Computational evidence for an early, amplified systemic inflammation program in polytrauma patients with severe extremity injuries

Extremity and soft tissue injuries contribute significantly to inflammation and adverse in-hospital outcomes for trauma survivors; accordingly, we examined the complex association between clinical outcomes inflammatory responses in this setting using in silico tools. Two stringently propensity-matched, moderately/severely injured (Injury Severity Score > 16) patient sub-cohorts of ~30 patients each were derived retrospectively from a cohort of 472 blunt trauma survivors and segregated based on their degree of extremity injury severity (above or below 3 on the Abbreviated Injury Scale). Serial blood samples were analyzed for 31 plasma inflammatory mediators. In addition to standard statistical analyses, Dynamic Network Analysis (DyNA) and Principal Component Analysis (PCA) were used to model systemic inflammation following trauma. Patients in the severe extremity injury sub-cohort experienced longer intensive care unit length of stay (LOS), total LOS, and days on a mechanical ventilator, with higher Marshall Multiple Organ Dysfunction (MOD) Scores over the first 7 days post-injury as compared to the mild/moderate extremity injury sub-cohort. The higher severity cohort had statistically significant elevated lactate, base deficit, and creatine phosphokinase on first blood draw, along with significant changes in multiple circulating inflammatory mediators. DyNA pointed to a sustained role for type 17 immunity in both sub-cohorts, along with IFN-γ in the severe extremity injury group. DyNA network complexity increased over 7 days post-injury in the severe injury group, while generally decreasing over this same time period in the mild/moderate injury group. PCA suggested a more robust activation of multiple pathways in the severe extremity injury group as compared to the mild/moderate injury group. These studies thus point to the possibility of self-sustaining inflammation following severe extremity injury vs. resolving inflammation following less severe extremity injury

Electronic Flight Data in Airport Traffic Control Towers: Literature Review

The Federal Aviation Administration (FAA) is investigating the potential effects of implementing electronic flight data systems (EFDSs) at Airport Traffic Control Towers (ATCTs). This literature review examines task analyses, published literature, and recent field observation data to explore the basic functionality of flight progress strips (FPSs) in the ATCT. The author identifies gaps in the research and searches for general principles to guide the design of an EFDS prototype. Given the proper design of the interface and automation, an EFDS should maintain some of the basic functionality and benefits of the FPSs, reduce workload related to flight data entry, tracking and sharing, and provide new features that will enhance controller performance and encourage use. The author presents possible risks and outcomes that may accompany an EFDS in FAA ATCTs

Concept Development and Design Description of Electronic Flight Data Interfaces for Airport Traffic Control Towers

This report documents and describes the development process, design rationale, and design description for two prototype Electronic Flight Data Interfaces (EFDIs) for an Airport Traffic Control Tower (ATCT). The author designed the EFDIs as part of a concept research program to examine the feasibility of using Electronic Flight Data (EFD) in an ATCT instead of paper Flight Progress Strips. The author designed the EFDIs based on literature review, working group and subject matter expert input, task analyses, low-risk usability tests, and a rapid prototype process. The Integrated EFDI incorporates EFD with the Airport Surface Detection Equipment - Model X (ASDE-X). The Perceptual-Spatial EFDI does not rely on ASDE-X, but presents EFD that controllers can arrange spatially on an airport surface map. Both EFDIs include separate displays for the local and ground controller positions and provide controllers with the ability to record, manage, and transfer flight data. The EFDIs will be used to automate some flight data management tasks, to provide new tools designed to reduce controller workload and improve safety, and to improve controller efficiency by integrating information. A provisional patent application is pending for the EFDIs

Tower Operations Digital Data System- Concept Refinement and Description of New Features

Human factors researchers at the Federal Aviation Administration have developed new methods of operation for Air Traffic Control Specialists working in Airport Traffic Control Towers (ATCT). The newly redesigned and enhanced Tower Operations Digital Data System (TODDS) provides a means to assist ATCT controllers with flight data management, communication, and coordination by reducing cognitive and physical task load. The TODDS prototype designs include separate solutions for ATCTs either with or without surface surveillance capability. This report addresses the results of a recent usability test by providing a description of design changes and new features that compose the TODDS. The author also recommends the use of a touchscreen training protocol. Pending further investigation, the TODDS may help reduce the risk of runway incursions, ease the flow of surface operations, and support the Staffed Virtual Tower concept

Comparing the Tower Operations Digital Data System To Paper Flight Progress Strips in Zero-Visibility Operations

The current experiment used a high-fidelity, human-in-the-loop simulation to compare the Tower Operations Digital Data System (TODDS) to paper flight progress strips (FPSs) during zero-visibility Airport Traffic Control Tower operations. Sixteen current controllers participated in groups of two. Each group received touchscreen and TODDS training before completing eight practice and eight test scenarios. The participants worked at both the ground and local control positions under four experimental conditions. The participants used either the Integrated TODDS (electronic flight data integrated with surface surveillance, weather information, and digital-taxi communications), FPSs with Airport Surface Detection Equipment \u2013 Model X (ASDE-X), Perceptual-Spatial TODDS (electronic flight data integrated with weather information and digital-taxi communications, but no surface surveillance), or FPSs only, to control airport traffic. The participants had a Standard Terminal Automation Replacement System (STARS) display in all four conditions, but did not have an out-the-window view. Dependent measures included the number and duration of airport operations, number and duration of communications, TODDS usability, and participant opinion. The data revealed advantages for surface surveillance and TODDS. The Integrated TODDS provided additional benefits that may help reduce the risk of runway incursions, ease the flow of surface operations, and support the Staffed Virtual Tower concept

New Electronic Flight Data Interface Designs for Airport Traffic Control Towers : Initial Usability Test

The Federal Aviation Administration (FAA) is examining electronic alternatives to the paper flight progress strips that air traffic controllers currently use in Airport Traffic Control Towers (ATCTs). FAA researchers have recently developed new concepts and human-computer interface designs for the management of electronic flight data in ATCTs. The authors of this report use a part-task simulation to assess the usability of the new Electronic Flight Data Interface (EFDI) concepts. The authors present objective and subjective data to evaluate (a) the participants\u2019 ability to learn how to use each EFDI, (b) the participants\u2019 ability to use the EFDIs as designed with the touch sensitive display, and (c) whether the participants\u2019 performance changes over a short period of time

Implications of Reduced involvement in En Route Air Traffic Control

The expansion of the National Route Program will allow airlines to be more flexible in filing and amending flight plans. This may result in a change in the role of the air traffic control specialist from direct control to a position with more monitoring responsibilities. This change may result in a reduction of situation awareness, memory and vigilance. This experiment investigated the effect of moving a controller from the current active control to a monitoring position. It examined the effect of the change in involvement and task load by measuring eye movements, workload, situation awareness, system performance, controller performance ratings, organization of information in memory, and responses to questionnaires. Controllers received training on a generic en route airspace, the Genera High sector, during four practice simulations of 40 minutes each. They then worked four 30-minute experimental scenarios. Results indicated that controllers showed a less structured scanning pattern under high task load and active involvement conditions. Measured workload correlated well with traffic volume. Under monitoring conditions, controllers perceived lower workload. Controller situation awareness was lower under monitoring conditions and decreased further with an increase in task load. Controllers perceived that their situation awareness did not change between active control and passive monitoring. The decrease in situation awareness warrants careful examination of the need for training and assistance of controllers for situations where they no longer function in the current active control position

Data Communications Segment 2 Airport Traffic Control Tower Human-in-the-Loop Simulation

This technical report provides a brief literature review of previous research on air traffic control concepts relevant to the Data Communications (Data Comm) program and examines the use of digital-taxi (D-Taxi) clearances for departure aircraft under three levels of data link equipage (Voice Only vs. 40% Data Comm vs. 75% Data Comm). Sixteen current controllers participated in a high-fidelity, human-in-the-loop simulation to assess the potential effects of D-Taxi on controller communications, workload, and performance. We collected measures of airport system efficiency and usability measures for the Tower Operations Digital Data System that enabled the D-Taxi functions and taxiway conformance monitoring. We examined the specific effects of taxi conformance monitoring and a complete data link system failure in an additional exploratory scenario. This report provides a detailed set of results and recommendations for future research and requirements generation that the Federal Aviation Administration should consider when implementing the Data Comm Segment 2 concepts

Human-in-the-Loop Evaluation of An integrated Arrival/Departure Air Traffic Control Service for Major Metropolitan Airspaces

Abstract The increasing number of U.S. air flights has placed a severe strain on the National Airspace System (NAS), especially airspace surrounding major metropolitan areas. In a recent study, Truitt, McAnulty, and Willems (2004) tested and found benefits in procedures designed to address some of the pressures around New York airspace. The procedures included extending terminal lateral separation standards (3 nm) and procedures (diverging courses) into en route airspace as well as collocating terminal and en route facilities to promote more effective communication and coordination. The Integrated Arrival/Departure Air Traffic Control Service, termed the Big Airspace (BA) concept, applies these procedures to other busy areas and includes the use of Area Navigation(RNAV) routes as well as dynamic resectorization to make airspace boundaries more flexible. Twenty-four controllers from en route and terminal facilities participated in a simulation that compared a baseline (BL) condition using current airspace standards and procedures to two BA conditions. In one condition, en route and terminal participants managed traffic in the same control room, and in the other condition they worked as if in separate facilities. Overall, the results provided support for the BA concept. The aircraft moved through the arrival corridor more efficiently in the BA conditions than in the BL condition, and participants made fewer ground-ground transmissions and issued fewer altitude and heading clearances. Subjective ratings of performance, situation awareness, and the ability to move traffic through the sector were also higher in the BA conditions

Effects of Collocation and Reduced Lateral Separation Standards in the New York integrated Control Complex

The authors used a high fidelity, human-in-the-loop simulation in two experiments examining the concept of the New York Integrated Control Complex (NYICC). The first experiment examined the potential effects of collocation alone and collocation with expanded terminal separation standards on the arrival traffic flow into Newark. The second experiment examined the same effects on the departure traffic flows primarily from Newark International (EWR) and LaGuardia (LGA) airports. Each experiment compared three different conditions. In the Normal condition, the participants controlled traffic as they normally would, and a removable wall physically separated the terminal and en route sectors. During the Collocated condition, experimenters removed the wall, and the participants could engage in face-to-face communication and look at each other\u2019s radar displays. During the Terminalized condition, we collocated the sectors and reduced the separation standard for one or both en route sectors from 5 nm to 3 nm. We collected measures throughout the experiments including system performance, subjective ratings of workload, subject matter expert ratings of performance, communication behaviors, and participant opinion. Overall, both experiments provided support for the NYICC concept of operations. Sponsor FAA Eastern Region Air Traffic Division Airspace Branch, Jamaica, New Yor