NextGen Flight Deck Data Comm: Auxiliary Synthetic Speech Phase I

Data Comm—a text-based controller-pilot communication system—is critical to many NextGen improvements. With Data Comm, communication becomes a visual task. Interacting with a visual Data Comm display may yield an unsafe increase in head-down time, particularly for single-pilot operations. This study examined the feasibility of supplementing Data Comm with synthetic speech. To this end, thirty-two pilots flew two experimental scenarios in a Cessna 172 Flight Training Device. In one scenario, ATC communication was with a text-only Data Comm display, in the other, communication was with a text Data Comm display with synthetic speech that read aloud each message (i.e., text+speech). Pilots heard traffic with similar call signs on the party line and received a conditional clearance (in both scenarios); in either scenario, pilots received a clearance that was countermanded by a live controller. Results indicated that relative to the text-only display, the text+speech display aided single-pilot performance by reducing head-down time, and may have prevented participants from acting early on the conditional clearance. Supplementing text Data Comm with speech did not introduce additional complications: participants were neither more likely to erroneously respond to similar call signs, nor to ignore a live ATC countermand

WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.Peer reviewe

NextGen Flight Deck Data Comm: Auxiliary Synthetic Speech--Phase I

Data Comm—a digital, text-based controller-pilot communication system—is critical to many NextGen improvements. With Data Comm, communication becomes a visual task. Although Data Comm brings many advantages, interacting with a visual display may yield an increase in head-down time, particularly for single-pilot operations. This study examined the feasibility of supplementing the visual Data Comm display with an auxiliary synthetic speech presentation. Thirty-two pilots flew two experimental scenarios in a Cessna 172 Flight Training Device. In one scenario, ATC communication was with a text-only Data Comm display; in the other, the text Data Comm display was supplemented with a synthetic speech display annunciating each message (i.e., text+speech). In both scenarios, pilots heard traffic with similar call signs on the party line and received a conditional clearance; however in just one scenario (counter-balanced between communication conditions), pilots received a clearance that was countermanded by a live controller before it was displayed. Results indicated that relative to the text-only display, the text+speech display aided single-pilot performance by reducing head-down time; and it may have prevented participants from acting prematurely on the conditional clearance. Supplementing text Data Comm with speech did not introduce additional complications: participants were neither more likely to erroneously respond to similar call signs, nor to ignore a live ATC voice countermand. The results suggest that the text+speech display did not hinder single-pilot performance and offered some benefits compared to the text-only display. --U.S. Department of Transportation websit

NextGen Flight Deck Data Comm: Auxiliary Synthetic Speech Phase I

Data Comm—a text-based controller-pilot communication system—is critical to many NextGen improvements. With Data Comm, communication becomes a visual task. Interacting with a visual Data Comm display may yield an unsafe increase in head-down time, particularly for single-pilot operations. This study examined the feasibility of supplementing Data Comm with synthetic speech. To this end, thirty-two pilots flew two experimental scenarios in a Cessna 172 Flight Training Device. In one scenario, ATC communication was with a text-only Data Comm display, in the other, communication was with a text Data Comm display with synthetic speech that read aloud each message (i.e., text+speech). Pilots heard traffic with similar call signs on the party line and received a conditional clearance (in both scenarios); in either scenario, pilots received a clearance that was countermanded by a live controller. Results indicated that relative to the text-only display, the text+speech display aided single-pilot performance by reducing head-down time, and may have prevented participants from acting early on the conditional clearance. Supplementing text Data Comm with speech did not introduce additional complications: participants were neither more likely to erroneously respond to similar call signs, nor to ignore a live ATC countermand

Risk of COVID-19 after natural infection or vaccinationResearch in context

Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health

Risk of COVID-19 after natural infection or vaccinationResearch in context

Summary: Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health