Investigation of eye movement measures of mental workload in healthcare: Can pupil dilations reflect fatigue or overload when it comes to health information system use?

The use of health information systems (HIS) can result in high workloads and, consequently, poor performance characterized by e.g. increased occurrence of errors among clinicians. Pupillometry offers a good possibility to measure mental workload in a dynamic work setting. Currently, there is a lack of empirical research in the context of healthcare settings. Therefore, the aim of the present study was to examine whether specific eye movement measures are suitable for measuring mental workload in the healthcare setting, especially when working with HIS. 49 persons participated in our simulation-lab study. They had to complete a system-related task as well as an increasing n-back task. Both tasks were modified regarding task difficulty. Results show significant differences for objective and subjective workload measures between increasing task levels. There are also hints for an overload/fatigue indicator in pupil data. Our results are limited in terms of external validity, causality and effects. Future work should focus on high-fidelity simulations and less time-consuming analysis approaches.

Marginal Mandibulectomy Defect Reconstruction with Pectoralis Major Myocutaneous (PMMC) Flap in Cases of Carcinoma Buccal Mucosa: Experience from a Tertiary Cancer Institute

Patients with carcinoma buccal mucosa requiring marginal mandibulectomy pose various key challenges with regard to reconstruction. To study the role and feasibility of the PMMC flap reconstruction in patients of carcinoma buccal mucosa with intact mandible. Study design: retrospective analysis of prospectively maintained data at a tertiary cancer institute in India. Inclusion criteria: all patients of carcinoma buccal mucosa undergoing marginal mandibulectomy at our institute from 1st Jan 2015 to 31st March 2018 with reconstruction done by the PMMC flap. The retrospective analysis showed 82 patients satisfied the inclusion criteria. Median age of the patients was 46 years. Seventy-seven (93.90%) patients were male while 5 (6.09%) patients were female. Median Ryle's tube dependency was 13 days. Median follow-up period was 28 months. All the patients had acceptable cosmesis and mouth opening with minimal morbidity. PMMC flap reconstruction after marginal mandibulectomy in patients with carcinoma buccal mucosa is a robust, cosmetically, and functionally acceptable option.