A Comparison of Night Hazard Detection between Younger and Older Drivers under Driving Simulation and Real-World Conditions.

''Using eye-tracking technology, this study examined hazard detection at night. Using a 2 (younger versus older) x 2 (simulator versus on road) repeated-measures mixed design, 16 older adults and 17 younger adults drove their own vehicle and on a driving simulator under nighttime conditions wearing eye tracking technology. Both driving conditions had three roadway hazards of pedestrians looking at their cell phone while posed to cross the roadway. Pupil glances were recorded using outcome measures of total fixation duration, number of fixations, and time to first fixation. Results showed older adults detected hazards similarly to younger adults, especially during on-road performance. Night hazard detection was similar across driving conditions except for time to first fixation, which was faster on-road for both age groups. Results support potential use of driving simulators as a proxy for on-road with night driving needed for research and practice.

A Case for Raising the Camera: A Driving Simulator Test of Camera-Monitor Systems.

OBJECTIVE: This experiment provides a first-of-its-kind driving-simulator study to investigate the feasibility of camera-monitor systems (CMS) with displaced side-mounted cameras in sedans. BACKGROUND: Among the increasing number of studies investigating the replacement of side-mounted rearview mirrors with CMS, the placement of side-mounted cameras has been largely neglected. Moreover, user preferences with respect to camera placement have not been validated in a driving simulator. Past research merely has shown that the vertical camera position can affect distance perception. METHOD: In a driving simulator experiment, we investigated the effects of rearward camera placement on driver acceptance and performance. Thirty-six participants performed multiple lane changes in a last safe-gap paradigm. The camera position, ego-velocity, and velocity of the approaching vehicle varied across the experiment. RESULTS: The results suggest a clear preference for a high rearward perspective, whereas participants disliked the lower viewpoint. However, these stark differences were only marginally mirrored in lane change performance. Average safety margins tended to decrease and their variation tended to increase for the low camera position. CONCLUSION: Even if the impact of the camera position on driving behavior seems to be small in sedans, driver expectations show clear-cut preferences. When designing CMS, this should be taken into account, as these preferences could promote the use of CMS and thus their positive impact on safety. APPLICATION: Designers should place side-mounted cameras as high as possible to increase acceptance of CMS. Low camera positions are not recommended, as they might decrease safety margins and are not appreciated by drivers.

Visual Complexity of Head-Up Display in Automobiles Modulates Attentional Tunneling.

OBJECTIVE: To investigate how the visual complexity of head-up displays (HUDs) influence the allocation of driver's attention in two separate visual domains (near and far domains). BACKGROUND: The types and amount of information displayed on automobile HUDs have increased. With limited human attention capacity, increased visual complexity in the near domain may lead to interference in the effective processing of information in the far domain. METHOD: Near-domain and far-domain vision were separately tested using a dual-task paradigm. In a simulated road environment, 62 participants were to control the speed of the vehicle (SMT; near domain) and manually respond to probes (PDT; far domain) simultaneously. Five HUD complexity levels including a HUD-absent condition were presented block-wise. RESULTS: Near domain performance was not modulated by the HUD complexity levels. However, the far domain detection accuracies were impaired as the HUD complexity level increased, with greater accuracy differences observed between central and peripheral probes. CONCLUSION: Increased HUD visual complexity leads to a biased deployment of driver attention toward the central visual field. Therefore, the formulation of HUD designs must be preceded by an in-depth investigation of the dynamics of human cognition. APPLICATION: To ensure driving safety, HUD designs should be rendered with minimal visual complexity by incorporating only essential information relevant to driving and removing driving-irrelevant or additional visual details.

Simulator evaluation of an intersection maneuver assist system with connected and automated vehicle technologies.

Intersection crashes can be potentially mitigated through vehicle-to-infrastructure (V2I) and vehicle-to-vehicle (V2V) safety management systems. It is important, however, to consider some of the human factors related aspects of such systems to maximise potential safety benefits. In this study, Intersection Manoeuvre Assistance Systems were conceptualised and evaluated in a driving simulator. The systems were designed to assist drivers with intersection manoeuvres by making use of connected infrastructure and providing real-time feedback, guidance, and active vehicle controls. The study compared drivers' confidence, workload, glances at the instrument panel, and hazard anticipation when driving using three systems-System A (no alert or assist); System B (alert only); and System C (alert and assist). Study results show differences in drivers' confidence in such systems and potentially degraded visual gaze behaviours.Practitioner summary: Connected infrastructure-based intersection management assistance systems can potentially reduce crashes. This experimental driving simulation study evaluated drivers' perceptions and reactions to intersection management systems. Results indicate reduced confidence in automated systems, reduced visual scanning for external hazards at intersections, and increased off-road glances towards the instrument panel.

Effectiveness of a time to fixate for fitness to drive evaluation in neurological patients.

We present a method to automatically calculate time to fixate (TTF) from the eye-tracker data in subjects with neurological impairment using a driving simulator. TTF presents the time interval for a person to notice the stimulus from its first occurrence. Precisely, we measured the time since the children started to cross the street until the drivers directed their look to the children. From 108 neurological patients recruited for the study, the analysis of TTF was performed in 56 patients to assess fit-, unfit-, and conditionally-fit-to-drive patients. The results showed that the proposed method based on the YOLO (you only look once) object detector is efficient for computing TTFs from the eye-tracker data. We obtained discriminative results for fit-to-drive patients by application of Tukey's honest significant difference post hoc test (p < 0.01), while no difference was observed between conditionally-fit and unfit-to-drive groups (p = 0.542). Moreover, we show that time-to-collision (TTC), initial gaze distance (IGD) from pedestrians, and speed at the hazard onset did not influence the result, while the only significant interaction is among fitness, IGD, and TTC on TTF. Obtained TTFs are also compared with the perception response times (PRT) calculated independently from eye-tracker data and YOLO. Although we reached statistically significant results that speak in favor of possible method application for assessment of fitness to drive, we provide detailed directions for future driving simulation-based evaluation and propose processing workflow to secure reliable TTF calculation and its possible application in for example psychology and neuroscience.

Simulated driving in the epilepsy monitoring unit: Effects of seizure type, consciousness, and motor impairment.

People with epilepsy face serious driving restrictions, determined using retrospective studies. To relate seizure characteristics to driving impairment, we aimed to study driving behavior during seizures with a simulator. Patients in the Yale New Haven Hospital undergoing video-electroencephalographic monitoring used a laptop-based driving simulator during ictal events. Driving function was evaluated by video review and analyzed in relation to seizure type, impairment of consciousness/responsiveness, or motor impairment during seizures. Fifty-one seizures in 30 patients were studied. In terms of seizure type, we found that focal to bilateral tonic-clonic or myoclonic seizures (5/5) and focal seizures with impaired consciousness/responsiveness (11/11) always led to driving impairment; focal seizures with spared consciousness/responsiveness (0/10) and generalized nonmotor (generalized spike-wave bursts; 1/19) usually did not lead to driving impairment. Regardless of seizure type, we found that seizures with impaired consciousness (15/15) or with motor involvement (13/13) always led to impaired driving, but those with spared consciousness (0/20) or spared motor function (5/38) usually did not. These results suggest that seizure types with impaired consciousness/responsiveness and abnormal motor function contribute to impaired driving. Expanding this work in a larger cohort could further determine how results with a driving simulator may translate into real world driving safety.

Booster Dose of Attention Training Program for Young Novice Drivers: A Longitudinal Driving Simulator Evaluation Study.

OBJECTIVE: We examined the effectiveness of a second exposure to ACCEL, a novel driving training program, on latent hazard anticipation (HA) performance several months after their first exposure. BACKGROUND: Past research has demonstrated that PC-based driver training programs can improve latent HA performance in young novice drivers, but these improvements are below the ceiling level. METHOD: Twenty-five participants were randomly assigned to either the Placebo group, the ACCEL-1 group, or the ACCEL-2 group. Following the completion of the assigned training program, participants drove a series of eighteen scenarios incorporating latent hazards in a high-fidelity driving simulator with their eyes tracked. Participants returned two to six months following the first session and completed either the placebo program (ACCEL-1 and Placebo groups), or a second dose of training program (ACCEL-2 group), again followed by simulated evaluation drives. RESULTS: The ACCEL-2 group showed improved HA performance compared to the ACCEL-1 and Placebo groups in the second evaluation. CONCLUSION: ACCEL enhances young novice drivers' latent HA performance. The effectiveness of ACCEL is retained up to 6 months, and a second dose further improves HA performance. APPLICATION: Policy makers should consider requiring such training before the completion of graduate driver license programs. Young novice drivers that do not show successful latent HA performance could be required to complete additional training before being allowed to drive without restrictions.

Rater-Reliability of Assessing Driving Errors with a DriveSafety 250 Simulator.

This study aimed to establish inter-rater reliability among three raters while training new driver rehabilitation specialists to correctly identify driving errors on a DriveSafety 250 driving simulator. Five participants completed adaptation, residential and suburban, and city and highway scenarios. Intraclass correlation coefficients indicated scores between .623-.877 (p = .003-.122) for the total driving errors recorded in the two scenario drives with rater agreement initially ranging between 7-8%. When analyzing the data for types of driving errors, the intraclass correlation coefficients ranged from .556-.973 (p < .05) and rater agreement between 15-100%. Through proper training and strategy development, raters reached 100% consensus on all aspects of inter-rater reliability while assessing driving errors.

Effects of surgery for obstructive sleep apnea on cognitive function and driving performance.

BACKGROUND: Obstructive sleep apnea (OSA) is associated with a significantly increased risk of motor vehicle accidents in addition to such cognitive impairments as attention and memory deficits. The aim of the study was to examine the effect of upper airway surgery for OSA on driving and cognitive function. METHODS: Adult patients who underwent surgery for OSA at a tertiary medical center in 2016-2019 were prospectively recruited. Patients were assessed before and 3-6 months after surgery with a self-report and neurocognitive battery and a driving simulation platform. RESULTS: The cohort included 32 patients of average age 46.9 ± 11.6 years. During the 3 years before treatment, 9 patients had been involved in road accidents and 18 were detained by police for traffic violations. After surgery, there was a significant decrease in the Epworth Sleepiness Scale (13.7 vs. 8.1, p 0.043) and a significant reduction in time to completion of the Color Trail Test (part 1: 21.4 vs 18.7 s, p = 0.049; part 2: 46.8 vs 40.5 s, p = 0.038). Improvements in divided attention and selective attention response times were noted on the advanced stages of the Useful Field of Vision Scale (p = 0.013, p = 0.054). Before surgery, patients showed a high tendency to drive over the speed limit and to cross the dividing line to the opposite lane on the simulation test. Nevertheless, all considered themselves good drivers. These tendencies decreased after treatment. CONCLUSIONS: Surgery for OSA can significantly improve driving performance and cognitive function.

Automatic processing of gaze movements to quantify gaze scanning behaviors in a driving simulator.

Eye and head movements are used to scan the environment when driving. In particular, when approaching an intersection, large gaze scans to the left and right, comprising head and multiple eye movements, are made. We detail an algorithm called the gaze scan algorithm that automatically quantifies the magnitude, duration, and composition of such large lateral gaze scans. The algorithm works by first detecting lateral saccades, then merging these lateral saccades into gaze scans, with the start and end points of each gaze scan marked in time and eccentricity. We evaluated the algorithm by comparing gaze scans generated by the algorithm to manually marked "consensus ground truth" gaze scans taken from gaze data collected in a high-fidelity driving simulator. We found that the gaze scan algorithm successfully marked 96% of gaze scans and produced magnitudes and durations close to ground truth. Furthermore, the differences between the algorithm and ground truth were similar to the differences found between expert coders. Therefore, the algorithm may be used in lieu of manual marking of gaze data, significantly accelerating the time-consuming marking of gaze movement data in driving simulator studies. The algorithm also complements existing eye tracking and mobility research by quantifying the number, direction, magnitude, and timing of gaze scans and can be used to better understand how individuals scan their environment.

How visual information influences dual-task driving and tracking.

The study examined the impact of visual predictability on dual-task performance in driving and tracking tasks. Participants (N = 27) performed a simulated driving task and a pursuit tracking task. In either task, visual predictability was manipulated by systematically varying the amount of advance visual information: in the driving task, participants drove at night with low beam, at night with high beam, or in daylight; in the tracking task, participants saw a white line that specified the future target trajectory for 200, 400 or 800 ms. Concurrently with driving or tracking, participants performed an auditory task. They had to discriminate between two sounds and press a pedal upon hearing the higher sound. Results show that in general, visual predictability benefited driving and tracking; however, dual-task driving performance was best with highest visual predictability (daylight), dual-task tracking performance was best with medium visual predictability (400 ms). Braking/reaction times were higher in dual tasks compared to single tasks, but were unaffected by visual predictability, showing that its beneficial effects did not transfer to the auditory task. In both tasks, manual accuracy decreased around the moment the foot pressed the pedal, indicating interference between tasks. We, therefore, conclude that despite a general beneficial impact of predictability, the integration of visual information seems to be rather task specific, and that interference between driving and audiomotor tasks, and tracking and audiomotor tasks, seems comparable.

The effect of cannabidiol on simulated car driving performance: A randomised, double-blind, placebo-controlled, crossover, dose-ranging clinical trial protocol.

OBJECTIVE: Interest in the use of cannabidiol (CBD) is increasing worldwide as its therapeutic effects are established and legal restrictions moderated. Unlike Δ9 -tetrahydrocannabinol (Δ9 -THC), CBD does not appear to cause cognitive or psychomotor impairment. However, further assessment of its effects on cognitively demanding day-to-day activities, such as driving, is warranted. Here, we describe a study investigating the effects of CBD on simulated driving and cognitive performance. METHODS: Thirty healthy individuals will be recruited to participate in this randomised, double-blind, placebo-controlled crossover trial. Participants will complete four research sessions each involving two 30-min simulated driving performance tests completed 45 and 210 min following oral ingestion of placebo or 15, 300, or 1,500 mg CBD. Cognitive function and subjective drug effects will be measured, and blood and oral fluid sampled, at regular intervals. Oral fluid drug testing will be performed using the Securetec DrugWipe® 5S and Dräger DrugTest® 5000 devices to determine whether CBD increases the risk of "false-positive" roadside tests to Δ9 -THC. Noninferiority analyses will test the hypothesis that CBD is no more impairing than placebo. CONCLUSION: This study will clarify the risks involved in driving following CBD use and assist in ensuring the safe use of CBD by drivers.

Inside the clinical evaluation of sleepiness: subjective and objective tools.

PURPOSE: To critically review the available tools for evaluating excessive daytime sleepiness (EDS) in clinical practice. METHODS: Objective tests and subjective scales were divided into three groups in accordance with the different dimensions of sleepiness they measure, namely physiological, manifest, and introspective. Strengths, weaknesses, and limitations of each test have been analysed and discussed along with the available recommendations for their use in clinical practice. RESULTS: The majority of the tests developed for sleepiness evaluation do not have practical usefulness outside the research setting. The suboptimal correlation between different tests mainly depends on the different dimensions of sleepiness they analyse. Most importantly in-laboratory tests poorly correlate with sleepiness in real-life situations and, to date, none is able to predict the risk of injuries related to EDS, especially on an individual level. CONCLUSIONS: There exists not the one best test to assess EDS, however, clinicians can choose a more specific test to address a specific diagnostic challenge on the individual level. The development of novel performance tests with low cost and easy to administer is advisable for both screening purposes and fitness for duty evaluations in populations at high risk of EDS-related injuries, for example professional drivers.

Event-Related Electrodermal Response to Stress: Results From a Realistic Driving Simulator Scenario.

OBJECTIVE: The study goal was to test whether induced stress during driving could be measured at the event level through electrodermal activity responses. BACKGROUND: Stress measured in simulation scenarios could thus far show an overall change in the stress state, but not be well attributed to acute stressful events. Driving simulator scenarios that induce stress measurable at the event level in realistic situations are thus warranted. As such, acute stress reactions can be measured in the context of changing situational factors such as fatigue, substance abuse, or medical conditions. METHOD: Twelve healthy female participants drove the same route numerous times in a driving simulator, each time with different random traffic events occurring throughout. During one of the scenarios, unknown to the participants, 10 programmed neutral traffic events occurred, whereas in another scenario, at the same location, 10 stressful events occurred. RESULTS: Electrodermal response results showed both effects of scenario type and of events. The amplitude of the electrodermal response was significantly correlated with subjective stress experience. CONCLUSION: We conclude that our developed ecological driving simulation scenarios can be used to induce and measure stress at the event level. APPLICATION: The developed simulator scenarios enable us to measure stress reactions in driving situations at the time when the event actually happens. With these scenarios, we can measure how situational factors, such as fatigue or substance abuse, can change immediate stress reactions when driving. We can further measure more specifically how induced driving stress can affect physical and mental functioning afterward.

The effects of age on the contributions of head and eye movements to scanning behavior at intersections.

The current study was aimed at evaluating the effects of age on the contributions of head and eye movements to scanning behavior at intersections. When approaching intersections, a wide area has to be scanned requiring large lateral head rotations as well as eye movements. Prior research suggests older drivers scan less extensively. However, due to the wide-ranging differences in methodologies and measures used in prior research, the extent to which age-related changes in eye or head movements contribute to these deficits is unclear. Eleven older (mean 67 years) and 18 younger (mean 27 years) current drivers drove in a simulator while their head and eye movements were tracked. Scans, analyzed for 15 four-way intersections in city drives, were split into two categories: eye-only (consisting only of eye movements) and head+eye (containing both head and eye movements). Older drivers made smaller head+eye scans than younger drivers (46.6° vs. 53°), as well as smaller eye-only scans (9.2° vs. 10.1°), resulting in overall smaller all- gaze scans. For head+eye scans, older drivers had both a smaller head and a smaller eye movement component. Older drivers made more eye-only scans than younger drivers (7 vs. 6) but fewer head+eye scans (2.1 vs. 2.7). This resulted in no age effects when considering all-gaze scans. Our results clarify the contributions of eye and head movements to age-related deficits in scanning at intersections, highlight the importance of analyzing both eye and head movements, and suggest the need for older driver training programs that emphasize the importance of making large scans before entering intersections.

How sleep problems contribute to simulator sickness: Preliminary results from a realistic driving scenario.

Virtual reality and simulation tools enable us to assess daytime functioning in environments that simulate real life as close as possible. Simulator sickness, however, poses a problem in the application of these tools, and has been related to pre-existing health problems. How sleep problems contribute to simulator sickness has not yet been investigated. In the current study, 20 female chronic insomnia patients and 32 female age-matched controls drove in a driving simulator covering realistic city, country and highway scenes. Fifty percent of the insomnia patients as opposed to 12.5% of controls reported excessive simulator sickness leading to experiment withdrawal. In the remaining participants, patients with insomnia showed overall increased levels of oculomotor symptoms even before driving, while nausea symptoms further increased after driving. These results, as well as the realistic simulation paradigm developed, give more insight on how vestibular and oculomotor functions as well as interoceptive functions are affected in insomnia. Importantly, our results have direct implications for both the actual driving experience and the wider context of deploying simulation techniques to mimic real life functioning, in particular in those professions often exposed to sleep problems.

Driving status of patients with generalized spike-wave on EEG but no clinical seizures.

Generalized spike-wave discharges (SWDs) are the hallmark of generalized epilepsy on the electroencephalogram (EEG). In clinically obvious cases, generalized SWDs produce myoclonic, atonic/tonic, or absence seizures with brief episodes of staring and behavioral unresponsiveness. However, some generalized SWDs have no obvious behavioral effects. A serious challenge arises when patients with no clinical seizures request driving privileges and licensure, yet their EEG shows generalized SWD. Specialized behavioral testing has demonstrated prolonged reaction times or missed responses during SWD, which may present a driving hazard even when patients or family members do not notice any deficits. On the other hand, some SWDs are truly asymptomatic in which case driving privileges should not be restricted. Clinicians often decide on driving privileges based on SWD duration or other EEG features. However, there are currently no empirically-validated guidelines for distinguishing generalized SWDs that are "safe" versus "unsafe" for driving. Here, we review the clinical presentation of generalized SWD and recent work investigating mechanisms of behavioral impairment during SWD with implications for driving safety. As a future approach, computational analysis of large sets of EEG data during simulated driving utilizing machine learning could lead to powerful methods to classify generalized SWD as safe vs. unsafe. This may ultimately provide more objective EEG criteria to guide decisions on driving safety in people with epilepsy.

Lessons Learned: Gastric Motility Assessment During Driving Simulation.

In the era of technological advances and innovations in transportation technologies, application of driving simulators for the investigation and assessment of the driving process provides a safe and suitable testing environment. Although driving simulators are crucial for further improvements in transportation, it is important to resolve one of their main disadvantages-simulator sickness. Therefore, suitable methods for the assessment of simulator sickness are required. The main aim of this paper was to present a non-invasive method for assessing simulator sickness by recording gastric myoelectrical activity-electrogastrography. Open-source hardware for electrogastrography together with recordings obtained in 13 healthy volunteers is presented, and the main aspects of signal processing for artifact cancellation and feature extraction were discussed. Based on the obtained results, it was concluded that slow-wave electrical gastric activity can be recorded during driving simulation by following adequate recommendations and that proposed features could be beneficial in describing non-ordinary electrogastrography signals.

Effects of Visually Induced Motion Sickness on Emergency Braking Reaction Times in a Driving Simulator.

OBJECTIVE: The study explores associations of visually induced motion sickness (VIMS) with emergency braking reaction times (RTs) in driving simulator studies. It examines the effects over the progression of multiple simulated drives. BACKGROUND: Driving simulator usage has many advantages for RT studies; however, if it induces VIMS, the observed driving behavior might deviate from real-world driving, potentially masking or skewing results. Possible effects of VIMS on RT have long been entertained, but the progression of VIMS across simulated drives has so far not been sufficiently considered. METHOD: Twenty-eight adults completed six drives on 2 days in a fixed-base driving simulator. At five points during each drive, pedestrians entered the road, necessitating emergency braking maneuvers. VIMS severity was assessed every minute using the 20-point Fast Motion Sickness Scale. The progression of VIMS was considered in mixed model analyses. RESULTS: RT predictions were improved by considering VIMS development over time. Here, the relationship of VIMS and RT differed across days and drives. Increases in VIMS symptom severity predicted more prolonged RT after repeated drives on a given day and earlier within each drive. CONCLUSION: The assessment of VIMS in RT studies can be beneficial. In this context, VIMS measurements in close temporal proximity to the behaviors under study are promising and offer insights into VIMS and its consequences, which are not readily obtainable through questionnaires. APPLICATION: Driving simulator-based RT studies should consider cumulative effects of VIMS on performance. Measurement and analysis strategies that consider the time-varying nature of VIMS are recommended.

The effects of simulated acuity and contrast sensitivity impairments on detection of pedestrian hazards in a driving simulator.

Driving is a highly visual task, yet the vision requirements for driving licensure vary widely. All US states have a threshold for visual acuity (e.g. most use 20/40 for an unrestricted license). Contrast sensitivity (CS) is not measured for licensure, despite evidence that it may be a better predictor of crash risk than visual acuity (VA). Two experiments were conducted to investigate how simulated reductions in VA and CS affect the detection of pedestrians in a driving simulator during the daytime in a highway setting. Young normally-sighted current drivers wore goggles simulating different levels of VA and CS loss (within a range that would meet licensing criteria) and pressed the horn as soon as they saw a pedestrian. The proportion of pedestrians detected and driving speed was not different between the conditions. Reducing VA alone did not significantly reduce reaction time or the deceleration needed to stop before the collision point. However, adding a CS loss to a VA deficit increased both reaction time and the deceleration required to stop before the collision point. These results suggest that an individual's CS should be considered when determining visual fitness to drive, especially in the early stages of ocular disease, such as cataract, where CS may be impaired while high contrast VA is still relatively unimpaired.