Extended Reality Applications for Space Health.

INTRODUCTION: Spaceflight has detrimental effects on human health, imposing significant and unique risks to crewmembers due to physiological adaptations, exposure to physical and psychological stressors, and limited capabilities to provide medical care. Previous research has proposed and evaluated several strategies to support and mitigate the risks related to astronauts' health and medical exploration capabilities. Among these, extended reality (XR) technologies, including augmented reality (AR), virtual reality (VR), and mixed reality (MR) have increasingly been adopted for training, real-time clinical, and operational support in both terrestrial and aerospace settings, and only a few studies have reported research results on the applications of XR technologies for improving space health. This study aims to systematically review the scientific literature that has explored the application of XR technologies in the space health field. We also discuss the methodological and design characteristics of the existing studies in this realm, informing future research and development efforts on applying XR technologies to improve space health and enhance crew safety and performance.Ebnali M, Paladugu P, Miccile C, Park SH, Burian B, Yule S, Dias RD. Extended reality applications for space health. Aerosp Med Hum Perform. 2023; 94(3):122-130.

Objective Measurement of Learners' Cognitive Load During Simulation-Based Trauma Team Training: A Pilot Study.

INTRODUCTION: Literature has shown cognitive overload which can negatively impact learning and clinical performance in surgery. We investigated learners' cognitive load during simulation-based trauma team training using an objective digital biomarker. METHODS: A cross-sectional study was carried out in a simulation center where a 3-h simulation-based interprofessional trauma team training program was conducted. A session included three scenarios each followed by a debriefing session. One scenario involved multiple patients. Learners wore a heart rate sensor that detects interbeat intervals in real-time. Low-frequency/high-frequency (LF/HF) ratio was used as a validated proxy for cognitive load. Learners' LF/HF ratio was tracked through different phases of simulation. RESULTS: Ten subjects participated in 12 simulations. LF/HF ratios during scenario versus debriefing were compared for each simulation. These were 3.75 versus 2.40, P < 0.001 for scenario 1; 4.18 versus 2.77, P < 0.001 for scenario 2; and 4.79 versus 2.68, P < 0.001 for scenario 3. Compared to single-patient scenarios, multiple-patient scenarios posed a higher cognitive load, with LF/HF ratios of 3.88 and 4.79, P < 0.001, respectively. CONCLUSIONS: LF/HF ratio, a proxy for cognitive load, was increased during all three scenarios compared to debriefings and reached the highest levels in a multiple-patient scenario. Using heart rate variability as an objective marker of cognitive load is feasible and this metric is able to detect cognitive load fluctuations during different simulation phases and varying scenario difficulties.