Aerospace medicine and human performance最新文献

{"title":"Performance of Fluid Infusion Systems in the Changing Atmospheric Pressures Encountered in Aviation.","authors":"Ka Siu Fan, Megan Paterson, Fariba Shojaee-Moradie, Antonios Manoli, Victoria Edwards, Vivienne Lee, Ewan Hutchison, Robert M Gifford, Iain T Parsons, Gerd Koehler, Chantal Mathieu, Julia K Mader, Bruce R King, David Russell-Jones, Easa Consortium","doi":"10.3357/AMHP.6477.2024","DOIUrl":"https://doi.org/10.3357/AMHP.6477.2024","url":null,"abstract":"<p><strong>Introduction: </strong>With the increasing use of aeromedical transport for critically ill patients, it is essential to understand the impact of pressure changes on drug infusion delivery systems. As airplanes ascend and descend, gases/bubbles are released from solutions when ambient pressure decreases and dissolves when pressure increases. This may affect mechanical fluid delivery systems and cause clinically significant changes, especially within a critical care setting. We aimed to evaluate the impact of pressure changes on volumetric pumps and syringe drivers.</p><p><strong>Methods: </strong>An in vitro study of six volumetric pumps and eight syringe drivers was conducted in a hypobaric chamber to mimic pressure changes during flights. Infusion devices were set to deliver water at 0.2 ml ⋅ h-1 and infused volumes were measured. There were 15 open-ended syringes also studied.</p><p><strong>Results: </strong>During ascent, syringe drivers and volumetric pumps over-delivered 173 µL and 38 µL of fluid. During descent, syringe drivers under-delivered by 166 µL, whereas volumetric pumps under-delivered by 9 µL. Syringe drivers experienced statistically significant changes in fluid delivery during both ascent and descent. In volumetric pumps, only the descent phase infusion differed significantly from other phases. The volume of fluid expansion is dependent on volume and the mechanical properties of the fluid.</p><p><strong>Discussion: </strong>Decreasing ambient pressure causes bubble formation, which displaces fluid, and increasing ambient pressure causes bubble reabsorption in mechanical infusion devices. Hence, atmospheric pressure changes during air travel may alter fluid delivery from medical fluid delivery systems and affect critically ill patients who require both aeromedical evacuation and accurate infusion of drugs. Fan KS, Paterson M, Shojaee-Moradie F, Manoli A, Edwards V, Lee V, Hutchison E, Gifford RM, Parsons IT, Koehler G, Mathieu C, Mader JK, King BR, Russell-Jones D; EASA Consortium. Performance of fluid infusion systems in the changing atmospheric pressures encountered in aviation. Aerosp Med Hum Perform. 2025; 96(1):4-11.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"96 1","pages":"4-11"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professionalism in Aerospace Medicine.","authors":"Robert Orford","doi":"10.3357/AMHP.9601PP.2024","DOIUrl":"https://doi.org/10.3357/AMHP.9601PP.2024","url":null,"abstract":"","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"96 1","pages":"2-3"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abating Heat Accrual During Exercise in Microgravity and Implications for Future Long-Term Missions.","authors":"Katherine Maguire, Margaret Wydotis, Lance Bollinger, John Caruso","doi":"10.3357/AMHP.6536.2024","DOIUrl":"https://doi.org/10.3357/AMHP.6536.2024","url":null,"abstract":"<p><strong>Introduction: </strong>Space agencies will embark on manned journeys to Mars on smaller vehicles than those used previously. In-flight exercise on those flights must abate the adverse effects microgravity (μG) has on humans. Due to space constraints on these vehicles, a single exercise device must address multiple fitness needs. Exercise and μG individually cause body heat accrual. During in-flight exercise they conspire to exacerbate heat gain. Given the duration of Mars missions and volume of exercise they entail, excess heat accrual must be addressed.</p><p><strong>Methods: </strong>This review presents data on μG, thermoregulation, and exercise. Since their relationships are impacted by other variables, energy balance, body water, and cerebral and vascular physiology are discussed. Data are integrated to acknowledge the challenges long-term missions, and the in-flight exercise that accompanies them, impose on thermoregulation. Strategies to limit heat accrual are discussed.</p><p><strong>Results: </strong>Current in-flight exercise and hardware will not address heat accrual mitigation or operational performance needs for Mars missions.</p><p><strong>Discussion: </strong>This review suggests for future missions, crewmembers: 1) consume beverages with high sodium contents; 2) employ palm cooling for conductive heat transfer; and 3) perform plyometric exercise on gravity-independent hardware. Research should continue to evaluate these treatments to abate heat gain in μG. Maguire K, Wydotis M, Bollinger L, Caruso J. Abating heat accrual during exercise in microgravity and implications for future long-term missions. Aerosp Med Hum Perform. 2025; 96(1):53-61.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"96 1","pages":"53-61"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Factors Associated with Insomnia and Sleep Apnea in U.S. Military Aviators, 2006-2022.","authors":"John A Caldwell, Joseph J Knapik","doi":"10.3357/AMHP.6524.2024","DOIUrl":"https://doi.org/10.3357/AMHP.6524.2024","url":null,"abstract":"<p><strong>Introduction: </strong>Insomnia and sleep apnea (SA) can have adverse effects on operating aircraft. This study examined trends in insomnia and SA incidence rates in U.S. military aviators from 2006-2022 and examined associated demographic and operational factors.</p><p><strong>Methods: </strong>Data on incidence cases of outpatient insomnia and SA, aviator demographics, and operational factors were obtained from the Defense Medical Epidemiological Database, a comprehensive online archive of military medical data. Insomnia and SA cases were identified using specific International Classification of Diseases codes.</p><p><strong>Results: </strong>For the entire military aviator population (N = 331,992 ± 1649, mean ± SD) overall rates of insomnia and SA were 10.2 and 24.9 cases/1000 person-years, respectively. Compared to the entire U.S. military nonaviator population, aviators had lower incidence of insomnia, but higher incidence of SA. Insomnia rates among aviators increased up to 2015 and declined afterwards, while SA rate generally rose over the period. Insomnia and SA rates among aviators increased with age, were higher among those of black and other nonwhite races, were highest among Army personnel (compared to other services) and were highest among helicopter pilots (compared to fixed-wing aircraft pilots). Insomnia rates were similar among male and female aviators, but SA rates were higher among men.</p><p><strong>Discussion: </strong>These data indicate that insomnia and SA are prevalent within the military aviation population; however, the incidence of insomnia appears to have fallen as the tempo of military operations has decreased while the incidence of SA continues on an upward trajectory, possibly associated with the growing problem of obesity. Caldwell JA, Knapik JJ. Trends and factors associated with insomnia and sleep apnea in U.S. military aviators, 2006-2022. Aerosp Med Hum Perform. 2025; 96(1):23-30.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"96 1","pages":"23-30"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aeromedical Concerns in Asymptomatic Aviators with Left Bundle Branch Block.","authors":"Pei-Chun McGregor, Edwin Valencia Palileo, Jared Travis Haynes, Eddie Dean Davenport","doi":"10.3357/AMHP.6363.2024","DOIUrl":"https://doi.org/10.3357/AMHP.6363.2024","url":null,"abstract":"<p><strong>Introduction: </strong>Left bundle branch block (LBBB) is disqualifying for aircrew in the U.S. Air Force (USAF), although outcomes for these patients is limited. We used data from the USAF School of Aerospace Medicine to study this population.</p><p><strong>Methods: </strong>A retrospective review was performed on aircrew with LBBB identified using the Central Electrocardiographic Library database. Analysis included baseline participant demographics, cardiac risk factors, and any available cardiovascular results. Critical endpoints were coronary artery disease (CAD), cardiomyopathy (CM) (left ventricular ejection fraction of <50%) and/or clinical heart failure, and death from any cause.</p><p><strong>Results: </strong>At diagnosis: 271 patients met eligibility; mean age of 40.24 ± 7.39 yr. Of the 147 (54%) patients who had coronary angiography, 7 (2.6%) had aggregate stenosis 50-119% and 5 (1.8%) had aggregate stenosis ≥120%. Two patients underwent percutaneous coronary intervention, with an additional 13 (4.8%) patients demonstrating left ventricular ejection fraction of <50%; 12 were nonischemic. Longitudinal data was available for 177 (65%) patients; median follow-up was 10 yr (range 0-58 yr). During this period, 2 patients developed CAD with aggregate stenosis ≥120% and 5 had myocardial infarction. There were 37 (20%) patients who developed CM. Among 41 deaths, mean age was 75.1 ± 14.1 yr. Nine were premature (<60 yr).</p><p><strong>Discussion: </strong>Asymptomatic aviators with LBBB had elevated risk for CM (20%). Association with CAD exceeded 10% at 10 yr. Findings support current USAF policy requiring extensive cardiac evaluation and follow-up for LBBB. More prospective research is needed to validate these findings. McGregor P-C, Palileo EV, Haynes JT, Davenport ED. Aeromedical concerns in asymptomatic aviators with left bundle branch block. Aerosp Med Hum Perform. 2024; 95(12):902-907.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"95 12","pages":"902-907"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142875809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-Time Neurophysiological and Subjective Indices of Cognitive Engagement in High-Speed Flight.","authors":"Matthew D'Alessandro, Ryan Mackie, Tom Berger, Carl Ott, Christopher Sullivan, Ian Curry","doi":"10.3357/AMHP.6489.2024","DOIUrl":"https://doi.org/10.3357/AMHP.6489.2024","url":null,"abstract":"<p><strong>Introduction: </strong>Managing cognitive demand is critical for aviation safety. Yet, accurately assessing pilot workload during complex flight maneuvers remains challenging. This study evaluated an integrated methodology combining real-time cognitive engagement indicators to provide a comprehensive assessment and assess the reliability of physiological and subjective measures for monitoring operator state.</p><p><strong>Methods: </strong>Six experienced U.S. Army rotary-wing pilots completed simulated high-workload flight scenarios like low-altitude, reconnaissance, and air threat avoidance maneuvers. Continuous wireless electroencephalography (EEG), heart rate data, and subjective workload ratings were recorded during the flights.</p><p><strong>Results: </strong>EEG engagement indices and heart rate variability metrics demonstrated reliable within-subject consistency across trials for individual pilots, with mean intraclass correlation coefficient values ranging from 0.59-0.69. Both measures exhibited synchronized fluctuations across pilots at key events, increasing during high workload segments and decreasing in lower demand periods. Subjective ratings also showed good within-subject reliability, with mean intraclass correlation coefficient values ranging from 0.74-0.85. These findings underscore the reliability of our measurements, instilling confidence in the validity of our research.</p><p><strong>Discussion: </strong>The findings of this study provide strong support for the feasibility of using a multi-measure approach that integrates EEG, heart rate variability, and subjective ratings. This approach can continuously monitor real-time cognitive workload fluctuations during simulated rotary-wing operations. While objective measures showed within-subject consistency, substantial between-subject variability highlights the importance of individualized neurocognitive profiling. The integration of neurophysiological, autonomic, subjective, and environmental data holds great promise for the future of pilot workload assessment despite the challenges posed by individual differences. D'Alessandro M, Mackie R, Berger T, Ott C, Sullivan C, Curry I. Real-time neurophysiological and subjective indices of cognitive engagement in high-speed flight. Aerosp Med Hum Perform. 2024; 95(12):885-896.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"95 12","pages":"885-896"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142875899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Proposed Framework to Regulate Mental Health in Airline Pilots.","authors":"William R Hoffman, Anne Suh, Timothy Sprott, Kate Manderson, Quay Snyder, Malcolm Sparrow, Anthony Tvaryanas","doi":"10.3357/AMHP.6508.2024","DOIUrl":"https://doi.org/10.3357/AMHP.6508.2024","url":null,"abstract":"<p><strong>Introduction: </strong>The current regulatory approach to U.S. airline pilot mental health may have unintended negative consequences including healthcare avoidance and screening imprecision. An alternative approach should aim to address these factors while maintaining safety. The authors summarize the following related to mental health in U.S. airline pilots: 1) current regulatory approach and limitations, 2) available regulatory tools within the Sparrow fundamentals, and 3) a proposed novel regulatory approach. The authors propose the simultaneous utilization of multiple models to minimize the negative consequences of healthcare avoidance and screening imprecision. The proposed framework aims to address current limitations. Hoffman WR, Suh A, Sprott T, Manderson K, Snyder Q, Sparrow M, Tvaryanas A. A proposed framework to regulate mental health in airline pilots. Aerosp Med Hum Perform. 2024; 95(12):940-943.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"95 12","pages":"940-943"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142875803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor re: Clinical Significance of Mottling Rashes in Diving Decompression Sickness.","authors":"Simon Mitchell, Ilana Breen","doi":"10.3357/AMHP.6580.2024","DOIUrl":"https://doi.org/10.3357/AMHP.6580.2024","url":null,"abstract":"","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"95 12","pages":"945-946"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142875870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial Expression Perception and Psychological Changes During Space Analogs.","authors":"Scott Van Hoy","doi":"10.3357/AMHP.6504.2024","DOIUrl":"https://doi.org/10.3357/AMHP.6504.2024","url":null,"abstract":"<p><strong>Introduction: </strong>Facial expression perception is the process by which someone can interpret the emotion of another individual using their facial cues. Below-average scores on tests designed to measure facial expression recognition (FER) accuracies are associated with inappropriate behavioral responses and are often linked to mental or neurological disorders. Head-down bed rest microgravity analog studies show changes in facial emotion processing that may indicate a behavioral health risk during spaceflight.</p><p><strong>Methods: </strong>During short-duration space analog missions at two separate facilities, 15 subjects took daily FER tests before, during, and after the mission. Each test was accompanied by questionnaires measuring either potential causal or impacted variables: stress, depression, loneliness, irritability, risk-taking, empathy, and intrinsic motivation.</p><p><strong>Results: </strong>Analysis of variance and post hoc t-tests showed that during the mission, the subjects were less likely to identify angry, sad, or fearful faces as disgusted compared to the baseline. Also, interest/enjoyment and perceived competence increased throughout the mission lifecycle. Multiple regression analyses were able to account for greater than 20% of the variance for depression and health/safety risk-taking using the FER data.</p><p><strong>Discussion: </strong>Changes in FER during space mission simulations show that perception changes are not limited to microgravity analogs. A perceptual change was observed during the short-duration missions, but there is not sufficient evidence to show behavioral health impacts. However, associations between FER and the questionnaires show a potential to develop predictive models, countermeasures, or psychological monitoring tools using FER. Additional research is required to determine the efficacy of such tools during long-duration spaceflight. Van Hoy S. Facial expression perception and psychological changes during space analogs. Aerosp Med Hum Perform. 2024; 95(12):913-918.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"95 12","pages":"913-918"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142875817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methods of Aircraft Disinfection to Reduce Airborne Infectious Disease Transmission.","authors":"Charles DeJohn, Kris Belland, Diego Garcia","doi":"10.3357/AMHP.6348.2024","DOIUrl":"https://doi.org/10.3357/AMHP.6348.2024","url":null,"abstract":"<p><strong>Introduction: </strong>This review aims to assess the safety and efficacy of the use of ultraviolet-C technology for disinfecting aircraft and compare it with other methods currently used in the aviation industry.</p><p><strong>Methods: </strong>The authors conducted a comprehensive, systematic review of the literature on disinfection of aircraft. Independent double reviews were conducted and consultations with a third reviewer were performed in the event of disagreements.</p><p><strong>Discussion: </strong>Although infectious disease transmission in aircraft cabins has been shown to be low, a recent study has described reports of passengers on commercial aircraft infecting other passengers. Incorporating ultraviolet-C technology into aircraft disinfection protocols holds the potential to add a significant level of risk mitigation to effectively reduce disease transmission and enhance safety. DeJohn C, Belland K, Garcia D. Methods of aircraft disinfection to reduce airborne infectious disease transmission. Aerosp Med Hum Perform. 2024; 95(12):930-936.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"95 12","pages":"930-936"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142875883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}