Workload and Performance in FOPA: A Strategic Planning Interface for Air Traffic Control

The Flight Organizer Planning Aid (FOPA) interface was designed to aid strategic planning in air traffic control. In particular, FOPA was designed to address difficulties in solving en route sequencing problems (combining multiple streams of traffic into a single stream heading for a destination). We compared the planning performance of 12 full performance level air traffic controllers using either the FOPA interface or normal flight progress strips. Planning performance was significantly better when using FOPA; subjective workload was also reduced. The results indicate that a key advantage of FOPA lies in its dynamic linkage between the flight organizer screen where aircraft tokens can be categorized into color-coded blocks and their matching spatial representation on the radar.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Effect of B-type natriuretic peptide-guided treatment of chronic heart failure on total mortality and hospitalization: an individual patient meta-analysis

Aims Natriuretic peptide-guided (NP-guided) treatment of heart failure has been tested against standard clinically guided care in multiple studies, but findings have been limited by study size. We sought to perform an individual patient data meta-analysis to evaluate the effect of NP-guided treatment of heart failure on all-cause mortality. Methods and results Eligible randomized clinical trials were identified from searches of Medline and EMBASE databases and the Cochrane Clinical Trials Register. The primary pre-specified outcome, all-cause mortality was tested using a Cox proportional hazards regression model that included study of origin, age (45%) as covariates. Secondary endpoints included heart failure or cardiovascular hospitalization. Of 11 eligible studies, 9 provided individual patient data and 2 aggregate data. For the primary endpoint individual data from 2000 patients were included, 994 randomized to clinically guided care and 1006 to NP-guided care. All-cause mortality was significantly reduced by NP-guided treatment [hazard ratio = 0.62 (0.45-0.86); P = 0.004] with no heterogeneity between studies or interaction with LVEF. The survival benefit from NP-guided therapy was seen in younger (<75 years) patients [0.62 (0.45-0.85); P = 0.004] but not older (≥75 years) patients [0.98 (0.75-1.27); P = 0.96]. Hospitalization due to heart failure [0.80 (0.67-0.94); P = 0.009] or cardiovascular disease [0.82 (0.67-0.99); P = 0.048] was significantly lower in NP-guided patients with no heterogeneity between studies and no interaction with age or LVEF. Conclusion Natriuretic peptide-guided treatment of heart failure reduces all-cause mortality in patients aged <75 years and overall reduces heart failure and cardiovascular hospitalizatio

Aiding Planning in Air Traffic Control: An Experimental Investigation of the Effects of Perceptual Information Integration

Prior research examined how controllers plan in their traditional environment and identified various information uncertainties as detriments to planning. A planning aid was designed to reduce this uncertainty by perceptually representing important constraints. This included integrating spatial information on the radar screen with discrete information (planned sequences of air traffic). Previous research reported improved planning performance and decreased workload in the planning aid condition. The purpose of this paper was to determine the source of these performance improvements. Analysis of computer interactions using loglinear modeling showed that the planning interface led to less repetitive - but more integrated - information retrieval compared with the traditional planning environment. Ecological interface design principles helped explain how the integrated information retrieval gave rise to the performance improvements. Actual or potential applications of this research include the design and evaluation of interface automation that keeps users in active control by modification of perceptual task characteristics.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Extending the scope of pooled analyses of individual patient biomarker data from heterogeneous laboratory platforms and cohorts using merging algorithms

Background: A common challenge in medicine, exemplified in the analysis of biomarker data, is that large studies are needed for sufficient statistical power. Often, this may only be achievable by aggregating multiple cohorts. However, different studies may use disparate platforms for laboratory analysis, which can hinder merging. Methods: Using circulating placental growth factor (PIGF), a potential biomarker for hypertensive disorders of pregnancy (HDP) such as preeclampsia, as an example, we investigated how such issues can be overcome by inter-platform standardization and merging algorithms. We studied 16,462 pregnancies from 22 study cohorts. PIGF measurements (gestational age >= 20 weeks) analyzed on one of four platforms: R & Systems, Alere (R) Triage, Roche (R) Elecsys or Abbott (R) Architect, were available for 13,429 women. Two merging algorithms, using Z-Score and Multiple of Median transformations, were applied. Results: Best reference curves (BRC), based on merged, transformed PIGF measurements in uncomplicated pregnancy across six gestational age groups, were estimated. Identification of HDP by these PIGF-BRCS was compared to that of platform-specific curves. Conclusions: We demonstrate the feasibility of merging PIGF concentrations from different analytical platforms. Overall BRC identification of HDP performed at least as well as platform-specific curves. Our method can be extended to any set of biomarkers obtained from different laboratory platforms in any field. Merged biomarker data from multiple studies will improve statistical power and enlarge our understanding of the pathophysiology and management of medical syndromes. (C) 2015 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.Peer reviewe

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Display Requirements and Alerting Modalities of a Flight Deck Based Runway Safety Alerting System

This paper presents the results of a human in the loop simulation that evaluated the display of runway safety relevant traffic and runway indications and alerts on a cockpit display of traffic information (CDTI). The simulation investigated differences between directive versus nondirective alert types and between an airport map with and without taxiway information. 24 pilots evaluated the CDTI in 18 airport surface scenarios that contained conflict opportunities. Findings indicate that with directive alerts, pilots avoided all conflict opportunities, while with nondirective alerts 90 % of conflicts were avoided. Response to directive alerts was generally faster than to non-directive alerts. Limitations for non-directive alerts became apparent in scenarios where pilots had to respond under time pressure. While pilots preferred taxiway information to be displayed on the CDTI, no performance differences were found compared to CDTI’s with taxiway information. The paper concludes with implications for the development of avionics standards

Effectiveness of Ground-Based Direct Pilot Warnings in Mitigating Runway Safety- Critical Human Errors

Three simulation studies were performed to determine opportunities and limitations of ground-based direct pilot warnings to increase runway safety. Sixty pilots participated in these studies and operated a flight simulator under active and passive warning. Passive warnings facilitated crew awareness about their current location on the airport. Active warnings provided time critical information about runway status and other traffic to facilitate safety mitigation behavior by pilots. Participants completed simulation scenarios with opportunities for safety incidents that could be avoided if pilots achieved complete situation awareness. Warning effectiveness was measured by comparing numbers of encountered safety incidents between baseline and warning conditions. Simulation findings indicate that passive warnings are frequently unable to correct erroneous pilot expectations, thereby replicating similar historic incidents such as the crash of a commuter jet in Lexington, Kentucky in August 2006, where the flight-crew took off from a too short runway. Visual ground-based active warnings on the other hand seemed effective in the runway entrance environment and for departure situations. For arrival situations, allocation of pilot attention seemed to play a crucial role in moderating warning effectiveness. We report opportunities and limitations of the described warning methodology and suggest next steps for runway safety research and system development

Effectiveness of Ground-Based Direct Pilot Warnings in Mitigating Runway Safety- Critical Human Errors

Three simulation studies were performed to determine opportunities and limitations of ground-based direct pilot warnings to increase runway safety. Sixty pilots participated in these studies and operated a flight simulator under active and passive warning. Passive warnings facilitated crew awareness about their current location on the airport. Active warnings provided time critical information about runway status and other traffic to facilitate safety mitigation behavior by pilots. Participants completed simulation scenarios with opportunities for safety incidents that could be avoided if pilots achieved complete situation awareness. Warning effectiveness was measured by comparing numbers of encountered safety incidents between baseline and warning conditions. Simulation findings indicate that passive warnings are frequently unable to correct erroneous pilot expectations, thereby replicating similar historic incidents such as the crash of a commuter jet in Lexington, Kentucky in August 2006, where the flight-crew took off from a too short runway. Visual ground-based active warnings on the other hand seemed effective in the runway entrance environment and for departure situations. For arrival situations, allocation of pilot attention seemed to play a crucial role in moderating warning effectiveness. We report opportunities and limitations of the described warning methodology and suggest next steps for runway safety research and system development

Effect of B-type natriuretic peptide-guided treatment of chronic heart failure on total mortality and hospitalization: an individual patient meta-analysis

Natriuretic peptide-guided (NP-guided) treatment of heart failure has been tested against standard clinically guided care in multiple studies, but findings have been limited by study size. We sought to perform an individual patient data meta-analysis to evaluate the effect of NP-guided treatment of heart failure on all-cause mortality. Eligible randomized clinical trials were identified from searches of Medline and EMBASE databases and the Cochrane Clinical Trials Register. The primary pre-specified outcome, all-cause mortality was tested using a Cox proportional hazards regression model that included study of origin, age ( <75 or ≥75 years), and left ventricular ejection fraction (LVEF, ≤45 or >45%) as covariates. Secondary endpoints included heart failure or cardiovascular hospitalization. Of 11 eligible studies, 9 provided individual patient data and 2 aggregate data. For the primary endpoint individual data from 2000 patients were included, 994 randomized to clinically guided care and 1006 to NP-guided care. All-cause mortality was significantly reduced by NP-guided treatment [hazard ratio = 0.62 (0.45-0.86); P = 0.004] with no heterogeneity between studies or interaction with LVEF. The survival benefit from NP-guided therapy was seen in younger ( <75 years) patients [0.62 (0.45-0.85); P = 0.004] but not older (≥75 years) patients [0.98 (0.75-1.27); P = 0.96]. Hospitalization due to heart failure [0.80 (0.67-0.94); P = 0.009] or cardiovascular disease [0.82 (0.67-0.99); P = 0.048] was significantly lower in NP-guided patients with no heterogeneity between studies and no interaction with age or LVEF. Natriuretic peptide-guided treatment of heart failure reduces all-cause mortality in patients aged <75 years and overall reduces heart failure and cardiovascular hospitalizatio