Aerospace medicine and human performance最新文献

INTRODUCTION: Sleep inertia is the transition state during which alertness and cognitive performance are temporarily impaired after awakening. Magnitude and time course of sleep inertia are characterized by high individual variability with large differences between the cognitive functions affected. This period of impairment is of concern to pilots, who take sleep or nap periods during on-call work hours or in-flight rest, then need to perform safety-critical tasks soon after waking. This review analyzes literature related to sleep inertia and countermeasures applicable for aviation.METHODS: The large part of scientific literature that focuses on sleep inertia is based on studies in patients with chronic sleep inertia. We analyzed 8 narrative reviews and 64 papers related to acute sleep inertia in healthy subjects.DISCUSSION: Sleep inertia is a multifactorial, complex process, and many different protocols have been conducted, with a low number of subjects, in noncontrolled laboratory designs, with questionnaires or cognitive tests that have not been replicated. Evidence suggests that waking after sleep loss, or from deeper stages of sleep, can exacerbate sleep inertia through complex interactions between awakening and sleep-promoting brain structures. Nevertheless, no meta-analyses are possible and extrapolation to pilots' performances is hypothetical. Studies in real life or simulated operational situations must be conducted to improve the description of the impact of sleep inertia and kinetics on pilots' performances. Taking rest or sleep time remains the main method for pilots to fight against fatigue and related decreases in performance. We propose proactive strategies to mitigate sleep inertia and improve alertness.Sauvet F, Beauchamps V, Cabon P. Sleep inertia in aviation. Aerosp Med Hum Perform. 2024; 95(4):206-213.

INTRODUCTION: The illusions of head motion induced by galvanic vestibular stimulation (GVS) can be used to compromise flight performance of pilots in fixed-base simulators. However, the stimuli used in the majority of studies fail to mimic disorientation in realistic flight because they are independent from the simulated aircraft motion. This study investigated the potential of bilateral-bipolar GVS coupled to aircraft roll in a fixed-base simulator to mimic vestibular spatial disorientation illusions, specifically the "post-roll illusion" observed during flight.METHODS: There were 14 nonpilot subjects exposed to roll stimuli in a flight simulator operating in a fixed-base mode. GVS was delivered via carbon rubber electrodes on the mastoid processes. The electrical stimulus was driven by the high-pass filtered aircraft roll rate to mimic the semicircular canals' physiological response. The post-roll test scenarios excluded outside visual cues or instruments and required subjects to actively maintain a constant bank angle after an abrupt stop following a passive prolonged roll maneuver. The anticipated outcome was an overshot in roll elicited by the GVS signal.RESULTS: The responses across subjects showed large variability, with less than a third aligning with the post-roll illusion. Subjective ratings suggest that the high-pass filtered GVS stimuli were mild and did not induce a clear sense of roll direction. However, uncontrolled head movements during stimulation might have obscured the intended effects of GVS-evoked illusory head movements.CONCLUSION: The mild and transient GVS stimuli used in this study, together with the uncontrolled head movements, did not convincingly mimic the post-roll illusion.Houben MMJ, Stuldreher IV, Forbes PA, Groen EL. Using galvanic vestibular stimulation to induce post-roll illusion in a fixed-base flight simulator. Aerosp Med Hum Perform. 2024; 95(2):84-92.

BACKGROUND: In this study, we investigated the impact of a loss of horizon due to atmospheric conditions on flight performance and workload of helicopter pilots during a low-altitude, dynamic flight task in windy conditions at sea. We also examined the potential benefits of a helmet-mounted display (HMD) for this specific task.METHODS: In a fixed-based helicopter simulator, 16 military helicopter pilots were asked to follow a maneuvering go-fast vessel in a good visual environment (GVE) and in a degraded visual environment (DVE). DVE was simulated by fog, obscuring the horizon and reducing contrast. Both visual conditions were performed once with and once without an HMD, which was simulated by projecting head-slaved symbology in the outside visuals. Objective measures included flight performance, control inputs, gaze direction, and relative positioning. Subjective measures included self-ratings on performance, situation awareness, and workload.RESULTS: The results showed that in DVE the pilots perceived higher workload and were flying closer to the go-fast vessel than in GVE. Consequently, they responded with larger control inputs to maneuvers of the vessel. The availability of an HMD hardly improved flight performance but did allow the pilots to focus their attention more outside, significantly improving their situation awareness and reducing workload. These benefits were found in DVE as well as GVE conditions.DISCUSSION: DVE negatively affects workload and flight performance of helicopter pilots in a dynamic, low-altitude following task. An HMD can help improve situation awareness and lower the workload during such a task, irrespective of the visual conditions.Ledegang WD, van der Burg E, Valk PJL, Houben MMJ, Groen EL. Helicopter pilot performance and workload in a following task in a degraded visual environment. Aerosp Med Hum Perform. 2024; 95(1):16-24.

INTRODUCTION: High quality cardiopulmonary resuscitation and medical care in an emergency can save lives, especially when resources are limited, as when in flight on a commercial airplane. A medical student or resident may be the most qualified person to offer assistance during an in-flight cardiac arrest; however, he/she may not yet have experience acting as a sole provider on the ground. Moreover, physicians-in-training may feel an ethical obligation to help a fellow passenger in need, but later worry that their help is subject to questions of tort liability action. This commentary will discuss who should volunteer to help in flight, considering the capability, ethics, and legal consequences of medical students and residents providing medical assistance on an airplane. It will also discuss how changes in medical curriculum due to the COVID-19 pandemic may aid medical trainees' ability to help during an in-flight emergency as well as propose further opportunities for training.Edelson J, Ruskin K. Considerations for medical students' and residents' response to an in-flight call for help. Aerosp Med Hum Perform. 2024; 95(1):59-60.