Frontal Electroencephalogram Alpha Asymmetry during Mental Stress Related to Workplace Noise.

This study aims to investigate the effects of workplace noise on neural activity and alpha asymmetries of the prefrontal cortex (PFC) during mental stress conditions. Workplace noise exposure is a pervasive environmental pollutant and is negatively linked to cognitive effects and selective attention. Generally, the stress theory is assumed to underlie the impact of noise on health. Evidence for the impacts of workplace noise on mental stress is lacking. Fifteen healthy volunteer subjects performed the Montreal imaging stress task in quiet and noisy workplaces while their brain activity was recorded using electroencephalography. The salivary alpha-amylase (sAA) was measured before and immediately after each tested workplace to evaluate the stress level. The results showed a decrease in alpha rhythms, or an increase in cortical activity, of the PFC for all participants at the noisy workplace. Further analysis of alpha asymmetry revealed a greater significant relative right frontal activation of the noisy workplace group at electrode pairs F4-F3 but not F8-F7. Furthermore, a significant increase in sAA activity was observed in all participants at the noisy workplace, demonstrating the presence of stress. The findings provide critical information on the effects of workplace noise-related stress that might be neglected during mental stress evaluations.

Virtual-reality-enhanced mannequin to train emergency physicians to examine dizzy patients using the HINTS method.

Introduction: Acute vertigo is a frequent chief complaint in the emergency departments, and its efficient management requires thorough training. The HINTS protocol is a valid method to screen patients in the emergency room, but its application in routine is hindered by the lack of training. This study aimed to evaluate the training of emergency physicians for the HINTS method based on a mannequin-based virtual reality simulator (MBVRS). Methods: We conducted a monocenter, prospective, longitudinal, and randomized cohort study in an Emergency Department at a regional university hospital. We included 34 emergency physicians randomized into two equal groups matched by age and professional experience. The control group attended a theoretical lesson with video demonstrations and the test group received a simulation-based training in addition to the lecture. Results: We showed that the test group had a higher diagnosis performance for the HINTS method compared to the control group as evaluated by the simulator at 1 month (89% sensitivity versus 45, and 100% specificity versus 86% respectively, p < 001, Fisher's exact test). Evaluation at 6 months showed a similar advantage to the test group. Discussion: The MBVRS is a useful pedagogic tool for the HINTS protocol in the emergency department. The advantage of a unique training session can be measured up to 6 months after the lesson.

Effects of saccade delay, side of deficit, and training on detection of catch-up saccades during head-impulse test in virtual-reality-enhanced mannequin.

In this study, a training simulator for the examination of dizzy patients based on a virtual-reality-enhanced mannequin (VREM) was developed to evaluate the detection of catch-up saccades during head impulse test (HIT) and the effect of training in VREM. For novices (n = 35), 2 trials were conducted before and after a training session. Experts (n = 7) were submitted to an evaluation session. In each trial, a left or a right horizontal canal deficit with an overt catch-up saccade (delay between 110 and 320 ms) was randomly presented. Participants scored the difficulty in performing the maneuver, in recognizing the saccades, and the self-confidence in the diagnosis using a visual analogue scale (VAS). Saccade delay significantly influenced the performance. Training significantly improved the sensitivity in the residents (69.1% before to 97.9% after the training, p < 0.001, Fisher's exact test, n = 560 tests), surpassing experts' performances (p < 0.001, versus 87% in experts, Fisher's exact test). The specificity also increased to the expert level (78% before to 95% after the training, and 95% in experts, p < 0.001, Fisher's exact test). The VAS showed a decrease difficulty to execute the HIT, with an increase in the confidence after training. VREM improved the HIT execution performance and the confidence in novice practitioners.