Better operating room efficiency and reduced staff demand: Individualised versus off-the-shelf total knee arthroplasty.

PURPOSE: The purpose of this pilot cross-sectional study was to compare the operating room (OR) efficiency and intraoperative staff task load when performing individualised versus off-the-shelf (OTS) total knee arthroplasty (TKA). METHODS: A consecutive series of 28 patients randomised (1:1) to receive either OTS TKA or individualised TKA were included. The OR staff workload was assessed with the NASA Task Load Index (TLX), a subjective grading system assessing mental demand, physical demand, temporal demand, performance, effort and frustration on a scale from 0 (very low) to 20 (very high). The time for patient preparation, surgical time, closure and total OR time was recorded to assess OR efficiency. Effect sizes of differences between OTS and individualised TKA were expressed as mean differences (MDs) with 95% confidence intervals (CIs). RESULTS: Patients in both cohorts were similar in age (OTS vs. individualised TKA (median [IQR]), 67 [63-76] vs. 71 [68-79]; p = 0.207) and body mass index (BMI) (29 [24-33] vs. 29 [26-31]; p = 0.807), and there were no significant differences in other preoperative characteristics. The OR staff perceived individualised TKA as less demanding than OTS TKA: Individualised TKA was rated significantly better across the six domains of the NASA TLX: mental demand by 5.6 points, physical demand by 6.3 points, temporal demand by 5.3 points, performance by 3.6 points, effort by 5.9 points and frustration by 5.8 points. Individualised TKA resulted in statistically significantly shorter mean total OR time (MD, 10 min; p = 0.018). CONCLUSION: The staff in the OR found that individualised TKA is less mentally, physically and temporally demanding than OTS TKA. The average total time spent in the OR during individualised TKA is 10 min less than during OTS TKA. CLINICAL TRIAL REGISTRATION: This study constitutes a part of a larger registered randomised controlled trial comparing patient satisfaction following OTS versus individualised TKA (NCT04460989). LEVEL OF EVIDENCE: Level III.

Calibrated to drive: Measuring self-assessed driving ability and perceived workload after prolonged sitting and sleep restriction.

Self-assessed driving ability may differ from actual driving performance, leading to poor calibration (i.e., differences between self-assessed driving ability and actual performance), increased risk of accidents and unsafe driving behaviour. Factors such as sleep restriction and sedentary behaviour can impact driver workload, which influences driver calibration. This study aims to investigate how sleep restriction and prolonged sitting impact driver workload and driver calibration to identify strategies that can lead to safer and better calibrated drivers. Participants (n = 84, mean age = 23.5 ± 4.8, 49 % female) undertook a 7-day laboratory study and were randomly allocated to a condition: sitting 9-h sleep opportunity (Sit9), breaking up sitting 9-h sleep opportunity (Break9), sitting 5-h sleep opportunity (Sit5) and breaking up sitting 5-h sleep opportunity (Break5). Break9 and Break5 conditions completed 3-min of light-intensity walking on a treadmill every 30 min between 09:00-17:00 h, while participants in Sit9 and Sit5 conditions remained seated. Each participant completed a 20-min simulated commute in the morning and afternoon each day and completed subjective assessments of driving ability and perceived workload before and after each commute. Objective driving performance was assessed using a driving simulator measuring speed and lane performance metrics. Driver calibration was analysed using a single component and 3-component Brier Score. Correlational matrices were conducted as an exploratory analysis to understand the strength and direction of the relationship between subjective and objective driving outcomes. Analyses revealed participants in Sit9 and Break9 were significantly better calibrated for lane variability, lane position and safe zone-lane parameters at both time points (p < 0.0001) compared to Sit5 and Break5. Break5 participants were better calibrated for safe zone-speed and combined safe zone parameters (p < 0.0001) and speed variability at both time points (p = 0.005) compared to all other conditions. Analyses revealed lower perceived workload scores at both time points for Sit9 and Break9 participants compared to Sit5 and Break5 (p = <0.001). Breaking up sitting during the day may reduce calibration errors compared to sitting during the day for speed keeping parameters. Future studies should investigate if different physical activity frequency and intensity can reduce calibration errors, and better align a driver's self-assessment with their actual performance.

Evaluating the performance of the cognitive workload model with subjective endorsement in addition to EEG.

The aptitude-oriented exercises from almost all domains impose cognitive load on their operators. Evaluating such load poses several challenges owing to many factors like measurement mode and complexity, nature of the load, overloading conditions, etc. Nevertheless, the physiological measurement of a specific genre of cognitive load and subjective measurement have not been reported along with each other. In this study, the electroencephalography (EEG)-driven machine learning (Support Vector Machine (SVM)) model is sought along with the support of NASA's Task Load Index (NASA-TLX) rating scale for a novel purpose in workload exploration of operators. The Cognitive Load Theory (CLT) was used as the foundation to design the intrinsic stimulus (Spot the Difference task), as most workloads operators are exposed to are notably intrinsic. The SVM-based three-level classification accuracy ranged from 85.4 to 97.4% (p < 0.05), and the NASA-TLX-based three-level classification accuracy ranged from 88.33 to 97.33%. The t-test results show that the neurometric indices contributing to the classification significantly differed (p < 0.05) for every level. The NASA-TLX scale was utilised for validation in its basic form after the validity (Pearson correlation coefficients 0.338 to 0.805 (p < 0.05)) and reliability (Cronbach's α = 0.753) test. This modeling is beneficial to phase out particular-level cognitive exercises from the curriculum during under or overload workload (critical) conditions.

Identifying and validating perceived workload metrics for emergency medical services.

The most common workload surrogates used by Emergency Medical Services (EMS)- overall call volume (CV) and unit hour utilization (UHU)-have not been validated. This study investigates the relationship between EMS operational metrics and perceived workload, measured through the NASA task load index (TLX) survey. We paired crew member survey responses with the operational metrics based on dispatch data. Linear regression was used to evaluate the influence of each metric on perceived workload. Logistic regression was used to identify values of workload indicating a fair day's work. We found that the overall CV (p < 0.001, R2=0.32) and UHU (p < 0.001, R2=0.22) explained less variability in perceived workload than a priority (P)-stratified CV (p < 0.001, R2=0.41). However, we found no clear fair day's workload threshold. We conclude that a priority-stratified CV is a better workload surrogate than a CV and UHU.

Exploring the Impact of Hand Dominance on Laparoscopic Surgical Skills Development Using Network Models.

BACKGROUND: Laparoscopic surgery demands high precision and skill, necessitating effective training protocols that account for factors such as hand dominance. This study investigates the impact of hand dominance on the acquisition and proficiency of laparoscopic surgical skills, utilizing a novel assessment method that combines Network Models and electromyography (EMG) data. METHODS: Eighteen participants, comprising both medical and non-medical students, engaged in laparoscopic simulation tasks, including peg transfer and wire loop tasks. Performance was assessed using Network Models to analyze EMG data, capturing muscle activity and learning progression. The NASA Task Load Index (TLX) was employed to evaluate subjective task demands and workload perceptions. RESULTS: Our analysis revealed significant differences in learning progression and skill proficiency between dominant and non-dominant hands, suggesting the need for tailored training approaches. Network Models effectively identified patterns of skill acquisition, while NASA-TLX scores correlated with participants' performance and learning progression, highlighting the importance of considering both objective and subjective measures in surgical training. CONCLUSIONS: The study underscores the importance of hand dominance in laparoscopic surgical training and suggests that personalized training protocols could enhance surgical precision, efficiency, and patient outcomes. By leveraging advanced analytical techniques, including Network Models and EMG data analysis, this research contributes to optimizing clinical training methodologies, potentially revolutionizing surgical education and improving patient care.

Evaluating User Perceptions of a Vibrotactile Feedback System in Trunk Stabilization Exercises: A Feasibility Study.

Low back pain patients often have deficits in trunk stability. For this reason, many patients receive physiotherapy treatment, which represents an enormous socio-economic burden. Training at home could reduce these costs. The problem here is the lack of correction of the exercise execution. Therefore, this feasibility study investigates the applicability of a vibrotactile-controlled feedback system for trunk stabilisation exercises. A sample of 13 healthy adults performed three trunk stabilisation exercises. Exercise performance was corrected by physiotherapists using vibrotactile feedback. The NASA TLX questionnaire was used to assess the practicability of the vibrotactile feedback. The NASA TLX questionnaire shows a very low global workload 40.2 [29.3; 46.5]. The quality of feedback perception was perceived as good by the subjects, varying between 69.2% (anterior hip) and 92.3% (lower back). 80.8% rated the feedback as helpful for their training. On the expert side, the results show a high rating of movement quality. The positive evaluations of the physiotherapists and the participants on using the vibrotactile feedback system indicate that such a system can reduce the trainees fear of independent training and support the users in their training. This could increase training adherence and long-term success.

Assessing mental demand in consecutive interpreting: Insights from an fNIRS study.

Consecutive interpreting involves a demanding language task where mental workload (MWL) is crucial for assessing interpreters' performance. An elevated cognitive load in interpreters may lead to the interpretation failures. The widely used NASA-TLX questionnaire effectively measures MWL. However, a global score was employed in previous interpretation studies, overlooking the distinct contributions of MWL components to the interpreters' performance. Accordingly, we recruited twenty novice interpreters who were postgraduate students specializing in interpreting to complete the consecutive interpreting task. Throughout the process, we used functional near-infrared spectroscopy (fNIRS) to monitor the hemodynamic response in participants' brains. The NASA-TLX was used to measure the MWL during interpreting with six components, including mental demand, physical demand, temporal demand, performance, effort, and frustration. Five interpretation experts were invited to assess the interpretation quality. The Bayes factor approach was employed to explore the components that contributes the most to the interpretation quality. It indicated that mental demand strongly contributed to the interpretation quality. Moreover, the mediation analysis revealed a positive correlation between mental demand and brain activation in three brain areas, which, in turn, was negatively correlated with interpretation quality, indicating the predictive role of mental demand in interpretation quality through the mediating of brain activation. The functions of the mediating brain areas, including the inferior frontal gyrus, middle temporal gyrus, and inferior temporal gyrus, aligned with the three efforts proposed by Gile's effort model, which emphasizes the significance of three fundamental efforts in achieving successful interpreting. These findings have implications for interpreter learning and training.

Loosely controlled experimental EEG datasets for higher-order cognitions in design and creativity tasks.

Understanding neural mechanisms in design and creativity processes remains a challenging endeavor. To address this gap, we present two electroencephalography (EEG) datasets recorded in design and creativity experiments. We have discussed the details, similarities, differences, and corresponding cognitive tasks of the two datasets in the following sections. The design dataset (Dataset A) comprises EEG recordings of 27 participants during loosely controlled design creation experiments. Each experiment included six design problems. In each design problem, participants performed five cognitive tasks, including problem understanding, idea generation, rating idea generation, idea evaluation, and rating idea evaluation. The NASA Task Load Index was used in rating tasks. The creativity dataset (Dataset B) includes EEG signals recorded from 28 participants in creativity experiments which were based on a modified variant of the Torrance Test of Creative Thinking (TTCT-F). Participants were presented with three incomplete sketches and were asked to perform three creativity tasks for each sketch: idea generation, idea evolution, and idea evaluation. In both datasets, we structured the experiments into predefined steps, primarily to ensure participants' comfort and task clarity. This was the only control applied to the experiments. All the tasks were loosely controlled: open-ended (up to 3 min) and self-paced. 64-channel EEG signals were recorded at 500 Hz based on the international 10-10 system by the Brain Vision EEG recording system while the participants were performing their assigned tasks. EEG channels were pre-processed and finally referenced to the Cz channel to remove artifacts. EEGs were pre-processed using popular pipelines widely used in previous studies. Preprocessed EEG signals were finally segmented according to the tasks to facilitate future analyses. The EEG signals are stored in the .mat format. While the present paper mainly addresses pre-processed datasets, it also cites raw EEG recordings in the following sections. We aim to promote research and facilitate the development of experimental protocols and methodologies in design and creativity cognition by sharing these resources. There exist important points regarding the datasets which are worth mentioning. These datasets represent a novel contribution to the field, offering insights into design and creativity neurocognition. To our knowledge, publicly accessible datasets of this nature are scarce, and, to the best of our knowledge, our datasets are the first publicly available ones in design and creativity. Researchers can utilize these datasets directly or draw upon the considerations and technical insights provided to inform their studies. Furthermore, we introduce the concept of loosely controlled cognitive experiments in design and creativity cognition. These experiments strike a balance between flexibility and control, allowing participants to incubate creative ideas over extended response times while maintaining structured experimental sections. Such an approach fosters more natural data recording procedures and holds the potential to enhance the accuracy and reliability of future studies. The loosely controlled approach can be employed in future cognitive studies. This paper also conducts a comparative analysis of the two datasets, offering a holistic view of design and creativity tasks. By exploring various aspects of these cognitive processes, we provide an understanding for future researchers.

Factors influencing the mental health status of support nurses and their workload during the COVID-19 epidemic.

OBJECTIVES: The authors used the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and general health questionnaire to analyze the factors influencing the mental health status and the workload of support nurses during the COVID-19 epidemic. MATERIAL AND METHODS: The authors conducted a cross-sectional survey of 349 support nurses in April-October 2022. Using QuestionStar, a powerful online survey tool, the authors administered surveys to the participants, collected data on the mental health status and workload of support nurses, and analyzed the influencing factors based on the collected data. RESULTS: A total of 316 questionnaires were successfully collected, with an effective rate of 98.75%. The proportion of support nurses with mental health problems was 25% and the value of the NASA-TLX questionnaire was: M±SD 68.91±7.28 pts. Multi-factor analysis revealed that the number of children, family support, and nursing support location were the influencing factors of mental health status, while the multivariate analysis revealed that the presence of symptoms, nursing support location, support work type, and total 12-item General Health Questionnaire (GHQ-12) score were the influencing factors of the workload of support nurses. CONCLUSIONS: Compared to their counterparts in the plains, nurses working in isolated plateau regions who were caring for children and lacked family support, were more likely to have mental health issues. There was a positive correlation between the changes in GHQ-12 and NASA-TLX scores of the study participants. Compared to their counterparts in the plains and the tropical regions, nurses working in plateau regions had a heavier workload. As part of the follow-up measures to prevent and treat patients impacted by the COVID-19 epidemic, it is important to improve the mental health evaluation, consultation, and treatment of the support nurses to guarantee the high quality of the first-line support work. Int J Occup Med Environ Health. 2023;36(6)761-72.

Effects of cognitive load and different exercise intensities on perceived effort in sedentary university students: a follow up of the Cubo Fitness Test validation.

Work and intellectually fatiguing environments can significantly influence the health of individuals, which is strictly bound to motor efficiency. In particular, desk workers and university students may have a sedentary lifestyle and a condition of mental fatigue caused by daily routine, which could impair motor efficiency. The assessment is a starting point for enhancing awareness of the individual's psychophysical condition through the perception of one's body motor efficiency, motivating to move towards improvement. This way, a submaximal test based on perceived exertion was developed (Cubo Fitness Test, CFT) and validated in previous studies. Hence, two further studies were employed to enhance the consistency and accuracy of this instrument in different conditions. The first study investigated the internal responsiveness of CFT, evaluating if mental fatigue could affect motor efficiency. The second study investigated which perceived intensity (weak, moderate, strong, or absolute maximum) could be more reliable for applying the CFT (as previous research focused the investigation only on moderate intensity). In the first investigation, participants assessed two stimuli (mental fatigue induced with a Stroop color-word task and a neutral condition based on the vision of a documentary) lasting 60 min each. The quality of psychophysical recovery (total quality recovery) and the mood state (Italian Mood State questionnaire) were evaluated before the stimuli. After the fatiguing or the neutral task, the mood state was newly assessed, together with the evaluation of the workload's characteristics (Nasa TLX) and the CFT motor efficiency. In the second investigation, participants had to perform CFT twice for each at different intensities of Borg's Scale of perceived exertion. Researchers successfully requested to fill out the NASA TLX questionnaire regarding the perceived workload characteristics of CFT, and the reliability of each intensity was assessed. Results seem to enhance the consistency and the accuracy of the instrument. Indeed, findings evidenced that CFT is not influenced by mental fatigue conditions typical of the intellectual work of desk workers and university students for which this test was specifically conceived. Moreover, moderate and strong perceived intensity are the most adequate conditions to assess motor efficiency in these populations.

Video game experience affects performance, cognitive load, and brain activity in laparoscopic surgery training.

Objectives: Video games can be a valuable tool for surgery training. Individuals who interact or play video games tend to have a better visuospatial ability when compared to non-gamers. Numerous studies suggest that video game experience is associated with faster acquisition, greater sharpening, and longer retention of laparoscopic skills. Given the neurocognitive complexity of surgery skill, multimodal approaches are required to understand how video game playing enhances laparoscopy skill. Material and Methods: Twenty-seven students with no laparoscopy experience and varying levels of video game experience performed standard laparoscopic training tasks. Their performance, subjective cognitive loading, and prefrontal cortical activity were recorded and analyzed. As a reference point to use in comparing the two novice groups, we also included data from 13 surgeons with varying levels of laparoscopy experience and no video game experience. Results: Results indicated that video game experience was correlated with higher performance (R2 = 0.22, p <0.01) and lower cognitive load (R2 = 0.21, p <0.001), and the prefrontal cortical activation of students with gaming experience was relatively lower than those without gaming experience. In terms of these variables, gaming experience in novices tended to produce effects similar to those of laparoscopy experience in surgeons. Conclusion: Our results suggest that along the dimensions of performance, cognitive load, and brain activity, the effects of video gaming experience on novice laparoscopy trainees are similar to those of real-world laparoscopy experience on surgeons. We believe that the neural underpinnings of surgery skill and its links with gaming experience need to be investigated further using wearable functional brain imaging.

Demands of surgical teams in robotic-assisted surgery: An assessment of intraoperative workload within different surgical specialties.

BACKGROUND: Current approaches to assessing workload in robotic-assisted surgery (RAS) focus on surgeons and lack real-world data. Understanding how workload varies by role and specialty aids in identifying effective ways to optimize workload. METHODS: SURG-TLX surveys with six domains of workload were administered to surgical staff at three sites. Staff reported workload perceptions for each domain on a 20-point Likert scale, and aggregate scores were determined per participant. RESULTS: 188 questionnaires were obtained across 90 RAS procedures. Significantly higher aggregate scores were reported for gynecology (Mdn â€‹= â€‹30.00) (p â€‹= â€‹0.034) and urology (Mdn â€‹= â€‹36.50) (p â€‹= â€‹0.006) than for general (Mdn â€‹= â€‹25.00). Surgeons reported significantly higher scores for task complexity (Mdn â€‹= â€‹8.00) than both technicians (Mdn â€‹= â€‹5.00) (p â€‹= â€‹0.007), and nurses (Mdn â€‹= â€‹5.00). CONCLUSIONS: Staff reported significantly higher workload during urology and gynecology procedures, and experienced significant differences in domain workload by role and specialty, elucidating the need for tailored workload interventions.

A comprehensive experimental framework based on analysis of the pilot's EEG and NASA-TLX questionnaire in a VR environment.

The relationship framework between electroencephalogram (EEG) signals and subjective perception during pilots' missions was established to improve pilots' training efficiency and flight safety. Primarily, this study constructs a real flight scene through virtual reality (VR) and then obtains EEG data in simulated scenes. Researchers use VR technology to build a mission simulation room and then acquire EEG data from participants wearing EEG acquisition devices in the simulated room. The experimental process is divided into flight simulation and a questionnaire survey. Based on the participants' EEG analysis, the researchers verified the changes of ß rhythm under a high-difficulty operation mission. In addition, this study infers the mechanism of affecting pilots' mental workload under high-difficulty operation by analyzing the correlation between subjective questionnaire results and ß rhythms. The results showed that in the context of pilots performing flight missions in the aircraft space environment, the pilots' mental load had the most excellent rhythmic relationship with the regions representing ß rhythm. Therefore, a comprehensive experimental framework constructed in this study based on virtual simulation space to analyze the relationship between EEG and NASA-TLX subjective questionnaire provides a set of more accurate reference information for the design of a pilot training system based on pilot training efficiency and flight safety.

A brief body scan mindfulness practice has no positive effect on the recovery of heart rate variability and cognitive tasks in female professional basketball players.

Introduction: In this study, we examined the acute effects of a short video-based body scan mindfulness practice on the heart rate variability (HRV) and cognitive performance of professional female basketball players after the first half of a simulated basketball game. Methods: In this crossover randomized controlled trial, nine professional athletes completed a physical loading protocol on two separate days. The protocol consisted of a 10-min Yo-Yo Intermittent Recovery Test Level 1 in the first quarter, followed by a 10-min basketball game in the second quarter. Immediately afterward, they were asked to engage in a 10-min mindfulness practice or watch a 10-min nature-based documentary as a type of mental intervention. Their HRV, Rating of Perceived Exertion (RPE), National Aeronautics and Space Administration Task Load Index 2 (NASA TLX-2), and Go/No-Go test scores were recorded immediately before and after the physical loading and after the mental intervention. Results: The physical demand, effort, and frustration level subscales of the NASA TLX-2 and the RPE scores were found to be significantly higher after the physical loading, and they returned to the baseline level after both types of mental intervention. The Go/No-Go test scores did not differ depending on the measurement time. All time- and frequency-domain heart rate variability parameters, except the low-to-high frequency ratio, were found to be significantly high immediately after the physical loading protocol. However, these parameters returned to their initial levels after both types of mental intervention. Discussion: Completing the tests involved in the study protocol successfully induced physical fatigue, as evidenced by consistent measurement tools, but the one-time and short-term mindfulness practice had no additional benefits for the recovery of heart rate variability, cognitive tasks, or subjective assessment methods, such as RPE and NASA TLX-2, in basketball players with no previous experience of mindfulness practice.

Mental workload during endoscopic sinus surgery is associated with surgeons' skill levels.

Introduction: Surgeons' mental workload during endoscopic sinus surgery (ESS) has not been fully evaluated. The assessment was challenging due to the great diversity of each patient's anatomy and the consequence variety of surgical difficulties. In this study, we examined the mental workload of surgeons with various surgical skill levels during ESS under the standardized condition provided by novel-designed 3D sinus models. Materials and methods: Forty-seven participants performed a high-fidelity ESS simulation with 3D-printed sinus models. Surgeons' mental workload was assessed with the national aeronautics and space administration-task load index (NASA-TLX). Associations between the total and subscales score of NASA-TLX and surgical skill index, including the board certification status, the number of experienced ESS cases, and the objective structured assessment of technical skills (OSATS), were analyzed. In addition, 10 registrars repeated the simulation surgery, and their NASA-TLX score was compared before and after the repetitive training. Results: The total NASA-TLX score was significantly associated with OSATS score (p = 0.0001). Primary component analysis classified the surgeons' mental burden into three different categories: (1) the skill-level-dependent factors (temporal demand, effort, and performance), (2) the skill-level-independent factors (mental and physical demand), and (3) frustration. After the repetitive training, the skill-level-dependent factors were alleviated (temporal demand; z = -2.3664, p = 0.0091, effort; z = -2.1704, p = 0.0346, and performance; z = -2.5992, p = 0.0017), the independent factors were increased (mental demand; z = -2.5992, p = 0.0023 and physical demand; z = -2.2509, p = 0.0213), and frustration did not change (p = 0.3625). Conclusion: Some of the mental workload during ESS is associated with surgical skill level and alleviated with repetitive training. However, other aspects remain a burden or could worsen even when surgeons have gained surgical experience. Routine assessment of registrars' mental burdens would be necessary during surgical training to sustain their mental health.

Cognitive tasks and combined statistical methods to evaluate, model, and predict mental workload.

Mental workload (MWL) is a concept that is used as a reference for assessing the mental cost of activities. In recent times, challenges related to user experience are determining the expected MWL value for a given activity and real-time adaptation of task complexity level to achieve or maintain desired MWL. As a consequence, it is important to have at least one task that can reliably predict the MWL level associated with a given complexity level. In this study, we used several cognitive tasks to meet this need, including the N-Back task, the commonly used reference test in the MWL literature, and the Corsi test. Tasks were adapted to generate different MWL classes measured via NASA-TLX and Workload Profile questionnaires. Our first objective was to identify which tasks had the most distinct MWL classes based on combined statistical methods. Our results indicated that the Corsi test satisfied our first objective, obtaining three distinct MWL classes associated with three complexity levels offering therefore a reliable model (about 80% accuracy) to predicted MWL classes. Our second objective was to achieve or maintain the desired MWL, which entailed the use of an algorithm to adapt the MWL class based on an accurate prediction model. This model needed to be based on an objective and real-time indicator of MWL. For this purpose, we identified different performance criteria for each task. The classification models obtained indicated that only the Corsi test would be a good candidate for this aim (more than 50% accuracy compared to a chance level of 33%) but performances were not sufficient to consider identifying and adapting the MWL class online with sufficient accuracy during a task. Thus, performance indicators require to be complemented by other types of measures like physiological ones. Our study also highlights the limitations of the N-back task in favor of the Corsi test which turned out to be the best candidate to model and predict the MWL among several cognitive tasks.

Near-1: the evaluation of usability and task load demand of a motorized lifter for patient transfer.

PURPOSE: Despite the proven benefits of motorized lifting devices in reducing the physical stresses experienced by nurses during patient transfers, the low adoption of these devices remains limited. The study aimed to assess the perceptions of nurses regarding the new motorized lifting device (NEAR-1) in terms of their perceived workload and usability during patient transfers. MATERIALS AND METHODS: A cross-sectional study was conducted to evaluate the perceptions of nurses (n = 45) and students (n = 6) when performing patient transfers from bed to wheelchair and vice versa using the NEAR-1 compared to an existing floor lift, walking belt, and manual transfer. Participants filled out surveys evaluating the perceived task demands and usability of the NEAR-1, as well as open-ended interviews. RESULTS: The use of the NEAR-1 significantly reduced the mean of all NASA-TLX constructs (p < 0.001) when compared to manual transfer. When comparing with other existing lifting devices, the NEAR-1 (24.4 ± 3.0) recorded the lowest overall score of NASA-TLX perceived workload, followed by the existing floor lift (26.1 ± 11.6), a robotic-assisted transfer device (28.3 ± 6.8) and mechanical floor lift (31.5 ± 9.3). The participants recorded a usability score of 76.86, indicating positive perceptions of the nurses towards the technology. CONCLUSIONS: Overall, the NEAR-1 has the potential to reduce the physical stresses on nurses and decrease the likelihood of work-related musculoskeletal disorders (WMSDs). The NEAR-1 may represent a promising new intervention for transferring patients that is capable of minimizing the nurses' perceived workload in clinical and non-clinical settings.IMPLICATIONS FOR REHABILITATION:The NEAR-1 motorized lifting device reduced perceived workload for nurses while handling and transferring patients between a bed and wheelchair.The nurses recorded a usability score of 76.86 for the NEAR-1, reflecting their positive perceptions towards the technology.The new device has the potential to reduce the physical stress on nurses and decrease the incidence of work-related musculoskeletal disorders.

Stress and Workload Assessment in Aviation-A Narrative Review.

In aviation, any detail can have massive consequences. Among the potential sources of failure, human error is still the most troublesome to handle. Therefore, research concerning the management of mental workload, attention, and stress is of special interest in aviation. Recognizing conditions in which a pilot is over-challenged or cannot act lucidly could avoid serious outcomes. Furthermore, knowing in depth a pilot's neurophysiological and cognitive-behavioral responses could allow for the optimization of equipment and procedures to minimize risk and increase safety. In addition, it could translate into a general enhancement of both the physical and mental well-being of pilots, producing a healthier and more ergonomic work environment. This review brings together literature on the study of stress and workload in the specific case of pilots of both civil and military aircraft. The most common approaches for studying these phenomena in the avionic context are explored in this review, with a focus on objective methodologies (e.g., the collection and analysis of neurophysiological signals). This review aims to identify the pros, cons, and applicability of the various approaches, to enable the design of an optimal protocol for a comprehensive study of these issues.

Traffic Noise at Moderate Levels Affects Cognitive Performance: Do Distance-Induced Temporal Changes Matter?

Urbanization leads to an increased demand for urban housing, which can be met by building dwellings closer to streets. Regulations often limit equivalent sound pressure levels which do not account for changes in time structure that occur when decreasing the road distance. This study investigates the effect of such temporal changes on subjective workload and cognitive performance. A group of 42 participants performed a continuous performance test as well as a NASA-TLX workload test under three different sound conditions, i.e., close traffic, far traffic, both with the same equivalent sound pressure level of LAeq≈40 dB, and silence. Additionally, participants answered a questionnaire regarding their preferred acoustic environment for concentrated working. Significant effects of the sound condition on the multivariate workload results as well as on the number of commission errors in the continuous performance test were found. Post hoc tests showed no significant differences between the two noise conditions, but there were significant differences between noise and silence. This indicates that moderate traffic noise levels can influence cognitive performance and perceived workload. If there is a difference in the human response to road traffic noise with constant LAeq but different time structures, the used methods are not suitable to detect them.

Validation and effect of the NASA-TLX score on the assessment of the workload of pediatric robotic operations.

OBJECTIVE: The objective of the study was to assess the validity of the NASA-TLX score in rating the workload of pediatric robotic operations. METHODS: The workload of 230 pediatric gastrointestinal and thoracic robotic operations was rated using the NASA-TLX score. The difference between the high workload group and the low workload group in each subscale of the NASA-TLX score was analyzed. The correlation of each subscale with the total workload score in the high workload group and low workload group was also analyzed. A logistic regression analysis was subsequently conducted to assess the effects of different factors (sex, age, weight, procedure duration, procedure specialties, combined malformation and blood loss) on the workload. RESULTS: The average NASA-TLX score was 56.5 ± 5.1 for the total group, 56.9 ± 5.0 for the gastrointestinal group and 54.6 ± 4.8 for the thoracic group, p = 0.007. The score of the high workload group was 62.7 ± 3.2, while it was 50.6 ± 2.7 for the low workload group (p < 0.001). The score on each subscale was also significantly different between the high and low workload groups. In the high workload group, a stronger correlation was observed between the total score and TD and Fr and a lower correlation with MD and Pe. In the low workload group, all six subscales showed a moderate correlation with the total score. A multivariate logistic regression analysis revealed that the procedure duration was an independent influencing factor for a higher workload score. CONCLUSIONS: NASA-TLX is a valid tool to rate the surgeon's workload in pediatric robotic surgery. A longer operative time contributes to a higher workload.