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A quarter of the rescued IPE victims died because of early cardiac arrest.DISCUSSION Helicopter evacuation is indicated when vital prognosis (IPE and pulmonary overpressure in particular) or neurological functional prognosis (decompression sickness) is of concern. IPE is the primary etiology in patients with serious dive injuries that are life-threatening and who will benefit from helicopter evacuation. A non-invasive ventilation device with inspiratory support and positive expiratory pressure must be used, in particular for IPE.Corgie L, Huiban N, Pontier J-M, Brocq F-X, Boulard J-F, Monteil M. Diving accident evacuations by helicopter and immersion pulmonary edema. Aerosp Med Hum Perform. 2020; 91(10)806811.BACKGROUND Piloting an aircraft is a complex cognitive task. Human error represents a major contributing factor in aviation accidents. Emotion plays an important role in aviation safety. We performed a functional magnetic resonance imaging (fMRI) study to explore whether pilots and nonpilots may differ in the neural mechanisms responsible for the processing of conflict emotional information.METHODS A total of 27 civil aviation pilots and 24 nonpilot controls performed the emotional Stroop task, in which participants were required to identify the facial expressions of the stimuli while ignoring the congruent or incongruent emotional words superimposed on the faces. Neural responses to the stimuli were compared between pilots and controls. Also, a psychophysiological interaction (PPI) analysis was performed to explore whether there were differences in effective connectivity between pilots and nonpilots.RESULTS Behavioral data showed that pilots (21.23 ms) and nonpilots (26.78 ms) had equivalent congruency effects. Nevertheless, their neural activation patterns differed. Compared with pilots, nonpilots exhibited neural activity in the right supramarginal gyrus when processing incongruent stimuli, and more regions were activated in the process of conflict monitoring. The PPI analysis showed greater activity between the right supramarginal gyrus and the right lingual gyrus when nonpilots confronted incongruent vs. congruent stimuli. However, this effective connectivity was not found in pilots.CONCLUSION These results suggest different mechanisms underlying emotional conflict control between pilots and the general population.Jiang H, Xu K, Chen X, Wang Q, Yang Y, Fu C, Guo X, Chen X, Yang J. The neural underpinnings of emotional conflict control in pilots. Aerosp Med Hum Perform. 2020; 91(10)798805.BACKGROUND Flight-associated neck pain (FANP) is a serious problem in fighter pilots. Despite the high impact of FANP there is little evidence for effective management. [https://www.selleckchem.com/products/Gefitinib.html see more] However, self-kinematic training showed a positive effect in the general population. The purpose of this study was to investigate the effectiveness of a self-kinematic training program using virtual reality in improving neck pain in fighter pilots.METHODS There were 45 pilots with FANP who were randomized to a control group (N 23) or a training group (N 22). Training participants were instructed to exercise using a personalized self-training program, for 20 min/wk, for 4 wk. Primary outcome measures were neck disability (NDI%) and mean velocity ( s1), and secondary were pain, health status, accuracy, and isometric strength. Assessments were conducted by a blinded assessor and intention-to-treat analysis by a blinded statistician.RESULTS There were 40 pilots who completed the postintervention assessments, and 35 completed the 6-mo follow-up. Baseline measurements showed mild pain and disability (mean VAS 43 22.73, NDI 17.76 9.59%) and high kinematic performance. Compliance with self-training was poor. No differences were observed in self-reported measures and strength. Exercise duration was correlated with NDI% improvement.DISCUSSION This self-kinematic training promoted kinematic performance, but was ineffective in engaging the pilots to exercise, and consequently did not improve pain and disability. Poor compliance was previously reported in self-training for FANP, suggesting further studies should prioritize supervised training. Considering the high baseline kinematic performance, kinematics does not seem to be a key factor in FANP, and future exercise research should aim for intense strengthening to increase endurance to the high Gz pilots experience.Sarig Bahat H, German D, Palomo G, Gold H, Frankel Nir Y. Self-kinematic training for flight-associated neck pain a randomized controlled trial. Aerosp Med Hum Perform. 2020; 91(10)790797.INTRODUCTION We compared the physiological responses, psychomotor performances, and hypoxia symptoms between 7000 m and 7500 m (23,000 and 24,600 ft) exposure to develop a safer hypoxia training protocol.METHODS In altitude chamber, 66 male pilots were exposed to 7000 and 7500 m. Heart rate and arterial oxygen saturation were continuously monitored. Psychomotor performance was assessed using the computational task. The hypoxic symptoms were investigated by a questionnaire.RESULTS The mean duration time of hypoxia was 323.0 56.5 s at 7000 m and 218.2 63.3 s at 7500 m. The 6-min hypoxia training was completed by 57.6% of the pilots and 6.1% of the pilots at 7000 m and at 7500 m, respectively. There were no significant differences in pilots heart rates and psychomotor performance between the two exposures. The Spo₂ response at 7500 m was slightly severer than that at 7000 m. During the 7000 m exposure, pilots experienced almost the same symptoms and similar frequency order as those during the 7500 m exposure.CONCLUSIONS There were concordant symptoms, psychomotor performance, and very similar physiological responses between 7000 m and 7500 m during hypoxia training. The results indicated that 7000-m hypoxia awareness training might be an alternative to 7500-m hypoxia training with lower DCS risk and longer experience time.Wen D, Tu L, Wang G, Gu Z, Shi W, Liu X. Psychophysiological responses of pilots in hypoxia training at 7000 and 7500 m. Aerosp Med Hum Perform. 2020; 91(10)785789.INTRODUCTION Hypoxia-induced hyperventilation is an effect of acute altitude exposure, which may lead to respiratory muscle fatigue and secondary locomotor muscle fatigue. The purpose of this study was to determine if resistive and/or endurance respiratory muscle training (RRMT and ERMT, respectively) vs. placebo respiratory muscle training (PRMT) improve cycling performance at altitude.METHODS There were 24 subjects who were assigned to PRMT (N 8), RRMT (N 8), or ERMT (N 8). Subjects cycled to exhaustion in a hypobaric chamber decompressed to 3657 m (12,000 ft) at an intensity of 55% sea level maximal oxygen consumption (Vo2max) before and after respiratory muscle training (RMT). Additionally, subjects completed a Vo2max, pulmonary function, and respiratory endurance test (RET) before and after RMT. All RMT protocols consisted of three 30-min training sessions per week for 4 wk.RESULTS The RRMT group increased maximum inspiratory (PImax) and expiratory (PEmax) mouth pressure after RMT (PImax 117.7 11.6 vs. 162.