A meta-analysis on the effectiveness of anthropomorphism in human-robot interaction.

The application of anthropomorphic design features is widely assumed to facilitate human-robot interaction (HRI). However, a considerable number of study results point in the opposite direction. There is currently no comprehensive common ground on the circumstances under which anthropomorphism promotes interaction with robots. Our meta-analysis aims to close this gap. A total of 4856 abstracts were scanned. After an extensive evaluation, 78 studies involving around 6000 participants and 187 effect sizes were included in this meta-analysis. The majority of the studies addressed effects on perceptual aspects of robots. In addition, effects on attitudinal, affective, and behavioral aspects were also investigated. Overall, a medium positive effect size was found, indicating a beneficial effect of anthropomorphic design features on human-related outcomes. However, closer scrutiny of the lowest variable level revealed no positive effect for perceived safety, empathy, and task performance. Moreover, the analysis suggests that positive effects of anthropomorphism depend heavily on various moderators. For example, anthropomorphism was in contrast to other fields of application, constantly facilitating social HRI. The results of this analysis provide insights into how design features can be used to improve the quality of HRI. Moreover, they reveal areas in which more research is needed before any clear conclusions about the effects of anthropomorphic robot design can be drawn.

[Decision process in a multidisciplinary cancer team with limited evidence]. / Entscheidungsprozesse im Tumorboard bei eingeschränkter Evidenzlage.

BACKGROUND: The Head and Neck Cancer Tumor Board is a multispeciality comprehensive conference that brings together experts with different backgrounds to make group decisions about the appropriate treatment. Due to the complexity of the patient cases and the collaboration of different medical disciplines most of these decisions have to be made under uncertainty, i. e., with-out knowing all relevant factors and without being quite sure about the outcome. METHODS: To develop effective team decision making under uncertainty, it is necessary to understand how medical experts perceive and handle uncertainties. The aim of this field study was to develop a knowledge base by exploring additionally the factors that influence group decision making processes. A structured nonparticipant observational study was employed to address the research goal. Video data were analyzed by 2 independent observers using an observation checklist. A total of 20 videotaped case discussions were studied. Observations were complemented by a questionnaire gathering subjective evaluations of board members about the process and quality of their decisions (N=15). RESULTS: The results show that uncertainty is recognized by board members. Reasons for uncertainty may stem from the complexity of the cases (e. g. therapy options) or the assessment from different disciplines coming together at the board. CONCLUSION: With respect to handling uncertainty and guaranteeing an optimal decision making process potential for improvement could be defined. This pertains to the handling of different levels of competence, the promotion of a positive discussion culture as well as structuring of the decision making process.

Impact of navigated-control assistance on performance, workload and situation awareness of experienced surgeons performing a simulated mastoidectomy.

BACKGROUND: Navigated control (NC) is an advanced image-guided navigation system that provides an additional control function to enhance patient safety. It automatically stops the surgical instrument if it comes close to critical anatomical structures that need to be protected during surgery. The purpose of this study was to explore the human performance consequences of computer-based navigated control assistance. METHODS: Seven experienced surgeons conducted a simulated mastoidectomy manually and with support of the NC system. The impact on surgical performance, workload and situation awareness was analysed. RESULTS: NC support led to a better quality of surgical outcome and a lower level of physiological effort during surgery. Cost effects were reflected in reduced time efficiency and an increased subjectively experienced workload. CONCLUSION: The results demonstrate the potential of NC support in terms of lower workload and enhanced patient safety. Cost effects might be reduced by remodelling the control function.

[Clinical experiences with an automatic collision warning system: instrument navigation in endoscopic transnasal surgery]. / Klinische Erfahrungen mit einem Kollisionswarnsystem: Instrumentennavigation in der endo- und transnasalen Chirurgie.

PROBLEM: The goal of this work is the extension of instrument navigation with a collision warning function. With the help of an additional distance display and warning system the performance of surgical navigation systems should be improved. MATERIAL AND METHODS: The collision warning system (DCS) is an extension of an optoelectric navigation system (NPU, Karl Storz GmbH&Co.KG, Tuttlingen, Germany). The measurement of situation awareness was performed on phantom models of functional endoscopic surgery of the paranasal sinuses (FESS; Phacon, Leipzig). Altogether 450 measurement pairs for the analysis of surgical accuracy to the risk structure (frontal skull base, lamina papyracea, internal carotid artery) were available. To examine the influence on the clinical process, a prospective analysis of intraoperative complications was carried out. Of the 104 FESS patients, two groups, one of 56 patients with only navigation (NAV) and one of 48 patients (NAV+DCS), were examined. Efficiency was evaluated on the basis of times for system preparation and intraoperative application. RESULTS: A significant increase in the assumed and actual distance values between instrument tip and risk structure using the collision warning system was seen at 76%. The complication rate was more favorable for the NAV+DCS group. The time needed for preparation of the navigation system with the application of the collision warning system increased on average by 48%, or 1.2 min. However, the relation between preparation time and utilization time was approximately the same at 53.5% in the NAV group and 57.4% in the NAV+DCS group. CONCLUSIONS: This work supports the clinical use and efficiency of a collision warning system as an addition to well-known instrument navigation in endo- and transnasal surgery. The segmenting algorithm is suitable for clinical requirements.

Automation in surgery: a systematic approach.

This chapter proposes a classification of surgical assistance systems with respect to their type and level of automation. This classification is based on previous work in the field of human factors and takes two aspects into consideration, the type of information-processing function of the surgeon that is supported by the system, as well as the type of function allocation between surgeon and systems. With respect to the former, three basic functions are distinguished, referred to as information acquisition and analysis, decision making and planning, and execution of surgical action. With respect to the type of function allocation, the status of being either "passive" or "active" comes into consideration for both objects of reference (i.e. the surgeon and the machine), depending on whether a given function is mainly performed by the surgeon, by the system, or collaboratively by both. Hence, a classification results for intraoperative assistance systems in six categories, each of these representing a different degree of automation. The classification scheme is explained and illustrated on the basis of examples of surgical assistance systems from various fields.

[Automation in surgery: a systematical approach]. / Automation in der HNO-Chirurgie.

Surgical assistance systems permit a misalignment from the purely manual to an assisted activity of the surgeon (automation). Automation defines a system, that partly or totally fulfils function, those was carried out before totally or partly by the user. The organization of surgical assistance systems following application (planning, simulation, intraoperative navigation and visualization) or technical configuration of the system (manipulator, robot) is not suitable for a description of the interaction between user (surgeon) and the system. The available work has the goal of providing a classification for the degree of the automation of surgical interventions and describing by examples. The presented classification orients itself at pre-working from the Human-Factors-Sciences. As a condition for an automation of a surgical intervention applies that an assumption of a task, which was alone assigned so far to the surgeon takes place via the system. For both reference objects (humans and machine) the condition passively or actively comes into consideration. Besides can be classified according to which functions are taken over during a selected function division by humans and/or the surgical assistance system. Three functional areas were differentiated: "information acquisition and -analysis", "decision making and action planning" as well as "execution of the surgical action". From this results a classification of pre- and intraoperative surgical assist systems in six categories, which represent different automation degrees. The classification pattern is described and illustrated on the basis of surgical of examples.

[Clinical efficiency and the influence of human factors on ear, nose, and throat navigation systems]. / Ist der Vorteil eines Navigationssystems in der HNO-Chirurgie messbar? Ein Konzept zur Evaluation ergonomischer und chirurgischer Erfolgsparameter.

BACKGROUND: The aim of this study was to evaluate the Navibase navigation system for ear, nose, and throat (ENT) surgery. A new methodology for evaluating surgical and human factors is developed. PATIENTS AND METHODS: The evaluation is based on 102 ENT surgical applications, including 89 cases of functional endoscopic sinus surgery (FESS). The evaluation of surgical and human factors was performed by seven ENT surgeons. To evaluate surgical performance, level of quality (LOQ) in the 89 cases of FESS was determined, comparing the surgeon's own impressions with those of the navigation system on a scale from 0 to 100 and further comparing them with clinical results. Intraoperative changes in surgical strategy were documented. The human factors of total confidence (trust), situation awareness, skill set requirement and workload shift were recorded as level of reliance (LOR). RESULTS: The maximum deviation amounted to 1.93 mm. Averaging the quality of information resulted in an LOQ of 63.59. Every second application of the navigation system (47.9%) led to a change in surgical strategy. Total confidence showed a positive evaluation of 3.35 points in LOR. CONCLUSION: Application-relevant information relevant to the application beyond only technical details permits comparison with other assisting systems.

HUMEX, a study on the survivability and adaptation of humans to long-duration exploratory missions, part I: lunar missions.

The European Space Agency has recently initiated a study of the human responses, limits and needs with regard to the stress environments of interplanetary and planetary missions. Emphasis has been laid on human health and performance care as well as advanced life support developments including bioregenerative life support systems and environmental monitoring. The overall study goals were as follows: (i) to define reference scenarios for a European participation in human exploration and to estimate their influence on the life sciences and life support requirements; (ii) for selected mission scenarios, to critically assess the limiting factors for human health, wellbeing, and performance and to recommend relevant countermeasures; (iii) for selected mission scenarios, to critically assess the potential of advanced life support developments and to propose a European strategy including terrestrial applications; (iv) to critically assess the feasibility of existing facilities and technologies on ground and in space as testbeds in preparation for human exploratory missions and to develop a test plan for ground and space campaigns; (v) to develop a roadmap for a future European strategy towards human exploratory missions, including preparatory activities and terrestrial applications and benefits. This paper covers the part of the HUMEX study dealing with lunar missions. A lunar base at the south pole where long-time sunlight and potential water ice deposits could be assumed was selected as the Moon reference scenario. The impact on human health, performance and well being has been investigated from the view point of the effects of microgravity (during space travel), reduced gravity (on the Moon) and abrupt gravity changes (during launch and landing), of the effects of cosmic radiation including solar particle events, of psychological issues as well as general health care. Countermeasures as well as necessary research using ground-based test beds and/or the International Space Station have been defined. Likewise advanced life support systems with a high degree of autonomy and regenerative capacity and synergy effects were considered where bioregenerative life support systems and biodiagnostic systems become essential. Finally, a European strategy leading to a potential European participation in future human exploratory missions has been recommended.

Monitoring of mental performance during spaceflight.

Mental performance of astronauts during spaceflight may suffer from both direct effects of microgravity on perceptual, cognitive, and psychomotor processes, and unspecific stress effects on these functions due to high workload sleep disturbances, or the general burden of adapting to the extreme living conditions in space. Early detection of any signs of mental performance impairments seems to be essential for mission success and to prevent obvious performance decrements in critical mission tasks. One possible approach to this problem is to assess the astronaut's performance on specific screening tests repeatedly during a space mission and to compare the results with a self-referenced baseline established pre-flight. The selection of screening tests for this purpose should be guided by three different criteria: 1) their reliability; 2) their sensitivity (i.e., their power to reveal subtle mental performance changes induced by internal or external stressors during spaceflight); and 3) their diagnosticity (i.e., their capability to reveal the underlying processes that lead to these performance deficits). Based on a discussion of these theoretical issues, first attempts to monitor mental performance of astronauts during spaceflight by means of short-term laboratory tasks are reviewed. The results of these studies suggest that, in particular, perceptual-motor tasks (tracking) and tasks placing comparatively high demands on attentional processes (e.g., dual-tasks) represent sensitive monitoring measures. First studies on the diagnositicity of tracking performance decrements during spaceflight suggest that they reflect both microgravity-related changes in the sensory-motor system as well as unspecific stress-effects, with the former factor reflected primarily in tracking performance decrements during early adaptation to the microgravity environment.

Summary of research issues in monitoring of mental and perceptual-motor performance and stress in space.

This article describes the papers presented in the workshop that cover the monitoring of stress and perceptual-motor performance. Monitoring is necessary for early detection and intervention of individual and group stress, especially on long-term missions. Test batteries will need to be developed that provide diagnostic information about the cause of deficits so that countermeasures can be applied.

Impairments of manual tracking performance during spaceflight: more converging evidence from a 20-day space mission.

Studies of human performance during spaceflight have consistently revealed degradations of manual tracking performance in space. The present investigation analysed these performance decrements in more detail by applying frequency-response analyses of tracking performance. It was hypothesized that tracking impairments result from two factors: at an early adaptation phase in space they primarily reflect effects of microgravity on human visuo-motor processes, whereas later into the mission they are also caused by impairments of attentional processes induced by cumulative workload and fatigue. In order to investigate this hypothesis, performance of one cosmonaut in a first-order unstable tracking task was repeatedly assessed before, during and after a 20-day space mission. Single-case statistical analyses revealed the following effects: tracking performance declined at the first assessment in space and in two later inflight sessions compared to pre-flight baseline. Whereas the early tracking decrement was mainly due to an increase of the effective time-delay during tracking and accompanied by only minor changes of mood or workload, one of the later inflight impairments was due to an increase of effective time-delay, a decreased tracking gain, and an increase of tracking remnant, and both were associated with considerably higher workload ratings. This pattern of effects supports the two-factor hypothesis.

Changed visuomotor transformations during and after prolonged microgravity.

A series of step-tracking experiments was conducted before, during, and after a 3-week space mission to assess the effects of prolonged microgravity on a non-postural motor-control task. In- and post-flight accuracy was affected only marginally. However, kinematic analyses revealed a considerable change in the underlying movement dynamics: too-small force and, thus, too-low velocity in the first part of the movements was mainly compensated by lengthening the deceleration phase of the primary movement, so that accuracy was regained at its end. The observed in-flight decrements in peak velocity and peak acceleration point to an underestimation of mass, in agreement with the re-interpretation hypothesis of Bock et. al. Post-flight no reversals of the in-flight changes (negative aftereffects) were found. Instead, there was a general slowing down, which could be due to post-flight physical exhaustion.

Human performance during spaceflight.

NASA: The paper focuses on three different questions: (1) What attributes cause space to be an extreme environment for humans? (2) What do we know about mental performance during spaceflight? (3) What kinds of psychological countermeasures are currently applied and/or conceivable for prolonged spaceflight which might help maintain mental efficiency and stabilize the emotional state of astronauts? Topics discussed include stressors that originate in the space environment, stressors related to the space habitat and its life-support system, stressors related to the mission specific workload of astronauts, stressors that arise from the psychosocial situation in a space habitat, manual performance during spaceflight, and psychological countermeasures for prolonged spaceflight.^ieng

Mental performance during short-term and long-term spaceflight.

During the last years several attempts have been made to describe changes in the mental efficiency of astronauts during space missions by means of performance monitoring studies. These studies are characterized by repeated multivariate assessment of different functions of the human information-processing system. In the present paper, a first review of performance monitoring studies during short-term and long-term spaceflight is given. Despite the comparatively small number of studies, a fairly consistent pattern of effects can be derived: Whereas no or only slight impairments of elementary and complex cognitive functions or spatial processing were found in space, clear disturbances could be identified in visuo-motor tracking and dual-task performance. Both of these latter effects appear to be closely related to adaptation to altered gravity conditions. General issues of this strategy of research are discussed which concern the disentanglement of microgravity-related effects and unspecific stress effects on mental performance under conditions of spaceflight. In addition, possible mechanisms which may be responsible for tracking disturbances under microgravity are discussed, and some directions for future human performance research in space are outlined.

Joint NASA-ESA-DARA Study. Part three: effects of chronically elevated CO2 on mental performance during 26 days of confinement.

BACKGROUND: Short-term exposures to increased CO2 concentrations in breathing air up to 5% are assumed to have only negligible behavioral effects. In the present study it was examined to what extent prolonged exposures to moderately elevated levels of CO2 in the ambient air affect human performance. METHOD: During two phases of 26 d of confinement in a diving chamber a group of four subjects was exposed to two different levels of CO2 (0.7% and 1.2%). Cognitive, visuo-motor, and time-sharing performance were assessed repeatedly before, during, and after the exposure by means of a task battery including grammatical reasoning, memory search, unstable tracking, and dual tasks. In addition, subjective workload and mood ratings were collected. A second group of four subjects served as a control group who performed the different tasks on the same 26-d time schedule without being exposed to confinement and elevated CO2. RESULTS: During exposure to 0.7% CO2 only tracking performance was slightly disturbed compared with baseline levels, whereas performance of the control group remained stable. The time course of this effect suggested that it was related to chamber adaptation rather than to increased levels of CO2. During exposure to 1.2% CO2, tracking performance again was significantly impaired. In contrast to the lower exposure condition, the time course of this effect appeared to be related to the CO2 load and covaried with a loss of subjective alertness. CONCLUSIONS: The study indicates that at least visuomotor performance might be affected by CO2 concentrations in the ambient atmosphere as small as 1.2% if subjects are chronically exposed to these concentrations in a confined environment. The strength of these effects, however, does not appear to be of operational relevance.

Mental performance in extreme environments: results from a performance monitoring study during a 438-day spaceflight.

During their stay in a space habitat, astronauts are exposed to many different stressors that may entail detrimental effects on mood and performance. In order to monitor the effects of the space environment on different human information processing functions during an extraordinary long-term space mission, the cognitive. visuo-motor and time-sharing performance of one Russian cosmonaut was repeatedly assessed (29 times) during his 438-day stay in space. The performance tasks used were chosen from the AGARD-STRES battery and included grammatical reasoning, Sternberg memory-search, unstable tracking, and a dual-tasks consisting of unstable tracking with concurrent memory-search. In addition to performance assessment, several subjective ratings concerning mood and workload were collected. Comparisons of pre-flight, in-flight, post-flight and two follow-up assessments 6 months after the mission revealed, (1) no impairments of basic cognitive functions during the flight, (2) clear impairments of mood, feelings of raised workload, and disturbances of tracking performance and time-sharing during the first 3 weeks in space and the first 2 weeks after return to Earth, (3) an impressive stability of mood and performance during the second to fourteenth month in space, where mood and performance had returned to pre-flight baseline level, and (4) no long-lasting performance deficits at follow-up assessments. From these results it is concluded that the first 3 weeks of long-term spaceflights and the first 2 weeks back on Earth represent critical periods where adverse effects on attentional processes are to be expected, induced by the demands to adjust to the extreme environmental changes. The stability of mood and performance observed after successful adaptation to the space environment indicates that mental efficiency and emotional state can be maintained on a level as high as on Earth even during extraordinary long-term space missions.

Two-crew operations: stress and fatigue during long-haul night flights.

BACKGROUND: As part of a research program concerning legal aspects of two-pilot operations on long-haul routes, the purpose of the study was to investigate two-crew extended range operations during a flight roster with two consecutive night flights and a short layover. HYPOTHESIS: Present flight time regulations may not be adequate for two-crew minimum operations. METHODS: The study was conducted in cooperation with a German airline company on the route Frankfurt (FRA)-Mahe (SEZ). There were 11 rotations (22 flights) that were investigated by pre-, in- and post-flight data collection each time from the two pilots. Recordings included sleep, taskload, fatigue and stress by measurement of EEG, ECG, motor activity, and subjective ratings. The average actual flight times were 9:15 h (FRA-SEZ) and 9:53 h (SEZ-FRA). All flights took place at night. The layover duration in Mahe was 13:30 h during day-time. RESULTS: During layover, sleep was shortened by 2 h on average compared with 8-h baseline sleep. The two consecutive night duties resulted in a sleep loss of 9.3 h upon return to home base. Inflight ratings of taskload showed moderate grades, but for fatigue ratings an increasing level was observed. Fatigue was more pronounced during the return flight and several pilots scored their fatigue at a critical level. Motor activity, brainwave activity (occurrences of micro-events) and heart rate indicated drowsiness and a low state of vigilance and alertness during both night flights, but these effects were more pronounced during the second flight. CONCLUSIONS: From the findings it is concluded that a duty roster, as conducted in this study, may impose excessive demands on mental and physiological capacity.

Performance and brain electrical activity during prolonged confinement.

A subset of the AGARD-STRES battery including memory search, unstable tracking, and a combination of both tasks (dual-task), was applied repeatedly to the four chamber crew members before, during, and after the 60-day isolation period of EXEMSI. Five ground control group members served as a control group. A subjective state questionnaire was also included. The results were subjected to a quantitative single-subject analysis. Electroencephalograms (EEG) were recorded to permit correlation of changes in task performance with changes in the physiological state. Evaluation of the EEG focused on spectral parameters of spontaneous EEG waves. No physiological data were collected from the control group. Significant decrements in tracking ability were observed in the chamber crew. The time course of these effects followed a triphasic pattern with initial deterioration, intermediate recovery to pre-isolation baseline scores after the first half of the isolation period, and a second deterioration towards the end. None of the control group subjects displayed such an effect. Memory search (speed and accuracy) was only occasionally impaired during isolation, but the control group displayed a similar pattern of changes. It is suggested that a state of decreased alertness causes tracking deterioration, which leads to a reduced efficiency of sustained cue utilization. The assumption of low alertness was further substantiated by higher fatigue ratings by the chamber crew compared to those of the control group. Analysis of the continuous EEG recordings revealed that only two subjects produced reliable alpha wave activity (8-12 Hz) over Pz and, to a much smaller extent, Fz-theta wave activity (5-7 Hz) during task performance. In both subjects Pz-alpha power decreased consistently under task conditions involving single-task and dual-task tracking. Fz-theta activity was increased more by single-task and dual-task memory search than by single-task tracking. The alpha attenuation appears to be associated with an increasing demand on perceptual cue utilization required by the tracking performance. In one subject marked attenuation of alpha power occurred during the first half of the confinement period, where he also scored the highest fatigue ratings. A striking increase in fronto-central theta activity was observed in the same subject after six weeks of isolation. The change was associated with an efficient rather than a degraded task performance, and a high rating of the item "concentrated" and a low rating of the item "fatigued." This finding supports the hypothesis that the activation state associated with increased fronto-central theta activity accompanies efficient performance of demanding mental tasks. The usefulness of standardized laboratory tasks as monitoring instruments is demonstrated by the direct comparability with results of studies obtained from other relevant research applications using the same tasks. The feasibility of a self-administered integrated psychophysiological assessment of the individual state was illustrated by the nearly complete collection of data. The large number of individual data collected over the entire period permitted application of quantitative single-subject analysis, allowing reliable determination of changes in the individual state in the course of time. It thus appears that this assessment technique can be adapted for in-flight monitoring of astronauts during prolonged spaceflights. Parallel EEG recording can provide relevant supplementary information for diagnosing the individual activation state associated with task performance. The existence of large individual differences in the generation of task-sensitive EEG rhythms forms an important issue for further studies.

Dual-task performance in space: results from a single-case study during a short-term space mission.

During spaceflights, astronauts are exposed to many stressors (e.g., microgravity, confinement) that may impair human information-processing capabilities. In order to analyze the possible effects of the space environment on human time-sharing efficiency, a single-case experiment was conducted in which the time course of dual-task performance (unstable tracking with concurrent memory search) of one space crew member was monitored repeatedly (13 times) throughout an 8-day space mission. Tasks were taken from the Advisory Group for Aerospace Research and Development battery of Standardized Tests for Research with Environmental Stressors. Comparisons of in-flight, preflight, and postflight performance revealed no decrements in single-task memory search performance but did reveal clear impairments in single-task tracking and dual-task performance. From these results we conclude that psychomotor processes and higher attentional functions are particularly prone to disturbance effects in space.

Psychological countermeasures for extended manned spaceflights.

NASA: The authors examine psychological issues and countermeasures in extended space flight. Individual-oriented pre-flight countermeasures include basic psychological selection and training of astronaut candidates. Crew-oriented pre-flight countermeasures include crew composition based on psychological compatibility and psychological mission preparation. Psychological inflight support measures include those that address the emotional state and well-being of astronauts, performance efficiency, and prevention of task overload. Suggestions for an integrated approach to psychological countermeasures for extended flights are presented. Case reports examine psychological selection and training of German astronauts in preparation for the STS-55 mission.^ieng