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Introduction: Surgical autonomy for trainees has remained elusive to quantify. Proportion of active control time (ACT) of a trainee during a robotic case can be used as a broad measure of autonomy. However, this metric lacks in the granular detail of quantifying at what specific steps trainees were actively participating. We aim to quantify trainee involvement during robotic-assisted hiatal hernia repair at a task-specific level., Methods: We performed a retrospective review of surgical performance data from robotic-assisted hiatal hernia repairs performed. These cases were segmented into 5 tasks by AI-assisted annotation with human review. The segmented tasks included: hiatal dissection, gastric fundus mobilization, mediastinal dissection, cruroplasty and fundoplication. Tasks were excluded if video segmentation of tasks was incorrect. During each task, ACT was recorded for resident, fellow and attending. Resident and fellow ACT per task was compared using the Mann-Whitney U test., Results: Residents had the highest %ACT in the hiatal dissection (53%), gastric fundus mobilization (84%) and fundoplication (57%) tasks. Fellows had greater than 80% ACT in all 5 tasks, with the highest %ACT in the gastric fundus mobilization (100%) and hiatal dissection (88%). There was a significant difference between resident and fellow ACT during mediastinal dissection and cruroplasty., Conclusions: This study demonstrates how objective performance metrics and automated case segmentation can quantify trainee participation at a task-specific level. By utilizing data afforded by a robotic surgery platform, we are able to provide an objective and automated form of assessment with minimal impact on the workflow of attendings and residents. Our findings can serve to inform residents on what steps they can expect to be involved in during the procedure, appropriate to their PGY level. With this task-level data, we can provide a roadmap for trainee progression to achieve full surgical autonomy., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Acute stress exposure can significantly impact a train driver's capacity to maintain safe train operations. However, research examining how train drivers perceive the impacts of acute stressors is limited. This study investigated train driver perceptions regarding performance impacts of stressful events and potential strategies for reducing negative impacts. 71 Australian train drivers were presented with three stressful event scenarios via an online survey and asked to rate the impacts on driving performance. Results showed that participants perceived that stress would enhance performance, but that impacts differed depending on the event type. The findings suggest that train drivers may not be subjectively aware of negative impacts of acute stress, which has important practical implications for risk management following an incident. Qualitative results revealed the most frequently reported stress impact related to cognition. Practical implications and future research directions to prevent and manage stressful event exposure are discussed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Surgeons are often exposed to different types of operative room (OR) noise, for instance machine alarms, phone calls, and interacting objects. The aim of this study was to evaluate the effect of OR noise on the surgeons' laparoscopic performance., Methods: A total of 30 laparoscopic novices participated in this single-center, prospective, randomized cross-over trial after completing a standardized laparoscopic training until reaching proficiency. Afterward, all participants performed four different laparoscopic tasks (peg transfer, circle cutting, balloon resection, suture, and knot) twice, once under noise exposure (intervention group), and once without any noise (control group). Primary endpoints were the force exertion and motion analyses. To assess the psychological workload the NASA task load index score was used., Results: The error rates varied and were significantly different between the noise and the control group. More complex tasks like the circle cutting and suture and knot task revealed higher error rates concerning precision (circle cutting: P < 0.01; suture and knot: P < 0.01). In line with increased error rates in the circle cutting task, increased NASA task load index scores were observed in this task (P = 0.03). However, no significant differences were found in force parameters, such as the maximal force exertion (peg transfer: P = 0.43; circle cutting: P = 0.54; balloon resection: P = 0.64; suture and knot: P = 0.63) and the mean force exertion (peg transfer: P = 0.43; circle cutting: P = 0.54; balloon resection: P = 0.64; suture and knot: P = 0.63) between the groups., Conclusions: Exposure to normal OR noise led to higher error rates in two of four tasks. This effect could be linked to an increased psychological workload that was present under normal OR noise exposure. However, normal OR noise does not appear to impact surgical novices' laparoscopic task performance regarding applied forces and instrument motion., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: Wheelchair users and people with disabilities have limited access to physical exercise due to various factors, including medical follow-up and training facilities. Although tele-exercise guided by experts has become a viable option, there is limited knowledge about the acute performance decrement (APD) resulting from remote training methods. The current cross-sectional study aimed to: (1) assess the APD of muscle resistance strength after three synchronous tele-exercise training methods in wheelchair users and (2) compare the training loads associated with each training method., Materials and Methods: Eighteen male and female wheelchair users who participated in tele-exercise strength practices were recruited. The participants performed a maximum resistance strength test by synchronous tele-assessment (push-up test, PUT) at baseline and immediately after three training methods: high-intensity interval training (HIIT), moderate-intensity continuous training (MICT) and sprint interval training (SIT). The primary outcome was the APD, which was measured by the percentage decrease in the number of repetitions of the PUT immediately after the training methods., Results: APD was observed for all three training methods, with no significant differences between them (-34.8%, -29.9% and -38.0% for MICT, SIT and HII, respectively), and presented a non-significant correlation with the training loads. HIIT had a significantly higher training load than MICT and SIT., Conclusions: APD occurred in all training sessions, but did not correlate with training load, indicating that it is not an appropriate metric for comparison. Findings provide insight into APD response and highlight the need to consider multiple metrics when comparing training protocols.

OCCUPATIONAL APPLICATIONSWhen compared to not using a soft-hand exoskeleton, the IronHand ® caused both increases and decreases in forearm muscle activity while completing automotive assembly tasks. Surprisingly, although there were reductions in muscle activity when wearing the IronHand ® , only a few of these decreases resulted in muscle activity changing such that they fell to below recommended ergonomic thresholds. Despite this, some individuals in our study clearly benefited from the device, and this suggests that there is potential for widespread use of such a device if fine tuned to the individual and task demands. Much work is still required for a design that will allow for optimal physical benefit.

Three-dimensional high-definition (3D HD) and ultra-high-definition (4 K HD) endovision systems are rapidly adopted in academic setting. However, transferability of laparoscopic skills acquired from these systems to two-dimensional high-definition (2D HD) endovision system is not known. Forty stereo-enabled surgical residents were randomized into two groups. They performed three standardized surgical tasks, Task 1(Peg transfer), Task 2(Precision touch on uneven surface) and Task 3(Surgical knotting on rubber tube) for 15 repetitions using either 3D HD or 4 K HD. Both groups then performed the same tasks using 2D HD for 5 repetitions. Their performances were evaluated for execution time (speed) and error scores (safety). The residents in 3D HD group performed all three tasks significantly faster than residents in 4 K HD group with comparable error scores. The time taken to complete the tasks on 2D HD were comparable between residents trained in 3D HD and 4 K HD in two out of three tasks (p = 0.027, P = 0.115, p = 0.368 in task 1, 2 and 3 respectively). However, in two out of three tasks, residents trained on 3D HD committed significantly more errors than residents trained on 4 K HD (p < 0.0001, p < 0.001 in task 1 and task 2 respectively). Skill acquired on 4 K HD seems transferable to 2D HD environment. Participants trained in 3D HD made more errors while performing the tasks in 2D HD. It may be prudent to offer additional training on 2D HD to residents trained on 3D HD for safer laparoscopic surgical practice., (© 2024. Italian Society of Surgery (SIC).)

Objectives: Slump sitting at workstations has been focused on by clinicians and researchers nowadays; however, there is limited evidence to date that improper positioning affects the mental state. Accordingly, the main objective of this research was to examine the impact of slump posture on mental fatigue and task performance., Methods: A sample of 60 participants, 30 in each group including those with normal and slump postures were recruited to perform an hour of typing on the computer. Mental fatigue through EEG and task performances were considered as outcome measures and then were analyzed statistically in the first and last 3 min of typing., Results: The EEG showed a significant increasing trend in theta rhythm at different brain regions during 60 min of typing (P < 0.05). Besides, an interaction between time and posture was observed; it can mean the increasing trend of theta rhythm is different in normal and slump posture acquired sets (P < 0.05). Interestingly the speed of typing was found to be better (P < 0.05) in the normal posture group while no difference found between the groups in terms of errors (P > 0.05)., Conclusion: Our results showed poor posture can induce more mental fatigue during the given task, than the normal posture. These findings have provided evidence to indicate that in addition to the peripheral and biomechanical component, the assessment of the cortex as the central component should be considered in poor posture individuals. Besides, for any possible physical therapy rehabilitation protocol for the management of poor posture, the peripheral and central components should be focused., Trial Registration: Registered on the Iranian Registry of Clinical Trials on September 21, 2022, IRCT Identifier: IRCT20161026030516N2., Competing Interests: Declaration of competing interest The authors clarify that they have no known competing of interest concerning this article., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Descriptive research on work ability is well advanced. However, literature is still far from explaining its consequences. Besides, Turkish literature has been quite limited in terms of considering the work ability concept. In the research, the work ability index, and task performance scale were adapted to Turkish. The research was patterned with quantitative method. According to findings, the improvement of work ability levels and increase in job satisfaction and task performance are related in the same direction. Moreover, work ability positively contributes to directly predicting job satisfaction and task performance. Furthermore, work ability positively contributes to indirectly predicting task performance through job satisfaction. This mediation effect, determined for the first time, is an important research finding regarding its contribution to literature. Apart from these, there are significant differences in work ability among age groups, and certain age group categories have a moderating effect on the relationship between work ability and task performance. This study demonstrated that work ability index is a valid and reliable tool for the Turkish sample. Besides, the study provides holistic findings thanks to work ability levels and direct and indirect effect analysis. The theoretical and practical implications were discussed, and directions were made to further research.

Introduction: Robotic surgery without contact-force feedback could be less safe, as forces exerted by the robot system may exceed tissue tolerance. This study aimed to evaluate the benefit of contact-force feedback., Methods: Nine junior and 11 senior surgeons performed two tasks using Saroa, a robotic surgical system with a force feedback function. In Task A, the participants estimated the order of stiffness of substances when feedback was on and off. In Task B, the effect of feedback on compression with a designated force (3 N) was assessed., Results: In Task A, the proportion of participants who correctly estimated the order of stiffness of the substances was similar when feedback was on and off. However, the median maximum force applied to the substances was significantly smaller when feedback was on than when it was off (5.0 vs. 6.9 N, p = .011), which was more obvious among the junior surgeons (5.0 vs. 7.7 N, p = .015) than among the senior surgeons (4.7 vs. 5.9 N, p = .288). In Task B, deviations from the designated force (3 N) for three substances were smaller when feedback was on (0, -0.1, and 0.7, respectively) than when it was off (-0.3, -0.5, and 1.3, respectively). Regarding the dispersion of the force to the substances, the interquartile range tended to be smaller with feedback; this trend was more obvious in the junior surgeons., Conclusion: With contact-force feedback, tissue stiffness could be estimated with a small force, particularly by the junior surgeons; specified force could be accurately applied to the tissue., (© 2024 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.)

The rapid technological advancement in higher education necessitates understanding the factors influencing university teachers' professional growth and task performance. This study investigates the relationships among Achievement Recognition, Career Adaptability, and Organizational Seniority, focusing on their impact on the task performance of Chinese university teachers. A longitudinal, time-lagged survey design was employed, collecting data from 1444 Chinese university teachers over three waves, each one month apart. The survey included Achievement Recognition, Career Adaptability, and Task Performance measures, with Organizational Seniority as a moderating variable. Achievement Recognition significantly predicted Career Adaptability. The interaction between career adaptability and organizational seniority was significant, indicating that the positive effect of career adaptability on task performance varied with levels of organizational seniority. Conditional Effects were substantial. Career Adaptability positively affected Work Performance for individuals with less than five years of seniority but had a weaker effect for those with 11-15 years and an adverse effect for those with >21 years of seniority. The indirect impact of Achievement Recognition on Work Performance through Career Adaptability was significant for newly employed workers but non-significant for experienced workers. The study underscores the importance of Achievement Recognition in enhancing Career Adaptability and, subsequently, Work Performance. The moderating role of Organizational Seniority suggests that interventions to boost Career Adaptability and Work Performance should be tailored to different career stages. Academic institutions should implement recognition programs, adaptability training, and mentorship schemes that consider faculty members' career stages to foster a high-performing, adaptable workforce., Competing Interests: Declaration of competing interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objective:  This study aimed to explore the impact of high-fidelity simulator (HFS) training on the bronchoscopy operation skills, confidence, stress, and learning satisfaction of trainees who further their training at endoscopy center in our hospital. The study also investigated the practical application effects of HFS training and provided a reference for the development of clinical teaching and training programs in hospitals., Methods:  The 18 trainees who furthered their training at the endoscopy center were evaluated for their bronchoscopy operation skills, confidence, and stress levels before and after HFS training. A survey on learning satisfaction was conducted after the completion of HFS training. The scores of all evaluations were collected for comparison of differences before and after HFS training., Results:  HFS training improved the clinical operation skill levels and confidence of trainees who further their training at the endoscopy center, reduced their stress, and achieved 100% satisfaction from this training. Education level and department had no significant impact on trainees' operational skills and confidence improvement, and stress reduction ( p  > 0.05). The results of this study supported the influence of the history of endoscopy operations on the improvement of trainees' improved operational skills after HFS training, but it had no relation to the improvement of confidence and stress reduction. Trainees with a history of endoscopy operations had higher operation skill scores before and after HFS training ( n  = 5, 94.80 ± 2.95 and 97.60 ± 1.82, respectively) than those without a history of endoscopy operations ( n  = 13, 80.62 ± 2.53 and 86.38 ± 2.82, respectively), and the difference was significant ( p  < 0.05)., Conclusion:  HFS training is an effective clinical teaching method that can significantly improve trainees' bronchoscopy operation skills and confidence, reduce stress, and achieve high levels of satisfaction., Competing Interests: None declared., (Thieme. All rights reserved.)

Objective: This study aimed to assess the plausibility of self-control depletion, or ego-depletion, as the underlying cognitive resource responsible for performance decrements on the sustained attention to response task., Background: Researchers suggested that self-control is a limited cognitive resource used to complete a myriad of processes, including sustained attention. Past research showed that trait self-control affects some sustained attention tasks. However, little research has investigated the effect of self-control as a limited cognitive resource that varies over time (i.e., as a state-dependent variable)., Methods: This experiment investigated the effect of self-control (trait and state) on a sustained motor-inhibition task (e.g., sustained attention to response task; SART). State self-control was manipulated using a between-subjects design-participants in the experimental condition completed a task designed to deplete state self-control prior to performing the SART while the control condition completed a modified version that did not deplete self-control., Results: Trait self-control predicted performance on the SART, but the depletion task (state self-control) had no detectable effect., Conclusion: Given the evidence, it is unlikely that state self-control plays a causal role in performance decrements in the SART, but there appears to be some association between performance on the SART and trait self-control., Application: Trait self-control ought to be considered in future work for personnel selection in real-world tasks that the SART models such as long-distance driving, air traffic control, and TSA operations.

Background: Cognitive-motor dual-task walking results a decrease in walking performance of patients with multiple sclerosis (PwMS) and it is known as dual-task cost (DTC). However, there is a lack of evidence about the effects of dual-tasks with hierarchical difficulty on DTC in PwMS., Research Question: This study aimed to investigate the effect of task difficulty on DTC during cognitive-motor dual-task walking in people with multiple sclerosis (PwMS)., Methods: 32 PwMS and 32 healthy controls were included. The 6-meter walking test (6-Meter WT) with comfortable speed was used as single-task walking condition. For dual-task conditions, walking tasks and cognitive tasks at two difficulty levels (simple and difficult) were combined and DTC for four cognitive-motor dual-task walking conditions as simple motor-simple cognitive (SM-SC), simple motor-difficult cognitive (SM-DC), difficult motor-simple cognitive (DM-SC) and difficult motor-difficult cognitive (DM-DC) were calculated. The 6-Meter WT was used also for simple dual-task walking task. The 6-Meter WT was applied by walking in a narrow base condition for creating a difficult dual-task walking task. For cognitive task difficulty, participants were asked to count backwards by 3 as simple cognitive task and by 7 as difficult cognitive task., Results: DTC was higher in PwMS than control subjects. DTC in all conditions were different (SM-SC

Purpose: To evaluate the effect of being under time pressure on procedural performance using hand motion analysis., Materials and Methods: Eight radiology trainees performed central venous access on a phantom while recording video and hand motion data using an electromagnetic motion tracker. Each trainee performed the procedure six times: the first three trials without any prompts (control), while for the next three, they were asked to perform the task as fast as possible (time pressure). Validated hand motion metrics were analyzed, and two blinded and independent evaluators rated procedural performance using a previously validated task-specific global rating scale (GRS). Motion/time ratios and linear mixed-effect methods were used to control for time, and constants for both strategies were compared., Results: Hand motion analysis showed that trainees completed the simulated procedure faster under time pressure (46 ± 18 s vs. 56 ± 27 s, p = 0.008) than during the control strategy. However, when controlling for time, trainees moved their hands 79 more centimeters (p = 0.04), made 15 more translational movements (p = 0.003) and 18 more rotational movements (p = 0.01) when under time pressure compared to at their own pace., Conclusion: Although trainees could perform the procedure faster under time pressure, there was a deterioration in hand motion economy and smoothness. This suggests that hand motion metrics offer a more comprehensive assessment of technical performance than time alone., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).)

Introduction: A recent needs assessment in Canadian cardiac surgery programs identified the desire for a coronary artery bypass (CABG) and aortic valve replacement (AVR) simulation model for home practice. We aimed to develop and assess a portable, adjustable task trainer for cardiac surgical skills with high functional task alignment., Methods: Intraoperative measurements were taken from patients undergoing elective CABG and AVR (N = 30). Measurements were taken in 3 axes and used to create a chest cavity that resembles the mediastinal constraints of a patient undergoing CABG and AVR. The task trainer is adjustable on the following 3 levels: (1) size of the incision, (2) depth of the chest, and (3) relative position of coronary artery or aortic valve model within the chest. Three groups (novices, intermediates, and experts) of cardiac surgery members evaluated the task trainer for functional task alignment and construct validity., Results: The CABG and AVR model had high functional task alignment. There was a high satisfaction for both models and all participants would recommend the AVR and CABG model as an educational tool. Performance time significantly differed between the groups for both models (CABG: P = 0.032 and AVR: P = 0.001), as well as number of errors (CABG: P = 0.04 and AVR: P = 0.043)., Conclusions: Using real patient data, we were able to develop an adjustable task trainer for training principles of CABG and AVR. Our pilot study provides preliminary sources of evidence for validity and future study will look to assess transferability of skill to the operating room., Competing Interests: The author declares no conflict of interest., (Copyright © 2023 Society for Simulation in Healthcare.)

Introduction: This study aimed to investigate the test-retest reliability of the L test under single and dual-task conditions in women with fibromyalgia. To analyze the concurrent validity of the L test and Timed Up and Go test (TUG) and the relationship between the L test and the impact of the disease., Methods: A cross-sectional study with 22 women with fibromyalgia. The Intraclass Correlation Coefficient (ICC) 3,1 evaluated the reliability. The concurrent validity was established between the L test and the TUG. The Pearson product-moment correlation assessed the correlation between the L test and the impact of the disease., Results: Results revealed an ICC of 0.95 (0.876-0.979) in the single condition with the stopwatch and 0.95 (0.872-0.978) with the Chronopic. In the dual-task condition 0.93 (0.832-0.971) with the stopwatch and 0.94 (0.854-0.975) with the Chronopic. The L test and the TUG showed significant relationships with a stopwatch in the single (test-r = 0.839; retest-r = 0.897) and the dual-task conditions (test-r = 0.793; retest-r = 0.882). These findings were also found with the Chronopic in the single (test-r = 0.876; retest-r = 0.901) and the dual-task conditions (test-r = 0.872; retest-r = 0.897). Significant relationships were found between the L test and the impact of the disease with a stopwatch in the single (test-r = 0.502; retest-r = 0.647) and the dual-task conditions (test-r = 0.428; retest-r = 0.571). And with the Chronopic in the single (test-r = 0.528; retest-r = 0.663) and the dual-task conditions (test-r = 0.482; retest-r = 0.608)., Conclusions: L test is a reliable tool under single and dual-task conditions in women with fibromyalgia. This test is a valid method when compared with the TUG, and it is related to the impact of the disease., Competing Interests: Declaration of competing interest The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The integration of virtual reality (VR) and multisensory experiences offers a novel approach to enhancing workspace design, particularly for home office environments. This preliminary study examines the effects of visual and olfactory stimuli in a VR-simulated smart home environment on presence, task performance, heart rate, and mood. Sensory conditions, including visual, olfactory, and combined stimuli, were controlled in an experiment with 60 participants to assess both physiological and psychological responses. Task performance was measured through cognitive tests, while heart rate and mood states were monitored using a heart rate sensor and the Positive and Negative Affect Schedule (PANAS), respectively. Statistical results showed that the sense of presence provided by VR and specific conditions-such as visual stimuli (e.g., intelligent lighting systems)-effectively enhanced work efficiency, with task performance under visual stimuli significantly outperforming that under olfactory stimuli (e.g., peppermint scent). However, these sensory stimuli did not significantly affect heart rate or emotions. Our findings underscore the potential of sensory design to improve task performance and highlight the importance of the sensory environment in designing home offices, suggesting that sensory stimuli can enhance work efficiency in remote or virtual work settings., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: The workload of organ transplant coordinators is increasing as administrative tasks become more diverse with changing laws and regulations. These changes have heightened the demand for organ transplant coordinators with expertise in the field. This study aimed to determine the status of human resources of organ transplant coordinators and conduct job analysis using the Developing A Curriculum (DACUM) method., Methods: We conducted a questionnaire survey with 107 transplant coordinators employed at medical centers across Korea. The questionnaire gathered data on general and job-related characteristics of organ transplant coordinators and assessed the importance, difficulty, and frequency of their task elements., Results: The job of organ transplantation was categorized into five duties, 14 tasks, and 97 task elements. These duties included recipient management, donor management, organ donation activation management, organ transplantation administration, and professional capability development. We noted statistically significant differences in the importance scores of organ donation activation based on age, as well as in the difficulty scores for recipient management and administrative tasks based on work experience. Furthermore, the frequency of task performance varied significantly according to the number of coworkers and the total number of transplants conducted., Conclusions: This study confirmed the current status of the workforce and task performance of organ transplant coordinators. The findings will serve as basic data to enhance the expertise of coordinators in the future.

The study tested a brief intervention to stimulate and help supervisors reduce work-related interruptions among their employees, both at work and during leisure time. The core of the short-term intervention was a workplace analysis of work-related interruptions, which was fed back to supervisors in combination with a work redesign stimulation explaining why and how to reduce interruptions. Two intervention sessions, as one-on-one physical meetings, that lasted 1.5 h each and were 2 wk apart. The sample consisted of 20 managers and 89 employees. The non-experimental repeated measurement design comprised three questionnaire measurements of the 89 employees (two pre-measurements and one post-measurement). Repeated measure hierarchical linear models showed that the intervention significantly predicted reduced interruptions during work and work-related interruptions of leisure time. Although the intervention effect sizes were small, the current work design intervention with supervisors as mediating actors can reasonably contribute to occupational health prevention.

Background: Motor learning, a primary goal of pediatric rehabilitation, is facilitated when tasks are presented at a "just-right" challenge level-at the edge of the child's current abilities, yet attainable enough to motivate the child in persistent efforts for success. Immersive virtual reality (VR) may be ideally suited for "just-right" task challenges because it enables precise adjustments of task parameters in motivating environments. Rehabilitation-specific VR tasks often use dynamic difficulty algorithms based on task performance to personalize task difficulty. However, these approaches do not consider relevant cognitive processes that could also impact "just-right" challenges, such as attention and engagement. Objective physiological measurement of these cognitive processes using wearable sensors could support their integration within "just-right" challenge detection and prediction algorithms. As a first step, it is important to explore relationships between objectively and subjectively measured psychophysiological states at progressively challenging task difficulty levels., Objective: This study aims to (1) evaluate the performance of wearable sensors in a novel movement-based motor learning immersive VR task; (2) evaluate changes in physiological data at 3 task difficulty levels; and (3) explore the relationship between physiological data, task performance, and self-reported cognitive processes at each task difficulty level., Methods: This study uses the within-participant experimental design. Typically developing children and youth aged 8-16 years will be recruited to take part in a single 90-minute data collection session. Physiological sensors include electrodermal activity, heart rate, electroencephalography, and eye-tracking. After collecting physiological data at rest, participants will play a seated unimanual immersive VR task involving bouncing a virtual ball on a virtual racket. They will first play for 3 minutes at a predefined medium level of difficulty to determine their baseline ability level and then at a personalized choice of 3 progressive difficulty levels of 3 minutes each. Following each 3-minute session, participants will complete a short Likert-scale questionnaire evaluating engagement, attention, cognitive workload, physical effort, self-efficacy, and motivation. Data loss and data quality will be calculated for each sensor. Repeated-measures ANOVAs will evaluate changes in physiological response at each difficulty level. Correlation analyses will determine individual relationships between task performance, physiological data, and self-reported data at each difficulty level., Results: Research ethics board approval has been obtained, and data collection is underway. Data collection was conducted on December 12, 2023, and April 12, 2024, with a total of 15 typically developing children. Data analysis has been completed, and results are expected to be published in the fall of 2024., Conclusions: Wearable sensors may provide insights into the physiological effects of immersive VR task interaction at progressive difficulty levels in children and youth. Understanding the relationship between physiological and self-reported cognitive processes is a first step in better identifying and predicting "just-right" task challenges during immersive VR motor learning interventions., International Registered Report Identifier (irrid): DERR1-10.2196/55730., (©Samory Houzangbe, Martin Lemay, Danielle E Levac. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 23.09.2024.)

The quadriceps are particularly susceptible to fatigue during repetitive lifting, lowering, and carrying (LLC), affecting worker performance, posture, and ultimately lower-back injury risk. Although robotic exoskeletons have been developed and optimized for specific use cases like lifting-lowering, their controllers lack the versatility or customizability to target critical muscles across many fatiguing tasks. Here, we present a task-adaptive knee exoskeleton controller that automatically modulates virtual springs, dampers, and gravity and inertia compensation to assist squatting, level walking, and ramp and stairs ascent/descent. Unlike end-to-end neural networks, the controller is composed of predictable, bounded components with interpretable parameters that are amenable to data-driven optimization for biomimetic assistance and subsequent application-specific tuning, for example, maximizing quadriceps assistance over multiterrain LLC. When deployed on a backdrivable knee exoskeleton, the assistance torques holistically reduced quadriceps effort across multiterrain LLC tasks (significantly except for level walking) in 10 human users without user-specific calibration. The exoskeleton also significantly improved fatigue-induced deficits in time-based performance and posture during repetitive lifting-lowering. Last, the system facilitated seamless task transitions and garnered a high effectiveness rating postfatigue over a multiterrain circuit. These findings indicate that this versatile control framework can target critical muscles across multiple tasks, specifically mitigating quadriceps fatigue and its deleterious effects.

We reconcile two significant lines of Cognitive Neuroscience research: the relationship between the structural and functional architecture of the brain and behaviour on the one hand and the functional significance of oscillatory brain processes to behavioural performance on the other. Network neuroscience proposes that the three elements, behavioural performance, EEG oscillation frequency, and network connectivity should be tightly connected at the individual level. Young and old healthy adults were recruited as a proxy for performance variation. An auditory inhibitory control task was used to demonstrate that task performance correlates with the individual EEG frontal theta frequency. Older adults had a significantly slower theta frequency, and both theta frequency and task performance correlated with the strengths of two network connections that involve the main areas of inhibitory control and speech processing. The results suggest that both the recruited functional network and the oscillation frequency induced by the task are specific to the task, are inseparable, and mark individual differences that directly link structure and function to behaviour in health and disease., (© 2024. The Author(s).)

Purpose: The purpose of the current study was to assess dual-task interference (i.e., changes between the dual-task and baseline condition) in a listening effort dual-task paradigm in normal-hearing (NH) adults, hearing aid (HA) users, and cochlear implant (CI) users., Method: Three groups of 31 participants were included: (a) NH adults, (b) HA users, and (c) CI users. The dual-task paradigm consisted of a primary speech understanding task in a quiet condition, and a favorable and unfavorable noise condition, and a secondary visual memory task. Dual-task interference was calculated for both tasks, and participants were classified based on their patterns of interference. Descriptive analyses were established and differences between the three groups were examined., Results: The descriptive results showed varying patterns of dual-task interference between the three listening conditions. Most participants showed the pattern of visual memory interference (i.e., worse results for the secondary task in the dual-task condition and no difference for the primary task) in the quiet condition, whereas the pattern of speech understanding priority trade-off (i.e., worse results for the secondary task in the dual-task condition and better results for the primary task) was most prominent in the unfavorable noise condition. Particularly, in HA and CI users, this shift was seen. However, the patterns of dual-task interference were not statistically different between the three groups., Conclusions: Results of this study may provide additional insight into the interpretation of dual-task paradigms for measuring listening effort in diverse participant groups. It highlights the importance of considering both the primary and secondary tasks for accurate interpretation of results., Supplemental Material: https://doi.org/10.23641/asha.26409088.

Purpose: To investigate the effect of a newly developed hand rim in wheelchair tennis players from a lab and field perspective., Methods: Nine wheelchair tennis players performed a set of field and lab tests with the new rim (NR) and regular rim on the racket side. Each player had a 60- to 120-minute regular training session with the NR. Three wheelchair tennis field tests (20-m sprint, Illinois, spider) were completed on a hard court using inertial measurement units. The inertial measurement units enabled analysis of linear/rotational velocity and acceleration. In the lab, two 4-minute submaximal tests (at 1.5 and 2 m/s, 0.2 W/kg), followed directly by a 5-second sprint, on a wheelchair ergometer were completed. Force and velocity were measured continuously throughout all tests. Mixed linear models investigated the effect between the 2 hand rims., Results: During the spider test, mean rotational velocity to the racket side (-2%, P = .005) was lower in the NR, and end times were similar between hand-rim conditions. No differences were observed in the 20-m sprint and Illinois field tests. In the lab, contact angle (+6%, P = .04), cycle time (+12%, P = .007), and work per push (+13%, P = .005) were higher in the NR during submaximal propulsion. Work per push (+13%, P = .007), peak velocity (+3%, P < .001), and distance covered (+4%, P = .02) were higher with the NR during the 5-second sprint test., Conclusions: The NR seems slightly favorable compared with the regular rim during performance testing on a wheelchair ergometer in wheelchair tennis players. A longer practice time might show more insights between the hand-rim types.

Dynamic sitting may mitigate low back pain during prolonged seated work. The current study compared pelvis and lumbar spine kinematics, pain, and work productivity, in traditional and dynamic sitting. Sixteen participants completed three 20-min blocks of computer work and activity guided tasks in a traditional office chair or backless and multiaxial rotating seat pan while kinematics were measured from accelerometers on the low back. Pain ratings were recorded on a visual analogue scale every 10 min. Similar pelvis and lumbar kinematics emerged when performing computer work in traditional and dynamic sitting. Pelvis and lumbar sagittal and frontal plane shifts and fidgets were largest for dynamic sitting in the activity guided tasks. Buttocks pain was higher in dynamic sitting, but low back pain and work productivity were unaffected. Dynamic sitting increased spine movement during activity guided tasks, without negatively impacting lumbar kinematics, low back pain, or productivity during seated computer work., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

INTRODUCTION: The benefits of using head-up displays (HUDs) include reducing head-down time during critical flight phases, enhancing awareness of the external environment, and improving in-flight crew performance. However, the monochromatic nature of HUDs, increased head rotation, and longer gaze movement paths might affect pilots' reactions to different types of alerts. METHODS: Pilot workload and behavior differences were examined between HUD and head-down display (HDD) configurations in three alert scenarios. The study was carried out in an A320 flight simulator and 12 pilots participated. RESULTS: Except for one engine-on-fire scenario, pilot workload when using a HUD was significantly lower than using an HDD. In one engine-on-fire (3.98 s vs. 3.57 s) and one gear-disagree (5.42 s vs. 4.69 s) scenario, pilot response time to alerts using HUD was significantly longer than using an HDD. The angle deviations were significantly smaller when using HUDs in both go-around-under-crosswind (2.67° vs. 3.37°) and one engine-on-fire scenario (1.22° vs. 1.89°). DISCUSSION: The HUD is suitable for a lengthy process of manual flight control inputs, which not only reduces workload but also promotes control accuracy. For tasks that rely on automation, the benefits for workload become less obvious. In addition, head rotation and reorientation of attention adversely affected the response time to non-time-critical warnings and cautions. For instantaneous control with high precision requirements, HUDs did not demonstrate a significant advantage. Zheng Y, Lu Y, Jie Y, Fu S. Pilots' reactions to different types of alerts when using head-up displays . Aerosp Med Hum Perform. 2024; 95(9):688-694.

The role of task priority on task selection in multi-task management is unclear based on prior work, leading to a common finding of 'priority neglect'. However, properties such as urgency and conflict may influence whether operators weigh priority in their decision. We examined the role of instructed task prioritization, bolstered by more urgent and conflicting conditions, on how operators select among emergent, concurrent tasks when multitasking. Using the Multi-Attribute Task Battery (MATB) multitasking platform we tested both an auditory communications task and a manual tracking task as the priority tasks. Results showed that instructed priority significantly increased target task selection under the conflicting task conditions for both tasks. Urgency itself may modulate whether instructions to prioritize affect task selection choices when multitasking, and therefore counter to prior results instructions may yet be useful for helping operators select a higher priority task under conflict, a generalizable effect to be further explored., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: Neurocognitive and motor impairments are often observed both before and after liver transplantation, resulting in inefficiencies in dual-task performance. Specific aim: The aim of this study was to evaluate the motor-cognitive dual-task performance in liver recipients, with a particular emphasis on cognition, performance status, and the impact of the COVID-19 pandemic. Design: A prospective, cross-sectional, web-based design with a control group was used. The study included 22 liver transplant recipients and 23 controls. Participants completed a motor-cognitive dual-task test (timed up and go test, TUG), a cognitive assessment (mini mental state examination), and a physical performance test (5-repetition sit-to-stand test). The study also used a functional performance status scale (The Karnofsky performance status) and assessed fear of coronavirus disease (fear of COVID-19 scale). Dual-task interference was assessed and the rate of correct responses per second was calculated to assess cognitive performance. Results: The results indicated no statistically significant difference in TUG time and TUG correct responses per second between the groups (group × condition interactions; P > 0.05). There was no significant difference in cognitive and motor dual-task interference during the TUG test between the two groups (P > 0.05). The Karnofsky Performance Status score was significantly correlated with TUG motor dual-task interference (r = -0.424 and P = 0.049). Conclusion: This study suggests that dual-task performance does not differ in cognitive or motor performance between liver recipients and healthy controls under the same dual-task condition. However, further controlled studies are needed to improve the generalizability of these findings.

Work-related musculoskeletal disorder of upper extremity multi-task assessment methods (Revised Strain Index [RSI], Distal Upper Extremity Tool [DUET]) and manual handling multi-task assessment methods (Revised NIOSH Lifting Equation [RNLE], Lifting Fatigue Failure Tool [LiFFT]) were compared. RSI and DUET showed a strong correlation (r s  = 0.933, p < 0.001) where increasing risk factor exposure resulted in increasing outputs for both methods. RSI and DUET demonstrated fair agreement (κ = 0.299) in how the two methods classified outputs into risk categories (high, moderate or low) when assessing the same tasks. The RNLE and LiFFT showed a strong correlation (r s  = 0.903, p = 0.001) where increasing risk factor exposure resulted in increasing outputs, and moderate agreement (κ = 0.574) in classifying the outputs into risk categories (high, moderate or low) when assessing the same tasks. The multi-task assessment methods provide consistent output magnitude rankings in terms of increasing exposure, however some differences exist between how different methods classify the outputs into risk categories., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

With software developments and advances in display technologies substantially improved, augmented reality (AR) application has gained popularity. In this study, we discuss using classic PowerPoint and AR for two kinds of scaffolding tasks (task-lifeline assembly and hedge assembly) for users with different spatial ability. We considered both objective and subjective measures of performance, i.e., correct rate and system usability and the ITC-sense of presence inventory (ITC-SOPI) scale. The results of the study show that participants using AR achieved higher operating performance than those using PowerPoint. Furthermore, the users' learning effect was influenced by spatial ability when using PowerPoint. Participants with high spatial ability achieved higher performance than participants with low spatial ability in PowerPoint. However, participants who used AR as a training method did not show significantly different operating performance at different levels of spatial ability. Consequently, AR was believed to be a potential method for enhancing training performance.

Paramedics face various unconventional and secondary task demands while driving ambulances, leading to significant cognitive load, especially during lights-and-sirens responses. Previous research suggests that high cognitive load negatively affects driving performance, increasing the risk of accidents, particularly for inexperienced drivers. The current study investigated the impact of anticipatory treatment planning on cognitive load during emergency driving, as assessed through the use of a driving simulator. We recruited 28 non-paramedic participants to complete a simulated baseline drive with no task and a cognitive load manipulation using the 1-back task. We also recruited 18 paramedicine students who completed a drive while considering two cases they were travelling to: cardiac arrest and infant seizure, representing varying difficulty in required treatment. The results indicated that both cases imposed considerable cognitive load, as indicated by NASA Task Load Index responses, comparable to the 1-back task and significantly higher than driving with no load. These findings suggest that contemplating cases and treatment plans may impact the safety of novice paramedics driving ambulances for emergency response. Further research should explore the influence of experience and the presence of a second individual in the vehicle to generalise to broader emergency response driving contexts., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This study investigated the roles of phishing knowledge, cue utilization, and decision styles in contributing to phishing email detection. Participants (N = 145) completed an online email sorting task, and measures of phishing knowledge, email decision styles, cue utilization, and email security awareness. Cue utilization was the only factor that uniquely predicted the capacity to discriminate phishing from genuine emails. Phishing knowledge was associated with greater phishing detection and a bias towards classifying all emails as phishing. A preference for intuitive decision making predicted lower detection of phishing emails, driven by a greater tendency to classify emails as genuine. These findings support the proposition that cue utilization is a distinct cognitive process that enables expert performance. The outcomes indicate that, in addition to increasing phishing knowledge and developing safe behavioral patterns, anti-phishing training needs to provide opportunities for trainees to develop meaningful cue associations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Several studies have assessed and validated the impact of exoskeletons on back and shoulder muscle activation; however, limited research has explored the role that exoskeletons could play in mitigating lower arm-related disorders. This study assessed the impact of Ironhand, an active hand exoskeleton (H-EXO) designed to reduce grip force exertion, on worker exertion levels using a two-phase experimental design., Method: Ten male participants performed a controlled, simulated drilling activity, while three male participants completed an uncontrolled concrete demolition activity. The impact of the exoskeleton was assessed in terms of muscle activity across three different muscles using electromyography (EMG), perceived exertion, and perceived effectiveness., Results: Results indicate that peak muscle activation decreased across the target muscle group when the H-EXO was used, with the greatest reduction (27%) observed in the Extensor Carpi Radialis (ECR). Using the exoskeleton in controlled conditions did not significantly influence perceived exertion levels. Users indicated that the H-EXO was a valuable technology and expressed willingness to use it for future tasks., Practical Applications: This study showcases how glove-based exoskeletons can potentially reduce wrist-related disorders, thereby improving safety and productivity among workers. Future work should assess the impact of the H-EXO in various tasks, different work environments and configurations, and among diverse user groups., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 National Safety Council and Elsevier Ltd. All rights reserved.)

Background: Female urologists report higher rates of work-related physical discomfort compared to male urologists. We compared ergonomics during simulated ureteroscopy, the most common surgery for kidney stones, between male and female urologists., Methods: Surface electromyography was used to measure muscle activation during common ureteroscopic tasks in urology trainees and staff with different surgeon positions and ureteroscopes. Subjective workload was assessed using the NASA Task Load Index (NASA-TLX). Paired t-tests, Wilcoxon rank-sum tests, and multivariate regressions were used to compare muscle activation by gender for each trial condition., Results: There was no difference in age or distribution of training level between genders, though men had larger glove sizes. Across all conditions, women required greater muscle activation in multiple muscle groups and had greater NASA-TLX scores compared to men., Conclusions: There may be gender differences in ergonomics during ureteroscopy based on muscle activation and subjective workload, suggesting potential for personalizing surgical ecosystems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The 5.0 industry promotes collaborative robots (cobots). This research studies the impacts of cobot collaboration using an experimental setup. 120 participants realized a simple and a complex assembly task. 50% collaborated with another human (H/H) and 50% with a cobot (H/C). The workload and the acceptability of the cobotic collaboration were measured. Working with a cobot decreases the effect of the task complexity on the human workload and on the output quality. However, it increases the time completion and the number of gestures (while decreasing their frequency). The H/C couples have a higher chance of success but they take more time and more gestures to realize the task. The results of this research could help developers and stakeholders to understand the impacts of implementing a cobot in production chains., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Perineal proctectomy is a complex procedure that requires advanced skills. Currently, there are no simulators for training in this procedure. As part of our objective of developing a virtual reality simulator, our goal was to develop and validate task-specific metrics for the assessment of performance for this procedure. We conducted a three-phase study to establish task-specific metrics, obtain expert consensus on the appropriateness of the developed metrics, and establish the discriminant validity of the developed metrics., Methods: In phase I, we utilized hierarchical task analysis to formulate the metrics. In phase II, a survey involving expert colorectal surgeons determined the significance of the developed metrics. Phase III was aimed at establishing the discriminant validity for novices (PGY1-3) and experts (PGY4-5 and faculty). They performed a perineal proctectomy on a rectal prolapse model. Video recordings were independently assessed by two raters using global ratings and task-specific metrics for the procedure. Total scores for both metrics were computed and analyzed using the Kruskal-Wallis test. A Mann-Whitney U test with Benjamini-Hochberg correction was used to evaluate between-group differences. Spearman's rank correlation coefficient was computed to assess the correlation between global and task-specific scores., Results: In phase II, a total of 23 colorectal surgeons were recruited and consensus was obtained on all the task-specific metrics. In phase III, participants (n = 22) included novices (n = 15) and experts (n = 7). There was a strong positive correlation between the global and task-specific scores (rs = 0.86; P < 0.001). Significant between-group differences were detected for both global (χ 2  = 15.38; P < 0.001; df = 2) and task-specific (χ 2  = 11.38; P = 0.003; df = 2) scores., Conclusions: Using a biotissue rectal prolapse model, this study documented high IRR and significant discriminant validity evidence in support of video-based assessment using task-specific metrics., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: This study uses a detection task to measure changes in driver vigilance when operating four different partially automated systems., Background: Research show temporal declines in detection task performance during manual and fully automated driving, but the accuracy of using this approach for measuring changes in driver vigilance during on-road partially automated driving is yet unproven., Method: Participants drove four different vehicles (Tesla Model 3, Cadillac CT6, Volvo XC90, and Nissan Rogue) equipped with level-2 systems in manual and partially automated modes. Response times to a detection task were recorded over eight consecutive time periods., Results: Bayesian analysis revealed a main effect of time period and an interaction between mode and time period. A main effect of vehicle and a time period x vehicle interaction were also found., Conclusion: Results indicated that the reduction in detection task performance over time was worse during partially automated driving. Vehicle-specific analysis also revealed that detection task performance changed across vehicles, with slowest response time found for the Volvo., Application: The greater decline in detection performance found in automated mode suggests that operating level-2 systems incurred in a greater vigilance decrement, a phenomenon that is of interest for Human Factors practitioners and regulators. We also argue that the observed vehicle-related differences are attributable to the unique design of their in-vehicle interfaces.

We investigated the effects of a cognitive-motor dual-task training (CMDT) integrated into a physical training circuit. Specific tests on sprint, agility, and cognitive processes associated with anticipatory event-related potential (ERP) components and behavioural performance during a cognitive discrimination response task (DRT) were evaluated before and after the intervention. Thirty skilled basketball players were recruited and divided into an experimental group executing the "physical CMDT" and a control group performing standard physical training. The CMDT session was performed by four athletes simultaneously who executed different circuits. One circuit was the CMDT, implemented with interactive devices thus engaging strong motor control, preparedness, and quick decision-making during task performance. Results on physical performance showed that only the experimental group improved in completion time on sprint (5.83%) and agility (3.55%) tests. At the brain level, we found that in the DRT the motor anticipation increased by over 50%, and the response time became 10% faster. Instead, regarding cognitive preparation, both protocols were equally effective and response accuracy parallelly increased in the post-test. In conclusion, the proposed "physical CMDT" integrated into a group session, can improve sprint and agility and the neural correlate of this effect is the increase of motor preparation in the premotor cortex in only five weeks.

Background: In people with lower limb amputation (LLA), the loss of limb structures and peripheral motor and sensory systems result in significant mobility challenges, including impaired postural stability., Objective: The primary objective of this study was to evaluate the dual-task interference (DTI) on postural control and dual-task interference on cognition during static and dynamic balance in people with LLA and compare the same with controls. The secondary objective of this study was to compare the DTI on postural control and DTI on cognition between LLA of different etiology., Design: Cross-sectional observational study METHODOLOGY: Fifteen people with unilateral LLA and 15 age and gender-matched controls participated in this study at a tertiary care hospital. The outcome measures used were anterior-posterior stability index (APSI), medial-lateral stability index, and overall stability index (OSI) using Biodex Balance System and a cognitive task parameter, namely correct response rate in serial seven subtraction test. Quantitative variables were compared using a Wilcoxon rank-sum test. Spearman's correlation test was used to establish the correlation between the DTI on cognition and the DTI on postural control., Results: DTI on postural control during static balance was significantly higher in people with LLA than controls (APSI, OSI). No significant difference was observed in DTI on postural control during dynamic balance. No significant difference was observed in DTI on cognition during static and dynamic balance. A significant negative correlation was observed between DTI on cognition and DTI on postural control (APSI) during static balance people with LLA., Significance: In people with unilateral LLA, the addition of a cognitive task results in significant deterioration of sagittal plane postural control during static balance but not during dynamic balance due to the over-allocation of resources to a cognitive task., Competing Interests: Declaration of Competing Interest The authors declare that the research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: Uncertainty exists regarding the best method for teaching thrust joint manipulation (TJM) to student physical therapists. The purpose of this study was to compare the effectiveness of Peyton's 4-step (P4) approach with the "see one, do one" (S1D1) approach for teaching students to perform a lumbar spine TJM task in an academic setting. Secondary objectives were to compare the effects of each instructional approach on students' attitudes and beliefs toward spinal TJM and on their motivation to learn to perform lumbar spine TJM., Review of Literature: The S1D1 approach is used in the health care professions for teaching clinical tasks to students. It is unclear whether the P4 approach may better prepare students to practice TJM., Subjects: Student physical therapists., Methods: Using a factorial quasi-experimental design, an equal number of students were assigned to a P4 or S1D1 instruction group for the TJM task. Students' performance accuracy, time, and outcome performing TJM in an academic setting were measured. Paper surveys were used to collect data about students' attitudes and beliefs toward spinal TJM and their motivation to learn TJM. A generalized estimating equations approach was used for data analysis., Results: Fifty-eight students (29 per group) completed the study. There was an interaction between the instruction group and time on task performance accuracy favoring the P4 approach (P = .03). There was no interaction between the instruction group and task performance time, task performance outcome, attitudes and beliefs toward spinal TJM, or motivation to learn TJM (all P > .19)., Discussion and Conclusion: The P4 approach more effectively improved student accuracy when performing the TJM task in an academic setting than the S1D1 approach. However, no differences between instruction were found for performance time or outcome. Students reported a favorable perception of learning lumbar spine TJM. These preliminary results suggest that instructors may use the P4 approach to improve students' TJM procedural knowledge before task practice. However, limitations of the study may affect the internal validity and generalizability of results., Competing Interests: The authors report no conflict of interest., (Copyright © 2023 Academy of Physical Therapy Education, APTA.)

Sterile Processing Departments (SPDs) must clean, maintain, store, and organize surgical instruments which are then delivered to Operating Rooms (ORs) using a Courier Network, with regular coordination occurring across departmental boundaries. To represent these relationships, we utilized the Systems Engineering Initiative for Patient Safety (SEIPS) 101 Toolkit, which helps model how health-related outcomes are affected by healthcare work systems. Through observations and interviews which built on prior work system analyses, we developed a SEIPS 101 journey map, PETT scan, and tasks matrices to represent the instrument reprocessing work system, revealing complex interdependencies between the people, tools, and tasks occurring within it. The SPD, OR and Courier teams are found to have overlapping responsibilities and a clear co-dependence, with critical implications for the successful functioning of the whole hospital system., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

We used an armband with embedded surface electromyography (sEMG) electrodes, together with machine-learning (ML) models, to automatically detect lifting-lowering activities and classify hand loads. Nine healthy participants (4 male and 5 female) completed simulated lifting-lowering tasks in various conditions and with two different hand loads (2.3 and 6.8 kg). We compared three sEMG signal feature sets (i.e., time, frequency, and a combination of both domains) and three ML classifiers (i.e., Random Forest, Support Vector Machine, and Logistic Regression). Both Random Forest and Support Vector Machine models, using either time-domain or time- and frequency-domain features, yielded the best performance in detecting lifts, with respective accuracies of 79.2% (start) and 86.7% (end). Similarly, both ML models yielded the highest accuracy (80.9%) in classifying the two hand loads, regardless of the sEMG features used, emphasizing the potential of sEMG armbands for assessing exposure and risks in occupational lifting tasks., (Copyright © 2024. Published by Elsevier Ltd.)

Floor inclination can alter hand force production, and lower limb kinetics, affecting control operations, and threatening operator safety in various domains, such as aviation, naval, construction industry, or agriculture. This study investigates the effects of different floor inclinations, on handle push or pull force production. Participants performed maximal isometric contraction tasks requiring to exert a maximal voluntary force either by pulling or pushing a handle, at different floor inclinations from -30° to +30° about the transverse and longitudinal axes. Maximal hand force and Ground Reaction Forces about both feet were recorded. The results revealed non-equivalent variations in hand and feet responses as a function of inclination angle. Specifically, there was a significant reduction in handle push-pull force production, up to 70% (p < 0.001) for extreme inclinations, around both axes. This study provides critical data for design engineers, highlighting the challenge of production forces at steep angles., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: This work was financially supported by the ANR as part of the France Relance plan of the French government, in collaboration with Naval Group (France). However, the authors do not derive any commercial benefit from this work., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

INTRODUCTION: No current astronauts have surgical training, and medical capabilities for future missions do not account for it. We sought to determine the effect of communication delays and text-based communication on emergency medicine physician (EMP) performance of a simulated surgical procedure and the ideal training paradigm for remote surgery. METHODS: In this study, 12 EMPs performed an appendectomy on a virtual reality laparoscopic simulator after tutorial. EMPs were randomized into two groups: one (bedside) group performing with bedside directing from a surgeon and the second (remote) group performing with text-based communications relayed to the surgeon after a 210-s time delay. Both groups performed a second simulated surgery 7 mo later with 240-s delay. Collected data included time to completion, number of movements, path length, economy of motion, percentage of time with appropriate camera positioning, texts sent, and major complications. RESULTS: The remote group took significantly longer to complete the task, used more total movements, had longer path length, and had significantly worse economy of motion during the initial trial. At the 7-mo simulation, there were no significant differences between the two groups. There was a nonsignificant increase in critical errors in the remote group at follow-up (50% vs. 20% of trials). DISCUSSION: EMPs are technically able to perform a surgical operation with delayed just-in-time telementoring guidance via text-based communication. However, the ideal paradigm for training non-surgeons to perform surgical operations is unclear but is likely real-time bedside training rather than remote training. Kamine TH, Siu M, Stegemann S, Formanek A, Levin D. Long round-trip time delay effects on performance of a simulated appendectomy task . Aerosp Med Hum Perform. 2024; 95(9):703-708.

Biomechanical evidence is needed to determine to what extent the use of a mobility assistance dog (ADMob) may minimize mechanical loads and muscular demands at the upper limbs among manual wheelchair users. This study quantified and compared upper limb efforts when propelling up a ramp with and without an ADMob among manual wheelchair users. Ten manual wheelchair users with a spinal cord injury who own an ADMob ascended a ramp with and without their ADMob. The movements of the wheelchair and upper limbs were captured and the forces applied at the pushrims were recorded to compute shoulder mechanical loading. Muscular demand of the pectoralis major, anterior deltoid, biceps, and the triceps was normalized against the maximum electromyographic values. The traction provided by the ADMob significantly reduced the total force applied at the pushrim and its tangential component while the mechanical effectiveness remained similar. The traction provided by the ADMob also resulted in a significant reduction in shoulder flexion, internal rotation, and adduction moments. The muscular demands of the anterior deltoid, pectoralis major, biceps, and triceps were significantly reduced by the traction provided by the ADMob. The use of ADMob represents a promising mobility assistive technology alternative to minimize upper limb mechanical loads and muscular demands and optimize performance during wheelchair ramp ascent. [ABSTRACT FROM AUTHOR]

BackgroundObsessive-compulsive disorder (OCD) is associated with an abnormally large error-related negativity (ERN), an electrophysiological measure of error monitoring in response to performance errors, but it is unclear if hoarding disorder (HD) also shows this abnormality. This study aimed to determine whether the neurophysiological mechanisms underlying error monitoring are similarly compromised in HD and OCD.MethodWe used a visual flanker task to assess ERN in response to performance errors in 14 individuals with HD, 27 with OCD, 10 with HD+OCD, and 45 healthy controls (HC). Age-corrected performance and ERN amplitudes were examined using analyses of variance and planned pairwise group comparisons.ResultsA main effect of hoarding on ERN (p = 0.031) was observed, indicating ERN amplitudes were attenuated in HD relative to non-HD subjects. A group × age interaction effect on ERN was also evident. In HD-positive subjects, ERN amplitude deficits were significantly greater in younger individuals (r = -0.479, p = 0.018), whereas there were no significant ERN changes with increasing age in OCD and HC participants.ConclusionsThe reduced ERN in HD relative to OCD and HC provides evidence that HD is neurobiologically distinct from OCD, and suggests that deficient error monitoring may be a core pathophysiological feature of HD. This effect was particularly prominent in younger HD participants, further suggesting that deficient error monitoring manifests most strongly early in the illness course and/or in individuals with a relatively early illness onset.

The tendency to mimic the behaviour of others is affected by a variety of social factors, and it has been argued that such "mirroring" is often unconsciously deployed as a means of increasing affiliation during interpersonal interactions. However, the relationship between automatic motor imitation and status/power is currently unclear. This paper reports five experiments that investigated whether social status (Experiments 1, 2, and 3) or power (Experiments 4 and 5) had a moderating effect on automatic imitation (AI) in finger-movement tasks, using a series of different manipulations. Experiments 1 and 2 manipulated the social status of the observed person using an associative learning task. Experiment 3 manipulated social status via perceived competence at a simple computer game. Experiment 4 manipulated participants' power (relative to the actors) in a card-choosing task. Finally, Experiment 5 primed participants using a writing task, to induce the sense of being powerful or powerless. No significant interactions were found between congruency and social status/power in any of the studies. Additionally, Bayesian hypothesis testing indicated that the null hypothesis should be favoured over the experimental hypothesis in all five studies. These findings are discussed in terms of their implications for AI tasks, social effects on mimicry, and the hypothesis of mimicry as a strategic mechanism to promote affiliation.

Prolonged mesolimbic dopamine concentration changes have been detected during spatial navigation, but little is known about the conditions that engender this signaling profile or how it develops with learning. To address this, we monitored dopamine concentration changes in the nucleus accumbens core of rats throughout acquisition and performance of an instrumental action sequence task. Prolonged dopamine concentration changes were detected that ramped up as rats executed each action sequence and declined after earned reward collection. With learning, dopamine concentration began to rise increasingly earlier in the execution of the sequence and ultimately backpropagated away from stereotyped sequence actions, becoming only transiently elevated by the most distal and unexpected reward predictor. Action sequence-related dopamine signaling was reactivated in well-trained rats if they became disengaged in the task and in response to an unexpected change in the value, but not identity of the earned reward. Throughout training and test, dopamine signaling correlated with sequence performance. These results suggest that action sequences can engender a prolonged mode of dopamine signaling in the nucleus accumbens core and that such signaling relates to elements of the motivation underlying sequence execution and is dynamic with learning, overtraining and violations in reward expectation.

The finding that an item of type A pops out from an array of distractors of type B typically is taken to support the inference that human vision contains a neural mechanism that is activated by items of type A but not by items of type B. Such a mechanism might be expected to yield a neural image in which items of type A produce high activation and items of type B low (or zero) activation. Access to such a neural image might further be expected to enable accurate estimation of the centroid of an ensemble of items of type A intermixed with to-be-ignored items of type B. Here, it is shown that as the number of items in stimulus displays is increased, performance in estimating the centroids of horizontal (vertical) items amid vertical (horizontal) distractors degrades much more quickly and dramatically than does performance in estimating the centroids of white (black) items among black (white) distractors. Together with previous findings, these results suggest that, although human vision does possess bottom-up neural mechanisms sensitive to abrupt local changes in bar-orientation, and although human vision does possess and utilize top-down global attention filters capable of selecting multiple items of one brightness or of one color from among others, it cannot use a top-down global attention filter capable of selecting multiple bars of a given absolute orientation and filtering bars of the opposite orientation in a centroid task.