Ergonomic differences in mesh placement and mesh fixation between laparoscopic and robotic inguinal hernia repair with mesh.

PURPOSE: General differences in surgeon ergonomics between laparoscopic and robotic-assisted inguinal hernia repairs (LIHR vs. RIHR) have been previously studied. However, specific differences in the ergonomics of mesh placement (MP) and mesh fixation (MF) are undetermined. Our aim was to determine if there are differences in the ergonomics of MP and MF between the surgical approaches. We hypothesize that we will identify differences, with the potential for worse ergonomics during LIHR. METHODS: Data was collected from fifteen LIHR and fifteen RIHR. All cases were elective, primary inguinal hernias completed by a fellowship-trained minimally invasive surgeon. Surface electromyography (EMG) of four upper extremity muscle groups, including the upper trapezius (UT), anterior deltoid (AD), flexor carpi radialis (FCR) and extensor digitorum (ED), was recorded bilaterally during MP and MF. Muscle activation as a percent of maximum voluntary contraction (%MVCRMS) and muscle fatigue denoted as the median frequency of muscle activations (Fmed) were calculated for each muscle. RESULTS: EMG analysis showed increased %MVCRMS in LIHR compared to RIHR cases, with significant findings in the left UT, right UT, ED, and FCR for MP and MF and the left FCR during MP. Muscle fatigue was decreased in LIHR compared to RIHR cases, with significant differences in left FCR and right ED and AD. CONCLUSION: Despite greater muscle activations during LIHR, RIHR had greater muscle fatigue. It is possible that short periods of high muscle activation are ergonomically protective during minimally invasive inguinal hernia repair. Identifying these differences may aid in development of procedure-specific interventions to improve ergonomics.

Supporting left-handed trainees in sinus and skull base surgery: A call for inclusive ergonomics.

KEY POINTS: The surgeon's hand dominance impacts ergonomics in endoscopic endonasal surgery. Left-handed trainees experience difficulty learning certain surgical techniques. OR adjustments optimize ergonomics for left-handed trainees without compromising others.

Postural supporting cervical traction workstation to improve resting state brain activity in digital device users: EEG study.

Objective: This study aimed to determine the effect of postural support workstation on inducing effective brain activity during rest. Methods: Thirty-five healthy digital overusers were recruited as participants. We conducted two interventions of head weight support traction (ST) and conventional traction (CT) strength on all participants in random order. Participants' arousal levels and psychological comfort were assessed. In addition, changes in brain activity caused by traction were confirmed by measuring changes in resting state brain activity using an electroencephalogram (EEG). Results: Under the ST condition, psychological comfort improved while alert levels were maintained. In addition the resting brain activity of EEG was characterized by strong focused attention and relaxed activity, as evidenced by increased alpha waves throughout the brain. By contrast, in the CT condition, no significant improvement in comfort was observed. Furthermore, high-frequency brain activity, such as beta 3 and gamma waves, was observed across the entire brain regions. Conclusion: In this study, the ST workstation was shown to effectively improve resting attention and psychological comfort in individuals who excessively use digital devices by inducing resting state alpha activity without stimulating high-frequency brain waves, while maintaining an upright posture with appropriate traction.

Actionable insights for human factors and ergonomics to achieve the Sustainable Development Goals: mapping past advancements and proposing future strategic paths.

Despite significant strides in linking Human Factors and Ergonomics (HFE) and sustainability, research lacks precision in debating HFE's role, especially concerning the Sustainable Development Goals (SDGs). This paper maps concrete contributions of HFE to the SDGs, offering strategic actions for target achievement. The methodological approach involved the application of PRISMA to define a sample, SciMAT and VOSviewer for visual and temporal thematic mapping, deductive content analysis and categorical analysis. The results show that there is an already rich and unique set of contributions across a wide range of SDGs, not just the most common related to HFE, SDG8 (Decent work). The importance of HFE is highlighted in various aspects, such as the sustainable adoption of industry 4.0 technologies (SDG9) and the development of sustainable production (SDG12), energy (SDG7) and urban (SDG11) systems. Strategic actions specifying targets for each mapped SDG are offered for policymakers, industry professionals and researchers.

This paper maps concrete contributions of HFE to the SDGs, including aspects such as sustainable adoption of industry 4.0 technologies and the development of sustainable production, energy and urban systems. Policymakers, industry professionals and researchers can benefit from the strategic pathways offered to further advance the SDGs.

Ergonomics in ENT Practice.

The term Ergonomics is derived from two Greek words "Ergos" meaning work and "nomos" meaning laws. So, Ergonomics in simple term means "laws of work". It actually concerns with optimizing the relations between a worker and his work of environment. Ergonomics is a science that studies workplaces with the aim to optimise the interaction between the worker, equipment, task and the environment (Campbell in Ergonomics in otorhinolaryngology. Ent and audiology news, 2024) Workplace ergonomics is a poorly understood subject when it comes to medical professionals. Musculo- skeletal disorders (MSD) are one of the commonest occupational health problem for surgeons. Though, Ergonomics apply to every surgeon/medical professional, this article will in specifically discuss the importance of understanding ergonomics for ENT (otolaryngologists) surgeons.

Pilot turning behavior cognitive load analysis in simulated flight.

Background: To identify the cognitive load of different turning tasks in simulated flight, a flight experiment was designed based on real "preliminary screening" training modules for pilots. Methods: Heart Rate Variability (HRV) and flight data were collected during the experiments using a flight simulator and a heart rate sensor bracelet. The turning behaviors in flight were classified into climbing turns, descending turns, and level flight turns. A recognition model for the cognitive load associated with these turning behaviors was developed using machine learning and deep learning algorithms. Results: pnni_20, range_nni, rmssd, sdsd, nni_20, sd1, triangular_index indicators are negatively correlated with different turning load. The LSTM-Attention model excelled in recognizing turning tasks with varying cognitive load, achieving an F1 score of 0.9491. Conclusion: Specific HRV characteristics can be used to analyze cognitive load in different turn-ing tasks, and the LSTM-Attention model can provide references for future studies on the selection characteristics of pilot cognitive load, and offer guidance for pilot training, thus having significant implications for pilot training and flight safety.

Study of SME employees' awareness level on lean manufacturing and ergonomics implementation in Malaysian and Indonesian production environments.

SMEs are small to medium-sized businesses with relatively fewer workers and lower revenues than large companies. However, SMEs also contribute to the local economic growth of a region, so the smooth production process needs to be considered to increase productivity. Applying lean manufacturing (LM) and Ergonomics concepts in the production process is critical because it can overcome smooth production and maintain the health and safety of SMEs workers. LM focuses on minimizing waste, while ergonomics focuses on humans as a source of energy in the smooth running of production activities. So, this study aims to measure the level of understanding of Malaysian and Indonesian SMEs workers on applying LM and Ergonomics concepts on the production floor and determine the effect of these two concepts using the SPSS and SmartPLS4 applications. SPSS serves to measure the validity, reliability and mean for the category of workers' understanding of LM and Ergonomics. SmartPLS4 helps us understand the influence of the two concepts. Based on the calculation of the mean for each variable of LM and ergonomics, it is found that Malaysian workers understand enough compared to Indonesian SMEs workers. As for the effect, Ergonomics has a significant influence on LM.

Musculoskeletal disorders in emergency medical services personnel: a systematic review and meta-analysis.

OBJECTIVES: Emergency medical services personnel are frequently subjected to strenuous physical tasks, such as lifting and moving patients, as well as working in awkward postures. These activities can result in a variety of debilitating injuries, including musculoskeletal disorders (MSDs). As a result, this systematic review and meta-analysis study aimed to examine the frequency of MSDs among emergency medical services personnel. STUDY DESIGN: Systematic review and meta-analysis. METHODS: This systematic review and meta-analysis study was conducted based on the PRISMA guidelines. The protocol of this work is registered in PROSPERO with the code CRD42024506958. Searches were conducted without time limits in several databases including PubMed, Scopus, Web of Science, Science Direct, SID, ISC, and Google Scholar until February 12, 2024. The I2 index was used to assess heterogeneity, and random effects model was used for meta-analysis. Data were analyzed using STATA version 14. RESULTS: A total of 709 articles were obtained by initial search in the mentioned databases. Following a thorough screening and quality assessment, 27 articles were chosen for meta-analysis. The findings revealed that the overall prevalence of MSDs among emergency medical services personnel is 56.52% (95% CI: 35-78.04, I2 = 99.8%, P < 0.001) and the prevalence in different areas of the body are as follows: the low back (47.38%), upper back (35.15%), neck (31.19%), shoulder (30%), knee (27.07%), hand (20.70%), hip/thigh (19.48%), feet (19.11%), and elbow (17.36%). CONCLUSION: The prevalence of MSDs among emergency medical services personnel is very high. Considering the importance of the role of these employees and the specific risk factors of their jobs, it is recommended that periodic screening is prioritized. In addition, attention should be paid to the ergonomic evaluation of the work environment and the design of appropriate ergonomic interventions.

Musculoskeletal disorders among sonographers: a systematic review and meta-analysis.

INTRODUCTION: The job of sonographers exposes them to numerous ergonomic risk factors, making the sonography profession one of the high-risk job groups vulnerable to musculoskeletal disorders (MSDs). The present systematic review and meta-analysis specifically examined the prevalence of MSDs among sonographers. MATERIALS AND METHODS: The present review study was carried out in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The protocol of the study was registered in the international prospective register of systematic review (PROSPERO) with the code CRD42024507972. Searches were conducted in databases including PubMed, Scopus, Web of Science, Science Direct, SID, ISC, and Google Scholar, without imposing a time limit until February 7th, 2024. The random-effects model was employed for meta-analysis, and the I2 index was used to assess heterogeneity among studies. Finally, data analysis was performed using STATA (version 14). RESULTS: Based on the search in different databases, a total of 4367 articles were identified. Finally, after screening, selecting, and quality evaluation of the studies, 30 studies were considered for meta-analysis in which 13,916 sonographers were examined. According to the results of the meta-analysis, the overall prevalence of MSDs among sonographers was reported as 75.80% (95% CI: 65.37-86.23, I2 = 99.7%, P < 0.001). Additionally, the prevalence rates of these disorders in the neck (63.73%), shoulder (60.13%), upper back (53.69%), lower back (49.84%), wrist (44.41%), elbow (27.46), hip (24.93%), knee (19.59), and ankle (16.92%) were determined. CONCLUSION: Given the relatively high prevalence of MSDs among sonographers and the importance of reducing specific risk factors associated with their duties, it is recommended to consider solutions such as carrying out ergonomic assessments and interventions, as well as providing training programs and appropriate corrective exercises to mitigate MSDs among sonographers.

What is known about near miss events in the operating room? A systematic review of studies of mixed methods design.

BACKGROUND: A near miss event (NME) in healthcare is an event that did not happen but would have caused serious harm if it did. The operating room (OR) is prone to risk and incidents, with estimates that 50% of all hospital adverse events occur in the OR, yet reporting of NME is uncommon in the OR. OBJECTIVE: To carry out a systematic review of studies with mixed methods to establish what is known about NME reporting in the OR. METHOD: Inclusion criteria will be those studies of mixed methods design, which have been conducted in the OR, with teams of surgeons, anaesthetists or nurses alone or in any combination. Using a publication timeframe of 2001-2023, the following databases were searched: Medline (OVID), CINAHL, Pubmed and Google Scholar. Selected papers for the review were assessed using the Quality Assessment Tool for Studies of Diverse Designs. RESULTS: Fourteen papers were included in the review. NMEs are common occurrences that are underreported in the OR. When NMEs occur in multiples for the same patient, the risk of serious harm increases. Feedback and education about NME helps to improve reporting; ORs with high rates of NME reporting have less serious patient harm events. DISCUSSION: The implications of the findings for improving healthcare safety are discussed and in particular the adoption of the science of Human Factors Ergonomics into healthcare.

Postural Risks in Dental Practice: An Assessment of Musculoskeletal Health.

In recent years, Romania's stomatology private practice sector has seen substantial growth, with many dentists fully committing to building and expanding their own practices, often funded by their personal income. This study aimed to explore how various postures affect the muscle groups of dentists (380), particularly focusing on identifying positions that may jeopardize their musculoskeletal health. A group of dentists effectively participated in this study (10), adhering to their regular work routines while wearing wearable sensors on their backs to monitor posture and activity. The data gathered from these sensors were analyzed using the RULA (rapid upper-limb assessment) and REBA (rapid entire-body assessment) tools. The findings indicated that the head and shoulder movements during dental procedures involved considerable and repetitive angular shifts, which could strain the neck and back muscles and heighten the risk of musculoskeletal problems. Additionally, the standing postures adopted by the dentists were associated with an increased risk of postural issues and greater overall fatigue. Extended periods of trunk and head tilting were also identified as contributing factors to posture-related challenges.

Impact of Self-Contained Breathing Apparatus (SCBA) Weights on Firefighter's Kinematics During Simulated Firefighter Tasks.

Firefighters face a multitude of hazards in their line of duty, with overexertion being one of the foremost causes of injuries or fatalities. This high risk is often exacerbated by the burden of carrying a heavy self-contained breathing apparatus (SCBA). This study aims to explore the impact of SCBA weight on firefighters' musculoskeletal joint movements. Six firefighters participated in this study, performing four simulated firefighting tasks under three different SCBA weight conditions. A hybrid inverse kinematics approach was employed to analyze the kinematic data from two participants. The results revealed a notable decrease in lumbar range of motion (ROM) as the weight increased, particularly noticeable during hose advancement and stair climbing tasks. Conversely, an increase in hip ROM during stair climbing was observed, suggesting a compensatory response to reduced spinal flexibility. These findings underscore the critical need to understand the implications of turnout gear and SCBA weight to enhance firefighter performance and reduce the risk of injury.

Effect of a Novel Ergonomic Sheath on Dental Device-Related Muscle Work, Fatigue and Comfort-A Pilot Clinical Study.

Background: Dental instrumentation with hand-held devices is associated with discomfort, fatigue and musculoskeletal diseases or repetitive stress injuries. The goal of this in vivo study was to determine the effect of an ergonomic handle sheath on muscle work, comfort and fatigue associated with (a) piezoelectric scaling by hygienists with and without musculoskeletal disorders (MSDs), and (b) dental cavity preparation by healthy dentists using a dental micromotor. Materials and Methods: Two groups of ten hygienists each tested the piezoelectric scaler. Hygienists in Group 1 had no MSDs, while those in Group 2 had been diagnosed with MSDs. Additionally, ten dentists with no MSDs used a dental micromotor to prepare four standardized cavities. Time-based work in four muscles, comfort and fatigue were recorded in the presence and absence of an add-on soft, insulating handle sheath. Data were analyzed using a repeated measures analysis of variance model with Tukey's post-hoc test. Results: Comfort, fatigue and muscle work were significantly better for both devices when the sheath was used. While hygienists with MSDs used more muscle work to complete the set scaling task, and the sheath-related reduction in work was somewhat greater, these MSD-related differences did not quite reach significance. Conclusions: The results of this pilot study show that the ergonomic performance of an ultrasonic scaler and a dental micromotor may be improved by the use of an ergonomic handle sheath.

Inertial Motion Capture-Driven Digital Human for Ergonomic Validation: A Case Study of Core Drilling.

In the evolving realm of ergonomics, there is a growing demand for enhanced comfortability, visibility, and accessibility in the operation of engineering machinery. This study introduces an innovative approach to assess the ergonomics of a driller's cabin by utilizing a digital human. Through the utilization of inertial motion capture sensors, the method enables the operation of a virtual driller animated by real human movements, thereby producing more precise and realistic human-machine interaction data. Additionally, this study develops a simplified model for the human upper limbs, facilitating the calculation of joint forces and torques. An ergonomic analysis platform, encompassing a virtual driller's cabin and a digital human model, is constructed using Unity 3D. This platform enables the quantitative evaluation of comfortability, visibility, and accessibility. Its versatility extends beyond the current scope, offering substantial support for product development and enhancement.

How Effective Are Forecasting Models in Predicting Effects of Exoskeletons on Fatigue Progression?

Forecasting can be utilized to predict future trends in physiological demands, which can be beneficial for developing effective interventions. This study implemented forecasting models to predict fatigue level progression when performing exoskeleton (EXO)-assisted tasks. Specifically, perceived and muscle activity data were utilized from nine recruited participants who performed 45° trunk flexion tasks intermittently with and without assistance until they reached medium-high exertion in the low-back region. Two forecasting algorithms, Autoregressive Integrated Moving Average (ARIMA) and Facebook Prophet, were implemented using perceived fatigue levels alone, and with external features of low-back muscle activity. Findings showed that univariate models without external features performed better with the Prophet model having the lowest mean (SD) of root mean squared error (RMSE) across participants of 0.62 (0.24) and 0.67 (0.29) with and without EXO-assisted tasks, respectively. Temporal effects of BSIE on delaying fatigue progression were then evaluated by forecasting back fatigue up to 20 trials. The slope of fatigue progression for 20 trials without assistance was ~48-52% higher vs. with assistance. Median benefits of 54% and 43% were observed for ARIMA (with external features) and Prophet algorithms, respectively. This study demonstrates some potential applications for forecasting models for workforce health monitoring, intervention assessment, and injury prevention.

Workplace Well-Being in Industry 5.0: A Worker-Centered Systematic Review.

The paradigm of Industry 5.0 pushes the transition from the traditional to a novel, smart, digital, and connected industry, where well-being is key to enhance productivity, optimize man-machine interaction and guarantee workers' safety. This work aims to conduct a systematic review of current methodologies for monitoring and analyzing physical and cognitive ergonomics. Three research questions are addressed: (1) which technologies are used to assess the physical and cognitive well-being of workers in the workplace, (2) how the acquired data are processed, and (3) what purpose this well-being is evaluated for. This way, individual factors within the holistic assessment of worker well-being are highlighted, and information is provided synthetically. The analysis was conducted following the PRISMA 2020 statement guidelines. From the sixty-five articles collected, the most adopted (1) technological solutions, (2) parameters, and (3) data analysis and processing were identified. Wearable inertial measurement units and RGB-D cameras are the most prevalent devices used for physical monitoring; in the cognitive ergonomics, and cardiac activity is the most adopted physiological parameter. Furthermore, insights on practical issues and future developments are provided. Future research should focus on developing multi-modal systems that combine these aspects with particular emphasis on their practical application in real industrial settings.

The dark art of light curing in dentistry.

OBJECTIVE: This study was designed to show that the commonly reported irradiance values that are quoted in most publications inadequately describe the light output from light curing units (LCUs). METHODS: The total spectral radiant power (mW) output from 12 contemporary LCUs was measured with a fiberoptic spectroradiometer and a calibrated integrating sphere. Five recordings were taken for each LCU and exposure mode. In addition, the irradiances (mW/cm²) delivered at 0-mm, 5-mm and 10-mm distances were recorded through a 6-mm diameter aperture and the radiant exposures (J/cm²) from the LCUs were calculated. Light beam profiles from the LCUs were recorded using a beam profiler, and the images were overlaid on a molar tooth to simulate a clinical setting. Data were analyzed using ANOVA followed by Tukey post-hoc test (α = 0.05). RESULTS: The mean power outputs from the LCUs ranged from 380 to 2472 mW (p < 0.0001). The highest irradiance was recorded from the Cicada CV 215-G7 (3091 mW/cm² in its highest mode) and the lowest from the Radii Cal CX (731 mW/cm²). The emission spectra differed, even among the multi-peak and single-peak LCUs. Radiant exposures from the entire light tip ranged from 18.3 J/cm², Radii Cal CX, in its standard 25 s exposure mode to 3.9 J/cm² from the Monet Laser in a 3 s exposure setting. Half (50 %) of the measured irradiance values from the LCUs differed from the manufacturers' value by more than 10 %. There were significant differences in the impact of distance from the tip. The beam profiles visually highlighted the varying effects of distance from the LCU tip among different units. CONCLUSION: There were significant differences in the emission spectra, power outputs, tip diameters, irradiances, radiant exposures, and the effect distance from the light tips. These differences underline the importance of manufacturers and researchers correctly measuring and reporting the output from the LCU to ensure that research is reproducible and that patients receive acceptable dental restorations. CLINICAL SIGNIFICANCE: This article alerts clinicians, researchers and journal editors that providing only the tip irradiance (radiant exitance) value from the LCU is no longer sufficient. Manufacturers and researchers should include information on the spectral radiant power, emission spectrum, tip diameters, and also the effect of distance on the irradiance and radiant exposure, beam profiles and tooth access information when describing an LCU.

Musculoskeletal models determine the effect of a soft active exosuit on muscle activations and forces during lifting and lowering tasks.

Exosuits have the potential to mitigate musculoskeletal stress and prevent back injuries during industrial tasks. This study aimed to 1) validate the implementation of a soft active exosuit into a musculoskeletal model of the spine by comparing model predicted muscle activations versus corresponding surface EMG measurements, and 2) evaluate the effect of the exosuit on peak back and hip muscle forces. Fourteen healthy participants performed squat and stoop lift and lower tasks with boxes of 6 and 10 kg, with and without wearing a 2.7 kg soft active exosuit. Participant-specific musculoskeletal models, which included the exosuit, were created in OpenSim. Model validation focused on the back and hip extensors, where temporal agreement between EMG and model estimated muscle activity was generally strong to excellent (average cross-correlation coefficients ranging from 0.84 to 0.98). Root mean square errors of muscle activity (0.05-0.10) were similar with and without the exosuit, and compared well to prior model validation studies without the exosuit (average root mean square errors ranging from 0.05 to 0.19). In terms of performance, the exosuit reduced the estimated peak erector spinae forces during lifting and lowering phases across all lifting tasks but reduced peak hip extensor muscles forces only in a squat lift task of 10 kg. These reductions in total peak muscle forces were approximately 1.7-4.2 times greater than the corresponding exosuit assistance force, which were 146 ± 19 N and 102 ± 14 N at the times of peak erector spinae forces in lifting and lowering, respectively. Overall, the results support the hypothesis that exosuits reduce soft tissue loading, and thereby potentially reduce fatigue and injury risk during manual materials handling tasks. Incorporating exosuits into musculoskeletal models is a valid approach to understand the impact of exosuit assistance on muscle activity and forces.

The effect of weapon handling during load carriage across a range of military-relevant walking speeds.

This study investigated the effects of weapon handling on the physiological responses and walking-gait kinematics during load carriage. Seventeen soldiers completed four twelve-minute bouts of treadmill walking at incremental speeds (3.5, 5.5, 6.5 km.h-1 and self-selected) carrying 23.2-kg of additional load, while either handling a weapon or not handling a weapon. Physiological, perceptual and biomechanical outcomes were measured throughout each trial. A weapon-by-speed interaction (p < .05) was observed for hip flexion-extension during loading response and mid-swing. Weapon handling elevated (p < .05) cardiorespiratory responses at 6.5 km.h-1. Main effects (p < .05) of weapon handling were observed for ventilation, oxygen pulse, effort perception, stride length and knee flexion-extension during toe-off. No main effects of weapon handling were observed for any other biomechanical measures. These findings demonstrate that physiological and biomechanical responses to weapon handling are likely walking-speed dependent.Practitioner summary: Weapon handling is an important part of many load-carriage tasks but is rarely investigated. Physiological and biomechanical responses were assessed at incremental speeds during load carriage. Despite similar biomechanics, there was greater physiological demands at faster walking speeds, suggesting an increased contribution from isometric muscle contractions for weapon stabilisation.

Critical success factors for ergonomics programs and their relationship to benefits of health and safety in Mexico's manufacturing industries.

This research determines the critical factors for implementing ergonomics programs related to health and safety benefits in the manufacturing industries of Ciudad Juarez, Mexico, from the middle/upper management perspective. The sample was non-probabilistically selected for convenience, comprising individuals in middle and senior management positions. An original questionnaire containing 105 items measuring five latent variables was developed, reviewed, and validated for data collection. The sample size totalled 206 participants. Structural equation models using partial least squares (PLS) were employed to analyse interrelationships between variables. This research demonstrated acceptable reliability and quality indices. Management commitment emerged as the most significant factor, exerting the highest direct, indirect, and total effects on the work environment and prevention activities, significantly enhancing health and safety benefits. Consequently, manufacturing companies in Juarez City must strive to improve management commitment in the working environment and prevention activities since both strategies can increase employee health and safety benefits.

This paper presents a method focusing on the critical success factors of ergonomics programs associated with health and safety benefits in Mexico's manufacturing industries. The study uses structural equation modelling from the middle/upper management perspective. The proposed approach has potential applications across various industries.