Search

Aims/hypothesis: Glycaemic control and clinical outcomes in diabetes are improved by continuous subcutaneous insulin infusion (CSII). Atmospheric pressure changes during flights may affect insulin delivery from pumps and cause unintended metabolic consequences, including hypoglycaemia, in people with type 1 diabetes. The present report evaluates both hypobaric flight simulation and real-world data in pilots using insulin pumps while flying., Methods: In the flight simulation part of this study, an in vitro study of insulin pumps was conducted in a hypobaric chamber, de-pressurised to 550 mmHg to mimic the atmospheric pressure changes in airliner cabins during commercial flights. Insulin delivery rates and bubble formation were recorded for standard flight protocol. Insulin infusion sets, without pumps, were tested in a simulated rapid decompression scenario. The real-world observational study was a 7.5-year retrospective cohort study in which pre- and in-flight self-monitored blood glucose (SMBG) values were monitored in pilots with insulin-treated diabetes. Commercial and private pilots granted a medical certificate to fly within the European Union Aviation Safety Agency approved protocol and receiving insulin either by pump or multiple daily injections (MDI) were included., Results: In the flight simulation study, full cartridges over-delivered 0.60 U of insulin during a 20 min ascent and under-delivered by 0.51 U during descent compared with ground-level performance. During emergency rapid decompression, 5.6 U of excess insulin was delivered. In the real-world study, seven pilots using CSII recorded 4656 SMBG values during 2345 h of flying across 1081 flights. Only 33 (0.7%) values were outside an acceptable safe range (5.0-15.0 mmol/l [90-270 mg/dl]). No clinically significant fall in the median SMBG concentration was observed after aircraft ascent and no in-flight SMBG values were within the hypoglycaemic range (<4.0 mmol/l [<72 mg/dl]). Compared with pilots receiving MDI therapy, pilots using CSII recorded more SMBG values within the acceptable range (99.3% vs 97.5%), fewer values in the low red range (0.02% vs 0.1%), fewer in-flight out-of-range values (0.2% vs 1.3%) and maintained stricter glycaemic control during flight., Conclusions/interpretation: Ambient pressure reduction during simulated flights results in bubble formation and expansion within insulin cartridges. This causes unintended delivery of small insulin doses independent of pre-determined delivery rates and represents the maximum amount of insulin that could be delivered and retracted. However, in vivo, pilots using CSII in-flight did not experience a fall in blood glucose or episodes of hypoglycaemia during these atmospheric pressure changes and the use of insulin pumps can be endorsed in view of their clinical benefits., (© 2024. The Author(s).)

Jet fuel plays a crucial role as an essential energy source in aerospace and aviation operations. The recent increase in fuel prices has presented airlines with the new challenge of managing jet fuel costs to ensure consistent cash flow and minimize operational uncertainties. The conventional risk prediction models used by airlines often assume that risks are normally distributed according to the classical Central Limit Theorem, which can lead to under-hedging. This paper proposes an innovative approach using the stable Paretian model to analyze the price return of jet fuel in large samples. It comprehensively compares the fitting effect of the stable Paretian distribution with that of the normal distribution based on specific criteria and non-parametric significance tests. Furthermore, it investigates the accuracy of risk measures such as Value at Risk (VaR) and Conditional Value at Risk (CVaR) predicted by both models. In addition to comparing differences in VaR between predicted values and actual values, this paper provides a more comprehensive comparison of risk measures under rolling window forecast situation. Results suggest that despite indistinguishable results in VaR backtest, the stable Paretian distribution has a overall better fitting effect as well as a less biased predicted CVaR based on the AIC of -14099.46, BIC of -14110.98, p = 0.58 in Kolmogorov-Smirnov test and p = 0.46(0.92) in the 0.01(0.05) significance level of Expected Shortfall Regression Test. This might be explained by its ability to capture asset return dynamics while maintaining shape stability with few parameters. This research can provide valuable insights for guiding airlines' risk management decisions. its ability to capture asset return dynamics while maintaining shape stability with few parameters. This research can provide valuable insights for guiding airlines' risk management decisions., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Lin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Hybrid closed-loop (HCL) systems remain underexplored within aviation, and as atmospheric pressure changes can independently affect insulin pumps and continuous glucose monitoring readings, this preliminary study assessed the feasibility of HCL safety evaluation, in both fasting and post-prandial states, by using hypobaric chamber to simulate flights. Participants with type 1 diabetes and on HCL were studied: Medtronic Guardian 4-Medtronic 780G-SmartGuard ( n = 4), Dexcom G6-Omnipod DASH-Android APS ( n = 1), and Dexcom G6-Ypsomed Pump-CamAPS ( n = 1). Flight cabin pressures of 550 mmHg and 750 mmHg were simulated in a hypobaric chamber. Seven-hundred-50 glucose measurements were taken, with glucose levels demonstrating a stable decline to 4 mmol/L during fasting. To maintain a tight fasting and post-prandial glucose range across the different pressure settings, the HCL administered insulin as expected. While not demonstrating any apparent issues, repeating flight simulation protocol with other systems, examining longer flights, and undertaking larger, powered randomised controlled trials can confirm their safety in aviation.

When entering a coordinated flight turn without visual references, the perception of roll-angular displacement is determined by vestibular cues, and/or probably by assessment of the G load (G magnitude) and its translation into the corresponding bank angle. Herein, we examined whether repeated exposures to hypergravity (G training) in a centrifuge, would advance, not only the ability to accurately assess the G load, but also the capacity to detect or estimate the corresponding roll inclination of the centrifuge gondola. To this end, in 9 men without piloting experience, the subjective estimation of G load and roll tilt were assessed, in complete darkness, during 5-min coordinated turns in the centrifuge, performed at 1.1G (25° roll-tilt angle) and 2.0G (60° roll tilt angle). These trials were conducted before and after 5-weeks of G training [3×40-min sessions･week -1 ; protocol: 20×1-min at G levels close to the individual relaxed G-level tolerance (range: ∼2.6G(~67°)-3.6G(74°)), separated by 1-min intervals at idle speed (1.4G)], while continual feedback to the subjects was limited to the G load. As expected, G training improved subjects' capacity to assess G load, especially at 2.0 G ( P =0.006). The perception of roll tilt, however, was consistently underestimated (by ~70-80%), and not enhanced by G training ( P ≥0.51). The present findings demonstrate that prolonged repeated G-induced roll-tilts in a centrifuge gondola, while external feedback is restricted to graviception, enhance the capacity to perceive G load, but fail to advance the ability to detect or consciously estimate the magnitude of roll-angular displacement during a coordinated turn.

The COVID-19 pandemic affected countries across the globe, demanding drastic public health policies to mitigate the spread of infection, which led to economic crises as a collateral damage. In this work, we investigate the impact of human mobility, described via international commercial flights, on COVID-19 infection dynamics on a global scale. We developed a graph neural network (GNN)-based framework called Dynamic Weighted GraphSAGE (DWSAGE), which operates over spatiotemporal graphs and is well-suited for dynamically changing flight information updated daily. This architecture is designed to be structurally sensitive, capable of learning the relationships between edge features and node features. To gain insights into the influence of air traffic on infection spread, we conducted local sensitivity analysis on our model through perturbation experiments. Our analyses identified Western Europe, the Middle East, and North America as leading regions in fueling the pandemic due to the high volume of air traffic originating or transiting through these areas. We used these observations to propose air traffic reduction strategies that can significantly impact controlling the pandemic with minimal disruption to human mobility. Our work provides a robust deep learning-based tool to study global pandemics and is of key relevance to policymakers for making informed decisions regarding air traffic restrictions during future outbreaks., (© 2024. The Author(s).)

Introduction: One of the most important factors affecting visual performance during vision aided by night vision goggles (NVGs) is image quality, which depends mainly on the image-intensifier technology used. Although NVGs with green image color (P43 phosphor) are only accepted in military aviation, white image (P45 phosphor) seems to be equally well-regarded by aviators. The aim of our study was to determine if the experience of using NVGs with the green screen affects image preference for that color, and if the screen color preference is related to luminance level., Methods: Subjects (127 military pilots, 26-56 yr, M = 37.2; 62 pilots with flight experience with NVG use) were asked to observe a model terrain board at two different luminance levels (corresponding roughly to ambient conditions during starlight and one-half moonlight) while using two types of NVGs (green P43 and white P45 phosphor screens). The pilots were asked to answer a questionnaire about their preference for NVG display color., Results: The findings showed a significant difference between screen color preference and pilots' experience with the green-phosphor-based NVGs (43.5% vs. 23.1% for white screens). However, there was no relationship between screen color preference and luminance level., Discussion: Previous NVG experience seems to play an important role in shaping a user's individual preference for a certain phosphor screen color, although green and white phosphor screens both provide satisfactory visibility. Nevertheless, when deciding, it is advisable to experiment with both colors and select the one that suits the user's preferences and needs. Lewkowicz R, Dereń-Szumełda J. Phosphor screens color preferences depending on night vision experience and luminance level. Aerosp Med Hum Perform. 2024; 95(10):749-757.

Introduction: Hypoxia training is mandatory for military pilots, but variability in hypoxia symptoms challenges the training. In a previous study we showed that 64% of pilots recognized hypoxia faster in their second normobaric hypoxia session conducted 2.4 yr after the first. Our aim here was to evaluate whether a third session conducted 5.0 yr after the first would provide further benefit., Methods: This study was conducted under normobaric conditions in a tactical F/A-18C Hornet simulator in three sessions in which the pilots performed visual identification missions and breathed 21% oxygen in nitrogen. The breathing gas was changed to a hypoxic mixture containing either 8%, 7%, or 6% oxygen in nitrogen without the pilot's knowledge. Data were collected from 102 military pilots. The primary outcome was the time taken for initial identification of hypoxia symptoms., Results: Hypoxia symptoms were recognized on average in the first session in 8% oxygen in 100 s, 7% oxygen in 90 s, and 6% oxygen in 78 s; in the second in 87 s, 80 s, and 71 s, respectively; and in the third in 79 s, 67 s, and 64 s, respectively. In 2 sessions 20 pilots and in each 3 training sessions 3 pilots had slow recognition times., Discussion: Hypoxia symptom recognition improved the further the repeated normobaric hypoxia training went. More emphasis should be put on the 23% group of slow hypoxia symptom recognizers and more customized hypoxia training for them should be offered. Leinonen AM, Varis NO, Kokki HJ, Leino TK. Normobaric hypoxia symptom recognition in three training sessions. Aerosp Med Hum Perform. 2024; 95(10):758-764.

The visual approach is the most accident-prone phase of a flight, especially in low-visibility conditions. This preliminary study aimed to examine the effects of flight experience on pilots' decision-making and visual scanning pattern in low-visibility approaches. Twenty pilots were separated into two groups based on their flight experience and completed the high- and low-visibility approaches in balanced order using a high-fidelity flight simulator. Pilots' mental workload and visual scanning patterns were recorded via an eye tracker. The results showed that, compared to less flight-experienced pilots (20%, 3/15), experienced pilots (80%, 4/5) were more likely to make go-around decisions in the low-visibility approaches. Furthermore, they exhibited a more flexible and adaptable visual scanning pattern by quickly shifting their attention, as evidenced by decreased fixations and increased saccades. These findings suggest that the integration of visual scanning strategy and training solution with a marginally meteorological approach may enhance decision-making safety for novice pilots.

The aviation regulations mandate that high-energy rotor components must possesses adequate containment capabilities. Ensuring the containment of the turbine wheel of the air turbine starter is of paramount importance. In this paper, the design thickness of the containment ring was determined and the containment ring deformation was given. Based on the design thickness and deformation of the containment ring, an outer casing structure design method was proposed by using FEM. Then, two containment tests were conducted for different distances between the containment ring and outer casing to validate the outer casing structure design method. The errors of the containment ring deformation are smaller than 7.5%, and the experimental results of the containment process are in accordance with the simulation, validating correctness of the outer casing structure design method. The containment ring deformation rate with the design thickness T = 10 mm is 115%. A safety margin of 1.05 is designed by considering the uniformity of containment ring deformation and the containment ring assembly error. The results illustrate that the deformed containment ring does not damage the outer casing, when the inner diameter of the outer casing is designed as 1.2 times the outer diameter of the containment ring., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2024 Tang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Competing Interests: Competing interests: None declared.

Background: Passengers on long-haul flights frequently consume alcohol. Inflight sleep exacerbates the fall in blood oxygen saturation (SpO 2 ) caused by the decreased oxygen partial pressure in the cabin. We investigated the combined influence of alcohol and hypobaric hypoxia on sleep, SpO 2 and heart rate., Methods: Two groups of healthy individuals spent either two nights with a 4-hour sleep opportunity (00:00-04:00 hours) in the sleep laboratory (n=23; 53 m above sea level) or in the altitude chamber (n=17; 753 hPa corresponding to 2438 m above sea level, hypobaric condition). Participants consumed alcohol before one of the nights (mean±SE blood alcohol concentration 0.043±0.003%). The order of the nights was counterbalanced. Two 8-hour recovery nights (23:00-07:00 hours) were scheduled between conditions. Polysomnography, SpO 2 and heart rate were recorded., Results: The combined exposure to alcohol and hypobaric condition decreased SpO 2 to a median (25th/75th percentile) of 85.32% (82.86/85.93) and increased heart rate to a median (25th/75th percentile) of 87.73 bpm (85.89/93.86) during sleep compared with 88.07% (86.50/88.49) and 72.90 bpm (70.90/78.17), respectively, in the non-alcohol hypobaric condition, 94.97% (94.59/95.33) and 76.97 bpm (65.17/79.52), respectively, in the alcohol condition and 95.88% (95.72/96.36) and 63.74 bpm (55.55/70.98), respectively, in the non-alcohol condition of the sleep laboratory group (all p<0.0001). Under the combined exposure SpO 2 was 201.18 min (188.08/214.42) below the clinical hypoxia threshold of 90% SpO 2 compared with 173.28 min (133.25/199.03) in the hypobaric condition and 0 min (0/0) in both sleep laboratory conditions. Deep sleep (N3) was reduced to 46.50 min (39.00/57.00) under the combined exposure compared with both sleep laboratory conditions (alcohol: 84.00 min (62.25/92.75); non-alcohol: 67.50 min (58.50/87.75); both p<0.003)., Conclusions: The combination of alcohol and inflight hypobaric hypoxia reduced sleep quality, challenged the cardiovascular system and led to extended duration of hypoxaemia (SpO 2 <90%)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Disruptive passenger behaviour (DPB) incidents spiked during the COVID-19 pandemic period, compromising the safety of commercial flights on a daily basis. This qualitative semi-structured interview study examined the perceived triggering factors and motivations for DPB and the subsequent impact of DPB upon cabin crew well-being and safety. Twenty-four European cabin crew disclosed experiences, subjective observations of perpetrator traits, assessment of DPB development and information regarding their well-being and perceived safety. Thematic analysis revealed that the perceived frequency of DPB had increased, driven by an accumulation of pandemic-related factors - such as enforcing mask wearing amongst intoxicated passengers. DPB was found to decrease resilience and spur maladaptive coping strategies in crew. Suggested enhancements to current DPB mitigation consisted of stricter punishment for DPB as a deterrent, alcohol bans and higher quality training. These findings can inform decision-makers' efforts to support cabin crew well-being and create safer cabin workplaces in the future.

There is growing interest in cardiometabolic outcomes associated with nighttime noise, given that noise can disturb sleep and sleep disturbance can increase cardiometabolic risk such as hypertension. However, there is little empirical research evaluating the association between nighttime aircraft noise and hypertension risk. In this study, we expand on previous work to evaluate associations between nighttime aircraft noise exposure and self-reported hypertension incidence in the Nurses' Health Studies (NHS/NHSII), two US-wide cohorts of female nurses. Annual nighttime average aircraft sound levels (L night ) surrounding 90 airports for 1995-2015 (in 5-year intervals) were modeled using the Aviation Environmental Design Tool and assigned to participants' geocoded addresses over time. Hypertension risk was estimated for each cohort using time-varying Cox proportional-hazards models for L night dichotomized at 45 dB (dB), adjusting for individual-level hypertension risk factors, area-level socioeconomic status, region, and air pollution. Random effects meta-analysis was used to combine cohort results. Among 63,229 NHS and 98,880 NHSII participants free of hypertension at study baseline (1994/1995), we observed 33,190 and 28,255 new hypertension cases by 2014/2013, respectively. Although ∼1% of participants were exposed to L night ≥45 dB, we observed an adjusted hazard ratio (HR) of 1.10 (95% CI: 0.96, 1.27) in NHS and adjusted HR of 1.12 (95% CI: 0.98, 1.28) in NHSII, comparing exposure to L night ≥45 versus <45 dB(A). In meta-analysis, we observed an adjusted HR of 1.11 (95% CI: 1.01, 1.23). These results were attenuated with adjustment for additional variables such as body mass index. Our findings support a modest positive association between nighttime aircraft noise and hypertension risk across NHS/NHSII, which may reinforce the concept that sleep disturbance contributes to noise-related disease burden., Competing Interests: Declaration of competing interest Susan Redline reports a relationship with Jazz Pharmaceuticals Inc., Ireland that includes grant and consulting. All other authors declare they have no actual or potential competing financial interests., (Copyright © 2024. Published by Elsevier GmbH.)

Introduction: Flight attendants, as the front-line staff in the cabin, play a crucial role in improving air travel safety. This research explores how psychological safety affects flight attendants' adoption of mindful safety practices through voice participation. This mechanism also identifies ethical leadership and traditionality as two moderators., Methods: A self-reported questionnaire was used to collect data from 621 flight attendants in Chinese private commercial airline companies. PLS-SEM (partial least square structured equation modeling) is used to examine the hypotheses proposed in the present study., Results: After data analysis, the results reveal that the underlying mechanism covering both mediating and moderating effects through which flight attendants' voluntary and extra-role safety behavior could be improved., Discussion: The findings extend the existing literature regarding the antecedents of flight attendants' mindful safety practices adoption and obstacles to employee voice participation. Managerial implications are also provided in the commercial aviation industry and discussed along with future research directions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hu, Nadeem, Luo and Yi.)

Eccentric upper-body exercise performed 24 h prior to high-altitude decompression has previously been shown to aggravate venous gas emboli (VGE) load. Yet, it is unclear whether increasing the muscle mass recruited (i.e., upper vs. whole-body) during eccentric exercise would exacerbate the decompression strain. Accordingly, this study aimed to investigate whether the total muscle mass recruited during eccentric exercise influences the decompression strain. Eleven male participants were exposed to a simulated altitude of 24,000 ft for 90 min on three separate occasions. Twenty-four hours before each exposure, participants performed one of the following protocols: (i) eccentric whole-body exercise (ECCw; squats and arm-cycling exercise), (ii) eccentric upper-body exercise (ECCu; arm-cycling), or (iii) no exercise (control). Delayed onset muscle soreness (DOMS) and isometric strength were evaluated before and after each exercise intervention. VGE load was evaluated at rest and after knee- and arm-flex provocations using the 6-graded Eftedal-Brubakk scale. Knee extensor (-20 ± 14%, P = 0.001) but not elbow flexor (-12 ± 18%, P = 0.152) isometric strength was reduced 24 h after ECCw. ECCu reduced elbow flexor isometric strength at 24 h post-exercise (-18 ± 10%, P < 0.001). Elbow flexor DOMS was higher in the ECCu (median 6) compared with ECCw (5, P = 0.035). VGE scores were higher following arm-flex provocations in the ECCu (median (range), 3 (0-4)) compared with ECCw (2 (0-3), P = 0.039) and control (0 (0-2), P = 0.011), and in ECCw compared with control (P = 0.023). VGE were detected earlier in ECCu (13 ± 20 min) compared with control (60 ± 38 min, P = 0.021), while no differences were noted between ECCw (18 ± 30 min) and control or ECCu. Eccentric exercise increased the decompression strain compared with control. The VGE load varied depending on the body region but not the total muscle mass recruited. HIGHLIGHTS: What is the central question of this study? Does exercise-induced muscle damage (EIMD) resulting from eccentric exercise influence the presence of venous gas emboli (VGE) during a 90 min continuous exposure at 24,000 ft? What is the main finding and its importance? EIMD led to an earlier manifestation and greater VGE load compared with control. However, the decompression strain was dependent on the body region but not the total muscle mass recruited., (© 2024 The Author(s). Experimental Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.)

Background: Cardiologists will commonly assess patients who hold an aviation medical certificate and require unique assessments and communications with national civil aviation authorities (in Australia, the Civil Aviation Safety Authority [CASA] and in New Zealand, the Civil Aviation Authority of New Zealand [CAA NZ]). Cardiac conditions are the most common reason for disqualification from holding an aviation licence, and coronary artery disease is considered a high-risk condition for pilot incapacitation., Aim: To provide a contemporary update on the aeromedical approach to the evaluation, detection, and management of coronary artery disease in an Australasian context., Methods: A narrative view of current and historical practice in the area of aeromedical evaluation of coronary disease was undertaken., Results: This review highlights the aeromedical approach to risk stratification and specific challenges of the aviation environment for patients with coronary artery disease. Scenarios of coronary artery disease screening, common and rare acute coronary syndromes, and the assessment of established coronary artery disease are examined in detail. Suggestions to facilitate communications between specialists and CASA or CAA NZ to facilitate patient re-certification are also provided., Conclusion: Patients who are pilots have unique requirements in terms of their coronary assessment, management, and follow-up to maintain eligibility to fly. It is important for cardiologists to be aware of relevant occupational requirements to provide optimal care to their patients., Competing Interests: Conflicts of Interest Nil direct. Concepts discussed within this paper are accurate at time of publication and represent broad consensus only. Recommendations should not be represented as being the CASA’s or the CAA’s positions at law in the case of any individual patients., (Crown Copyright © 2024. Published by Elsevier B.V. All rights reserved.)

Recently, Sustainable Aviation Fuel (SAF) blends and novel combustion technologies have been introduced to reduce aircraft engine emissions. However, there is limited knowledge about the impact of combustion technology and fuel composition on toxicity of primary Particulate Matter (PM) emissions, comparable to regulated non-volatile PM (nvPM). In this study, primary PM was collected on filters using a standardised approach, from both a Rich-Quench-Lean (RQL) combustion rig and a bespoke liquid fuelled Combustion Aerosol Standard (CAST) Generator burning 12 aviation fuels including conventional Jet-A, SAFs, and blends thereof. The fuels varied in aromatics (0-25.2%), sulphur (0-3000 ppm) and hydrogen (13.43-15.31%) contents. Toxicity of the collected primary PM was studied in vitro utilising Air-Liquid Interface (ALI) exposure of lung epithelial cells (Calu-3) in monoculture and co-culture with macrophages (differentiated THP-1 cells). Cells were exposed to PM extracted from filters and nebulised from suspensions using a cloud-based ALI exposure system. Toxicity readout parameters were analysed 24 h after exposure. Results showed presence of genotoxicity and changes in gene expression at dose levels which did not induce cytotoxicity. DNA damage was detected through Comet assay in cells exposed to CAST generated samples. Real-Time PCR performed to investigate the expression profile of genes involved in oxidative stress and DNA repair pathways showed different behaviours after exposure to the various PM samples. No differences were found in pro-inflammatory interleukin-8 secretion. This study indicates that primary PM toxicity is driven by wider factors than fuel composition, highlighting that further work is needed to substantiate the full toxicity of aircraft exhaust PM inclusive of secondary PM emanating from numerous engine technologies across the power range burning conventional Jet-A and SAF., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Interest in post-coronavirus disease 2019 (COVID-19) syndrome following COVID-19 infection has been increasing. Maintaining quality of life (QoL) is vital for airline crews because they work in a special environment, where they are responsible for the passengers' safety. This study aims to closely investigate factors affecting the QoL of airline crews, including post-COVID-19 syndrome. Methods : This study was designed as a cross-sectional survey, comprising 167 crews. Findings : Age-specific significant differences were observed in social, overall, and total QoL scores. The physical domain QoL was significantly higher in the cockpit crews than that in the cabin crews. Significant differences were found in psychological and overall QoL depending on years of continuous service. Social domain and environmental QoL were lower in those who had no symptoms after being diagnosed with COVID-19 than in those who were symptomatic. Among the participants, 4.2% had post-COVID-19 syndrome, indicating significant differences in the physical domain, depending on whether they exhibit post-COVID-19 syndrome. Conclusion : It is urgent to develop measures to increase the QoL of airline crews, investigate post-COVID-19 syndrome before returning to work, and develop strategies to manage it. Application to practice : The QoL among airline crews differed not only by the demographic characteristics of the participants but also by the presence of symptoms during COVID-19 diagnosis and post-COVID-19 syndrome. Higher QoL among airline crews is associated with the safety of both airline crews and passengers. Therefore, it is necessary to establish a systematic management protocol for airline crews returning to work after following COVID-19 infection., Competing Interests: Conflict of InterestThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The study aimed at investigating the impact of an innovative Wake Vortex Alert (WVA) avionics on pilots' operation and mental states, intending to improve aviation safety by mitigating the risks associated with wake vortex encounters (WVEs). Wake vortices, generated by jet aircraft, pose a significant hazard to trailing or crossing aircrafts. Despite existing separation rules, incidents involving WVEs continue to occur, especially affecting smaller aircrafts like business jets, resulting in aircraft upsets and occasional cabin injuries. To address these challenges, the study focused on developing and validating an alert system that can be presented to air traffic controllers, enabling them to warn flight crews. This empowers the flight crews to either avoid the wake vortex or secure the cabin to prevent injuries. The research employed a multidimensional approach including an analysis of human performance and human factors (HF) issues to determine the potential impact of the alert on pilots' roles, tasks, and mental states. It also utilizes Human Assurance Levels (HALs) to evaluate the necessary human factors support based on the safety criticality of the new system. Realistic flight simulations were conducted to collect data of pilots' behavioural, subjective and neurophysiological responses during WVEs. The data allowed for an objective evaluation of the WVA impact on pilots' operation, behaviour and mental states (mental workload, stress levels and arousal). In particular, the results highlighted the effectiveness of the alert system in facilitating pilots' preparation, awareness and crew resource management (CRM). The results also highlighted the importance of avionics able to enhance aviation safety and reducing risks associated with wake vortex encounters. In particular, we demonstrated how providing timely information and improving situational awareness, the WVA will minimize the occurrence of WVEs and contribute to safer aviation operations., Competing Interests: Declaration of Competing Interest Declarations of interest: none, (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

INTRODUCTION: Accessible spaceflight may seem a distant concept. As part of a diverse European Space Agency funded Topical Team, we are working on the physiological feasibility of space missions being undertaken by people with physical disabilities. Here, the first activity of this team is presented in the form of key lessons learned from aviation to inform new work on space missions. DISCUSSION: The first lesson is agreeing on realistic expectations about impairments, their severity, and the possibility of flying independently. This is important in terms of astronaut recruitment and societal expectations. The second lesson relates to training and adjustments for people with disabilities. Flexibility is important while maintaining safety for everyone involved. The third lesson is about managing unconscious bias from the different stakeholders. We conclude by arguing that engagement with people from different backgrounds is essential for the success of the first space mission with people with physical disabilities. Miller-Smith MJ, Tucker N, Anderton R, Caplin N, Harridge SDR, Hodkinson P, Narici MV, Pollock RD, Possnig C, Rittweger J, Smith TG, Di Giulio I. Lessons for flying astronauts with disabilities drawn from experience in aviation . Aerosp Med Hum Perform. 2024; 95(9):716-719.

Without visual references, nonpilots exposed to coordinated flight turns underestimate the bank angle, because of discordant information of the roll-angular displacement from the otoliths, consistently signaling vertical position, versus the semicircular canals, enabling detection of the displacement. Pilots may also use their ability to perceive the G load and knowledge of the relation between load and angle to assess the bank angle. Our aim was to investigate whether the perception of bank angle can be improved by spatial orientation training in a centrifuge. Sixteen pilots/pilot students assessed their roll tilt, in complete darkness, during both real coordinated flight turns and gondola centrifugation, at roll tilts of 30° and 60°. The experiments were repeated after a 3-wk period, during which eight of the subjects performed nine training sessions in the centrifuge, comprising feedback on roll angle vs. G load, and on indicating requested angles. Before training, the subjects perceived in the aircraft and centrifuge, respectively: 37 (17)°, 38 (14)° during 60° turns and 19 (12)°, 20 (10)° during 30° turns. Training improved the perception of angle during the 60° [to 60 (7)°, 55 (10)°; P ≤ 0.04] but not the 30° [21 (10)°, 15 (9)°; P ≥ 0.30] turns; the improvement disappeared within 2 yr after training. Angle assessments did not change in the untrained group. The results suggest that it is possible to, in a centrifuge, train a pilot's ability to perceive large but not discrete-to-moderate roll-angular displacements. The transient training effect is attributable to improved capacity to perceive and translate G load into roll angle and/or to increased reliance on semicircular canal signals. NEW & NOTEWORTHY Spatial disorientation is a major problem in aviation. When performing coordinated flight turns without external visual cues (e.g., flying in clouds or darkness), the pilot underestimates the aircraft bank angle because the vestibular system provides unreliable information of roll tilt. The present study demonstrates that it is possible to, in a long-arm centrifuge, train a pilot's ability to perceive large but not discrete-to-moderate roll-angular displacements.

INTRODUCTION: The benefits of using head-up displays (HUDs) include reducing head-down time during critical flight phases, enhancing awareness of the external environment, and improving in-flight crew performance. However, the monochromatic nature of HUDs, increased head rotation, and longer gaze movement paths might affect pilots' reactions to different types of alerts. METHODS: Pilot workload and behavior differences were examined between HUD and head-down display (HDD) configurations in three alert scenarios. The study was carried out in an A320 flight simulator and 12 pilots participated. RESULTS: Except for one engine-on-fire scenario, pilot workload when using a HUD was significantly lower than using an HDD. In one engine-on-fire (3.98 s vs. 3.57 s) and one gear-disagree (5.42 s vs. 4.69 s) scenario, pilot response time to alerts using HUD was significantly longer than using an HDD. The angle deviations were significantly smaller when using HUDs in both go-around-under-crosswind (2.67° vs. 3.37°) and one engine-on-fire scenario (1.22° vs. 1.89°). DISCUSSION: The HUD is suitable for a lengthy process of manual flight control inputs, which not only reduces workload but also promotes control accuracy. For tasks that rely on automation, the benefits for workload become less obvious. In addition, head rotation and reorientation of attention adversely affected the response time to non-time-critical warnings and cautions. For instantaneous control with high precision requirements, HUDs did not demonstrate a significant advantage. Zheng Y, Lu Y, Jie Y, Fu S. Pilots' reactions to different types of alerts when using head-up displays . Aerosp Med Hum Perform. 2024; 95(9):688-694.

The assessment of the cognitive workload experienced by air traffic controllers is a complex and prominent issue in the research community. This study introduces new indicators related to gamma waves to detect controllers' workload and develops experimental protocols to capture their EEG data and NASA-TXL data. Then, statistical tests, including the Shapiro-Wilk test and ANOVA, were used to verify whether there was a significant difference between the workload data of the controllers in different scenarios. Furthermore, the Support Vector Machine (SVM) classifier was employed to assess the detection accuracy of these indicators across four categorizations. According to the outcomes, hypotheses suggesting a strong correlation between gamma waves and an air traffic controller's workload were put forward and subsequently verified; meanwhile, compared with traditional indicators, the indicators associated with gamma waves proposed in this paper have higher accuracy. In addition, to explore the applicability of the indicator, sensitive channels were selected based on the mRMR algorithm for the indicator with the highest accuracy, β + θ + α + γ, showcasing a recognition rate of a single channel exceeding 95% of the full channel, which meets the requirements of convenience and accuracy in practical applications. In conclusion, this study demonstrates that utilizing EEG gamma wave-associated indicators can offer valuable insights into analyzing workload levels among air traffic controllers.

The operating room is the environment where harm to the patient is most likely. Robotic surgery was listed as one of the top 10 health hazards as late as 2020. Taking inspiration from other fields of application, such as aeronautics, checklists have been increasingly implemented in medical practice over the years, becoming essential components of the operating theatre. In addition to checklists, simulation has taken on a fundamental importance in reducing errors. This paper aims to provide a narrative review to assess the importance of checklists and training in robotic surgery and how they improve the outcome. A comprehensive literature search from January 2000 to September 2023 was conducted. A total of 97 articles were included in the initial search. Eleven studies were deemed relevant and were considered eligible for full-text reading. Among these, ten studies focused on the analysis of training effectiveness. An article in our review assessed the benefits of introducing checklists in the operating room. Innovations created in aviation, such as checklists and simulation, have entered the medical field to prevent human error. Developing dedicated checklist and surgical teams, through theoretical and practical training, has become essential in modern medicine. Tools such as checklists, training, and simulation are among the best methods to reduce adverse medical events.

Pilot behavior is crucial for aviation safety. This study aims to investigate the EEG characteristics of pilots, refine training assessment methodologies, and bolster flight safety measures. The collected EEG signals underwent initial preprocessing. The EEG characteristic analysis was performed during left and right turns, involving the calculation of the energy ratio of beta waves and Shannon entropy. The psychological workload of pilots during different flight phases was quantified as well. Based on the EEG characteristics, the pilots' psychological workload was classified through the use of a support vector machine (SVM). The study results showed significant changes in the energy ratio of beta waves and Shannon entropy during left and right turns compared to the cruising phase. Additionally, the pilots' psychological workload was found to have increased during these turning phases. Using support vector machines to detect the pilots' psychological workload, the classification accuracy for the training set was 98.92%, while for the test set, it was 93.67%. This research holds significant importance in understanding pilots' psychological workload.

Background and objective Although mental health is always a major concern, particularly for airline pilots, knowledge of and attitudes toward mental health have not always been emphasized for safe operations in the aviation industry. Fear of self-reporting, stigmas, and lack of knowledge about mental health conditions are prevalent in this industry. The purpose of our research was to examine pilots' perceptions of mental health issues, the resources available to them, and the reasons they may or may not report these issues. Methods We conducted a qualitative, phenomenological study in which 21 commercial pilots were interviewed to better understand their perceptions of mental health issues, available self-help resources, and rationale for failing to report mental health issues. Results The results of our analysis using NVivo software showed that pilots neither reported the issues nor trusted the processes meant to address mental health issues. Three themes emerged from the research: (1) pilots avoid discussing mental health issues for fear of repercussions, (2) although resources exist, pilots generally distrust the confidentiality of reporting systems, and (3) pilots honestly believe that reporting any mental health issue will be devastating to their careers. Conclusions Airline companies and the Federal Aviation Administration (FAA) need to change processes and instill a sense of trust in reporting systems among pilots so that they feel safe reporting mental health concerns and receive improved treatment. This can lead to more accurate reporting of conditions and ensure safe flight operations., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Embry-Riddle Aeronautical University IRB issued approval 24-071. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Cross et al.)

This article provides an overview of the mental health challenges faced by pilots and air traffic controllers (ATCs), whose stressful professional lives may negatively impact global flight safety and security. The adverse effects of mental health disorders on their flight performance pose a particular safety risk, especially in sudden unexpected startle situations. Therefore, the early detection, prediction and prevention of mental health deterioration in pilots and ATCs, particularly among those at high risk, are crucial to minimize potential air crash incidents caused by human factors. Recent research in artificial intelligence (AI) demonstrates the potential of machine and deep learning, edge and cloud computing, virtual reality and wearable multimodal physiological sensors for monitoring and predicting mental health disorders. Longitudinal monitoring and analysis of pilots' and ATCs physiological, cognitive and behavioral states could help predict individuals at risk of undisclosed or emerging mental health disorders. Utilizing AI tools and methodologies to identify and select these individuals for preventive mental health training and interventions could be a promising and effective approach to preventing potential air crash accidents attributed to human factors and related mental health problems. Based on these insights, the article advocates for the design of a multidisciplinary mental healthcare ecosystem in modern aviation using AI tools and technologies, to foster more efficient and effective mental health management, thereby enhancing flight safety and security standards. This proposed ecosystem requires the collaboration of multidisciplinary experts, including psychologists, neuroscientists, physiologists, psychiatrists, etc. to address these challenges in modern aviation.

It is known that anthropometric data (weight, height, BMI, waist circumference and WHtR) and male gender are positively correlated with greater core strength, while age is negatively correlated. For competitive athletes with no significant differences in the anthropometric data stated above, there have hardly been any studies in which isometric core strength in a seated position is quantitatively compared among athletes in different sports. This study aimed to analyse different sports in well-trained athletes using military competitive sports as an example with regard to possible differences in core strength. For this purpose, Parachuting (n=28), Military Pentathlon (n=34) and Ski Platoon (n=38) groups were compared with regard to isokinetic core strength using dynamometry in seated position. In addition to the comparison of anthropometry and isokinetic results with descriptive statistics, ANOVA and Welch-ANOVA were used to compare the means of absolute and weight-adjusted core strength. It was shown that the Ski Platoon group had significantly higher flexion peak torque values than the Military Pentathlon and Parachuting groups. Even when adjusted for weight, the values were significantly higher than those measured in the Military Pentathlon group but not significantly higher than those in the Parachuting group. For extension peak torque, it was found that the Military Pentathlon group had significantly lower values than the Ski Platoon group and, in the weight-adjusted analysis, significantly lower values than the Parachuters. Using the example of competitive military sports, this study was able to show that there are significant differences in isokinetic core strength even among professional competitive athletes.This knowledge should be used to carry out detailed quantitative analyses of core strength, even in well-trained professional athletes, to find applications for prevention or to coordinate compensating exercises., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Objective: To evaluate neck muscle coactivation across different levels of mental workload during simulated flight tasks., Background: Neck pain (NP) is highly prevalent among military aviators. Given the complex nature within the flight environment, mental workload may be a risk factor for NP. This may induce higher levels of neck muscle coactivity, which over time may accelerate fatigue, increase neck discomfort, and affect flight task performance., Method: Three counterbalanced mental workload conditions represented by simulated flight tasks modulated by interstimulus frequency and complexity were investigated using the Modifiable Multitasking Environment (ModME). The primary measure was a neck coactivation index to describe the neuromuscular effort of the neck muscles as a system. Additional measures included perceived workload (NASA TLX), subjective discomfort, and task performance. Participants ( n = 60; 30M, 30F) performed three test conditions over 1 hr each while seated in a simulated seating environment., Results: Neck coactivation indices (CoA) and subjective neck discomfort corresponded with increasing level of mental workload. Average CoAs for low, medium, and high workloads were: .0278(SD = .0232), .0286(SD = .0231), and .0295(SD = .0228), respectively. NASA TLX mental, temporal, effort, and overall scores also increased with the level of mental workload assigned. For ModME task performance, the overall performance score, monitoring accuracy, and resource management accuracy decreased while reaction times increased with the increasing level of mental workload. Communication accuracy was lowest with the low mental workload but had higher reaction times relative to increasing workload., Conclusion: Mental workload affects neck muscle coactivation during combinations of simulated flight tasks within a simulated helicopter seating environment., Application: The results of this study provide insights into the physical response to mental workload. With increasing multisensory modalities within the work environment, these insights may assist the consideration of physical effects from cognitive factors.

The unexpected spread of the pandemic raised concerns regarding pilots' skill decay resulting from the significant drops in the frequency of flights by about 70%. This research retrieved 4761 Flight Data Monitoring (FDM) occurrences based on the FDM programme containing 123,140 flights operated by an international airline between June 2019 and May 2021. The FDM severity index was analysed by event category, aircraft type, and flight phase. The results demonstrate an increase in severity score from the pre-pandemic level to the pandemic onset on events that occurred on different flight phases. This trend is not present in the third stage, which indicates that pilots and the safety management system of the airline demonstrated resilience to cope with the flight disruptions during the pandemic. Through the analysis of event severity, FDM enables safety managers to recommend measures to increase safety resilience and self-monitoring capabilities of both operators and regulators. Practitioner summary: The onset of the pandemic led to a rise in the severity of flight data monitoring events in a large airline, likely linked to a lack of operational practice and skills decay. This was demonstrated across different flight phases and aircraft types. In the settled pandemic period, the severity index returned to pre-pandemic levels, indicating that the resilience of individual pilots and safety management systems is critical to operational safety.HIGHLIGHTSThe FDM event severity scores significantly increased following the pandemic onset, especially for event categories involving pilot core competencies.The FDM event severity scores stagnated or decreased during the later pandemic stage indicating resilience among the airline pilots and the airline's safety management system.The airline and pilots demonstrated resilience by effectively mitigating the effects of proficiency decay which took place as the pandemic started.FDM analysis has shown to be effective in establishing a proactive SMS programme to mitigate the negative impacts of the pandemic on aviation safety.

Introduction: COVID-19 has demonstrated the importance of competent staff with expertise in public health emergency preparedness and response in the civil aviation system. The civil aviation system is a critical sentinel and checkpoint to prevent imported cases and slow the spread of communicable diseases. Understanding the current competencies of staff to deal with public health emergencies will help government agencies develop targeted training and evidence-based policies to improve their public health preparedness and response capabilities., Methods: This cross-sectional pilot study was conducted from November 2022 to October 2023, involving 118 staff members from various positions within China's civil aviation system. A 59-item questionnaire was translated and developed according to a competency profile. Data were collected using the self-report questionnaire to measure the workforce's self-perceptions of knowledge and skills associated with public health emergency proficiency, categorized into (1) general competency, (2) preparedness competency, (3) response competency, and (4) recovery competency. KMO & Bartlett test and Cronbach's α reliability analysis were used to test the reliability and validity of the questionnaire. Descriptive statistics, independent sample T-test, ANOVA, and linear regression models were performed to analyze the competencies., Results: A total of 107 staff members from the aviation system were surveyed in this study. The KMO & Bartlett test, (KMO = 0.919, P < 0.001) and Cronbach's α coefficients (α = 0.985) for this questionnaire were acceptable. The results suggested that respondents scored a mean of 6.48 out of 9 for the single question. However, the staff needed to acquire more knowledge in investigating epidemic information (5.92) and case managing (5.91) in the response stage. Overall, males scored higher (409.05 ± 81.39) than females (367.99 ± 84.97), with scores in the medical department (445.67 ± 72.01) higher than management (387.00 ± 70.87) and general department (362.32 ± 86.93). Additionally, those with completely subjective evaluation (425.79 ± 88.10) scored higher than the general group (374.39 ± 79.91). To predict the total score, female medical workers were more likely to have lower scores (β = -34.5, P = 0.041). Compared with those in the medical department, the management workers (β = -65.54, P = 0.008) and general workers (β = -78.06, P < 0.001) were associated with a lower total score., Conclusions: There was still a gap between the public health emergency competencies of the civil aviation system and the demand. Staff in China's civil aviation systems demonstrated overall competence in public health emergency preparedness and response. However, there was a need to enhance the accumulation of practical experience. Implementing effective training programs for public health emergencies was recommended to mitigate knowledge gaps. Meanwhile, regular training evaluations were also recommended to give comprehensive feedback on the value of the training programs., (© 2024. The Author(s).)

Air traffic controllers' mental workload significantly impacts their operational efficiency and safety. Detecting their mental workload rapidly and accurately is crucial for preventing aviation accidents. This study introduces a mental workload detection model for controllers based on power spectrum features related to gamma waves. The model selects the feature with the highest classification accuracy, β + θ + α + γ, and utilizes the mRMR (Max-Relevance and Min-Redundancy) algorithm for channel selection. Furthermore, the channels that were less affected by ICA processing were identified, and the reliability of this result was demonstrated by artifact analysis brought about by EMG, ECG, etc. Finally, a model for rapid mental workload detection for controllers was developed and the detection rate for the 34 subjects reached 1, and the accuracy for the remaining subjects was as low as 0.986. In conclusion, we validated the usability of the mRMR algorithm in channel selection and proposed a rapid method for detecting mental workload in air traffic controllers using only three EEG channels. By reducing the number of EEG channels and shortening the data processing time, this approach simplifies equipment application and maintains detection accuracy, enhancing practical usability.

Cellulosic biomass-based sustainable aviation fuels (SAFs) can be produced from various feedstocks. The breakeven price and carbon intensity of these feedstock-to-SAF pathways are likely to differ across feedstocks and across spatial locations due to differences in feedstock attributes, productivity, opportunity costs of land for feedstock production, soil carbon effects, and feedstock composition. We integrate feedstock to fuel supply chain economics and life-cycle carbon accounting using the same system boundary to quantify and compare the spatially varying greenhouse gas (GHG) intensities and costs of GHG abatement with SAFs derived from four feedstocks (switchgrass, miscanthus, energy sorghum, and corn stover) at 4 km resolution across the U.S. rainfed region. We show that the optimal feedstock for each location differs depending on whether the incentive is to lower breakeven price, carbon intensity, or cost of carbon abatement with biomass or to have high biomass production per unit land. The cost of abating GHG emissions with SAF ranges from $181 Mg -1 CO 2 e to more than $444 Mg -1 CO 2 e and is lowest with miscanthus in the Midwest, switchgrass in the south, and energy sorghum in a relatively small region in the Great Plains. While corn stover-based SAF has the lowest breakeven price per gallon, it has the highest cost of abatement due to its relatively high GHG intensity. Our findings imply that different types of policies, such as volumetric targets, tax credits, and low carbon fuel standards, will differ in the mix of feedstocks they incentivize and locations where they are produced in the U.S. rainfed region.

Importance: Misaligned dietary rhythmicity has been associated with metabolic diseases; however, its association with mental health remains largely unexplored., Objective: To examine the association between dietary rhythms and the mental health condition of shift workers, specifically airline crew members., Design, Setting, and Participants: This cross-sectional study analyzed data collected from the Civil Aviation Health Cohort of China, an ongoing large-scale health survey of pilots, flight attendants, and air security officers employed by major airline companies in China. Participants aged 18 to 60 years were invited through text messages to complete a web-based survey. The data collection period was December 2022 to March 2023. Statistical analysis was performed from July 24, 2023, to April 12, 2024., Exposure: Data on timing of breakfast and dinner on workdays and rest days, daily time windows for food intake, and meal and eating jet lags were collected and calculated., Main Outcomes and Measures: Anxiety and depressive symptoms were measured using the 7-item Generalized Anxiety Disorder Assessment and the 9-item Patient Health Questionnaire. Multivariate logistic regressions were performed to evaluate the associations of anxiety and depression with meal timing, eating window time, meal jet lag (ie, delayed meals), and eating jet lag (ie, delayed eating). All models were adjusted for individual socioeconomic, demographic, and lifestyle characteristics., Results: Of the 22 617 participants (median [IQR] age, 29.1 [26.3-33.7] years; 13 712 males [60.6%]), 1755 (7.8%) had anxiety and 2768 (12.2%) had depression. After controlling for confounding factors, having dinner after 8 pm on morning-shift days was associated with increased odds of anxiety (adjusted odds ratio [AOR], 1.78; 95% CI, 1.53-2.05) and depression (AOR, 2.01; 95% CI, 1.78-2.27), compared with consuming dinner before 8 pm. Similar results were observed on night-shift days and rest days. An eating window of less than 12 hours was associated with reduced odds of anxiety (AOR, 0.84; 95% CI, 0.75-0.93) and depression (AOR, 0.81; 95% CI, 0.75-0.89) on morning-shift days; the results remained significant on rest days. Delayed dinner on morning-shift days was associated with increased odds of anxiety (AOR, 1.32; 95% CI, 1.13-1.54) and depression (AOR, 1.39; 95% CI, 1.22-1.58). On night-shift days, delayed dinner was associated with higher odds of anxiety (AOR, 1.22; 95% CI, 1.06-1.39) and depression (AOR, 1.21; 95% CI, 1.08-1.36). On morning-shift days, delayed eating rhythms were associated with higher odds of depression (AOR, 1.35; 95% CI, 1.13-1.61), whereas advanced eating rhythms were associated with lower odds of anxiety (AOR, 0.78; 95% CI, 0.70-0.87)., Conclusions and Relevance: This cross-sectional study found that meal timing, long eating window, and meal jet lags were associated with increased odds of depression and anxiety. These findings underscore the need for interventions and supportive policies that help mitigate the adverse implications of shift work and irregular working hours for the mental health of shift workers.

Objective: The objective of our work was to assess the impact of flight conditions by aircraft type on the workload estimated using NASA-Task Load Index (NASA-TLX)., Background: Learning about subjective workload is important for assessing the impact of a pilot's work environment on their performance in the cockpit. This is an important element of flight safety and includes the prevention of aviation accidents., Methods: The study included 146 military pilots that fly the following aircrafts: flying fast-jet (21), fixed-wing (24), and rotary-wing (101). The NASA-TLX questionnaire was used to assess workload and pilots were asked to determine the level of workload resulting from flying under the following conditions: daytime flight (VFR), night-vision flight performed under Night Visual Flight Rules (NVFR), and night-vision flight using night-vision goggles (NVGs)., Results: The highest level of workload was consistently attributed to flights performed under NVG conditions. NVFR conditions were rated as the most burdensome, while VFR conditions were rated as the least burdensome. Fast-jet pilots rated their mental performance and effort workload as significantly higher than pilots of other aircrafts., Conclusion: Pilots' perceived workload is influenced by both flight conditions and the type of aircraft they fly. Workload knowledge is important for flight safety and should be taken into account during training and flight-task planning., Application: The results of our study can be useful both in flight training and in work on the effectiveness of the human-machine interface. Awareness of one's own limitations due to the work environment can help improve flight safety., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. We would like to thank pilot Major Marek Gąsik for consulting on aviation knowledge The authors also wish to extend thanks to the anonymous reviewers for their valuable comments and suggestions for improving the quality of this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: We investigated the extent to which a voluntary-use range and bearing line (RBL) tool improves return-to-manual performance when supervising high-degree conflict detection automation in simulated air traffic control., Background: High-degree automation typically benefits routine performance and reduces workload, but can degrade return-to-manual performance if automation fails. We reasoned that providing a voluntary checking tool (RBL) would support automation failure detection, but also that automation induced complacency could extend to nonoptimal use of such tools., Method: Participants were assigned to one of three conditions, where conflict detection was either performed: manually, with RBLs available to use (Manual + RBL), automatically with RBLs (Auto + RBL), or automatically without RBLs (Auto). Voluntary-use RBLs allowed participants to reliably check aircraft conflict status. Automation failed once., Results: RBLs improved automation failure detection - with participants intervening faster and making fewer false alarms when provided RBLs compared to not (Auto + RBL vs Auto). However, a cost of high-degree automation remained, with participants slower to intervene to the automation failure than to an identical manual conflict event (Auto + RBL vs Manual + RBL). There was no difference in RBL engagement time between Auto + RBL and Manual + RBL conditions, suggesting participants noticed the conflict event at the same time., Conclusions: The cost of automation may have arisen from participants' reconciling which information to trust: the automation (which indicated no conflict and had been perfectly reliable prior to failing) or the RBL (which indicated a conflict)., Applications: Providing a mechanism for checking the validity of high-degree automation may facilitate human supervision of automation.

The General Ability Measure for Adults (GAMA) is a brief nonverbal assessment of general intellectual ability. Presently, there is a lack of research involving the use of the GAMA in a high-functioning population. Aviation pilots ( n =  59 ) were referred for a neuropsychological evaluation and were concluded to be cognitively intact. They were administered a battery that included the GAMA and Wechsler Adult Intelligence Scale - 4th edition (WAIS-IV). A paired samples t -test revealed that IQ scores on the GAMA were significantly lower than IQ scores on the WAIS-IV, with WAIS-IV IQ being 7.54 points higher on average. Fisher's exact test determined there was significant disagreement in score classification between the tests, with individuals classified as Above Average on the WAIS-IV often being classified as Average on the GAMA. The GAMA appears to significantly underrepresent true IQ in both score and classification when compared to a more robust measure of intellectual assessment. Clinically, this suggests that IQ screeners, such as the GAMA, may not be appropriate for assessing patients who are suspected to be of higher premorbid functioning. Future research should expand on these results to assess the validity of verbal-based IQ screening measures in high-functioning populations.

As urbanization and population growth escalate, the challenge of noise pollution intensifies, particularly within the aviation industry. This review examines current insights into noise-induced hearing loss (NIHL) in aviation, highlighting the risks to pilots, cabin crew, aircraft maintenance engineers, and ground staff from continuous exposure to high-level noise. It evaluates existing noise management and hearing conservation strategies, identifying key obstacles and exploring new technological solutions. While progress in developing protective devices and noise control technologies is evident, gaps in their widespread implementation persist. The study underscores the need for an integrated strategy combining regulatory compliance, technological advances, and targeted educational efforts. It advocates for global collaboration and policy development to safeguard the auditory health of aviation workers and proposes a strategic framework to enhance hearing conservation practices within the unique challenges of the aviation sector., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Humans working in modern work systems are increasingly required to supervise task automation. We examined whether manual aircraft conflict detection skill predicted participants' ability to respond to conflict detection automation failures in simulated air traffic control. In a conflict discrimination task (to assess manual skill), participants determined whether pairs of aircraft were in conflict or not by judging their relative-arrival time at common intersection points. Then in a simulated air traffic control task, participants supervised automation which either partially or fully detected and resolved conflicts on their behalf. Automation supervision required participants to detect when automation may have failed and effectively intervene. When automation failed, participants who had better manual conflict detection skill were faster and more accurate to intervene. However, a substantial proportion of variance in failure intervention was not explained by manual conflict detection skill, potentially reflecting that future research should consider other cognitive skills underlying automation supervision., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)

Background: The accumulated knowledge has led to a state of misunderstanding about the precise meanings of digitalization, and a precise framework to define smart airports is still missing., Objective: This study aims to reveal the current status and future direction of smart airports and digital transformation in the academic literature and to provide a comprehensive definition for smart airports., Methods: The identified keywords were searched in the Web of Science database covering the years 1989-2024 and a total of 372 studies were found. These studies were then analyzed using Bibliometrix (R package)., Results: We determined that the most influential academic source on the themes is the Journal of Air Transport Management, and the collaboration index in the literature is three. While conferences are the most productive sources in this field, academic journals are mostly cited in studies. Academic studies typically employ and evaluate "performance" and "model," "impact" and "air," and "economic development" and "location" in tandem, despite the distinction between technological and managerial issues., Conclusion: In the light of the findings, the definition of a smart airport can be "an airport ecosystem where personalized service is provided to users by using Industry 4.0 technologies on the basis of big data analysis and real-time sharing between objects; digitalization is turned into a holistic organizational culture starting from top management to cover all personnel; the decision-making process is carried out autonomously within the entire airport operation network; and the main goal of competitive advantage and high-level user experience is provided uninterruptedly."

Cosmic radiation exposure is one of the important health concerns for aircrews. In this work, we constructed a back propagation neural network model for the real-time and rapid assessment of cosmic radiation exposure to the public in aviation. The multi-dimensional dataset for this neural network was created from modeling the process of cosmic ray transportation in magnetic field by geomagnetic cutoff rigidity method and air shower simulation by a Monte Carlo based Geant4 code. The dataset was characterized by parameters including cosmic ray energy spectrum, Kp-index, coordinated universal time, altitude, latitude, and longitude. The effective dose and dose rate was finally converted from the particle fluxes at flight position by the neural network. This work shows a good agreement with other models from International Civil Aviation Organization. It is also illustrated that the effective dose rate by galactic cosmic ray is <10 μSv h-1 and the value during ground level enhancement (GLE) 42 is 4 ~ 10 times larger on the routes calculated in this work. In GLE 69, the effective dose rate reaches several mSv h-1 in the polar region. Based on this model, a real-time warning system is achieved., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Concerns about civil aviation's air quality and environmental impacts have led to recent regulations on nonvolatile particulate matter (nvPM) mass and number emissions. Although these regulations do not mandate measuring particle size distribution (PSD), understanding PSDs is vital for assessing the environmental impacts of aviation nvPM. This study introduces a comprehensive data set detailing PSD characteristics of 42 engines across 19 turbofan types, ranging from unregulated small business jets to regulated large commercial aircraft. Emission tests were independently performed by using the European and Swiss reference nvPM sampling and measurement systems with parallel PSD measurements. The geometric mean diameter (GMD) at the engine exit strongly correlated with the nvPM number-to-mass ratio (N/M) and thrust, varying from 7 to 52 nm. The engine-exit geometric standard deviation ranged from 1.7 to 2.5 (mean of 2.05). The study proposes empirical correlations to predict GMD from N/M data of emissions-certified engines. These predictions are expected to be effective for conventional rich-burn engines and might be extended to novel combustor technologies if additional data become available. The findings support the refinement of emission models and help in assessing the aviation non-CO 2 climate and air quality impacts.

The concept of an innovative human-machine interface and interaction modes based on virtual and augmented reality technologies for airport control towers has been developed with the aim of increasing the human performances and situational awareness of air traffic control operators. By presenting digital information through see-through head-mounted displays superimposed over the out-of-the-tower view, the proposed interface should stimulate controllers to operate in a head-up position and, therefore, reduce the number of switches between a head-up and a head-down position even in low visibility conditions. This paper introduces the developed interface and describes the exercises conducted to validate the technical solutions developed, focusing on the simulation platform and exploited technologies, to demonstrate how virtual and augmented reality, along with additional features such as adaptive human-machine interface, multimodal interaction and attention guidance, enable a more natural and effective interaction in the control tower. The results of the human-in-the-loop real-time validation exercises show that the prototype concept is feasible from both an operational and technical perspective, the solution proves to support the air traffic controllers in working in a head-up position more than head-down even with low-visibility operational scenarios, and to lower the time to react in critical or alerting situations with a positive impact on the human performances of the user. While showcasing promising results, this study also identifies certain limitations and opportunities for refinement, aimed at further optimising the efficacy and usability of the proposed interface., (© 2024. The Author(s).)

Introduction: Measuring an operator's physiological state and using that data to predict future performance decrements has been an ongoing goal in many areas of transportation. Regarding Army aviation, the realization of such an endeavor could lead to the development of an adaptive automation system which adapts to the needs of the operator. However, reaching this end state requires the use of experimental scenarios similar to real-life settings in order to induce the state of interest that are able to account for individual differences in experience, exposure, and perception to workload manipulations. In the present study, we used an individualized approach to manipulating workload in order to account for individual differences in response to workload manipulations, while still providing an operationally relevant flight experience., Methods: Eight Army aviators participated in the study, where they completed two visits to the laboratory. The first visit served the purpose of identifying individual workload thresholds, with the second visit resulting in flights with individualized workload manipulations. EEG data was collected throughout both flights, along with subjective ratings of workload and flight performance., Results: Both EEG data and workload ratings suggested a high workload. Subjective ratings were higher during the high workload flight compared to the low workload flight ( p < 0.001). Regarding EEG, frontal alpha ( p = 0.04) and theta ( p = 0.01) values were lower and a ratio of beta/(alpha+theta) ( p = 0.02) were higher in the baseline flight scenario compared to the high workload scenario. Furthermore, the data were compared to that collected in previous studies which used a group-based approach to manipulating workload., Discussion: The individualized method demonstrated higher effect sizes in both EEG and subjective ratings, suggesting the use of this method may provide a more reliable way of producing high workload in aviators., Competing Interests: AM was employed by Goldbelt Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Feltman, Vogl, McAtee and Kelley.)

Measuring pilot mental workload (MWL) is crucial for enhancing aviation safety. However, MWL is a multi-dimensional construct that could be affected by multiple factors. Particularly, in the context of a more automated cockpit setting, the traditional methods of assessing pilot MWL may face challenges. Heart rate variability (HRV) has emerged as a potential tool for detecting pilot MWL during real-flight operations. This review aims to investigate the relationship between HRV and pilot MWL and to assess the performance of machine-learning-based MWL detection systems using HRV parameters. A total of 29 relevant papers were extracted from three databases for review based on rigorous eligibility criteria. We observed significant variability across the reviewed studies, including study designs and measurement methods, as well as machine-learning techniques. Inconsistent results were observed regarding the differences in HRV measures between pilots under varying levels of MWL. Furthermore, for studies that developed HRV-based MWL detection systems, we examined the diverse model settings and discovered that several advanced techniques could be used to address specific challenges. This review serves as a practical guide for researchers and practitioners who are interested in employing HRV indicators for evaluating MWL and wish to incorporate cutting-edge techniques into their MWL measurement approaches.

Introduction: Pilots' safety attitude is crucial for aviation safety. Current research shows a correlation between perceived stress and safety attitude, yet the mechanism underlying this association remains unclear. Against the backdrop of heightened attention to pilots' stress, this study aims to thoroughly explore the inherent connection between pilot safety attitudes and their perceived stress, offering targeted insights into preventing and addressing safety attitude issues arising from pilot stress., Methods: Through path analysis of questionnaire data from 106 civil aviation pilots in China, this study systematically investigates the roles of job burnout and cognitive flexibility in the relationship between perceived stress and safety attitude. The study reveals the chain-mediated mechanism of these two factors., Results: The results demonstrate a significantly negative correlation between pilots' perceived stress and safety attitude, with cognitive flexibility and job burnout fully mediating this relationship, and cognitive flexibility affecting job burnout. A detailed analysis of the three dimensions of job burnout reveals varying impacts of emotional exhaustion, depersonalization, and reduced personal accomplishment on the aforementioned path. The research model exhibits a good fit (GFI=0.902), providing new theoretical perspectives on the association between pilots' perceived stress and safety attitude., Discussion: The findings offer practical implications for improving pilots' safety attitude by proposing targeted measures to alleviate the adverse impacts of perceived stress on safety attitude, thereby promoting aviation safety., Competing Interests: LP was employed by Zhuhai Xiangyi Aviation Technology Co., Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yanzeng, Keyong, Hongmin, Ziyu, Pengyu and Lijing.)

This study aims to conduct a bibliometric analysis to determine trends and emerging research directions of sustainable aviation between 2001 and 2023. 726 studies indexed in the Web of Science were examined through VOSviewer software. Science mapping and performance analyses were implemented to demonstrate a systematic quantitative review and the characteristics of the research area. Moreover, by using co-occurrence of keywords, citation, bibliographic coupling, co-authorship, and co-citation analyses, the trends of the research area were revealed in detail. Findings indicated that the publications on sustainable aviation literature were mainly conducted between 2020 and 2023. Research areas of the publications were mainly on "engineering" and "energy fuels". In terms of number of the publications, "International Journal of Sustainable Aviation Fuel" was the most productive source and Heyne was the most productive author. Co-occurrence analysis demonstrated that "sustainable aviation fuel" was the most frequently used keyword. Furthermore, sustainable aviation research has shifted in focus toward more challenging and technology-oriented research over time. Citation analysis indicated that the most cited author was Heyne, the most cited study was Ma et al.'s study on "Aviation biofuel from renewable resources: routes, opportunities and challenges" and the most cited sources was "Energy". Among countries, the U.S.A was the most cited country and Chinese Academy of Sciences was the most cited organization. Bibliographic analysis showed that Heyne was the author with the highest connection strength. Co-authorship analysis demonstrated that Washington State University was the most collaborative organization. Finally, co-citation analysis of cited references indicated that fundamental subjects and related references were mainly sustainable aviation fuel, production of sustainable aviation fuel and its use in aviation studies. It is anticipated that results of this study would contribute to sustainable aviation research and ensure guidance and new perspectives for future research topics and directions on sustainable aviation., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Reliable testing of aviation components depends on the quality and configuration flexibility of measurement systems. In a typical approach to test instrumentation, there are tens or hundreds of sensors on the test head and test facility, which are connected by wires to measurement cards in control cabinets. The preparation of wiring and the setup of measurement systems are laborious tasks requiring diligence. The use of smart wireless transducers allows for a new approach to test preparation by reducing the number of wires. Moreover, additional functionalities like data processing, alarm-level monitoring, compensation, or self-diagnosis could improve the functionality and accuracy of measurement systems. A combination of low power consumption, wireless communication, and wireless power transfer could speed up the test-rig instrumentation process and bring new test possibilities, e.g., long-term testing of moving or rotating components. This paper presents the design of a wireless smart transducer dedicated for use with sensors typical of aviation laboratories such as thermocouples, RTDs (Resistance Temperature Detectors), strain gauges, and voltage output integrated sensors. The following sections present various design requirements, proposed technical solutions, a study of battery and wireless power supply possibilities, assembly, and test results. All presented tests were carried out in the Components Test Laboratory located at the Łukasiewicz Research Network-Institute of Aviation.

Aviation has been shown to cause high particle number concentrations (PNC) in areas surrounding major airports. Particle size distribution and composition differ from motorized traffic. The objective was to study short-term effects of aviation-related UFP on respiratory health in children. In 2017-2018 a study was conducted in a school panel of 7-11 year old children (n = 161) living North and South of Schiphol Airport. Weekly supervised spirometry and exhaled nitric oxide (eNO) measurements were executed. The school panel, and an additional group of asthmatic children (n = 19), performed daily spirometry tests at home and recorded respiratory symptoms. Hourly concentrations of various size fractions of PNC and black carbon (BC) were measured at three school yards. Concentrations of aviation-related particles were estimated at the residential addresses using a dispersion model. Linear and logistic mixed models were used to investigate associations between daily air pollutant concentrations and respiratory health. PNC20, a proxy for aviation-related UFP, was virtually uncorrelated with BC and PNC50-100 (reflecting primarily motorized traffic), supporting the feasibility of separating PNC from aviation and other combustion sources. No consistent associations were found between various pollutants and supervised spirometry and eNO. Major air pollutants were significantly associated with an increase in various respiratory symptoms. Odds Ratios for previous day PNC20 per 3,598pt/cm 3 were 1.13 (95%CI 1.02; 1.24) for bronchodilator use and 1.14 (95%CI 1.03; 1.26) for wheeze. Modelled aviation-related UFP at the residential addresses was also positively associated with these symptoms, corroborating the PNC20 findings. PNC20 was not associated with daily lung function, but PNC50-100 and BC were negatively associated with FEV1. PNC of different sizes indicative of aviation and other combustion sources were independently associated with an increase of respiratory symptoms and bronchodilator use in children living near a major airport. No consistent associations between aviation-related UFP with lung function was observed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)