Pilot test of an online training module on near-infrared spectroscopy monitoring for the randomised clinical trial SafeBoosC-III

Cognitive Effort during Visuospatial Problem Solving in Physical Real World, on Computer Screen, and in Virtual Reality

Spatial cognition plays a crucial role in academic achievement, particularly in science, technology, engineering, and mathematics (STEM) domains. Immersive virtual environments (VRs) have the growing potential to reduce cognitive load and improve spatial reasoning. However, traditional methods struggle to assess the mental effort required for visuospatial processes due to the difficulty in verbalizing actions and other limitations in self-reported evaluations. In this neuroergonomics study, we aimed to capture the neural activity associated with cognitive workload during visuospatial tasks and evaluate the impact of the visualization medium on visuospatial task performance. We utilized functional near-infrared spectroscopy (fNIRS) wearable neuroimaging to assess cognitive effort during spatial-reasoning-based problem-solving and compared a VR, a computer screen, and a physical real-world task presentation. Our results reveal a higher neural efficiency in the prefrontal cortex (PFC) during 3D geometry puzzles in VR settings compared to the settings in the physical world and on the computer screen. VR appears to reduce the visuospatial task load by facilitating spatial visualization and providing visual cues. This makes it a valuable tool for spatial cognition training, especially for beginners. Additionally, our multimodal approach allows for progressively increasing task complexity, maintaining a challenge throughout training. This study underscores the potential of VR in developing spatial skills and highlights the value of comparing brain data and human interaction across different training settings.

Cerebral Oximetry Monitoring in Extremely Preterm Infants

BACKGROUND

The use of cerebral oximetry monitoring in the care of extremely preterm infants is increasing. However, evidence that its use improves clinical outcomes is lacking.

METHODS

In this randomized, phase 3 trial conducted at 70 sites in 17 countries, we assigned extremely preterm infants (gestational age, <28 weeks), within 6 hours after birth, to receive treatment guided by cerebral oximetry monitoring for the first 72 hours after birth or to receive usual care. The primary outcome was a composite of death or severe brain injury on cerebral ultrasonography at 36 weeks' postmenstrual age. Serious adverse events that were assessed were death, severe brain injury, bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, and late-onset sepsis.

RESULTS

A total of 1601 infants underwent randomization and 1579 (98.6%) were evaluated for the primary outcome. At 36 weeks' postmenstrual age, death or severe brain injury had occurred in 272 of 772 infants (35.2%) in the cerebral oximetry group, as compared with 274 of 807 infants (34.0%) in the usual-care group (relative risk with cerebral oximetry, 1.03; 95% confidence interval, 0.90 to 1.18; P = 0.64). The incidence of serious adverse events did not differ between the two groups.

CONCLUSIONS

In extremely preterm infants, treatment guided by cerebral oximetry monitoring for the first 72 hours after birth was not associated with a lower incidence of death or severe brain injury at 36 weeks' postmenstrual age than usual care. (Funded by the Elsass Foundation and others; SafeBoosC-III ClinicalTrials.gov number, NCT03770741.).