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Global navigation satellite systems have enabled significant improvements in aeronautical navigation. However, in recent years, a growing number of interference events have been reported by flight crews. In this paper, we first identify such events using crowd-sourced surveillance data collected between February and December 2022 for three different regions: the Baltic states, eastern Europe bordering the Black Sea, and the eastern Mediterranean. Then, we assess the extent and duration of these events to determine their impact on civil aviation. The analysis shows different characteristics, ranging from isolated events to regular large-scale and recurrent disruptions. Next, we identify aircraft types for the affected flights and evaluate flight plan data with respect to navigation equipment in order to identify flights that rely solely on satellite navigation and that might require assistance in the case of a loss of satellite navigation. Finally, we show the impact of radio frequency interference (RFI) on a selected passenger flight by analyzing automatic dependent surveillance-broadcast data as well as avionics data obtained from the airline's flight data monitoring department for that specific flight and link the observations to the warnings triggered by the aircraft to alert the flight crew while encountering RFI. [ABSTRACT FROM AUTHOR]

Excessive pilot workload is one of the significant causes of flight accidents. The detection of flight workload can help optimize aircraft crew operation procedures, improve cockpit human–machine interface (HMIs) design, and ultimately reduce the risk of flight accidents. However, traditional detection methods often employ invasive or patch-based devices that can interfere with the pilot's control. In addition, they generally lack real-time capabilities, while the workload of pilots actually varies continuously. Moreover, most models do not take individual physiological differences into account, leading to the poor performance of new pilots. To address these issues, this study developed a real-time pilot workload detection model based on low-interference devices, including telemetry eye trackers and a pressure-sensing seat cushion. Specifically, the Adaptive KNN-Ensemble Pilot Workload Detection (AKE-PWD) model is proposed, combining KNN in the outer layer for identifying the physiological feature cluster with the ensemble classifier corresponding to this cluster in the inner layer. The ensemble model employs random forest, gradient boosting trees, and FCN–Transformer as base learners. It utilizes soft voting for predictions, integrating the strengths of various networks and effectively extracting the sequential features from complex data. Results show that the model achieves a detection accuracy of 82.6% on the cross-pilot testing set, with a runtime of 0.1 s, surpassing most studies that use invasive or patch-based detection devices. Additionally, the model demonstrates high accuracy across different individuals, indicating good generalization. The results are expected to improve flight safety. [ABSTRACT FROM AUTHOR]

We aim to provide reference values for military aircrews participating in hypoxia awareness training (HAT). We describe several parameters with potential biomedical interest based on selected segments and slopes of the changes in oxygen saturation (SatO2) during a standard HAT. A retrospective analysis of 2298 records of the SatO2 curve was performed, including 1526 military men aged 30.48 ± 6.47 years during HAT in a hypobaric chamber. HAT consisted of pre-oxygenation at 100% and an ascent to 7620 m, followed by O2 disconnection starting the phase of descent of SatO2 until reaching the time of useful consciousness (TUC), and finally reconnection to 100% O2 in the recovery phase. Using an ad hoc computational procedure, the time taken to reach several defined critical values was computed. These key parameters were the time until desaturation of 97% and 90% (hypoxia) after oxygen mask disconnection (D97/D90) and reconnection (R97/R90) phases, the time of desaturation (TUC-D97) and hypoxia (TUC-D90) during disconnection, the total time in desaturation (L97) or hypoxia (L90), and the slopes of SatO2 drop (SDSAT97 and SDSAT90) and recovery (SRSAT97). The mean of the quartiles according to TUC were compared by ANOVA. The correlations between the different parameters were studied using Pearson's test and the effect size was estimated with ω2. Potentially useful parameters for the HAT study were those with statistical significance (p < 0.05) and a large effect size. D97, D90, R97, and R90 showed significant differences with small effect sizes, while TUC-D97, TUC-D90, L97, L90, and SDSAT97 showed significant differences and large effect sizes. SDSAT97 correlated with TUC (R = 0.79), TUC-D97 (R = 0.81), and TUC-D90 (R = 0.81). In conclusion, several parameters of the SatO2 curve are useful for the study and monitoring of HAT. The SDSAT97 measured during the test can estimate the TUC and thus contribute to taking measures to characterize and protect the aircrew members. [ABSTRACT FROM AUTHOR]

Introduction Cervical disc displacement (CDD) may disqualify pilots from flying and have a profound impact on military unit capability. The objective of this retrospective database review is to characterize the incidence and demographic predictors of symptomatic cervical spine disc displacement in pilots of fixed- and rotary-wing aircraft and ground-based controls. Materials and Methods The Defense Military Epidemiology Database was queried for first-occurrence ICD-9 code 722.0: CDD cases from 2007 to 2015. Injury count rates among aircraft groups and overall incidence per 1,000 person-years were calculated and standardized for age, gender, and military rank, and 95% confidence intervals (CIs) were compared to determine significance. Results There were 934 new cases of CDD among active duty U.S. Military pilots during the study period. The overall incidence of CDD in all pilots during this time frame was 2.715 per 1,000 person-years (95% CI, 2.603-2.830). Helicopter pilots had a significantly higher incidence compared to all other aircraft pilots and crew at 3.79 per 1,000 person-years (95% CI, 3.48-4.13). This finding remained statistically significant after standardizing for age, gender, and rank. Among all military officers, increasing age was a risk factor for CDD. Conclusions The U.S. Military helicopter pilots have an increased risk compared to fixed-wing pilots and non-pilot controls. CDD remains a rare, though career-threatening, condition. Increased education and awareness training are warranted for both helicopter pilots and flight physicians to recognize signs and symptoms of cervical pathology. Continued investigations into preventive measures to minimize injury and time unfit for flight are warranted. [ABSTRACT FROM AUTHOR]

The winter storm of late 2022 caused difficulties for many US-based airlines, but none more so than Southwest Airlines. Like other airlines, Southwest canceled flights in the early stages of the storm. Their attempted recoveries failed due to procedural and technology issues. The airline was unable to cope with the magnitude of canceled flights, aircraft and crews in the wrong places, disrupted passenger plans, and luggage separated from its owners. Over the next several days, Southwest canceled tens of thousands of flights, called in thousands of additional staff to support manual operations, and flew a reduced schedule for a time before returning to normal operations. The case provides numerous scenarios for you to analyze and research, to strengthen your understanding of the underlying concepts. [ABSTRACT FROM AUTHOR]

This study aims to enhance the performance of aircrew helmet liners made of 3D woven honeycomb composites through structural improvements. To achieve this, an optimization of the honeycomb design was carried out using a statistical tool by varying its geometrical parameters. A Box Behnken design was employed, using three independent factors: cell height, cell size, and cell wall thickness to assess its impact and their interactions on responses. The performance was evaluated using a multiobjective response to maximize impact energy absorption, achieve the target cushion factor, and balance relative density for lightweight design. Since the liner materials were subjected to flatwise compression and dynamic impact tests to assess the performance. Their behavior. The results revealed that the honeycomb core with a cell height of 15 mm, a cell size of 10 mm, and a cell wall thickness of 0.6 mm exhibited good behavior. The response surface analysis and contour plots were used to analyze the interactions and combined effects of variables on each response. It was observed that lesser cell size shows significant improvement in impact energy with higher wall thickness. However, the cushion factor implies inadequate energy mitigation. The analysis comparing desirability and confirmatory experiments highlighted the potential for the aircrew helmet liner to achieve its maximum performance. This study provides valuable insights into the structural design of 3D woven honeycomb composite liners for aircrew helmets and its findings signify the potential for applications in the aerospace and defense industries. [ABSTRACT FROM AUTHOR]

Crew recovery is one of the most critical phase of Human space flight missions. The current recovery strategies include both water (sea) and land-based recovery operations. The land-based recovery operations mandate additional systems to reduce impact loads whereas water-based operations involve mobilization of many recovery assets. Considering the increased frequency of human space flight missions, reuse of crew capsules, increased crew comfort, minimization of assets and reduced cost, it is necessary to explore alternate options for the recovery of the Crew Module (CM). A novel concept on Mid-Air-Recovery (MAR) of CM is explored to achieve the above objectives. MAR of CM will significantly reduce the assets required in comparison to land-based and sea-based recovery operations. With MAR operations, the CM can be carried directly to the recovery base in minimum time. The loads experienced by the Crew are also expected to be lesser in case of MAR operations. Since the CM is not subjected to any impact loads and not exposed to seawater, the reusability of modules is enhanced. Another advantage of MAR operation is the simplification of the overall recovery procedures (SOPs) and reduction in trained manpower requirements. A helicopter is chosen for study, since it offers great manoeuvrability and remarkable cargo capabilities. A Recovery chute is added to the CM and an engagement hook is designed to capture this chute during MAR. The overall configuration for MAR and subsystems that need to be developed have been discussed as a part of this study. The components that are being added in CM are planned to be a standalone system so that the performance of other systems is not affected in case of failure of MAR operations. The impact of MAR operations on the Crew, in terms of physiological loads is also addressed. • Mid Air Recovery is retrieving an object of importance in flight. • Mid Air Recovery for Human space flight missions. • Water-based recovery for reducing impact loads. • Land-based recovery for quick recovery. • Mid-Air Recovery reduces recovery time while reducing impact loads. [ABSTRACT FROM AUTHOR]

Flight crew experience fatigue due to sleep loss, circadian desynchrony, early duty start times, long duty periods, high and low workloads, and unscheduled duties. As fatigue is considered a significant safety risk in the air transport industry, the primary approaches to managing fatigue are mandating prescriptive limits for work and rest periods or adopting performance-based fatigue risk management systems (FRMS). However, recent aviation incidents indicate that current regulations may not be adequate to manage the fatigue risk experienced by the flight crew. This study evaluates Australian flight crew fatigue management regulations using a new fatigue regulation evaluation framework (FREF) adapted from Jones et al. (2005). Results show that Australian regulations for flight crew include limits on flight duty period (FDP), off duty period, FDP start time, sleep requirements for flight crew before starting an FDP, high and low workloads, circadian rhythm disruptions, and fatigue awareness. However, there are regulation variations in addressing lengths of sectors and methods to report fatigue, which may need to be reviewed to manage fatigue better. Recommendations are made to consider incorporating these factors into fatigue regulations to ensure a safe air transport system. • Fatigue is considered a significant safety risk in air transport. • Factors related to fatigue require to be adequately addressed in the regulations. • There are variations in addressing these flight crew fatigue related factors. • Adequately addressing the flight crew fatigue related factors in the regulations can assist to manage fatigue [ABSTRACT FROM AUTHOR]

The commercial and operations planning in airlines has traditionally been a hierarchical process starting with flight schedule design, followed by fleet assignment, aircraft rotation planning and finally the crew scheduling. The hierarchical planning approach has a drawback that the optimal solution for a planning phase higher in hierarchy may either be infeasible for the subsequent phase or may lead to a sub‐optimal overall solution. In this paper, we solve a profit‐maximizing integrated planning model for clean‐sheet "rotated" schedule design with flight re‐time option and crew scheduling for a low‐cost carrier (LCC) in an emerging market. While the aircraft rotation problem has been traditionally modeled in the literature as a daily routing of individual aircraft for maintenance requirement, in this work we address the requirement of planned aircraft rotations as part of schedule design for LCCs. The planned aircraft routing is important in our case to create as many via‐flights as possible due to the underserved nature of the emerging market. We solve this large‐scale integer‐programming problem using two approaches – Benders Decomposition and Lagrangian Relaxation. For Lagrangian Relaxation, we exploit the special structure of our problem and intuitive understanding behind the Lagrangian duals to develop a multiplier adjustment approach to find an improved lower bound of integrated model solution. The crew‐pairing sub‐problem is solved using column generation through multi‐label shortest path algorithm followed by branch‐and‐price for integer solution. We test our solution methodology on a flight universe of 378 unique flights for different problem sizes by varying the number of aircraft available for operations. Our computational results show that within a reasonable run time of few hours both the approaches, Benders Decomposition and Lagrangian Relaxation, are successful in finding lower bounds of the integrated model solution, which are higher than the solution of traditional hierarchical approach by 0.5%–2.5%. We find Lagrangian Relaxation methodology to usually attain an improved solution faster than the Benders Decomposition approach, particularly for large‐scale problems. [ABSTRACT FROM AUTHOR]

Simple Summary: During combat missions, military aircrew rely on their ability to make accurate life-or-death decisions within infinitesimal timeframes. Research shows that performing more challenging tasks (e.g., high cognitive load) requires a greater supply of oxygen to the brain, a process regulated by the autonomic nervous system. However, the influence of prolonged exposure to performing low and high cognitive loads, specifically related to flight operations, is unclear. Thus, the current study evaluated the response of the autonomic nervous system to sustained performance of tasks requiring low or high cognitive functions under two different environmental conditions: hypoxia (i.e., reduced oxygen content) and normoxia (i.e., standard oxygen content). Twenty military and civilian adults (19 to 45 years old) participated in the study, and each performed a series of low- and high-cognitive-load assessments for nearly two hours. All subjects performed these tests separately under hypoxic (14.0% oxygen) and normoxic (21.0% oxygen) conditions. Autonomic nervous system function was measured using a monitoring device placed on the upper right arm that collected heart rate and heart rate variability data. Our study found that prolonged exposure to high cognitive loads induced heightened activity of the autonomic nervous system, with subjects eliciting higher heart rates and lower heart rate variability relative to low cognitive loads. Additionally, the influence of high cognitive load was greater in the hypoxic environment. Accounting for the response of the autonomic nervous system to cognitive loads is important, as this stress likely compounds to the existing fight-or-flight response occurring during pre-flight and in-flight operations. Executing flight operations demand that military personnel continuously perform tasks that utilize low- and high-order cognitive functions. The autonomic nervous system (ANS) is crucial for regulating the supply of oxygen (O2) to the brain, but it is unclear how sustained cognitive loads of different complexities may affect this regulation. Therefore, in the current study, ANS responses to low and high cognitive loads in hypoxic and normoxic conditions were evaluated. The present analysis used data from a previously conducted, two-factor experimental design. Healthy subjects (n = 24) aged 19 to 45 years and located near Fort Novosel, AL, participated in the parent study. Over two, 2-h trials, subjects were exposed to hypoxic (14.0% O2) and normoxic (21.0% O2) air while simultaneously performing one, 15-min and one, 10-min simulation incorporating low- and high-cognitive aviation-related tasks, respectively. The tests were alternated across five, 27-min epochs; however, only epochs 2 through 4 were used in the analyses. Heart rate (HR), HR variability (HRV), and arterial O2 saturation were continuously measured using the Warfighter MonitorTM (Tiger Tech Solutions, Inc., Miami, FL, USA), a previously validated armband device equipped with electrocardiographic and pulse oximetry capabilities. Analysis of variance (ANOVA) regression models were performed to compare ANS responses between the low- and high-cognitive-load assessments under hypoxic and normoxic conditions. Pairwise comparisons corrected for familywise error were performed using Tukey's test within and between high and low cognitive loads under each environmental condition. Across epochs 2 through 4, in both the hypoxic condition and the normoxic condition, the high-cognitive-load assessment (MATB-II) elicited heightened ANS activity, reflected by increased HR (+2.4 ± 6.9 bpm) and decreased HRV (−rMSSD: −0.4 ± 2.7 ms and SDNN: −13.6 ± 14.6 ms). Conversely, low cognitive load (ADVT) induced an improvement in ANS activity, with reduced HR (−2.6 ± 6.3 bpm) and increased HRV (rMSSD: +1.8 ± 6.0 ms and SDNN: vs. +0.7 ± 6.3 ms). Similar observations were found for the normoxic condition, albeit to a lower degree. These within-group ANS responses were significantly different between high and low cognitive loads (HR: +5.0 bpm, 95% CI: 2.1, 7.9, p < 0.0001; rMSSD: −2.2 ms, 95% CI: −4.2, −0.2, p = 0.03; SDNN: −14.3 ms, 95% CI: −18.4, −10.1, p < 0.0001) under the hypoxic condition. For normoxia, significant differences in ANS response were only observed for HR (+4.3 bpm, 95% CI: 1.2, 7.4, p = 0.002). Lastly, only high cognitive loads elicited significant differences between hypoxic and normoxic conditions but just for SDNN (−13.3 ms, 95% CI, −17.5, −8.9, p < 0.0001). Our study observations suggest that compared to low cognitive loads, performing high-cognitive-load tasks significantly alters ANS activity, especially under hypoxic conditions. Accounting for this response is critical, as military personnel during flight operations sustain exposure to high cognitive loads of unpredictable duration and frequency. Additionally, this is likely compounded by the increased ANS activity consequent to pre-flight activities and anticipation of combat-related outcomes. [ABSTRACT FROM AUTHOR]

Aircraft crew are aware of the delay they have experienced at departure. However, uncertainties ahead, and in particular holdings at arrival, can have an impact on the final performance of their operations. When optimizing a trajectory, the expected cost at the arrival gate should be considered. Consequently, taking into account potential congestion and extra delay at the arrival airspace is paramount to avoid making sub-optimal decisions during the early stages of a flight. This paper presents a framework to optimize trajectories in the execution phase of the flight considering expected delays at arrival. A flight from Athens (LGAV) to London Heathrow (EGLL) is used as an illustrative example, systematically exploring a range of departure delays and expected holdings at arrival. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Cardiovascular (CV) diseases are a major public health issue, the prevention of which plays a key role in promoting flight safety. However, few studies have looked at the determinants of the overall risk of CV morbidity-mortality within the various aeronautical occupations. METHODS: A monocentric, observational, cross-sectional study was based on the retrospective data collected during 6 mo at the Toulon Aeromedical Center. From October 2017 to April 2018, 2792 professional aircrew ages 18--74 were included. The overall CV risk was estimated using the European Society of Cardiology SCORE and the Framingham model, as well as a summation model. RESULTS: More than two-thirds of this mainly male population (86.2%) had no more than one CV risk factor [69.9% (68.2--71.6)]. In 82.5% of cases, this was dyslipidemia according to current European criteria [55.8% (52.4--59.1)] or smoking [26.7% (23.8-29.8)]. An overall risk level of "moderate" to "very high" concerned only one subject in five according to the SCORE model [20.1% (18.6-21.6)], one in six according to Framingham [16.3% (14.9-17.7)] and almost one in three according to the summation model [30.1% (28.4-31.9)]. DISCUSSION: Multivariate analyses found no significant associations between socio-professional criteria and overall risk levels. The results have underlined the effect of dyslipidemia and smoking on early risk among applicants. Beyond the illustration of favorable cardiovascular status among aircrews related to the standards of selection and close monitoring process, areas for improvement were identified, inviting the development of prevention strategies around the "moderate" overall CV risk. [ABSTRACT FROM AUTHOR]

A flight safety warning method based on reachability analysis and fuzzy inference is proposed against aircraft icing. A nonlinear model of iced aircraft with uncertainty is proposed based on the existing research results on the effects of icing and the uncertainty in icing detection. To deal with the uncertainty caused by icing, reachability analysis is used to estimate the safe flight envelope of iced aircraft. On this basis, fuzzy inference is employed for flight safety warning which can be used to enhance the pilot's situational awareness in icing encounters. Simulations of the GTM (Generic Transport Model) aircraft show that, the proposed method has the potential to further increase the flight crew awareness about the risk of losing control in flight under icing. [ABSTRACT FROM AUTHOR]

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The human factor in the aeronautical environment has been analyzed in the most frequent cases of flight crew errors and air traffic control. The human factor directly causes many aviation accidents. Studies show that 80% of aviation errors involve human factors. If not detected in time, it can cause accidents. Awareness of the role of the human factor leads to an improvement in the quality of professional and personal activity, to an environment that facilitates the continuous safety of people or aircraft, and to more involvement and responsibility. Reducing the number of errors offers various benefits, from reducing accidents at work to decreasing the number of significant events. Most of the time the human factor is approached in relation to ways of mitigating the risk, preventing the development of problems. The paper aims to highlight multiple interpretations of the human factor in order to become aware of its value and complexity. [ABSTRACT FROM AUTHOR]

Fatigue Avoidance Scheduling Tool (FAST) is a computerized fatigue prevention tool, which was developed based on a Bio-mathematical model called SAPTE (Sleep, Activity, Performance and Task Effectiveness). Similarly, actigraphy technology is used as a tool for sleep evaluation. This study was an attempt to assess the employability of FAST (both independently and integrated with actigraphy) for detecting operational fatigue by determining the 'Measures for diagnostic accuracy'. 103 pre-flight medical checks from 51 aircrew were evaluated to detect fatigue both clinically and by using objective measures (FAST and actigraphy integrated FAST). The 'measures of diagnostic accuracy' namely sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio positive (LR +ve), likelihood ratio negative (LR -ve) and Youden's Index were determined and compared. The diagnostic measures for FAST were: sensitivity (68.4%), specificity (92.8%), PPV (68.4%), NPV (92.8%), LR+ve (9.5), LR-ve (0.34) and Youden's Index (0.61). For actigraphy integrated FAST these values were: sensitivity (84.2%), specificity (96.4%), PPV (94.2%), NPV (94.4%), LR+ve (23.5), LR-ve (0.16) and Youden's Index (0.80). The increase in sensitivity (from 68.4% to 84.2%), specificity (from 92.8% to 96.4%), PPV (from 68.4% to 94.2%), NPV (92.8% to 94.4%), LR+ve (9.5 to 23.5) and Youden's Index (0.61 to 0.80) indicated that actigraphy integrated FAST is a better screening tool in comparison to the independently employed FAST. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Coronary artery disease (CAD) is the leading cause of denial or withdrawal of flying privileges for aircrew. Screening for CAD is therefore crucial. The present study analyzed German military aircrew with diagnosed CAD and/or acute coronary syndrome despite close medical monitoring with the intention to further optimize individual outcomes and aeromedical disposition. METHODS: The digital information systems of the German Air Force Centre of Aerospace Medicine were searched for pilots and nonpilot aircrew with CAD and/or myocardial infarction (MI). They were retrospectively analyzed for age at initial diagnosis, body mass index, cardiovascular risk factors, diagnostic procedures, treatment, and aeromedical disposition. RESULTS: Between February 1987 and March 2023, 126 aircrew, 55% pilots and 45% nonpilot aircrew, were identified with CAD and/or MI. An accumulation of two to six risk factors was found in 77% of both groups. Most pilots (54%) received conservative treatment, 44% underwent percutaneous coronary intervention, and 3% coronary artery bypass grafting. In the group of nonpilot aircrew, conservative treatment was performed in 47%, coronary intervention in 37%, and bypass grafting in 16%. A total of 45 pilots (65%) returned to flying duties, albeit 39 (57%) with restrictions. In the group of nonpilot aircrew, 31 (54%) returned to flying duties. DISCUSSION: A small group of aircrew developed CAD over the years, some with severe coronary artery stenoses and MI. Further optimization of individual prognosis and aeromedical disposition should aim at appropriate CAD screening and risk factor elimination. CAD management needs a comprehensive approach regarding military aviation requirements and clinical guidance. [ABSTRACT FROM AUTHOR]

Purpose: Airline scheduling is an extremely complex process. Moreover, disruption in a single flight may damage the entire schedule tremendously. Using an efficient recovery scheduling strategy is vital for a commercial airline. The purpose of this paper is to present an integrated aircraft and crew recovery plans to reduce delay and prevent delay propagation on airline schedule with the minimum cost. Design/methodology/approach: A mixed-integer linear programming model is proposed to formulate an integrated aircraft and crew recovery problem. The main contribution of the model is that recovery model is formulated based on individual flight legs instead of strings. This leads to a more accurate schedule and better solution. Also, some important issues such as crew swapping, reassignment of aircraft to other flights as well as ground and sit time requirements are considered in the model. Benders' decomposition approach is used to solve the proposed model. Findings: The model performance is also tested by a case including 227 flights, 64 crew, 56 aircraft and 40 different airports from American Airlines data for a 24-h horizon. The solution achieved the minimum cost value in 35 min. The results show that the model has a great performance to recover the entire schedule when disruption happens for random flights and propagation delay is successfully limited. Originality/value: The authors confirm that this is an original paper and has not been published or under consideration in any other journal. [ABSTRACT FROM AUTHOR]

Cosmic rays are the primary source of the daily exposure of aircrew and passengers to ionising radiation. This study aims to estimate the effective doses of ionising radiation for aircraft crews in Bosnia and Herzegovina by taking into consideration factors such as flight duration and altitude, as well as the geographical position of airports. The CARI-7 algorithm and neural network method were used in the analysis of data obtained from the Sarajevo International Airport. The results show that the estimated annual effective doses in 2021 range from 0.06 to 10 mSv for flights to and from Belgrade and Dubai, respectively. Both linear regression and neural network models were developed to predict the effective dose based on flight duration, average altitude, latitude and maximum altitude. The findings reveal that flight duration is the most statistically significant factor, followed by average altitude, latitude and maximum altitude. [ABSTRACT FROM AUTHOR]

Efficient management of aircraft and crew recovery system is crucial for cost savings and improving the satisfaction, which are related to the airline's reputation. However, most existing work considers only one objective of minimizing costs or maximizing satisfaction. In this study, we propose a new integrated multi‐objective recovery system that takes both cost and satisfaction into account simultaneously. To better capture crew satisfaction in the event of airport closure, a bidding mechanism for early off‐duty task is designed. To overcome the experience‐dependent and labour‐consuming problems associated with current manual or mathematical recoveries, we develop an intelligent optimizer based on multi‐swarm and MOPSO frameworks, termed adaptive seeking and tracking multi‐objective particle swarm optimization algorithm (ASTMOPSO). Specifically, during the evolutionary process, the sub‐swarm size undergoes adaptive internal transfer while executing more efficient evolutionary strategies to approach the global Pareto front. Additionally, five ad‐hoc repair procedures are designed to ensure feasibility for our aircraft and crew recovery system. The ASTMOPSO is applied to real‐world instances from Shenzhen Airlines with different sizes. Experimental results demonstrate the statistical superiority of our method over other popular peer algorithms. And the infeasible solution repair procedures significantly improve the feasibility rate by at least 40%, particularly for large‐scale instances. [ABSTRACT FROM AUTHOR]

This theoretical article evaluates the changing dynamics caused by high turnover in aviation and how the lower level of experience impacts aeronautical companies' organizational strategic planning and partnerships. The aviation organization must adapt managerial practices and alter training capability and procedures to ensure appropriate skill levels. Without proper strategic planning, the company will have an imbalance of skills and accept more risk to operations. The aviation organization may be unable to adapt current scheduling practices to properly prepare the aircrew for challenging situations or sufficiently train maintenance personnel. The result is a need to leverage strategic partnerships, alter management practices toward personnel development, and increase retention of mid-career aviators and maintenance technicians. [ABSTRACT FROM AUTHOR]

Commercial aviation practices including the role of the pilot monitoring, the sterile flight deck rule, and computerised checklists have direct applicability to anaesthesia care. The pilot monitoring performs specific tasks that complement the pilot flying who is directly controlling the aircraft flight path. The anaesthesia care team, with two providers, can be organised in a manner that is analogous to the two-pilot flight deck. However, solo providers, such as solo pilots, can emulate the pilot monitoring role by reading checklists aloud, and utilise non-anaesthesia providers to fulfil some of the functions of pilot monitoring. The sterile flight deck rule states that flight crew members should not engage in any non-essential or distracting activity during critical phases of flight. The application of the sterile flight deck rule in anaesthesia practice entails deliberately minimising distractions during critical phases of anaesthesia care. Checklists are commonly used in the operating room, especially the World Health Organization surgical safety checklist. However, the use of aviation-style computerised checklists offers additional benefits. Here we discuss how these commercial aviation practices may be applied in the operating room. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, the question of how to reduce the risk of viral infection for international airline pilots without increasing the risk of fatigue was a novel and urgent theoretical and practical problem, which had never been encountered in the world civil aviation industry. A new scheduling method implemented by the Civil Aviation Administration of China (CAAC) is the extra augmented crew (EAC) schedule, which avoids crew layover in another country on international flights by extending the maximum duty time and adding two additional crew members to such long-haul flights. In this study, a multi-day flight crew fatigue assessment was conducted to evaluate the impact of EAC flight. We recruited 71 pilots as participants, and their fatigue during EAC flights was measured using a multimodality approach integrating a subjective fatigue report, a psychomotor vigilance task, sleep monitoring, and biomathematical model predictions. The results showed that the subjective fatigue level increased during duty time compared to off-duty time, but still with acceptable levels of under 7, as measured by the Karolinska Sleepiness Scale; objective secondary task performance, as measured by the classic psychomotor vigilance task, showed no differences; pilots were able to get around 6 h of sleep, although they slept less during duty time compared to off-duty time. Model fitting using the FAID biomathematical model of fatigue confirmed that the EAC scheduling was compliant with the FAID tolerance level 91.3% of the time. The results suggest that the EAC flight created some moderate level of increased fatigue but no severe fatigue to cross-continent long-haul flight crews. This research can inform current and future scheduling and fatigue risk control during the pandemic or for future time-sensitive periods. [ABSTRACT FROM AUTHOR]

The paper focuses on certain specific occurrences involving sports aircraft and their mechanical flight control chains. Usually the flight controls and their control chains are subject of thorough checking procedures, but frequently such details are not observed or are easily ignored during the maintenance and airframe checking processes. The authors aim to provide information enabling proper training of flight crews, technical, and design staff/ personnel, allowing the avoidance of severe occurrences/ events caused by failures of the mechanical control chains. The analysis focuses on lighter aircraft, such as sports aircraft, which have full mechanical control chains. [ABSTRACT FROM AUTHOR]

Methods for assessing the current state and forecasting critical events are developed in order to reduce the stress load on the pilot of an aircraft. These methods are based on the energy approach to flight control. Algorithms for forecasting the possibility of safe takeoff in the presence of high-rise obstacles on the trajectory are obtained. Forecast correction algorithms are introduced. Algorithms for calculating the braking distance depending on the runway condition are found in the modes of landing or emergency braking at takeoff. Some ways to correct forecasts considering the sequence and operation time of all braking devices are proposed. Model tests are carried out for the algorithms in the entire range of operating conditions. [ABSTRACT FROM AUTHOR]

In flight operations, the workload settings refer to the shift work, duty time, flight time, number of sectors, rest periods, time of day, duty patterns, number of time-zone transitions, number of consecutive duty days, and changes in the schedule. Workload factors, together with the biological mechanisms (the circadian rhythm, homeostatic sleep pressure, sleep inertia), can lead to the appearance of fatigue. Fatigue affects numerous tasks, such as performing inaccurate flight procedures, missing radio calls, missing or being too slow to pick up system warnings, forgetting or performing routine tasks inaccurately, and others. The focus of this paper is to determine which flight crew workload settings elements impact the appearance of fatigue. The process of collecting data regarding flight crew workload settings and fatigue is conducted on a sample of four airline pilots using an electronic CRD system of standardized chronometric cognitive tests and subjective self-assessment scales. Causal modeling tools of the IBM SPSS Statistics were used to detect correlations among flight crew workload settings, indicators of the subjective perception of fatigue, and measured fatigue indicators. In the final step, a set of simulations was created using simulation tools of the IBM SPSS Statistics to show how modifications of flight crew workload settings, such as modified duty time, number of days off, and others, can impact the level of fatigue. The obtained results can help improve the future planning of flight crew workload set-up and mitigate or prevent the appearance of fatigue in flight operations. [ABSTRACT FROM AUTHOR]

INTRODUCTION: +Gz tolerance is an important aspect for the success of fighter aircrew as it reflects the ability of the neuro-cardiovascular response to compensate and prevent adverse manifestations such as gray-out, black-out, and G-induced loss of consciousness (G-LOC) under high-G stress. METHODS: The data for aircrew taking the Operational Training in Aerospace Medicine for Fighters course at the Institute of Aerospace Medicine Indian Air Force (IAF) from January 2017 to December 2020 were analyzed to assess the effectiveness of the existing training goal to recommend a G-tolerance standard for fighter aircrew. RESULTS: During the study period, 334 aircrew took the Operational Training in Aerospace Medicine for Fighter course. Only three aircrew failed to achieve the training goal of the course (failure rate <1%). There was a significant difference in the relaxed gradual onset rate tolerance of aircrew experiencing G-LOC and not experiencing G-LOC during the training. The odds of experiencing G-LOC at 9 G after clearing the 7-G and 8-G profiles were 4.4 and 4.7, respectively. DISCUSSION: It is generally accepted that aircrew having higher G tolerance have less chance of G-LOC in the air. There is a need to have an operational definition of G tolerance for fighter aircrew that aligns with the operational training goal of the organization. The G tolerance of IAF aircrew is as per the institutional definition of the IAF Institute of Aerospace Medicine. The high-G training has stood the test of time and has served well for the IAF. [ABSTRACT FROM AUTHOR]

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(1) Background: Military personnel worldwide exhibit high rates of obesity. Obesity, and especially visceral obesity, contribute to various health issues, including type 2 diabetes and cardiovascular diseases (CVD). While BMI is commonly used to diagnose obesity, it has limitations and does not consider factors like fat distribution or muscle mass. This study aims to assess the relationship between BMI, percent body fat, waist circumference (WC), waist-to-height ratio (WHtR), and cardiovascular risk factors in Polish military flying personnel. Methods: This study involved 200 men from the Polish Air Force aged 38.8 ± 8.5 years. Anthropometric tests, body composition tests, and tests of biochemical markers of CVD were conducted. (2) Results: The prevalence of overweight and obesity varied based on the evaluation criterion; they were present in 63.5% of soldiers by BMI and in 52.5% by percent body fat; abdominal obesity was present in almost half (47%) of the surveyed soldiers according to WC and in 62.5% according to WHtR. All markers of obesity correlated positively with various biochemical markers of CVD, and 8.5% of subjects met the criteria for metabolic syndrome. (3) Conclusions: The prevalence of obesity in Polish military flying personnel, regardless of the evaluation criterion, is associated with significant metabolic complications in the form of lipid disorders and insulin resistance. [ABSTRACT FROM AUTHOR]

Objective: Our primary aim was to investigate crew performance during medical emergencies with and without ground-support from a flight surgeon located at mission control. Background: There are gaps in knowledge regarding the potential for unanticipated in-flight medical events to affect crew health and capacity, and potentially compromise mission success. Additionally, ground support may be impaired or periodically absent during long duration missions. Method: We reviewed video recordings of 16 three-person flight crews each managing four unique medical events in a fully immersive spacecraft simulator. Crews were randomized to two conditions: with and without telemedical flight surgeon (FS) support. We assessed differences in technical performance, behavioral skills, and cognitive load between groups. Results: Crews with FS support performed better clinically, were rated higher on technical skills, and completed more clinical tasks from the medical checklists than crews without FS support. Crews with FS support also had better behavioral/non-technical skills (information exchange) and reported significantly lower cognitive demand during the medical event scenarios on the NASA-TLX scale, particularly in mental demand and temporal demand. There was no significant difference between groups in time to treat or in objective measures of cognitive demand derived from heart rate variability and electroencephalography. Conclusion: Medical checklists are necessary but not sufficient to support high levels of autonomous crew performance in the absence of real-time flight surgeon support Application: Potential applications of this research include developing ground-based and in-flight training countermeasures; informing policy regarding autonomous spaceflight, and design of autonomous clinical decision support systems. [ABSTRACT FROM AUTHOR]

In this essay, we argue that the way of operating for the social well-being, the psychophysical health, the safety and protection of passengers and crew of civil flights, is the core of the work of flight and cabin personnel, an essential socio-professional category. This is the actual job of the cabin crew category and what distinguishes the know-how of the flight crew. Although its public image - from foundational myths to fetish-images - transits between the figures of the on-board service provider or an etiquette wrapped in "charm", such socially constructed ideas and imagery do not resist a more detailed analysis and characterization. Risky, dangerous, or emergency situations, as well as the definition, ranking, and implementation of appropriate measures for each case, are part of the core of this vital activity. These critical reflections were elaborated from an action-research with the Social Inquiry into the Living and Working Conditions of Flight and Cabin Crew. [ABSTRACT FROM AUTHOR]

The experiences of World War II bomber crews indicate that, unlike some scholars have theorized, distance from targets did not lessen the combat and other trauma resulting from prosecuting targets in the European theater. An analysis of Dave Grossman’s five factors of the likelihood of killing finds these air combat crews experienced significant psychological trauma, including moral injury, in the execution of their missions. [ABSTRACT FROM AUTHOR]

We analyzed the characteristics of sustained attention changes in flight crews during exempt and non-exempt flights. Fourteen pilots (aged 30–43 y) participated in this study, with seven involved in each flight type, all of which were intercontinental (China to North America). Pilots completed continuous performance tests (CPT) at the required flight stages without compromising safety while on duty. No significant differences in sleep and sustained attention emerged between the exempt and non-exempt flight crews. Pilots' fatigue was highest in the early morning hours. Their general stability of efficiency increased during the day and decreased at night. Non-exempt flight crews appeared to sacrifice reaction rate to improve accuracy. Exempt crews appeared to increase their test proficiency. The task stability time of the non-exempt flight crews was better than that of the exempt ones. Short-term stability was better for exempt inbound flights rather than for outbound ones. Pilots were more prone to error runs as their total time awake increased, especially on non-exempt flights. The addition of crew members to exempt flights, allowance for more in-flight rest shifts, and over-stop rest on non-exempt flights may alleviate pilot fatigue and preserve alertness. [ABSTRACT FROM AUTHOR]

Introduction: This prospective intervention study was designed to determine the efficacy of a standardized Preflight/Postflight Stretches (PPS) protocol to reduce subjective neck and back pain scores in helicopter aircrew. Aircrew transient back and neck pain is well documented, and there is currently no standardized preflight and postflight stretching protocol for Naval Aviation. Methods: Subjects were recruited from two carrier air wing MH-60R squadrons at Naval Air Station Jacksonville. These carrier air wing squadrons were selected to control for size (number of aircrew), age, and operational tempo (number of flight hours). Subjects consisted of both pilots and enlisted aircrew. One squadron was designated as the control group, although the second squadron served as the intervention group. Subjects from both groups filled out the questionnaire. Only the intervention group completed the PPS protocol immediately after completing the questionnaire and before departing the squadron spaces for the aircraft outside. Upon landing, the aircrew completed a postflight debrief. Only the intervention group completed the PPS protocol after debrief. Both the intervention and control groups once again completed the questionnaire. Questionnaires were matched by using a generated anonymous subject ID. The amounts of change and pain levels were then compared using the Mann–Whitney test and the Fisher's exact test, respectively. Results: The Kolmogorov–Smirnov test found the data to be nonparametric. The preflight and postflight overall (P ≤ .001), cervical (P ≤ .001), thoracic (P = .006), and lumbar (P = .004) differences between the control and intervention groups were found to be statistically significant when using the Mann–Whitney test. Preflight and postflight pain differences in the sacral region and "other" section were not found to be statistically significant (sacral, P = .618; others, P = .182). When evaluating the worsening of the pain level, 50 (92%) of the control flights in which PPS was not performed reported worse pain, compared to 21 (61.8%) in the intervention group where PPS was performed. The Fisher's exact test found the association between performing PPS and the worsening in pain to be statistically significant (P = .001) in the overall, cervical, thoracic, and lumbar regions. Therefore, the hypothesis was accepted in regard to overall pain, as well as in the cervical, thoracic, and lumbar regions. Conclusion: Aircrew back and neck pain because of flying is well documented. However, there is no standardized stretching protocol for aircrew to perform immediately preflight or postflight in U.S. Naval Aviation. This study demonstrated that PPS, a simple 5- to 7-min stretching routine, gives aircrew structure and can reduce postflight cervical, thoracic, lumbar, and overall pain. This phase proved to be safe as no adverse events were reported. The prehabilitation aspect could reduce conventional medical intervention, costly pharmacological management of neck and back pain, and be applied to other aviation populations in military and civilian communities. [ABSTRACT FROM AUTHOR]

BACKGROUND: Military aircrew frequently report cervico-thoracic pain and injury. The relationship between risk factors and future pain episodes is, however, uncertain. The aim of this study was to identify risk factors for cervico-thoracic pain and to determine the 1-yr cumulative incidence of such pain. METHODS: A total of 47 Swedish aircrew (fighter and helicopter pilots and rear crew) without pain in the cervico-thoracic region were surveyed about work-related and personal factors and pain prevalence using the Musculoskeletal Screening Protocol questionnaire. They also performed tests of movement control, active cervical range of motion, and isometric neck muscle strength and endurance. Aircrew were followed for a year with questionnaires. Logistic regressions were used to identify potential risk factors for future cervico-thoracic pain. RESULTS: Previous cervico-thoracic pain (OR: 22.39, CI: 1.79-280.63), lower cervical flexion range of motion (OR: 0.78, CI: 0.64-0.96), and lower neck flexor muscular endurance (OR: 0.91, CI: 0.83-0.99) were identified as risk factors for reporting cervico-thoracic pain. At follow-up, 23.4% (CI: 13.6-37.2) had reported cervico-thoracic pain during the 12-mo follow-up period. DISCUSSION: The Musculoskeletal Screening Protocol can identify risk factors for cervico-thoracic pain. The link between cervico-thoracic pain and previous pain, as well as lower performance of neck range of motion and muscular endurance, highlights the need for primary and secondary preventive action. The findings from this study can facilitate the development of such pain prevention programs for aircrew. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to discuss the dark side of luxury yachting, with specific focus on the treatment and well-being of yacht crews. Design/methodology/approach: The paper is based on a literature review of key terms: luxury yachting; yacht crews; well-being; maritime tourism and yacht guests. Findings: The paper observes luxury yachting as having a hidden dark side that is impacting on the overall well-being of yacht crews who are responsible for producing luxury yachting experiences. It discusses scholarly research and industry reports into both luxury yachting tourism and yacht crew management and experiences. Practical implications: The success of the Below Deck television franchise has had a direct influence on the growing phenomenon of luxury yachting tourism. Behind the happy smiles and grandeur of the luxury experience, there is a dark side to this booming industry that requires further investigation and resolutions to enhance yacht crew well-being without impacting the guest experience. Originality/value: This paper presents luxury yachting as a growing tourism phenomenon. It explores the dark side of this industry from the experiences of yacht crews, who are generally seen, but not heard. [ABSTRACT FROM AUTHOR]

BACKGROUND: In his daily practice, the expert may be confronted with a wide range of pathologies, the repercussions of which degrade flight performance. The potentially serious operational consequences can then naturally justify a decision of unfitness. But beyond the simple assessment of the compatibility between a morbid condition, expected performance levels and flight conditions, can a broader reflection on flight safety and the risk of in-flight incapacitation be reasonably concluded by a decision of unfitness? OVERVIEW: This question needs to be considered against a backdrop of increasing progress (medical and technological), and a regulatory framework authorizing operational limitations designed to "control" this risk by reducing it to a level deemed "acceptable". But could this approach be relevant in a military environment? In commercial civil aviation, it could make a lot of sense, since the simple addition of a second pilot could statistically reduce the risk of an accident caused by a pilot becoming incapacitated in flight by a factor of 1000. In other words, it would be virtually possible to "eliminate" this risk for air transport operations... But what would happen to a student pilot planning to become an airline pilot, but not yet holding a professional license at the time of the medical examination? Or a Class 2 private pilot? While this approach cannot be directly transposed outside commercial aviation, it appears that the level of safety required is generally lower in private than in commercial aviation. Some authors therefore recommend tolerating a higher risk of incapacitation for private pilots. So, apart from disabling pathologies, could the « simple » risk legitimately constrain the fitness decision? DISCUSSION: In the end, in our current practice, could a decision on unfitness for flight be reasonably motivated by risk factors alone, or by a morbid condition that would be transient or even chronic, but without functional damage or sequelae? We will attempt to develop this question in the light of recent experience at the Toulon AEMC, by using clinical illustrations of military and civilian aircrews, received as part of initial and renewal medical visits. Learning Objectives 1. To understand strategies for managing the risk of in-flight incapacitation. 2. To know the main causes of unfitness to fly decisions. [ABSTRACT FROM AUTHOR]

In France, civil aircrew members have a double medical follow-up by aeronautical physicians (AME) and by occupational physicians like all French employees. This survey is carried out at Air France's occupational medicine department. The Air France collective agreements specify the terms and conditions of exercise in the event of loss of license (definitive unfitness). Therefore, loss of license must be requested by the aircrew members. The aeromedical expert prepares the file with the various medical elements and then transmits the request to the Civil Aeronautics Medical Council (CMAC). After analyzing the medical file, the CMAC issues the notice of permanent or temporary loss of the medical license. Our study was carried out using computer data identified and entered within the occupational health medical service. This concerns the characterization of the loss of licenses of the Air France air crewmembers, pilots and cabincrews, over the last past ten years: identification according to their function and gender, and the medical causes of the loss of license. We have identified, around 300 loss of license, from 2013 to 2022: Cabincrew (0.42 ‰ to 3.94 ‰) and Pilots (0.27 ‰ to 4 ‰) per year. We will present and discuss about the physical and psychological reasons observed. We will also discuss the professional future within the company of those who have chosen the option of a retraining offered in the company according to their medico-professional skills, and the support offered for a retraining outside the company. Learning Objectives 1. This concerns the characterization of the loss of licenses of Air France air crewmembers, technical (pilot) and commercial (cabin crew). 2. Identification according to their function and gender, and the medical causes of the loss of license. [ABSTRACT FROM AUTHOR]

The article highlights the "Using Human Body Modeling to Prevent Injuries to Aircrew" panel, which explores advancements in digital human modeling for improving aviation safety.

INTRODUCTION: The scientific literature on the stresses and strains experienced by flight crews during long-range (LR) and ultra-longrange (ULR) operations has mainly focused on the pilots. There are few studies on cabin crews, and even fewer that compare cockpit (COC) and cabin crews (CAB). METHODS: Subjective fatigue, concentration, and responsiveness of 11 all-male COC members and 46 CAB (24 female) -- the average age was 35.3 (SD = 8.7) -- were examined at takeoff and landing via visual analogue scales (VAS). Included were 4 outbound flights from Germany to Canberra (AUS), Las Vegas, Dulles (USA), and Hiroshima (JPN), as well as the 4 corresponding return flights from Papeete (PYF), Las Vegas, Los Angeles (USA), and Seoul (KOR). In three flights a connection flight between first destination and second departure airport was conducted but not included in this analysis. Flight durations ranged from 9:50 to 19:43 h. Each itinerary, outbound plus corresponding return flight, was categorized in east and west by outbound direction. RESULTS: Overall, highly significant increases in fatigue and decreases in concentration and responsiveness were observed across all flights (p < 0.001). For outbound flights, CAB reported a higher reduction in concentration (p = 0.017) and responsiveness (p = 0.131) than COC, the latter effect being non-significant; the change in fatigue did not differ (p = 0.998). For return flights CAB reported greater exhaustion in all three dimensions, the results were not significant (p > 0.05). Further analyses revealed a poorer recovery of fatigue (p = 0.392) and concentration (p = 0.126) after flying eastward compared to westward. No effect was found for responsiveness (p = 0.609), t-tests performed were not significant. DISCUSSION: LR and ULR-flights cause flight crew members to become increasingly fatigued, with CAB surprisingly reporting greater levels of exhaustion than COC. Although the differences were small, these findings may indicate an underestimation of CAB workload. The results comparing layovers in the east and west appear to replicate the relevant literature; however, further studies are needed to improve statistical power. Learning Objectives 1. The participants will learn that (ultra-)long-range flights led to increased fatigue and reduced concentration and responsiveness in flight crew members. 2. The participants will learn that cabin crews reported greater levels of exhaustion, compared to cockpit crews. [ABSTRACT FROM AUTHOR]

INTRODUCTION: A higher prevalence of back complaints in flying personnel compared to the general population is well documented. Various causes have previously been described. While standard analysis approaches including clinical testing, imaging-based evaluation and electrophysiological testing are well established, the role of laboratory analyses are less known. As part of a larger study intended to explore the relationship between musculoskeletal pain and blood serum analytes, this study sought to evaluate the relationship between flight hours and relevant laboratory parameters. METHODS: Eighty military pilots and aircrew members were evaluated over a three-year period during their routine health check-ups. The sample was divided into 2 groups based on the median flight hours (150 hours/year). Independent samples T-tests and Mann-Whitney U-tests were used to assess differences in blood serum analytes between groups. RESULTS: The group of aviators showed different mean values for Interleukin-12 (IL-12), Macrophage Derived Chemokine (MDC), Monocyte Inflammatory Protein-1α, (MIP1-α), Vascular Endothelial Growth Factor-A (VEGF-A), and Placental Growth Factor (PlGF). CONCLUSION: These results, supported by past literature, suggest that increased flight hours correspond with elevated levels of proinflammatory serum analytes. Additional research is needed to determine whether the changes in serum analytes correspond with severity of musculoskeletal pain/injury. Learning Objectives 1. The participant will learn that a relationship may exist between amount of flight hours and changes in proinflammatory serum analytes. 2. The participant will discuss the function of the serum analytes that differed based on flight hours. [ABSTRACT FROM AUTHOR]

INTRODUCTION: This is a case of a fatal F-16 mishap due to G-induced loss of consciousness (GLOC), that highlights physiologic factors which may decrease a pilot's tolerance of G forces. BACKGROUND: G forces continue to be a significant threat in fighter aviation. Safety data shows that 157 G-related mishaps occurred between FY01 and FY11 with five Class As and three fatalities costing $86.2M. Almost all military pilots, as part of their flight training, will undergo some exposure to the high +G environment. Fast jet operations, however, are where the vast majority of high +G exposure occurs. Fighter pilots are given extensive tools and training to overcome the effects of +G, including centrifuge training, advanced technology anti-G suits (ATAGS), positive pressure breathing for +G, physical conditioning, and refresher training on the anti-G straining maneuver (AGSM) continuously throughout their careers. CASE PRESENTATION: The mishap pilot was a physically fit 34-yr-old man. He had over 600 total flying hours. He was a pilot instructor on T-6A and completed training the T-38 prior to entering training in the F-16. On a regular training sortie, the pilot executed a maneuver that caused him to experience negative G followed immediately by + 9G at which point he experienced GLOC. The pilot regained some level of consciousness prior to crashing and tried to eject, however, it was unsuccessful. The aircraft was destroyed and the pilot dead. He was current on all Aerospace Physiology training. Prior to the mishap sortie. After the crash, a postmortem tissue examination detected the consumption of a nutritional supplements. No carbon monoxide, ethanol, or illegal substances. The mishap aircraft was an F-16CM built in1991. DISCUSSION: This tragic accident is one of many that have occurred in military fighter pilots. As flight surgeons, we should be award of all factors that may negatively contribute to a pilots abilities in the jet, and be ready to educate air crew about how to stay healthy. In this presentation we will discuss some specific factors that affect G tolerance, including the push-pull effect, the effect of lifestyle on physiologic compensation and decision making under stress, as well as potential effects of common nutritional supplements. Learning Objectives 1. The audience will learn about the presentation, diagnosis, and/or treatment of an interesting Aerospace Medicine case. 2. The audience will learn about the similarities and differences in medical standards and pilot medical clearances for civilian, US and foreign military aviation professionals. [ABSTRACT FROM AUTHOR]

BACKGROUND: Since 2021, AstroAccess (AA) Medical Operations has treated operational capacity, not standard physiology, as the key consideration in crew selection. This elevation of ability over all over metrics, save for safety, has taken place in the context of an aerospace community committed to re-examining and redefining acceptable risk profiles; at a time when commercial aerospace has opened seats on suborbital flights to a wide range of human morphologies; when the word "parastronaut" has entered the vernacular of government aerospace and the larger industry; and when civilian aerospace agencies are reshaping standards to emphasize performance metrics over age-based cutoffs. OVERVIEW: In support of parabolic flights for crew of varied disabilities, AA Medical Operations adapted risk assessment and management standards and procedures used by past and current civilian, military and private spaceflight, expanding them to allow for the inclusion of flyers with physical limitations who are psychologically, cognitively, technically, and professionally qualified. The results have been overwhelmingly positive, with 76 potential flyers with disabilities screened and 23 supported to become parabolic flight crew aka "ambassadors." This ambassador cohort includes 5 individuals who are deaf or hard of hearing, 7 individuals who are blind or have low vision, and 11 individuals with mobility disabilities. Each flight or mission entailed 15-18 lunar, martian, or microgravity parabolas of between 20-30 seconds duration. Over the course of 33 parabolas, the only ambassador injury reported was a minor abrasion on the anterior thigh of one flyer, which went unnoticed until the flight suit was removed. In terms of illness, after parabola 10 on each flight, a few cases of nausea were reported and effectively managed with medication. No ambassador experienced vomiting. DISCUSSION: The lessons learned from these flights are many. They apply to space medicine operations more broadly and include shifting the onus of "right stuff" from the solitary domain flyers to the shared purview flight surgeons, who must now have the courage and creativity to lead aerospace into an era of judicious experimentation, open collaboration, and evolving consensus about prioritizing function over form in spaceflight while achieving the highest level of safety. Learning Objectives 1. The participant will be able to discuss current barriers for integration of disabled SFP including hardware modifications, lack of standardized medical screening, risk stratification, risk mitigation and address industry culture. 2. The audience will learn about disabled flyers' experience with parabolic flights and simulated microgravity. Their publicly-known demographics and medical team's implementation of COE CST recommendations and observed learnings. [ABSTRACT FROM AUTHOR]