“…Currently, there are various proprietary and open systems that can be used and/or adapted to the surgical scenario in order to estimate vigilance state (76) and workload metrics (77, 78). Other physiological measures of drowsiness have been repeatedly shown to be useful for predicting drowsiness in specific context, such as (i) PERCLOSE (79, 80), (ii) blinking rate, (iii) eyelid movements (81), (iv) head nodding, (v) leap stretch (82, 83), and so forth slow eye movements were shown to correlate with EEG theta and delta power band as well as with the nadir tympanic temperature and subjective sleepiness (84). Although these relations were proven to be robust only in a closed eye condition, hence limiting severely the usefulness of this metric in the field.…”