Augmented and virtual reality are transforming the practice of healthcare by providing powerful and intuitive methods of exploring and interacting with digital medical data, as well as integrating data into the physical world to create natural and interactive virtual experiences. These immersive technologies use lightweight stereoscopic head-mounted displays (HMDs) to place users into simulated and realistic three-dimensional digital environments, unlocking significant benefits from the seamless integration of digital information with the healthcare practitioner and patient's experience. This review article explores some of the current and emerging technologies and applications in surgery, their benefits and challenges around immersion, spatial awareness and cognition, and their reported and projected use in learning environments, procedure planning and peri-operative contexts and in the surgical theatre. The enhanced access to information, knowledge, and experience enabled by virtual and augmented reality will improve healthcare approaches and lead to better outcomes for patients and the wider community.

The Community for Open Antimicrobial Drug Discovery (CO-ADD) is a not-for-profit, collaborative approach to discovering new antibiotics. We access novel chemical diversity from academic synthetic chemists, who collectively possess millions of untested compounds with chemical diversity that lie outside commercial collections. We perform high-throughput antimicrobial screening of pure compounds derived from both synthetic and natural sources free of charge. The resulting data can be used by participants for publication, patenting and development purposes, and is fed back into the research community through an open-access database after a 2-year period during which information is kept confidential to the provider. CO-ADD is fundamentally asking two questions: can the community work together to address the global threat of antimicrobial resistance; and are there as yet undiscovered, novel antimicrobial compounds already present within our diverse global chemistry community?

Background: Virtual reality (VR) is a type of extended reality (XR) technology that is seeing increasing adoption in health care. There is robust evidence articulating how consumer-grade VR presents significant cybersecurity and privacy risks due to the often ubiquitous and wide range of data collection and user monitoring, as well as the unique user impact of attacks due to the immersive nature of the technology. However, little is known about how these risks translate in the use of VR systems in health care settings. Objective: The objective of this scoping review is to identify potential cybersecurity risks associated with clinical XR systems, with a focus on VR, and potential mitigations for them. Methods: The scoping review followed the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews), and publications were reviewed using Covidence software. The Google Scholar database was searched using the predefined search terms. The inclusion criteria of the articles were restricted to relevant primary studies published from 2017 to 2024. Furthermore, reviews, abstracts, viewpoints, opinion pieces, and low-quality studies were excluded. Additionally, data on publication statistics, topic, technology, cyber threats, and risk mitigation were extracted. These data were synthesized and analyzed using the STRIDE (spoofing, tampering, repudiation, information disclosure, denial of service, and elevation of privilege) framework, enterprise risk management framework, and National Institute of Standards and Technology Cybersecurity Framework, as well as developing threat taxonomies. Results: Google Scholar returned 482 articles that matched the search criteria. After title and abstract screening, 53 studies were extracted for a full-text review, of which 29 were included for analysis. Of these, the majority were published in the last 4 years and had a focus on VR. The greatest cyber threat identified to XR components was information disclosure followed by tampering when mapped against the STRIDE framework. The majority of risk mitigation strategies provide confidentiality and integrity and can potentially address these threats. Only 3 of 29 papers mention XR in the context of health care and none of the identified threats or mitigations have been studied in a clinical setting. Conclusions: This scoping review identified privacy threats where personal and health-related data may be inferred from VR usage data, potentially breaching confidentiality, as the most significant threat posited for health care VR systems. Additionally, immersive manipulation threats were highlighted, which could potentially risk user safety when launched from a compromised VR system. Many potential mitigations were identified for these threats, but these mitigations must first be assessed for their effectiveness and suitability for health care services. Furthermore, health care services should consider the usage and governance of XR for each individual application based on risk threshold and perceived benefits. Finally, it is also important to note that this scoping review was limited by the quality and scope of the studies returned by Google Scholar.

Objectives: The primary objective of this study was to co-design and conduct a pilot evaluation of a novel, immersive virtual reality (VR) experience for procedural pain and anxiety in an Australian healthcare setting. The secondary objective was to identify key parameters that can facilitate the development and implementation of VR experiences in clinical practice.Method: A qualitative, Design Box method was selected for co-design. It was used with adult burns survivors and adolescents and young adults (AYAs) with cancer, and healthcare professionals from these fields to identify the practical and design parameters required for the application of VR technology within the clinical setting. Results informed the development of the VR experience that was evaluated by consumers and healthcare professionals, who completed qualitative surveys. Thematic analysis was conducted on co-design notes and survey data.Results: Procedural pain and management was a challenge for both cohorts, but particularly the burns cohort. Anxiety was significant challenge for both cohorts. Boredom and quality of life was a significant challenge, particularly for the AYA oncology cohort. These results informed the development of “A Wanderers Tale,” an Australiana-themed, gaze-controlled VR application for Oculus Quest platforms. Thematic analysis results suggest that cultural preferences, procedural contexts of use, and agency through customization and interaction are three parameters to consider when creating or selecting VR experiences for application in health.Significance of results: This work describes a novel method for the use VR as an adjuvant pain management tool in patients with burns and cancer. The VR experience may provide a culturally, practice and procedure-appropriate tool in comparable settings of care. The study also describes interdisciplinary co-design and evaluation approaches that can help maximize the use of VR to improve healthcare approaches that address clinical challenges in pain, anxiety, and quality of life for patients while in hospital.