actions in gaming spaces and/or a lack of trust in moderation systems to be responsive. The prevalence of extreme sentiment in gaming cultures should raise concern from game makers, members of the gaming community, parents, and policy makers alike.

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The integration of technology in higher education has transformed teaching, turning students into active participants in their learning. Faced with the limitations of conventional methods, the integration of technological and creative methods adapted to current demands is being sought. Proficiency in word processing and spreadsheets is crucial in university education, especially in social sciences and law, where the lack of specialized technical training affects academic performance. This study analyzes the impact of incorporating serious games with technological tools and active teaching methods on students' motivation, engagement and academic performance.

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BACKGROUND: This study aimed to compare acceleration and deceleration demands of intercounty Camogie players, and differences across playing positions and halves of play. HYPOTHESIS: The middle 3 positions will have greatest accelerations and decelerations variables across match play and halves of play. STUDY DESIGN: Nonrandomized, repeated measures design. LEVEL OF EVIDENCE: Level 4. METHODS: Global positioning systems (GPS) (10 Hz) collected data from 28 participants during 18 competitive matches across 2 seasons; 206 individual player datasets were analyzed. RESULTS: Half-backs (P < 0.05; effect size [ES], -1.75) and midfielders (P < 0.05; ES, -1.68) covered significantly greater total number of accelerations than full-forwards. In acceleration zone 4, midfielders (P < 0.05; ES, = -1.67) and half forwards covered a significantly greater number than full-forwards (P < 0.01; ES, = -1.41). Midfielders accumulated a significantly greater distance in acceleration zone 4 than full-backs (P < 0.05; ES, = -0.57). Significant decrements were observed between halves in total number of accelerations (P < 0.01; ES, = 0.49), accelerations in zones 1 to 4 (P < 0.01; ES, 0.16-0.43), total distance of accelerations, and acceleration distance in zones 2 to 4 (P < 0.05; ES, 0.25; P < 0.01; ES, 0.45; P < 0.01; ES, 0.38). There were significant decrements in the total number of decelerations (P < 0.01; ES, 0.43), number of decelerations in zones 2 (P < 0.05; ES, 0.25), 3 (P < 0.01; ES, 0.45), and 4 (P < 0.01; ES, 0.38), and total deceleration distance (P < 0.01; ES, 0.16). CONCLUSION: Half-backs and midfielders covered significantly greater total number of accelerations than full-forwards. Significant decrements in several acceleration and deceleration variables were observed between halves. CLINICAL RELEVANCE: Players competing in intercounty Camogie should receive progressive exposure to acceleration and deceleration-based movement demands to prepare players for intercounty Camogie match play.

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Chasing refers to the escalation of betting behaviour. It is conventionally seen when losing but can also be seen after wins. Diagnostic and screening items for gambling problems describe chasing as returning 'another day' to gamble. However, gamblers may also chase within sessions, and this is particularly relevant in online gambling. This study focused on two expressions of within-session chasing: (1) increasing the bet amount, or (2) a reduced probability of quitting the session, as a function of prior losses or wins. These expressions were examined across five online gambling products: slot machines, probability games, blackjack, video poker, and roulette. Our results showed that gamblers bet more and played longer sessions after immediate losses, but they bet less and played shorter sessions when losing cumulatively. The reversed pattern in the cumulative model may be due to financial constraints. For wins, gamblers bet more after both immediate and cumulative wins, but they also played shorter sessions. Chasing patterns were qualitatively similar by game type-with limited evidence for our hypothesis that chasing would be greatest for slot machines as an established high-risk category. Overall, chasing is multi-faceted, varying across the behavioural expressions, by the immediate or cumulative timeframe of prior outcomes, and by game type.

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BACKGROUND: Enhancing the emergency competencies of healthcare professionals is essential for ensuring patient safety, optimizing emergency response efficiency, and fostering effective team collaboration. However, traditional simulation-based methods often struggle to accurately replicate real-life emergencies, resulting in outcomes that may not fully reflect actual performance, thereby undermining their effectiveness in training and developing the critical skills needed for emergency situations. OBJECTIVE: This study evaluated the effectiveness of using murder mystery games (MMGs) as a gamified learning method to enhance the emergency competencies of healthcare professionals. METHODS: Twelve scripts of emergency scenarios were developed for the MMGs, and five assessment scales were established, covering emergency response, scenario decision-making, team collaboration, emotional support, and human care. Questionnaire data were analyzed between the experimental and control groups using Chi-square tests for five dimensions and nineteen indicators of emergency competencies. RESULTS: The performance of the experimental group in emergency response and emotional support was significantly higher than that of the control group (P<0.001). The experimental group also showed notable excellence in scenario decision-making, team collaboration, and human care (P<0.005). CONCLUSIONS: Emergency capabilities can be significantly enhanced through murder mystery games, providing robust support for improving the quality of medical services.

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We study game-theoretic models of human evolution to analyze fundamentals of human nature. Rival-claimants games represent common situations in which animals can avoid conflict over valuable resources by mutually recognizing asymmetric claiming rights. Unlike social-dilemma games, rival-claimants games have multiple equilibria which create a rational role for communication, and so they may be good models for the role of language in human evolution. Many social animals avoid conflict by dominance rankings, but intelligence and language allow mutual recognition of more complex norms for determining political rank or economic ownership. Sophisticated forms of economic ownership could become more advantageous when bipedalism allowed adaptation of hands for manufacturing useful objects. Cultural norms for claiming rights could develop and persist across generations in communities where the young have an innate interest in learning from their elders about when one can appropriately claim desirable objects. Then competition across communities would favor cultures where claiming rights are earned by prosocial behavior, such as contributions to public goods. With the development of larger societies in which many local communities share a common culture, individuals would prefer to interact with strangers who identifiably share this culture, because shared cultural principles reduce risks of conflict in rival-claimants games.

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This single-participant case study examines the feasibility of using custom virtual reality (VR) gaming software in the home environment for low-dose Hand Arm Bimanual Intensive Training (HABIT). A 10-year-old with right unilateral cerebral palsy participated in this trial. Fine and gross motor skills as well as personal goals for motor outcomes were assessed before and after the intervention using the Box and Blocks Test, Nine-Hole Peg Test, and Canadian Occupational Performance Measure. Movement intensities collected via the VR hardware accelerometers, VR game scores, and task accuracy were recorded via the HABIT-VR software as indices of motor performance. The child and family were instructed to use the HABIT-VR games twice daily for 30 minutes over a 14-day period and asked to record when they used the system. The child used the system and completed the 14-hour, low-dose HABIT-VR intervention across 22 days. There was no change in Box and Blocks Test and Nine-Hole Peg Test scores before and after the intervention. Canadian Occupational Performance Measure scores increased but did not reach the clinically relevant threshold, due to high scores at baseline. Changes in motor task intensities during the use of VR and mastery of the VR bimanual tasks suggested improved motor efficiency. This case study provides preliminary evidence that HABIT-VR is useful for promoting adherence to HABIT activities and for the maintenance of upper extremity motor skills in the home setting.

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The aim of this contemporary piece is to discuss the student experience of co-design and the process involved in the co-creation of developing digital educational resources. A discussion of the need for digital educational resources in the era of pre-registration nursing students being digital natives is explored and the potential benefits or barriers for nursing education and practice are outlined. The need for co-design as a methodology in nurse education which is inclusive of the student-led role is discussed and a personal account of student experience will be detailed. By focusing on the student voice this article aims to provide a first-hand experience of working alongside academic and educational research teams, whilst also promoting student participation within co-design projects further than simply tokenistic involvement, highlighting the comprehensive benefits associated for all. The importance of support, knowledge sharing, and effective communication will be detailed to allow other students to gain insight and empower them to participate in a co-designed project should it arise in their university education.

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INTRODUCTION: Video games have a strong influence on children and adolescents. Video game addiction has negative effects on children's health. OBJECTIVE: To determine the relationship between video game addiction and bladder/bowel dysfunction in children. MATERIALS AND METHODS: Three hundred sixty-three children and their mothers who met the inclusion criteria constituted the sample of this correlational study. The data were collected using a descriptive information form, the Video Game Addiction Scale for Children, and the Childhood Bladder and Bowel Dysfunction Questionnaire. RESULTS: We found that 72.5% of the children were nine years old and 27.5% were ten years old; 50.4% were males and 49.6% were female. While 4.7% of the children who participated in the study were underweight, 19.6% were overweight, and 17.9% were obese. The mean Video Game Addiction Scale for Children score was 50.77 ± 16.17, whereas the mean Childhood Bladder and Bowel Dysfunction Questionnaire score was 29.98 ± 8.90. The ratio of children with a mean Video Game Addiction Scale for Children scores equal to or greater than 90 was 0.8% (n = 3). We found that 3.6% (n = 13) of the children had urinary/fecal incontinence while playing video games. There was a weak positive relationship between the dimensions of the Video Game Addiction Scale for Children scores, the Childhood Bladder and Bowel Dysfunction Questionnaire scores, and children's bladder and bowel function (r = 0.220; p ˂ 0.05). CONCLUSIONS: There is a correlation between children's video game addiction level and their bladder and bowel dysfunction grade. Higher video game addiction levels correspond to higher bladder and bowel dysfunction.

Introducción: Los videojuegos tienen una fuerte influencia en los niños y adolescentes. La adicción a ellos tiene efectos perjudiciales para la salud de los niños. Objetivo: Determinar la relación entre la adicción a los videojuegos y la disfunción vesical o intestinal en niños. Materiales y métodos: Los 373 niños y sus madres que cumplieron con los criterios de inclusión constituyeron la muestra de este estudio descriptivo y correlacional. Los datos se recopilaron mediante un formulario de información descriptiva, la Video Game Addiction Scale for Children y el Childhood Bladder and Bowel Dysfunction Questionnaire. Resultados: El 72,5 % de los niños tenía nueve años y, el 27,5 %, diez; el 50,4 % eran hombres y el 49,6 %, mujeres. El 4,7 % de los estudiantes que participaron en el estudio tenían bajo peso, el 19,6 % presentaba sobrepeso y el 17,9 % tenía obesidad. Se constató que las puntuaciones medias de las escalas fueron 50,77 ± 16,17 para la Video Game Addiction Scale for Children y 29,98 ± 8,90 para el Childhood Bladder and Bowel Dysfunction Questionnaire. La proporción de niños con una puntuación de 90 o superior en la dicha escala fue del 0,8 % (n = 3). Se encontró que el 3,6 % (n = 13) de los niños tenía incontinencia urinario-fecal mientras jugaba videojuegos. Se reveló que había una correlación positiva débil entre las dimensiones de las dos escalas evaluadas, y la función de la vejiga y el intestino (p ˂ 0,05). Conclusiones: El grado de adicción a los videojuegos de los niños está correlacionado con su grado de disfunción vesical o intestinal: entre mayor sea la adicción, mayor es la disfunción.

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BACKGROUND: Internet gaming disorder among university students has become a great concern for university counsellors worldwide since the COVID-19 pandemic. The factors influencing the development of internet gaming disorder in students during the COVID-19 pandemic could be different from those before the pandemic. OBJECTIVE: This study aims to explore the associations among social isolation, self-control, and internet gaming disorder in Chinese university students and to examine whether self-control mediates the positive effects of social isolation on internet gaming disorder. METHODS: A cross-sectional survey was employed to collect data from university students in Shandong province of China from April to September 2022. The Isolation subscale of the Self-Compassion Scale, Self-Control Scale, and Internet Gaming Disorder Scale were used to assess the social isolation, self-control, and internet gaming disorder among university students, respectively. Models 4 and 5 of PROCESS software were used to analyze the mediating role of self-control and the moderating role of gender on the association between social isolation and internet gaming disorder. RESULTS: A total of 479 students were recruited from 6 universities located in 3 different regions of Shandong, China. Students had low levels of internet gaming disorder and moderate levels of social isolation and self-control, with mean scores of 8.94 (SD 9.06), 12.04 (SD 3.53), and 57.15 (SD 8.44), respectively. Social isolation was positively correlated with internet gaming disorder (r=0.217; P<.001), and self-control was negatively correlated with social isolation (r=-0.355; P<.001) and internet gaming disorder (r=-0.260; P<.001). Self-control played a mediating role in the association between social isolation and internet gaming disorder (ß=-.185, 95% CI -.295 to -.087). The effects of social isolation on internet gaming disorder among female students were lower than those among male students. CONCLUSIONS: Self-control was a mediator in the association between social isolation and internet gaming disorder. Moreover, gender played a moderating role in the association between social isolation and internet gaming disorder. This study highlights the need to alleviate the development of internet gaming disorder among students during a pandemic, especially that of male students. Effective interventions that lessen social isolation and promote self-control should be developed.

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Location-based games are a highly technology-dependent game genre that has witnessed an exponential increase in popularity with the democratisation of smartphones as well as ubiquitous mobile data and access to satellite navigation. Moving forward into the future, location-based games can be expected to evolve as the technologies underlying the genre improve. In this conceptual work, we review the current state of the art in location-based games, and identify key trajectories and trends. We discovered 12 trends, based on which we jump ten years into the future and evaluate how current technology trends may end up influencing location-based gaming. For example, we propose that in the year 2035 through improvements in map data services and sensor data coverage, we will see locative games that are increasingly connected to elements in the physical world. We also expect to see gameplay that moves away from solely taking place on a smartphone screen to the adoption of multiple forms of interactions with location-based game worlds, especially as head-mounted displays and other wearables become more commonplace.

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Objective: The present study aimed to explore the influence of digital games on the social skills of male students in elementary schools, focusing on the impact of different games on various social behaviors. Methods: The study employed a causal-comparative design, utilising cluster random sampling to select participants. The sample consisted of 192 male students in the fourth through sixth grades, divided into players and nonplayers. Data were collected using the Social Support Scale Matson (1983) and a researcher-made questionnaire for computer games. The validity and reliability of the instruments were established through Cronbach's alpha coefficient, item correlation with dimensions, and correlation of dimensions with the total score and content validity. Results: The results indicated significant differences between player and nonplayer students in nonsocial behaviors, seeking superiority, and relationships with peers. Aggression and seeking superiority were higher in fifth-grade students than fourth- and sixth-grade students. Fifth- and sixth-grade students scored higher than fourth graders in these areas. The study found that Clash of Clans promoted appropriate social behaviors and peer relationships, while Fortnite had a significant positive effect on peer relationships. Mortal Kombat had a negative and significant effect on aggression and nonsocial behaviors compared to other games. Regression analysis revealed that playing time and type of play were significant predictors of social skills, with playing time being a more effective predictor than the type of play. Conclusion: The study concluded that digital games can significantly influence the social skills of male students in elementary schools. Specifically, Clash of Clans and Fortnite were found to have positive effects on social behaviors and peer relationships, while Mortal Kombat had negative effects. The findings suggest that the time spent playing games is a more critical factor in predicting social skills than the type of game played.

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Purpose: The present study aimed to investigate how prior research of TTRPG revealed the benefits of TTRPG as a psychological intervention and how further studies can overcome the challenges and limitations of TTRPG in those previous studies. Methods: The study used Scoping Review to explore the potential benefits of TTRPG. Three research questions were identified (1) the extent to which empirical research has been conducted regarding TTRPG as intervention, (2) the potential of TTRPG mentioned, and (3) the suggestions for future research. The study investigated the last 10 years (ie, 2013 to 2023) of research publications with all research methods included. The search focused on key terms of "Tabletop Role-playing Game", "TTRPG", "Dungeons and Dragons", and terms related to intervention. The databases used were in English and Indonesian and resulted in 109 papers but later eliminated due to various reasons until it became 51 papers to be reviewed. Results: Of the 51 papers included for final analysis, majority are of exploratory approach (n = 35; eg, literature review and qualitative design studies), indicating that research in TTRPG is still at the emerging stage. Quantitative design studies (n = 12) and mixed-method design studies (n = 4) on TTRPG are the minority. Majority papers (n = 30) are published in the United States, only three papers published in the Asian context, indicating that TTRPG research in the Asian context is scarce. Conclusion: From existing literature, TTRPG provides benefits to promote cognitive and psychosocial skills, to prevent negative effects and stress, as well as to intervene in psychological problems such as social anxiety, depressive symptoms, and autism spectrum disorders. Further studies can explore the use of TTRPG in Asia-representing collectivistic culture, to employ different systems of TTRPG and to examine the effects of TTRPG using experimental design to overcome the limitations of prior studies.

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Background: The aim of the current pilot study was to evaluate the usability, acceptability, and tolerability of virtual reality (VR)-based cognitive stimulation exercises (CSEs) in healthy young versus old populations before health care integration. A secondary aim was to assess the accuracy of VR games as a proxy for cognitive stimulation, specifically for attention. VR-based CSEs promise to improve attention and brain function through varied learning systems. Methods: This is a Phase 1 feasibility clinical trial at a single center. It involves 30 healthy volunteers randomly selected using the American Society of Anesthesiologists (ASA) physical status classification system. Participants fall into ASA 1 (age >18-35 years, n = 15) or ASA 2 (age >60 years, n = 15) categories. All participants tested the ReCognitionVR-based CSEs. Feasibility criterion: Participants in each group were monitored for completion of 20 minutes of VR-based CSEs. Acceptability criterion: Proportion of participants with system usability scale (SUS) >35 or SUS score of 87.5. Safety (tolerability) monitoring: Sessions were monitored for neurological, cardiovascular, or pulmonary adverse events (AEs). Safety criterion: No more than 10% of sessions stopped due to neurological, cardiovascular, or pulmonary AEs. Results: The primary outcome (feasibility) of ReCognitionVR-based CSEs was 100%. For the secondary outcome (acceptability), there was no group difference in SUS scores (ASA 1 = 88.17 ± 12.83 vs. ASA 2 = 88.39 ± 10.22, P = 0.81). For the tertiary outcome (safety), mild transient uneasiness was reported by two (13.4%) ASA 1 participants (resolved in 2 minutes), and one (6.67%) ASA 1 participant experienced a temporary >20% increase in blood pressure from baseline. No ASA 2 participants had AEs. Conclusion: The feasibility, acceptability, and safety of ReCognitionVR-based CSEs in healthy elderly volunteers are acceptable, indicating that the evaluation of the ReCognitionVR-based CSEs in hospitalized patients is reasonable.