The effects of Augmented Reality on operator Situation Awareness and Head-Down Time.

A lack of navigator's Situation Awareness (SA) is one of the leading causes of maritime accidents. Visually observing the area surrounding a vessel continues to be a critical aspect and best practice of safe navigation to establish and maintain SA. Augmented Reality (AR) allows the placement of information in a user's field of view, which can encourage navigators to spend more time looking up at their external environment whilst still having access to operational data. However, empirical evidence on the impact of AR on maritime operations is limited. This paper investigates the effects of AR on navigator SA & Head-Down Time (HDT) using a within-group quasi-experimental design. Seventeen licensed navigators and nautical students analysed twelve navigation scenarios: six non-AR (control) and six AR (experimental) scenarios using a maritime training simulator. SA was measured via SAGAT scores for each scenario and the SA-SWORD to compare preferences. Each scenario was video recorded and analysed for participant's total amount of HDT and head-down occurrences in each scenario. Results found that the addition of AR significantly reduced participant HDT (by a factor of 2.67) and head-down occurrences (by 62%) in comparison to navigation scenarios without AR. Furthermore, AR did not significantly improve mean SA. This study contributes to the limited empirical data on the effects of AR on operator performance, demonstrating the potential value of AR for improving SA and facilitating increased head-up time during maritime navigation, which in turn could improve safety at sea.

Comparing Smartphone Virtual Reality Exposure Preparation to Care as Usual in Children Aged 6 to 14 Years Undergoing Magnetic Resonance Imaging: Protocol for a Multicenter, Observer-Blinded, Randomized Controlled Trial.

BACKGROUND: A magnetic resonance imaging (MRI) procedure can cause preprocedural and periprocedural anxiety in children. Psychosocial interventions are used to prepare children for the procedure to alleviate anxiety, but these interventions are time-consuming and costly, limiting their clinical use. Virtual reality (VR) is a promising way to overcome these limitations in the preparation of children before an MRI scan. OBJECTIVE: The objective of this study is (1) to develop a VR smartphone intervention to prepare children at home for an MRI procedure; and (2) to examine the effect of the VR intervention in a randomized controlled trial, in which the VR intervention will be compared to care as usual (CAU). CAU involves an information letter about an MRI examination. The primary outcome is the child's procedural anxiety during the MRI procedure. Secondary outcomes include preprocedural anxiety and parental anxiety. We hypothesize that the VR preparation will result in a higher reduction of the periprocedural anxiety of both parents and children as compared to CAU. METHODS: The VR intervention provides a highly realistic and child-friendly representation of an MRI environment. In this randomized controlled trial, 128 children (aged 6 to 14 years) undergoing an MRI scan will be randomly allocated to the VR intervention or CAU. Children in the VR intervention will receive a log-in code for the VR app and are sent cardboard VR glasses. RESULTS: The VR smartphone preparation app was developed in 2020. The recruitment of participants is expected to be completed in December 2022. Data will be analyzed, and scientific papers will be submitted for publication in 2023. CONCLUSIONS: The VR smartphone app is expected to significantly reduce pre- and periprocedural anxiety in pediatric patients undergoing an MRI scan. The VR app offers a realistic and child-friendly experience that can contribute to modern care. A smartphone version of the VR app has the advantage that children, and potentially their parents, can get habituated to the VR environment and noises in their own home environment and can do this VR MRI preparation as often and as long as needed. TRIAL REGISTRATION: ISRCTN Registry ISRCTN20976625; https://www.isrctn.com/ISRCTN20976625. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/41080.

The Incidence of Post-Electroconvulsive Therapy Headache: A Systematic Review.

Headache is a common side effect of electroconvulsive therapy (ECT), but reports on its incidence vary widely. A broad array of treatment regimens have been proposed in the literature. The pathophysiology of post-ECT headache is unclear but a vascular origin has been suggested. A systematic literature search was executed in PubMed and Embase to identify relevant articles. Articles were screened on title, abstract, and full text according to predefined inclusion and exclusion criteria. Study characteristics and results concerning the incidence of post-ECT headache were extracted, and a weighted mean incidence was calculated. Forty-seven relevant articles were found, of which 36 reported on the incidence of post-ECT headache in patients and 9 on the incidence in sessions. The incidence of post-ECT headache varied greatly in the literature. The weighted mean incidence in patients was 32.8%, as 786 of a total population of 2399 patients experienced headache. The weighted mean incidence in sessions was between 9.4% (246 of 2604 sessions) and 12.1% (236/1958 sessions). The variation in incidences of post-ECT headache found might be due to different methods of measuring headache, different study designs, and different drugs used for anesthesia. The mean-weighted incidence of post-ECT headache in patients was 32.8% and in sessions between 9.4% and 12.1%.

Blood plasma levels of heavy metals and trace elements in white sharks (Carcharodon carcharias) and potential health consequences.

Heavy metals may adversely affect health in marine organisms. As top predators, sharks may be especially vulnerable to exposure over long lifespans. Here we evaluate plasma levels of 14 heavy metals and 12 trace elements in white sharks, Carcharodon carcharias, in South Africa to determine whether they are related to sex, body size, and/or body condition and other health parameters. High levels of mercury and arsenic were found in shark blood at levels considered toxic in other vertebrates. Heavy metal concentrations were not related to body size or sex. Metal concentrations were not related to body condition with exception of copper, which was positively correlated. Protective effects of elements such as selenium, zinc, and iron were not detected. No negative effects on health parameters, such as total leukocytes or granulocyte to lymphocyte ratios were observed. Results suggest that sharks may have protective mechanisms that mitigate harmful effects of heavy metal exposure, providing new opportunities for future studies.