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BACKGROUND: Airline pilots experience unique occupational demands that may contribute to adverse physical and psychological health outcomes. Epidemiological reports have shown a substantial prevalence of cardiometabolic health risk factors including excessive body weight, elevated blood pressure, poor lifestyle behaviors, and psychological fatigue. Achieving health guidelines for lifestyle behavior nutrition, physical activity, and sleep are protective factors against the development of noncommunicable diseases and may mitigate the unfavorable occupational demands of airline pilots. This narrative review examines occupational characteristics for sleep, nutrition, and physical activity and outlines evidence-based strategies to inform health behavior interventions to mitigate cardiometabolic health risk factors among airline pilots. METHODS: Literature sources published between 1990 and 2022 were identified through electronic searches in PubMed, MEDLINE (via OvidSP), PsychINFO, Web of Science, and Google Scholar databases, and a review of official reports and documents from regulatory authorities pertaining to aviation medicine and public health was conducted. The literature search strategy comprised key search terms relating to airline pilots, health behaviors, and cardiometabolic health. The inclusion criteria for literature sources were peer-reviewed human studies, meta-analyses, systematic reviews, and reports or documents published by regulatory bodies. RESULTS: The results of the review show occupational factors influencing nutrition, sleep, and physical activity behaviors and delineate evident occupational disruptions to these lifestyle behaviors. Evidence from clinical trials demonstrates the efficacy of nutrition, sleep, and physical activity interventions for enhancing the cardiometabolic health of airline pilots. CONCLUSION: This narrative review suggests that implementing evidence-based interventions focused on nutrition, physical activity, and sleep could help mitigate cardiometabolic health risk factors among airline pilots, who are particularly susceptible to adverse health outcomes due to unique occupational demands.

The localized crustal magnetic anomalies scattered across the surface Mars create a unique, hybrid magnetosphere. Over regions of strong crustal magnetism (100-1000 nT at the surface), the crustal anomalies protrude up to thousands of kilometers in space and a create a “mini-magnetospheric” interaction with the draped interplanetary magnetic field (IMF). One consequence of this interaction is the occurrence of discrete aurora on the nightside of Mars via electron precipitation and energy deposition into the planet’s atmosphere stimulating light emission (Bertaux et al., 2005). Discrete auroral emissions from electron impact with atmospheric CO2 in the mid ultra-violet have been observed via the Imaging Ultra-Violet Spectrograph (IUVS) instrument onboard the Mars Atmosphere and Volatile EvolutioN (MAVEN) spacecraft. These emissions have been preferentially observed over the region of strong crustal magnetism in the southern hemisphere (~153°-213° E longitude, 30°S-70°S latitude) and favor “open” magnetic field lines (i.e., one end connected to the IMF, the other connected to the planet) (Schneider et al., 2021). These trends suggest discrete aurora at Mars may form via magnetic reconnection between the strong crustal anomalies and the draped IMF around the planet. Magnetic reconnection is a process that can “open-up” the closed crustal magnetic fields at Mars and accelerate electrons along these magnetic field lines. However, there has yet to be a study that links these two phenomena directly, and as a result, our understanding of discrete auroral formation at Mars remains poorly understood. In this study, we uncover the relationship between magnetic reconnection and discrete aurora at Mars by analyzing the draped magnetic field conditions during 78 discrete auroral emissions observed via nadir observations taken by the IUVS within the region of strong crustal fields. First, we simplify the crustal field region into its two primary constituents: one crustal anomaly that is positioned in the northern half of the region and closes northward, and one crustal anomaly that is positioned in the southern half of the region and closes southward (Figure 1). We note that the discrete auroral emissions tend to fall on the “footprints” of the two crustal anomalies where the dominant component of the crustal magnetic field points radially into or out of the planet. Two plasma regimes are more susceptible to reconnection when their magnetic field orientations are anti-parallel to one another. Therefore, we hypothesize that if crustal field-draped IMF magnetic reconnection plays a role in discrete auroral formation over the strong crustal anomalies at Mars, then a southward draped IMF would activate auroral emissions over the northern crustal anomaly and a northward draped IMF would activate auroral emissions over the southern crustal anomaly. We estimate the orientation of the draped magnetic field over this region of strong crustal magnetism using data obtained from the magnetometer instrument onboard MAVEN along the same orbit in a discrete auroral emission was detected by IUVS. We find that the estimated orientation of the draped magnetic field associated with each discrete auroral event shows a regional dependence consistent with our hypothesis: discrete auroral emissions over the footprints of the northern anomaly are associated with southward draped fields, and emissions over the footprints of the southern anomaly are associated with northward draped fields (Figure 2). We also demonstrate that these findings hold implications for other trends reported in previous studies of discrete aurora over this region of crustal fields, namely a trend in local time and upstream IMF conditions. This study is the first to more definitively link magnetic reconnection to discrete aurora formation on the nightside of Mars. Bertaux, J., F. Leblanc, O. Witasse, E. Quemerais, J. Lilensten, S. Stern, B. Sandel, and O. Korablev (2005), Discovery of an aurora on Mars, Nature, 435(7043), 790-794. Schneider, N., et al. (2021), Discrete Aurora on Mars: Insights Into Their Distribution and Activity From MAVEN/IUVS Observations, Journal of Geophysical Research-Space Physics, 126(10).

Purpose The aim of this study was to evaluate the efficacy of a 17-week, 3-component lifestyle intervention for enhancing health behaviors during the coronavirus disease-2019 (COVID-19) pandemic. Methods A parallel-group (intervention and control) study was conducted amongst 79 airline pilots over a 17-week period during the COVID-19 pandemic. The intervention group (n = 38) received a personalized sleep, dietary, and physical activity (PA) program. The control group (n = 41) received no intervention. Outcome measures for sleep, fruit and vegetable intake, PA, and subjective health were measured though an online survey before and after the 17-week period. The changes in outcome measures were used to determine the efficacy of the intervention. Results Significant main effects for Time × Group were found for International Physical Activity Questionnaire-Walk (p = 0.02) and for all other outcome measures (p < 0.01). The intervention group significantly improved in sleep duration (p < 0.01; d = 1.02), Pittsburgh Sleep Quality Index score (p < 0.01; d = –1.01), moderate-to-vigorous PA (p < 0.01; d = 1.32), fruit and vegetable intake (p < 0.01; d = 3.11), Short-Form-12v2 physical score (p < 0.01; d = 1.84), and Short-Form-12v2 mental score (p < 0.01; d = 2.69). The control group showed significant negative change for sleep duration (p < 0.01; d = –0.47), Pittsburgh Sleep Quality Index score (p < 0.01; d = 0.28), and Short-Form-12v2 mental score (p < 0.01; d = –0.64). Conclusion Results provide preliminary evidence that a 3-component healthy sleep, eating and PA intervention elicit improvements in health behaviors and perceived subjective health in pilots and may improve quality of life during an unprecedented global pandemic., Graphical abstract Image, graphical abstract

International audience; Discrete aurorae have been observed at magnetized planets such as Earth and Jupiter, triggered by accelerated electrons. Similar aurorae have also been observed at Mars with only localized strong crustal magnetisms. However, our understanding of this phenomenon at Mars is still limited. In particular, direct and quantitative comparisons of the auroral and its source electron events are lacking as these two types of observations are usually made at different times and/or locations. In this study, we establish empirical criteria to select electron events ("auroral electrons") that could trigger detectable auroral emissions with Mars Atmosphere and Volatile EvolutioN measurements, thereby enabling a direct statistical comparison. We find auroral electrons share similar statistical characteristics to those previously reported for discrete auroral events. This study bridges the gap between electron observations and auroral detections and enables collaborations across different Mars missions, as well as comparative planetary studies of discrete aurora.

Discrete aurora are sporadic ultraviolet emissions on Mars. These emissions, which occur globally and in the upper atmosphere of Mars, are strongly correlated with martian crustal magnetic field. Crustal fields on Mars form from remanent magnetism locked in the crust, and vary in strength across the disk, with the strongest fields located in the southern hemisphere. Previous studies using data taken by the MAVEN spacecraft has revealed hundreds of detections in limb viewing and a single detection in the nadir observations. Further analysis of all nightside MUV nadir-viewing observations taken by the MAVEN Imaging Ultraviolet Spectrograph (IUVS) instrument has revealed approximately two hundred additional discrete aurora detections. While aurora occur globally and sporadically, events in the strongest crustal magnetic field regions of the martian southern hemisphere show high repeatability. Previous work reported using IUVS limb observations (Schneider et al., 2021) revealed detections occurring before midnight; the emissions identified in the nadir dataset show detections both occurring before midnight and after midnight in the strong field region. We find a previously unreported correlation and between local time and geographic location, with two distinct auroral event groups manifesting pre- and post-midnight in separate but adjacent locations in the strong field region. Magnetic field reconnection may explain this regional local time control of discrete aurora on Mars. To see the complete thesis, please visit https://scholar.colorado.edu/concern/undergraduate_honors_theses/cj82k859v.

Background: The occupational demands of professional airline pilots such as shift work, work schedule irregularities, sleep disruption, fatigue, physical inactivity, and psychological stress may promote adverse outcomes to cardiometabolic health. This review investigates the prevalence of cardiometabolic health risk factors for airline pilots. Methods: An electronic search was conducted utilizing PubMed, MEDLINE (via OvidSP), CINAHL, PsycINFO, SPORTDiscus, CENTRAL, and Web of Science for publications between 1990 and February 2022. The methodological quality of included studies was assessed using two quality assessment tools for cross-sectional and clinical trial studies. The prevalence of physiological, behavioral, and psychological risk factors was reported using descriptive analysis. Results: A total of 48 studies derived from 20 different countries, reviewing a total pooled sample of 36,958 airline pilots. Compared with general population estimates, pilots had a similar prevalence for health risk factors, yet higher sleep duration, lower smoking and obesity rates, less physical activity, and a higher overall rate of body mass index >25. Conclusions: The research reported substantial prevalence >50% for overweight and obesity, insufficient physical activity, elevated fatigue, and regular alcohol intake among pilots. However, the heterogeneity in methodology and the lack of quality and quantity in the current literature limit the strength of conclusions that can be established. Enhanced monitoring and future research are essential to inform aviation health practices and policies (Systematic Review Registration: PROSPERO CRD42022308287).

The aim of this study was to perform a 12-month follow-up of health parameters after a 17-week lifestyle intervention in overweight airline pilots. A parallel-group (intervention and control) study was conducted amongst 72 overweight airline pilots (body mass index > 25) over a 12-month period following the emergence of COVID-19. The intervention group (n = 35) received a personalized dietary, sleep, and physical activity program over a 17-week period. The control group (n = 37) received no intervention. Measurements for subjective health (physical activity, sleep quality and quantity, fruit and vegetable intake, and self-rated health) via an electronic survey, and objective measures of body mass and blood pressure were taken at baseline and at 12 months. Significant interactions for group × time from baseline to 12-months were found for all outcome measures (p < 0.001). Body mass and mean arterial pressure significantly decreased in the intervention group when compared to the control group (p < 0.001). Outcome measures for subjective health (physical activity, sleep quality and quantity, fruit and vegetable intake, and self-rated health) significantly increased in the intervention group when compared to the control group (p < 0.001). Results provide preliminary evidence that a brief three-component healthy sleep, diet and physical activity intervention can elicit and sustain long-term improvements in body mass and blood pressure management, health behaviors, and perceived subjective health in pilots and may support quality of life during an unprecedented global pandemic.

We developed a model, updated daily, to estimate undetected COVID-19 infections exiting quarantine following selectively opening New Zealand's borders to travellers from low-risk countries.The prevalence of infectious COVID-19 cases by country was multiplied by expected monthly passenger volumes to predict the rate of arrivals. The rate of undetected infections entering the border following screening and quarantine was estimated. Level 1, Level 2 and Level 3 countries were defined as those with an active COVID-19 prevalence of up to 1/105, 10/105 and 100/105, respectively.With 65,272 travellers per month, the number of undetected COVID-19 infections exiting quarantine is 1 every 45, 15 and 31 months for Level 1, Level 2 and Level 3 countries, respectively. The overall rate of undetected active COVID-19 infections exiting quarantine is expected to increase from the current 0.40 to 0.50 per month, or an increase of one extra infection every 10 months.Loosening border restrictions results in a small increase in the rate of undetected COVID-19 infections exiting quarantine, which increases from the current baseline by one infection every 10 months. This information may be useful in guiding decision-making on selectively opening of borders in the COVID-19 era.

BackgroundAntiretroviral therapy (ART) during pregnancy is important for both maternal health and prevention of perinatal HIV-1 transmission; however adequate data on the safety and efficacy of different ART regimens that are likely to be used by pregnant women are scarce. In this trial we compared the safety and efficacy of three antiretroviral regimens started in pregnancy: dolutegravir, emtricitabine, and tenofovir alafenamide fumarate; dolutegravir, emtricitabine, and tenofovir disoproxil fumarate; and efavirenz, emtricitabine, and tenofovir disoproxil fumarate.MethodsThis multicentre, open-label, randomised controlled, phase 3 trial was done at 22 clinical research sites in nine countries (Botswana, Brazil, India, South Africa, Tanzania, Thailand, Uganda, the USA, and Zimbabwe). Pregnant women (aged ≥18 years) with confirmed HIV-1 infection and at 14-28 weeks' gestation were eligible. Women who had previously taken antiretrovirals in the past were excluded (up to 14 days of ART during the current pregnancy was permitted), as were women known to be pregnant with multiple fetuses, or those with known fetal anomaly or a history of psychiatric illness. Participants were randomly assigned (1:1:1) using a central computerised randomisation system. Randomisation was done using permuted blocks (size six) stratified by gestational age (14-18, 19-23, and 24-28 weeks' gestation) and country. Participants were randomly assigned to receive either once-daily oral dolutegravir 50 mg, and once-daily oral fixed-dose combination emtricitabine 200 mg and tenofovir alafenamide fumarate 25 mg; once-daily oral dolutegravir 50 mg, and once-daily oral fixed-dose combination emtricitabine 200 mg and tenofovir disoproxil fumarate 300 mg; or once-daily oral fixed-dose combination of efavirenz 600 mg, emtricitabine 200 mg, and tenofovir disoproxil fumarate 300 mg. The primary efficacy outcome was the proportion of participants with viral suppression, defined as an HIV-1 RNA concentration of less than 200 copies per mL, at or within 14 days of delivery, assessed in all participants with an HIV-1 RNA result available from the delivery visit, with a prespecified non-inferiority margin of -10% in the combined dolutegravir-containing groups versus the efavirenz-containing group (superiority was tested in a pre-planned secondary analysis). Primary safety outcomes, compared pairwise among treatment groups, were the occurrence of a composite adverse pregnancy outcome (ie, either preterm delivery, the infant being born small for gestational age, stillbirth, or spontaneous abortion) in all participants with a pregnancy outcome, and the occurrence of grade 3 or higher maternal and infant adverse events in all randomised participants. This trial was registered with ClinicalTrials.gov, NCT03048422.FindingsBetween Jan 19, 2018, and Feb 8, 2019, we enrolled and randomly assigned 643 pregnant women: 217 to the dolutegravir, emtricitabine, and tenofovir alafenamide fumarate group, 215 to the dolutegravir, emtricitabine, and tenofovir disoproxil fumarate group, and 211 to the efavirenz, emtricitabine, and tenofovir disoproxil fumarate group. At enrolment, median gestational age was 21·9 weeks (IQR 18·3-25·3), the median HIV-1 RNA concentration among participants was 902·5 copies per mL (152·0-5182·5; 181 [28%] of 643 participants had HIV-1 RNA concentrations of

(1) Background: The aim of this study was to evaluate the effectiveness of a three-component nutrition, sleep, and physical activity (PA) program on cardiorespiratory fitness, body composition, and health behaviors in overweight airline pilots. (2) Methods: A parallel group study was conducted amongst 125 airline pilots. The intervention group participated in a 16-week personalized healthy eating, sleep hygiene, and PA program. Outcome measures of objective health (maximal oxygen consumption (VO2max), body mass, skinfolds, girths, blood pressure, resting heart rate, push-ups, plank hold) and self-reported health (weekly PA, sleep quality and duration, fruit and vegetable intake, and self-rated health) were collected at baseline and post-intervention. The wait-list control completed the same assessments. (3) Results: Significant group main effects in favor of the intervention group were found for all outcome measures (p < 0.001) except for weekly walking (p = 0.163). All objective health measures significantly improved in the intervention group when compared to the control group (p < 0.001, d = 0.41–1.04). Self-report measures (moderate-to-vigorous PA, sleep quality and duration, fruit and vegetable intake, and self-rated health) significantly increased in the intervention group when compared to the control group (p < 0.001, d = 1.00–2.69). (4) Conclusion: Our findings demonstrate that a personalized 16-week healthy eating, PA, and sleep hygiene intervention can elicit significant short-term improvements in physical and mental health outcomes among overweight airline pilots. Further research is required to examine whether the observed effects are maintained longitudinally.

BACKGROUND CONTEXT Elderly patients are increasingly meeting the indications for spinal fusion and are more likely to have suboptimal bone quality. Patients with suboptimal bone quality who have undergone posterior cervical fusion have increased risk of fixation failure of up to 5.4% and may require stronger forms of fixation. Adding supplemental fixation to lateral mass screws (LMS) can increase fixation as measured by pullout strength. PURPOSE This work addresses the question: can supplemental screw fixation of lateral mass screws improve pullout strength? STUDY DESIGN/SETTING Biomechanical cadaveric study. PATIENT SAMPLE Fifteen C3-C6 vertebral bodies and 15 additional motion segments (C3-C4 or C5-C6) (age: 49-67). OUTCOME MEASURES Lateral mass screw construct peak pullout strength. METHODS All specimens were CT scanned with a phantom to obtain bone mineral density (BMD). The individual vertebral bodies and the cranial body of the motion segments were implanted with bilateral lateral mass screws. Supplemental fixation was added on one side of the vertebral body using two 2.4mm diameter unicortical screws (length 8-12mm). One side of the cranial vertebral body of the motion segments was supplemented with a single 2.4mm diameter transfacet tricortical screw (length 12-16mm). Screw constructs were subjected to posterior pullout coincident with the axis of the lateral mass screw at a rate of 5mm/min until failure. RESULTS A paired comparison was made of the peak pullout force of the LMS alone and LMS with supplemental fixation. Analysis was also made comparing BMD and pullout force.In the vertebral bodies with two supplemental unicortical screws, pullout force was significantly higher in the supplemented screw side. The average pullout force was 48.2% higher with supplemental screws (865±213N vs 637±206N; p=0.0038). There was moderate correlation between pullout force and bone mineral density for both the supplemented and LMS alone (correlation coefficients of 0.34 and 0.45 respectively). In the motion segments, peak pullout force was significantly higher in the side supplemented with a tricortical transfacet screw. The pullout force was 25.9% higher with supplemental transfacet screw fixation (1055±521N vs 912±508N; p=0.047). The pullout strength of the LMS with transfacet fixation was highly correlated with BMD (correlation coefficient of 0.71) while the LMS pullout strength was moderately correlated with BMD (correlation coefficient of 0.64). CONCLUSIONS Our data confirms the hypotheses that the pullout strength of C3-C6 LMS fixation using LMS supplemented with two unicortical screws or LMS supplemented with one-tricortical transfacet screw is superior to LMS fixation alone. FDA DEVICE/DRUG STATUS Cervical Fusion System (Approved for this indication)

Historically, busbar pull tests have been used as a measure of metal–silicon adhesion for silicon solar cells; however, such measurements cannot be easily applied to evaluate finger adhesion and the propensity of metal fingers to peel. Finger adhesion will be increasingly important as the width of fingers decrease and busbars are effectively removed from the cell metallization. In this paper, we correlate metal-plated finger dislodgement measurements, which have been obtained using a stylus-based metallization testing tool, and busbar pull test forces with nanoindentation measurements of the Young's modulus in order to determine key determinants of strong finger adhesion. It is proposed that metal fingers with a higher Young's modulus dislodge at lower stylus impact forces because the energy associated with the impact is less easily dissipated along the fingers and consequently remains more focused on the impact location, causing not only finger dislodgement but more extensive finger peeling as well. It is shown how plating rate, chemistry, grid geometry, and postplating annealing can all contribute to plated metal finger adhesion, therefore necessitating an understanding of these factors for reliable plated metallization.