Experimental validation of COMETA model of mental workload in air traffic control

The sustained increase in air traffic during the last decades represents a challenge to the air traffic management system in general. Thus, it is of utmost importance to develop strategies that can safely increase air traffic controller's handling capacity without increasing task related strain. This research proposes and validates a predictive model of air traffic controller's mental workload. Our model is based on COMETA, a model that considers the effect of the most relevant air traffic events in the cognitive complexity of the task. In the version of COMETA used in this study we include the online effects of the controllers' actions on the state of the airspace. To validate the model, a laboratory experiment was conducted using a simulator to precisely control the task workload factors. We used traffic density and airspace complexity as experimental factors because they are the most commonly acknowledged sources of mental workload in air traffic control literature. The measured dependent variables were selected because they have been found to correlate with mental workload in ATC tasks, namely, ISA and NASA indexes, electrodermal activity, heart rate, and different performance measures. The results demonstrate that our model can successfully predict air traffic controllers' mental workload across a wide range of task workload conditions. In addition, our results provide a clear portrait of the complex interactions between the different sources of task workload and their effects on mental workload. In the conclusion we consider the limitations and opportunities for the application of this model to improve policie

The direct learning theory: a naturalistic approach to learning for the post-cognitivist era

Di Paolo, Buhrmann, and Barandiarán (2017) proposed a list of criteria that post cognitivist theories of learning should fulfill. In this article we describe the direct learning theory, developed under the ecological approach, and review research performed in this theoretical framework. We argue that the theory of direct learning fulfills most of the criteria put forward by Di Paolo et al. In this sense, the tools and concepts of the direct learning theory can be useful to other post cognitivist theories of learning. Direct learning holds that improvements with practice in perception and perceptually guided action are driven by information for learning. Such information can be found in the dynamic interaction of the organism that performs the action and the environment in which the action is performed. The theory formally describes information for learning as a vector field that spans a space that includes all perception action couplings that may be used to perform the action. Being located at a point of such a space means using a specific perception action coupling. Changes in perception action couplings due to learning can be represented as paths across the space, and can be explained with the vector field of information for learning. Previous research in the direct learning framework considered actions that were best understood with single perception action couplings. To conclude the article, and inspired by the criteria of Di Paolo et al., we discuss an extension of the theory to actions that are best understood with multiple perception action couplingsThis research was supported in part by funds from the Spanish Ministry of Economy and Competitiveness (grant number PSI2013 43742). Jorge Ibáñez Gijón was supported by funds from the Autonomous Region of Madrid (2016 T2/SOC1976

Task difficulty and physiological measures of mental workload in air traffic control: a scoping review

This study provides a systematic synthesis of empirical research on mental workload (MWL) in air traffic control (ATC). MWL is a key concept in research on innovative technologies, because the assessment of MWL is crucial to the evaluation of such technologies. Our specific focus was on physiological measures of MWL. The used search strategy identified 39 peer-reviewed publications that analysed ATC tasks, examined different levels of difficulty of the ATC task, and considered at least one physiological measure of MWL. Positive relations between measures of MWL and task difficulty were observed most frequently, indicating that the measures indeed allowed the assessment of MWL. The most commonly used physiological measures were brain measures (EEG and fNIR) and heart rate measures. The review revealed a need for more precise descriptions of crucial experimental parameters in order to permit a transition of the field towards more interactive and dynamic types of analysis. Practitioner summary: Research on innovative technology in air traffic control (ATC) depends on assessments of mental workload (MWL). We reviewed empirical research on MWL in ATC. Brain and heart measures often allow assessments of MWL. Better descriptions of experiments are needed to allow comparisons among studies and more dynamic and interactive analysesThis work was supported by a research contract involving UAM, ENAIRE, and CRID

The haptic moving room

In the moving room paradigm, visually perceived movements of the walls of a room affect the postural sway of individuals in the room. In this experiment, we used a virtual reality (VR) headset to provide visual information about the room, and a tactile device to provide haptic information about the front wall of the room. The tactile device consisted of 48 vibrotactile motors that were pressed against the abdomen and that provided continuous haptic stimulation. In experimental trials, the virtual room oscillated slowly (0.1 Hz) or quickly (0.75 Hz). Participants who stood on a force platform observed the room visually, haptically, or visually and haptically. The registered postural sway reflected the oscillations of the room in all conditions, including the purely haptic ones. The fact that participants coupled their body sway to the room in the visual conditions replicates previous findings that the moving room paradigm can be applied in VR. Although the coupling was less pronounced in the haptic conditions, the existence of this coupling demonstrates that a completely new type of flow information is spontaneously integrated in the elementary and highly practiced perceptual-motor activity of balance control. Applications in the fields of sensory substitution and rehabilitation are discussedThe contribution of Nicole S. Carver to this research was supported by the National Science Foundation Graduate Research Fellowship under Grant No. 2035701. The development of the haptic device was supported by INDRA and Fundación Universia through their awards Tecnologías Accesibles 201

Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate

BACKGROUNDRight hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).AIMTo investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.METHODSThis is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.RESULTSThree hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.CONCLUSIONPatients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complication's rate was not different between the two groups

The impact of stapling technique and surgeon specialism on anastomotic failure after right?sided colorectal resection: an international multicentre, prospective audit

Aim There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure. Method Any unit performing gastrointestinal surgery was invited to contribute data on consecutive adult patients undergoing right hemicolectomy or ileocolic resection to this prospective, observational, international, multicentre study. Patients undergoing stapled, side?to?side ileocolic anastomoses were identified and multilevel, multivariable logistic regression analyses were performed to explore factors associated with anastomotic leak. Results One thousand three hundred and forty?seven patients were included from 200 centres in 32 countries. The overall anastomotic leak rate was 8.3%. Upon multivariate analysis there was no difference in leak rate with use of a cutting stapler for apical closure compared with a noncutting stapler (8.4% vs 8.0%, OR 0.91, 95% CI 0.54–1.53, P = 0.72). Oversewing of the apical staple line, whether in the cutting group (7.9% vs 9.7%, OR 0.87, 95% CI 0.52–1.46, P = 0.60) or noncutting group (8.9% vs 5.7%, OR 1.40, 95% CI 0.46–4.23, P = 0.55) also conferred no benefit in terms of reducing leak rates. Surgeons reporting to be general surgeons had a significantly higher leak rate than those reporting to be colorectal surgeons (12.1% vs 7.3%, OR 1.65, 95% CI 1.04–2.64, P = 0.04). Conclusion This study did not identify any difference in anastomotic leak rates according to the type of stapling device used to close the apical aspect. In addition, oversewing of the anastomotic staple lines appears to confer no benefit in terms of reducing leak rates. Although general surgeons operated on patients with more high?risk characteristics than colorectal surgeons, a higher leak rate for general surgeons which remained after risk adjustment needs further exploration

Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit

Aim: The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method: This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a 2-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30\ua0days of surgery, determined using a prespecified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random-effect variable. Results: This study included 3208 patients, of whom 78.4% (n\ua0=\ua02515) underwent surgery for malignancy and 11.7% (n\ua0=\ua0375) underwent surgery for Crohn's disease. An anastomosis was performed in 94.8% (n\ua0=\ua03041) of patients, which was handsewn in 38.9% (n\ua0=\ua01183) and stapled in 61.1% (n\ua0=\ua01858). Patients undergoing handsewn anastomosis were more likely to be emergency admissions (20.5% handsewn vs 12.9% stapled) and to undergo open surgery (54.7% handsewn vs 36.6% stapled). The overall anastomotic leak rate was 8.1% (245/3041), which was similar following handsewn (7.4%) and stapled (8.5%) techniques (P\ua0=\ua00.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted OR\ua0=\ua01.43; 95% CI: 1.04\u20131.95; P\ua0=\ua00.03). Conclusion: Despite being used in lower-risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe

The relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit.

BACKGROUND: Anastomosis technique following right sided colonic resection is widely variable and may affect patient outcomes. This study aimed to assess the association between leak and anastomosis technique (stapled versus handsewn) METHODS: This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a two-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, using a pre-specified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random effect variable. RESULTS: This study included 3208 patients, of whom 78.4% (n=2515) underwent surgery for malignancy and 11.7% (n=375) for Crohn's disease. An anastomosis was performed in 94.8% (n=3041) of patients, which was handsewn in 38.9% (n=1183) and stapled in 61.1% (n=1858) cases. Patients undergoing handsewn anastomosis were more likely to be emergency admissions (20.5% handsewn versus 12.9% stapled) and to undergo open surgery (54.7% versus 36.6%). The overall anastomotic leak rate was 8.1% (245/3041), which was similar following handsewn (7.4%) and stapled (8.5%) techniques (p=0.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted odds ratio 1.43, 95% confidence interval 1.04-1.95, p=0.03). DISCUSSION: Despite being used in lower risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe. This article is protected by copyright. All rights reserve