36,254 results match your criteria Aviation Space and Environmental Medicine [Journal]


Direct Oral Anticoagulants and Travel-related Venous Thromboembolism.

Open Med (Wars) 2018 27;13:575-582. Epub 2018 Nov 27.

Division of Hematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Ext 80252, Thailand.

Travel- related thromboembolism reflects the relationship between venous thromboembolism (VTE) and long-haul flights. Although this condition is rare, it may cause significant morbidity and mortality. Therefore, travelers should be evaluated for the risks for thrombosis. Read More

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November 2018

How to Best Convey Information About Intensive/Comfort Care to the Family Members of Premature Infants to Enable Unbiased Perinatal Decisions.

Front Pediatr 2018 16;6:348. Epub 2018 Nov 16.

Department of Neurology, PLA Army General Hospital, Beijing, China.

As the infant's best interests are determined through the perinatal decisions of family members and physicians, it is important to understand the factors that affect such decisions. This paper investigated the separate and combined effects of various factors related to perinatal decision making and sought to determine the best way to convey information in an unbiased manner to family members. In total, 613 participants were consecutively recruited. Read More

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November 2018

Inattentional deafness to auditory alarms: inter-individual differences, electrophysiological signature and single trial classification.

Behav Brain Res 2018 Nov 30. Epub 2018 Nov 30.

ISAE-SUPAERO, Université de Toulouse, France.

Inattentional deafness can have deleterious consequences in complex real-life situations (e.g. healthcare, aviation) leading to miss critical auditory signals. Read More

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November 2018

Aviation Noise and Cardiovascular Health in the United States: a Review of the Evidence and Recommendations for Research Direction.

Curr Epidemiol Rep 2018 Jun 26;5(2):140-152. Epub 2018 Apr 26.

Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.

Purpose Of The Review: In the USA, there is mounting pressure on aviation operators and regulators to address concerns about community impacts of aircraft noise given increasing evidence of adverse health impacts, continuing community complaints, availability of cost-effective programs to reduce exposures to aircraft noise, and more stringent international policies. In the USA, regulation of civil aviation noise is the responsibility of the Federal Aviation Administration (FAA), which requires a "significant body of scientific support," particularly applicable to the USA, to inform health-based policy and regulatory decisions. However, there have been very few studies investigating the relationship between noise and health in the USA and limited studies across the globe characterizing the effects of aviation noise specifically on cardiovascular health. Read More

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Optimal Synthesis of Four-Bar Linkage Path Generation through Evolutionary Computation with a Novel Constraint Handling Technique.

Comput Intell Neurosci 2018 1;2018:5462563. Epub 2018 Nov 1.

Sustainable and Infrastructure Research and Development Center, Department of Mechanical Engineering, Faculty of Engineering, Khon Kaen University, Khon Kaen 40002, Thailand.

This paper presents a novel constraint handling technique for optimum path generation of four-bar linkages using evolutionary algorithms (EAs). Usually, the design problem is assigned to minimize the error between desired and obtained coupler curves with penalty constraints. It is found that the currently used constraint handling technique is rather inefficient. Read More

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November 2018

Field study of neutrality cabin temperature for Chinese passenger in economy class of civil aircraft.

J Therm Biol 2018 Dec 19;78:312-319. Epub 2018 Oct 19.

School of Aviation Science and Engineering, Beijing University of Aeronautics and Astronautics (BUAA), Beijing 100191, China.

Cabin thermal comfort is an important factor for the competitiveness of civil aviation. It has become a hot topic in recent years. However, there are still no clear standards for the thermal comfort in the aircraft cabin. Read More

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December 2018

Structure and motion design of a mock circulatory test rig.

J Med Eng Technol 2018 Nov 30:1-10. Epub 2018 Nov 30.

d Faculty of Arts, Science and Technology , University of Northampton , Northampton , UK.

Mock circulatory test rig (MCTR) is the essential and indispensable facility in the cardiovascular in vitro studies. The system configuration and the motion profile of the MCTR design directly influence the validity, precision, and accuracy of the experimental data collected. Previous studies gave the schematic but never describe the structure and motion design details of the MCTRs used, which makes comparison of the experimental data reported by different research groups plausible but not fully convincing. Read More

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November 2018

Safety and efficacy of targeted alpha therapy with Bi-DOTA-substance P in recurrent glioblastoma.

Eur J Nucl Med Mol Imaging 2018 Nov 29. Epub 2018 Nov 29.

European Commission, Joint Research Centre, Directorate for Nuclear Safety and Security, Karlsruhe, Germany.

Treatment options for recurrent glioblastoma multiforme (GBM) are very limited. GBM cells express high levels of the GPCR neurokinin type 1 receptor (NK-1R), and a modified substance P can be used as its ligand for the tumor cell targeting. Targeted alpha therapy with DOTA-Substance P labeled with the short range alpha emitter Bi allows for selective irradiation and killing of tumor cells. Read More

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November 2018
3 Reads

Ultra-wideband and Polarization-Insensitive Perfect Absorber Using Multilayer Metamaterials, Lumped Resistors, and Strong Coupling Effects.

Nanoscale Res Lett 2018 Nov 29;13(1):386. Epub 2018 Nov 29.

Information and Navigation College, Air Force Engineering University, Xi'an, 710077, China.

We theoretically and experimentally proposed a new structure of ultra-wideband and thin perfect metamaterial absorber loaded with lumped resistances. The thin absorber was composed of four dielectric layers, the metallic double split ring resonators (MDSRR) microstructures and a set of lumped resistors. The mechanism of the ultra-wideband absorption was analyzed and parametric study was also carried out to achieve ultra-wideband operation. Read More

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November 2018
2.779 Impact Factor

Managing emergencies: lessons from aviation.

Community Eye Health 2018 ;31(103):58-59

Flight Operations Manager: Mission Aviation Fellowship, Papua New Guinea.

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January 2018

Triage and Treatment of Mass Casualty Decompression Sickness After Depressurization at 6400 m.

Aerosp Med Hum Perform 2018 Dec;89(12):1085-1088

Decompression sickness is a condition that results from an abrupt change from a higher to a lower pressure. It is described most commonly in divers; however, it can occur in aviation incidents, which this case report will discuss. Following an acute cabin depressurization incident, 36 patients presented to a small outpatient clinic with multiple symptoms, including fatigue, headache, nausea, vomiting, and dizziness. Read More

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December 2018

A Novel Fault-Tolerant Navigation and Positioning Method with Stereo-Camera/Micro Electro Mechanical Systems Inertial Measurement Unit (MEMS-IMU) in Hostile Environment.

Micromachines (Basel) 2018 Nov 27;9(12). Epub 2018 Nov 27.

Shanxi Baocheng Aviation Instrument Co., Ltd., AVIC, Baoji 721006, China.

Visual odometry (VO) is a new navigation and positioning method that estimates the ego-motion of vehicles from images. However, VO with unsatisfactory performance can fail severely in hostile environment because of the less feature, fast angular motions, or illumination change. Thus, enhancing the robustness of VO in hostile environment has become a popular research topic. Read More

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November 2018
3 Reads

Damage Characteristics of PELE Projectile with Gradient Density Inner Core Material.

Materials (Basel) 2018 Nov 27;11(12). Epub 2018 Nov 27.

School of Basic Sciences for Aviation, Naval Aviation University, Yantai 264001, China.

The PELE (penetration with enhanced lateral efficiency) projectile is a new type of safe ammunition which can form a large number of fragments after perforating the target, and does not depend on any pyrotechnics. The damage characteristics of PELE projectile mainly include the penetration ability and fragmentation effect. There are many factors affecting the damage characteristics of PELE projectile, and this paper attempts to study the damage characteristics of PELE projectile, from the point of view of changing the single core material. Read More

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November 2018

Clemastine Alleviates Depressive-Like Behavior Through Reversing the Imbalance of Microglia-Related Pro-inflammatory State in Mouse Hippocampus.

Front Cell Neurosci 2018 13;12:412. Epub 2018 Nov 13.

Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, China.

Abundant reports indicate that neuroinflammatory signaling contributes to behavioral complications associated with depression and may be related to treatment response. The glial cells, especially microglia and astrocytes in brain regions of hippocampus and medial prefrontal cortex (mPFC), are major components of CNS innate immunity. Moreover, purinergic receptor P2X, ligand-gated ion channel 7 (P2X7R) was recently reckoned as a pivotal regulator in central immune system. Read More

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November 2018

Colossal tunability in high frequency magnetoelectric voltage tunable inductors.

Nat Commun 2018 Nov 27;9(1):4998. Epub 2018 Nov 27.

Center for Energy Harvesting Materials and Systems, Virginia Tech, Blacksburg, VA, 24061, USA.

The electrical modulation of magnetization through the magnetoelectric effect provides a great opportunity for developing a new generation of tunable electrical components. Magnetoelectric voltage tunable inductors (VTIs) are designed to maximize the electric field control of permeability. In order to meet the need for power electronics, VTIs operating at high frequency with large tunability and low loss are required. Read More

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November 2018
2 Reads

Checklists in emergencies.

Semin Perinatol 2018 Nov 14. Epub 2018 Nov 14.

Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda 20814, MD, United State. Electronic address:

Checklists are memory aids comprised of various tasks to complete a process and have been successful in preventing errors and improving performance in various fields including aviation, aeronautics, and construction. (1) In recent years, use of safety checklists has increased within the medical field to standardize care and improve communication amongst providers and they hold significant promise to improve outcomes during obstetric emergencies. Read More

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November 2018
2 Reads

Optimized deep neural network architecture for robust detection of epileptic seizures using EEG signals.

Clin Neurophysiol 2018 Nov 15;130(1):25-37. Epub 2018 Nov 15.

Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. Electronic address:

Objective: Automatic detection of epileptic seizures based on deep learning methods received much attention last year. However, the potential of deep neural networks in seizure detection has not been fully exploited in terms of the optimal design of the model architecture and the detection power of the time-series brain data. In this work, a deep neural network architecture is introduced to learn the temporal dependencies in Electroencephalogram (EEG) data for robust detection of epileptic seizures. Read More

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November 2018
2 Reads

Future Technology on the Flight deck: Assessing the use of touchscreens in vibration environments.

Ergonomics 2018 Nov 23:1-29. Epub 2018 Nov 23.

a Transportation Research Group, Faculty of Engineering and Environment , University of Southampton , Southampton , UK ;

Use of touchscreens in the flight deck has been steadily increasing, however their usability may be severely impacted when turbulent conditions arise. Most previous research focusses on using touchscreens in static conditions, therefore this study assessed touchscreen use whilst undergoing turbulent representative motion, generated using a 6-axis motion simulator. Touchscreens were tested in centre, side and overhead positions, to investigate how turbulence affected: (1) error rate, movement times and accuracy, (2) arm fatigue and discomfort. Read More

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November 2018
1 Read

Prevalence and Perceptions of Team Training Programs for Pediatric Surgeons and Anesthesiologists.

J Surg Res 2018 Dec 7;232:559-563. Epub 2018 Aug 7.

Department of Surgery, University of Rochester School of Medicine, Rochester, New York. Electronic address:

Background: Team training programs adapt crew resource management principles from aviation to foster communication and prevent medical errors. Although multiple studies have demonstrated that team training programs such as TeamSTEPPS improve patient outcomes and safety across medical disciplines, limited data exist about their application to pediatric surgical teams. The purpose of this study was to investigate usage and perceptions of team training programs by pediatric surgeons and anesthesiologists. Read More

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December 2018
2 Reads

Does effective gaze behavior lead to enhanced performance in a complex error-detection cockpit task?

PLoS One 2018 21;13(11):e0207439. Epub 2018 Nov 21.

Movement Control & Neuroplasticity Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium.

The purpose of the current study was to examine the relationship between expertise, performance, and gaze behavior in a complex error-detection cockpit task. Twenty-four pilots and 26 non-pilots viewed video-clips from a pilot's viewpoint and were asked to detect malfunctions in the cockpit instrument panel. Compared to non-pilots, pilots detected more malfunctioning instruments, had shorter dwell times on the instruments, made more transitions, visited task-relevant areas more often, and dwelled longer on the areas between the instruments. Read More

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November 2018
1 Read

An empirical study on solving an integrated production and distribution problem with a hybrid strategy.

PLoS One 2018 21;13(11):e0206806. Epub 2018 Nov 21.

College of Business Administration, Capital University of Economics and Business, Beijing, China.

Coordination is essential for improving supply chain performance, and one of the most critical factors in achieving the coordination of a supply chain is the integrated research of production and distribution. In this paper, a novel two-stage hybrid solution methodology is proposed. In the first stage, products are processed on the serial machines of multiple manufacturers located in two industrial parks. Read More

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November 2018
3.234 Impact Factor

Cost-effective high-spatial-resolution photon-counting optical time-domain reflectometry at 850  nm.

Appl Opt 2018 Oct;57(30):8824-8828

Optical time-domain reflectometry (OTDR) is a widely employed instrument for monitoring the property of fiber links. Traditional OTDR always suffers from the trade-off between its spatial resolution and the sensitivity of light detection. Therefore, it cannot be applied in critical applications, such as in aviation, where OTDR with a high spatial resolution of several centimeters is required. Read More

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October 2018

Study on Damage Accumulation and Life Prediction with Loads below Fatigue Limit Based on a Modified Nonlinear Model.

Materials (Basel) 2018 Nov 16;11(11). Epub 2018 Nov 16.

State Key Laboratory of Engines, Tianjin University, Tianjin 300072, China.

Most fatigue theories neglect the loads below fatigue limit in damage accumulation, which leads to inconsistency between the predicted and the actual fatigue lives. In this study, a novel damage model is proposed to take into account the loads below fatigue limit from two aspects: the strengthening effect and the cumulative damage. The strengthening effect is introduced by an exponential function and the cumulative damage is calculated by fuzzy method with membership functions (MFs). Read More

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November 2018
2 Reads

Toward an Epidemiology of Safety and Security Risks: An Organizational Vulnerability Assessment in International Airports.

Risk Anal 2018 Nov 19. Epub 2018 Nov 19.

School of Management, Queensland University of Technology, Brisbane, QLD, Australia.

International airports are complex sociotechnical systems that have an intrinsic potential to develop safety and security disruptions. In the absence of appropriate defenses, and when the potential for disruption is neglected, organizational crises can occur and jeopardize aviation services. This investigation examines the ways in which modern international airports can be "authors of their own misfortune" by adopting practices, attitudes, and behaviors that could increase their overall level of vulnerability. Read More

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November 2018
5 Reads

Treatment protocol, long-term follow-up, and predictors of mortality in 302 cases of atypical meningioma.

World Neurosurg 2018 Nov 14. Epub 2018 Nov 14.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University. TiantanXili 6, Dongcheng District, Beijing, 100050, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Brain Tumor, Beijing, China. Electronic address:

Objective: Despite the paucity of relevant data, treatment and outcomes in intracranial atypical meningioma (AM) remain unclear. The aim of this study was to find useful factors predicting survival and to evaluate the role of postoperative radiation (PRT ) following surgery.

Methods: Data were obtained from 302 patients with AM who received surgery between January 2008 and December 2015. Read More

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November 2018
1 Read

[Transfer of a cockpit strategy to anesthesiology : Clinical example: introduction of canned decisions to solve cannot intubate cannot oxygenate situations].

Anaesthesist 2018 Nov 16. Epub 2018 Nov 16.

Klinik für Anästhesiologie und Operative Intensivtherapie, Katholisches Klinikum Bochum, Universitätsklinikum der Ruhr-Universität Bochum, Gudrunstraße 56, 44791, Bochum, Deutschland.

Background: Safety strategies in civil aviation are well-established. The authors present a possible structure for induction of anesthesia, which includes elements of the so-called cockpit strategy. The objective is to reduce anesthesia-related mortality caused by the unexpected difficult airway through early detection and solution of cannot intubate cannot oxygenate (CICO) situations. Read More

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November 2018
2 Reads

Fundamentals of Force-Controlled Friction Riveting: Part I-Joint Formation and Heat Development.

Materials (Basel) 2018 Nov 15;11(11). Epub 2018 Nov 15.

Graz University of Technology, Institute of Materials Science, Joining and Forming, BMVIT Endowed Professorship for Aviation, 8010 Graz, Austria.

This work presents a systematic study on the correlations between process parameters and rivet plastic deformation, produced by force-controlled friction riveting. The 5 mm diameter AA2024 rivets were joined to 13 mm, nominal thickness, polyetherimide plates. A wide range of joint formations was obtained, reflecting the variation in total energy input (24⁻208 J) and process temperature (319⁻501 °C). Read More

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November 2018

The psychological and physiological health effects of fatigue.

Occup Med (Lond) 2018 Nov;68(8):502-511

Aviation Medicine Unit, RNZAF Base Auckland, Whenuapai, Auckland, New Zealand.

Background: The issue of employee fatigue is becoming increasingly prominent, particularly in safety-critical industries.

Aims: To produce an in-depth review collating the known psychological and physiological health and work effects of fatigue to guide mitigation strategies in safety-critical industries.

Methods: Literature searches were conducted via scientific databases using appropriate filters and keywords. Read More

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November 2018
8 Reads

Performance Analysis of NDT-based Graph SLAM for Autonomous Vehicle in Diverse Typical Driving Scenarios of Hong Kong.

Sensors (Basel) 2018 Nov 14;18(11). Epub 2018 Nov 14.

Interdisciplinary Division of Aeronautical and Aviation Engineering, The Hong Kong Polytechnic University, Hong Kong, China.

Robust and lane-level positioning is essential for autonomous vehicles. As an irreplaceable sensor, Light detection and ranging (LiDAR) can provide continuous and high-frequency pose estimation by means of mapping, on condition that enough environment features are available. The error of mapping can accumulate over time. Read More

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November 2018
7 Reads

Aeromedical Transfer of Patients with Viral Hemorrhagic Fever.

Emerg Infect Dis 2019 Jan 17;25(1). Epub 2019 Jan 17.

For >40 years, the British Royal Air Force has maintained an aeromedical evacuation facility, the Deployable Air Isolator Team (DAIT), to transport patients with possible or confirmed highly infectious diseases to the United Kingdom. Since 2012, the DAIT, a joint Department of Health and Ministry of Defence asset, has successfully transferred 1 case-patient with Crimean-Congo hemorrhagic fever, 5 case-patients with Ebola virus disease, and 5 case-patients with high-risk Ebola virus exposure. Currently, no UK-published guidelines exist on how to transfer such patients. Read More

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January 2019
7 Reads

Surveillance, anticipation and firefighting in hospital: Perspectives of patient safety from a New Zealand case study.

J Nurs Manag 2018 Nov 14. Epub 2018 Nov 14.

Faculty of Health, Victoria University of Wellington, Level 7 Clinical Services building, Wellington Regional Hospital New Zealand.

Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety.

Background: Despite healthcare systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by healthcare professionals with concerns raised about clinician engagement.

Design: Instrumental, embedded case study design using qualitative methods. Read More

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November 2018
3 Reads

Transcranial direct current stimulation reconstructs diminished thalamocortical connectivity during prolonged resting wakefulness: a resting-state fMRI pilot study.

Brain Imaging Behav 2018 Nov 14. Epub 2018 Nov 14.

Cognitive and Mental Health Research Center, Beijing Institute of Basic Medical Science, 27 Taiping Road, Haidian District, Beijing, 100850, People's Republic of China.

Reductions in the alertness and information processing capacity of individuals due to sleep deprivation (SD) were previously thought to be related to dysfunction of the thalamocortical network. Previous studies have shown that transcranial direct current stimulation (tDCS) can restore vigilance and information processing after SD. However, the underlying neural mechanisms of this phenomenon remain unclear. Read More

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November 2018
3 Reads

Aviation medicine considerations in parachuting operations.

J R Army Med Corps 2018 Nov 14. Epub 2018 Nov 14.

RAF Centre of Aviation Medicine, Royal Air Force, Henlow, UK.

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November 2018

The Simplified Carbapenem Inactivation Method (sCIM) for Simple and Accurate Detection of Carbapenemase-Producing Gram-Negative Bacilli.

Front Microbiol 2018 30;9:2391. Epub 2018 Oct 30.

Department of Clinical Laboratory, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

This study reports the simplified carbapenem inactivation method (sCIM) to detect carbapenemase-producing gram-negative bacilli in a simple and accurate manner. This method is based on the modified carbapenem inactivation method (mCIM) with the improvement of experimental procedures. Instead of incubating the antibiotic disk in the organism culture media, the organism to be tested was smeared directly onto the antibiotic disk in the sCIM. Read More

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October 2018
3 Reads

Non-coronary cardiac surgery and percutaneous cardiology procedures in aircrew.

Heart 2019 Jan;105(Suppl 1):s70-s73

Aeromedical Centre, Swiss Air Force, Dubendorf, Switzerland.

This manuscript focuses on the broad aviation medicine considerations that are required to optimally manage aircrew following non-coronary surgery or percutaneous cardiology interventions (both pilots and non-pilot aviation professionals). Aircrew may have pathology identified earlier than non-aircrew due to occupational cardiovascular screening and while aircrew should be treated using international guidelines, if several interventional approaches exist, surgeons/interventional cardiologists should consider which alternative is most appropriate for the aircrew role being undertaken; liaison with the aircrew medical examiner is strongly recommended prior to intervention to fully understand this. This is especially important in aircrew of high-performance aircraft or in aircrew who undertake aerobatics. Read More

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January 2019
1 Read

Congenital heart disease in aircrew.

Heart 2019 Jan;105(Suppl 1):s64-s69

Department of Cardiology, University Medical Center Utrecht and Central Military Hospital, Utrecht, The Netherlands.

This article focuses on the broad aviation medicine considerations that are required to optimally manage aircrew with suspected or confirmed congenital heart disease (both pilots and non-pilot aviation professionals). It presents expert consensus opinion and associated recommendations and is part of a series of expert consensus documents covering all aspects of aviation cardiology. This expert opinion was born out of a 3 year collaborative working group between international military aviation cardiologists and aviation medicine specialists, as part of a North Atlantic Treaty Organization (NATO) led initiative to address the occupational ramifications of cardiovascular disease in aircrew (HFM-251) many of whom also work with and advise civil aviation authorities. Read More

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January 2019
6 Reads

Contemporaneous management of valvular heart disease and aortopathy in aircrew.

Heart 2019 Jan;105(Suppl 1):s57-s63

Royal Air Force Aviation Clinical Medicine Service, RAF Centre of Aviation Medicine, RAF Henlow, Bedfordshire, UK.

Valvular heart disease (VHD) is highly relevant in the aircrew population as it may limit appropriate augmentation of cardiac output in high-performance flying and predispose to arrhythmia. Aircrew with VHD require careful long-term follow-up to ensure that they can fly if it is safe and appropriate for them to do so. Anything greater than mild stenotic valve disease and/or moderate or greater regurgitation is usually associated with flight restrictions. Read More

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January 2019
6 Reads

Heart muscle disease management in aircrew.

Heart 2019 Jan;105(Suppl 1):s50-s56

Royal Air Force Aviation Clinical Medicine Service, RAF Centre of Aviation Medicine, RAF Henlow, Bedfordshire, Oxfordshire, UK.

This manuscript focuses on the broad aviation medicine considerations that are required to optimally manage aircrew with suspected or confirmed heart muscle disease (both pilots and non-pilot aviation professionals). ECG abnormalities on aircrew periodic medical examination or presentation of a family member with a confirmed cardiomyopathy are the most common reason for investigation of heart muscle disease in aircrew. Holter monitoring and imaging, including cardiac MRI is recommended to confirm or exclude the presence of heart muscle disease and, if confirmed, management should be led by a subspecialist. Read More

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January 2019
4 Reads

Management of cardiac conduction abnormalities and arrhythmia in aircrew.

Heart 2019 Jan;105(Suppl 1):s38-s49

Royal Air Force Aviation Clinical Medicine Service, RAF Centre of Aviation Medicine, RAF Henlow, Bedfordshire, UK.

Cardiovascular diseases are the most common cause of loss of flying licence globally, and cardiac arrhythmia is the main disqualifier in a substantial proportion of aircrew. Aircrew often operate within a demanding physiological environment, that potentially includes exposure to sustained acceleration (usually resulting in a positive gravitational force, from head to feet (+Gz)) in high performance aircraft. Aeromedical assessment is complicated further when trying to discriminate between benign and potentially significant rhythm abnormalities in aircrew, many of whom are young and fit, have a resultant high vagal tone, and among whom underlying cardiac disease has a low prevalence. Read More

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January 2019
3 Reads

Management of established coronary artery disease in aircrew with previous myocardial infarction or revascularisation.

Heart 2019 Jan;105(Suppl 1):s31-s37

Royal Air Force Aviation Clinical Medicine Service, RAF Centre of Aviation Medicine, RAF Henlow, Bedford, UK.

This manuscript focuses on the broad aviation medicine considerations that are required to optimally manage aircrew with established coronary artery disease (CAD) without myocardial infarction (MI) or revascularisation (both pilots and non-pilot aviation professionals). It presents expert consensus opinion and associated recommendations and is part of a series of expert consensus documents covering all aspects of aviation cardiology.Aircrew may present with MI (both ST elevation MI (STEMI) and non-ST elevation MI (NSTEMI)) as the initial presenting symptom of obstructive CAD requiring revascularisation. Read More

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January 2019
3 Reads

Management of established coronary artery disease in aircrew without myocardial infarction or revascularisation.

Heart 2019 Jan;105(Suppl 1):s25-s30

Royal Air Force Aviation Clinical Medicine Service, RAF Centre of Aviation Medicine, Bedfordshire, UK.

This paper is part of a series of expert consensus documents covering all aspects of aviation cardiology. In this manuscript, we focus on the broad aviation medicine considerations that are required to optimally manage aircrew with established coronary artery disease in those without myocardial infarction or revascularisation (both pilots and non-pilot aviation professionals). We present expert consensus opinion and associated recommendations. Read More

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January 2019
4 Reads

The challenge of asymptomatic coronary artery disease in aircrew; detecting plaque before the accident.

Heart 2019 Jan;105(Suppl 1):s17-s24

Royal Air Force Aviation Clinical Medicine Service, RAF Centre of Aviation Medicine, RAF Henlow, Bedfordshire, UK.

Coronary events remain a major cause of sudden incapacitation, including death, in both the general population and among aviation personnel, and are an ongoing threat to flight safety and operations. The presentation is often unheralded, especially in younger adults, and is often due to rupture of a previously non-obstructive coronary atheromatous plaque. The challenge for aeromedical practitioners is to identify individuals at increased risk for such events. Read More

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January 2019
4 Reads

Assessing aeromedical risk: a three-dimensional risk matrix approach.

Heart 2019 Jan;105(Suppl 1):s9-s16

Royal Air Force Aviation Clinical Medicine Service, RAF Centre of Aviation Medicine, RAF Henlow, Bedfordshire, UK.

Early aeromedical risk was based on aeromedical standards designed to eliminate individuals from air operations with any identifiable medical risk, and led to frequent medical disqualification. The concept of considering aeromedical risk as part of the spectrum of risks that could lead to aircraft accidents (including mechanical risks and human factors) was first proposed in the 1980s and led to the development of the 1% rule which defines the maximum acceptable risk for an incapacitating medical event as 1% per year (or 1 in 100 person-years) to align with acceptable overall risk in aviation operations. Risk management has subsequently evolved as a formal discipline, incorporating risk assessment as an integral part of the process. Read More

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January 2019
1 Read

An introduction to aviation cardiology.

Heart 2019 Jan;105(Suppl 1):s3-s8

Aeromedical Consult Service, United States Air Force School of Aerospace Medicine, Wright-PAtterson AFB, Ohio, USA.

The management of cardiovascular disease (CVD) has evolved significantly in the last 20 years; however, the last major publication to address a consensus on the management of CVD in aircrew was published in 1999, following the second European Society of Cardiology conference of aviation cardiology experts. This article outlines an introduction to aviation cardiology and focuses on the broad aviation medicine considerations that are required to manage aircrew appropriately and optimally (both pilots and non-pilot aviation professionals). This and the other articles in this series are born out of a 3 year collaborative working group between international military aviation cardiologists and aviation medicine specialists, many of whom also work with and advise civil aviation authorities, as part of a North Atlantic Treaty Organization (NATO) led initiative to address the occupational ramifications of CVD in aircrew (HFM-251). Read More

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January 2019
1 Read

Beyond a 'wing and a prayer': building the evidence base for aviation cardiology.

Authors:
Edward D Nicol

Heart 2019 Jan;105(Suppl 1):s2

Aviation Medicine Clinical Service, RAF Centre of Aviation Medicine, RAF Henlow, Bedfordshire, UK.

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January 2019
3 Reads

Assessing cardiovascular risk in aviation: if only we had a crystal ball!

Authors:
Kim Rajappan

Heart 2019 Jan;105(Suppl 1):s1

Cardiac Department, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK.

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January 2019
2 Reads

Operational Impact of a Critical Care Transport Duty Time Tool Implementation: A Quality Improvement Project to Enhance Crew and Patient Safety.

Air Med J 2018 Nov - Dec;37(6):352-356. Epub 2018 Sep 8.

Critical Care Transport Team, Children's Hospital & Medical Center, Omaha, NE.

Objective: The Commission on Accreditation of Medical Transport Systems requires transport programs to have operational risk assessment tools that must address issues such as transport acceptance with tools for assessing pilot/driver and crew alertness and fatigue, aviation decision making, and mission acceptance/medical decision making. The objective of this study was to evaluate the impact the implementation of this tool has on programmatic operations.

Methods: This hospital-based dedicated pediatric/neonatal transport team has experienced rapid increase in volume as well as an expanding response area. Read More

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September 2018