Preliminary examination of the potential of robot-assisted sonography - An ergonomic tool for obstetric sonographers

A new approach for the implementation of ergonomics in sonography to prevent work-related musculoskeletal disorders (ErgoSon)

BACKGROUND

A substantial body of research has documented a high prevalence of neck, shoulder, wrist, and back pain among sonography users. However, the specific postures that contribute to these complaints have scarcely been systematically investigated, to date. This proposed study offers a novel method to record users' body posture during sonography examinations kinematically and to survey the complaints of sonography users in various specialities. Using this data, well-founded ergonomic recommendations for the prevention of work-related musculoskeletal disorders (WRMSDs) will be developed.

METHODS

A minimum of 38 study participants across two groups (19 beginners; 19 experienced) per speciality (head and neck sonography, abdominal sonography, cardiac sonography, musculoskeletal sonography, and obstetric/gynaecological sonography) will be assessed using kinematic whole-body (including finger movements) analysis based on inertial motion capture. Subsequently, ergonomic risk will be determined by integrating the quantitative data into the Rapid Upper Limb Assessment (RULA). Moreover, a questionnaire on musculoskeletal complaints and ergonomics in sonography will be used in certified sonography courses, ultrasound-based centres, and university teaching. The primary outcome measures of this proposed study include typical tasks based on joint angles and assessment using RULA scores. In addition, the prevalence of WRMSDs will be recorded. The Mann-Whitney-U test will be employed to calculate the differences between the two study groups in each speciality. In addition, inferential statistical comparisons will be conducted for continuous data using confidence bands; the statistical parametric mapping method will be employed here. The significance level will be set at p = 0.05.

CONCLUSIONS

This article proposes a study (or series of studies) to describe the continuous ergonomic risk for typical tasks across different disciplines of sonography and to identify increased ergonomic risks. Such studies offer significant potential for preventing WRMSDs. The insights gained could inform the future design of prevention programmes and the development of recommendations for action, as well as teaching sonography users an ergonomically optimised way of working. The results could suggest that ergonomics training is incorporated more thoroughly into ultrasound training curricula to minimise health risks for future users.

Assessment of Human Fetuses Undergoing Acute Pain: Validation of the Fetal-7 Scale

Improvements in fetal ultrasound have allowed for the diagnosis and treatment of fetal diseases in the uterus, often through surgery. However, little attention has been drawn to the assessment of fetal pain. To address this gap, a fetal pain scoring system, known as the Fetal-7 scale, was developed. The present study is a full validation of the Fetal-7 scale. The validation involved 2 steps: 1) 4 fetuses with the indication of surgery were evaluated in 3 conditions perioperatively: acute pain, rest, and under loud sound stimulation. Facial expressions were assessed by 30 raters using screenshots from 4D high-definition ultrasound films; 2) assessment of sensitivity and specificity of the Fetal-7 scale in 54 healthy fetuses and 2 fetuses undergoing acute pain after preoperative anesthetic intramuscular injection. There was high internal consistency with Cronbach's alpha (α) of .99. Intrarater reliability of the Fetal-7 scale (test-retest) calculated by intraclass correlation coefficient was .95, and inter-rater reliability was .99. The scale accurately differentiated between healthy fetuses at rest and those experiencing acute pain (sensitivity of 100% and specificity of 94.4%). The Fetal-7 scale is a valid tool for assessing acute pain-related behavior in third-trimester fetuses and may be of value in guiding analgesic procedures efficacy in these patients. Further research is warranted to explore the presence of postoperative pain in fetuses and its effects after birth. PERSPECTIVE: Recordings with 3-dimensional ultrasound of human fetuses undergoing preoperative anesthetic injections revealed complex facial expressions during acute pain, similar to those collected in newborns. This study presented the validation process and cut-off value of the Fetal-7 scale, paving the way for the study of pain before birth in humans.

Work-related musculoskeletal disorders in Polish sonographers-A questionnaire study

PURPOSE

The ultrasound specialists face a substantial issue with work-related musculoskeletal disorders (WMSDs), characterized by occupation-related pain, reaching an estimated frequency of up to 90.5%. The type and location of pain vary depending on the sonographers specialty and the specific anatomical areas being examined. Our study aimed to assess the prevalence and intensity of pain among Polish doctors from various specialties conducting ultrasound examinations.

MATERIALS AND METHODS

The study has been performed between July and December 2023, involving 90 participants (51.9% women) actively practicing ultrasound diagnostics. The data collection process utilized a structured questionnaire developed by the researchers for this study. The questionnaire covered personal factors, including gender and age, and work-related aspects like workplace, specialty, sonography experience, and the types of examinations conducted. Statistical analysis involved both descriptive statistics and correlation analysis.

RESULTS

The age distribution ranged from 26 to 74 years, with mean (SD) of 43.1 (12.2) years. The leading specialties among physicians were radiology (22.2%) and internal medicine (22.2%). Among all physicians, 65.6% reported pain during or after ultrasound scans, with a mean (SD) pain intensity of 6.17 (2) in a 1-10 scale. The analysis indicated no correlation between age and gender and the occurrence of discomfort.

CONCLUSIONS

WMSDs pose a significant risk to Polish sonographers, especially those specializing in vascular surgery, general surgery and obstetrics and gynecology specialties. The study underscores a notable deficit, with only 10% of the personnel reporting training in ergonomics for ultrasound work.

In robot we trust? The effect of emotional expressions and contextual cues on anthropomorphic trustworthiness

Following the evolution of technology and its application in various daily contexts, social robots work as an advanced artificial intelligence (AI) system to interact with humans. However, limited research has been done to discuss the role of emotional expressions and contextual cues in influencing anthropomorphic trustworthiness, especially from the design perspective. To address this research gap, the current study designed a specific robot prototype and conducted two lab experiments to explore the effect of emotional expressions and contextual cues on trustworthiness via a combination of subjective ratings and physiological measures. Results showed that: 1) positive (vs. negative) emotional expressions enjoyed a higher level of anthropomorphic trustworthiness and visual attention; 2) regulatory fit was expanded in parasocial interaction and worked as a prime to activate anthropomorphic trustworthiness for social robots. Theoretical contributions and design implications were also discussed in this study.