Handbergboisen3708

AbstractINTRODUCTION For over 50 yr, investigators have studied the physiological adaptations of the human system during short- and long-duration spaceflight exposures. Much of the knowledge gained in developing health countermeasures for astronauts onboard the International Space Station demonstrate terrestrial applications. To date, a systematic process for translating these space applications to terrestrial human health has yet to be defined.METHODS In the summer of 2017, a team of 38 international scientists launched the Bellagio ll Summit Initiative. The goals of the Summit were 1) To identify space medicine findings and countermeasures with highest probability for future terrestrial applications; and 2) To develop a roadmap for translation of these countermeasures to future terrestrial application. The team reviewed public domain literature, NASA databases, and evidence books within the framework of the five-stage National Institutes of Health (NIH) translation science model, and the NASA two-stage tranI Team. Bellagio II report terrestrial applications of space medicine research. Aerosp Med Hum Perform. 2021; 92(8)650669.INTRODUCTION Syncope is both incapacitating and unpredictable, presenting a significant challenge in aircrew assessment. Previous UK Civil Aviation Authority (CAA) guidance lacked transparency and relied heavily on specialist in-house cardiology and neurology opinion. A new algorithm was developed which elaborated and formalized the decision-making process. An analysis of its impact on historic cases was undertaken to ensure it aligned with previous certificatory outcomes.METHODS The medical literature on syncope and the approaches of other national aviation authorities were reviewed to help inform the development of a new algorithm. Using syncope cases in the CAA database, regulatory outcomes generated using the new algorithm were compared with previous decisions in terms of time off from flying (TOF) and Operational Multi-Crew Limitation (OML) duration.RESULTS There were 40 historic syncope cases (25 existing certificate holders,15 initial applicants) which were reassessed using the new algorithm. The mean TOF for existing pilots using the new algorithm was 7.1 9.8 (mean SD) vs. 4.2 3.5 mo under the old guidance with an OML duration of 21.4 34.9 vs. 24.5 25.2 mo. One less initial applicant experienced a delay to certification. Four cases with underlying pathology were detected using old and new guidance.DISCUSSION The reassessment of cases showed no statistically significant difference in TOF and OML duration; this is a positive finding from a regulatory perspective, enabling algorithm-led decision-making with less reliance on in-house expertise. A similar approach may be useful in future updates to other areas of regulatory practice.Anderton RA, Mitchell SJ, ONunain SS. Syncope in commercial pilots and new regulatory guidance. Aerosp Med Hum Perform. 2021; 92(8)642649.AbstractBACKGROUND Members of the public will soon be taking commercial suborbital spaceflights with significant Gx (chest-to-back) acceleration potentially reaching up to 6 Gx. Pulmonary physiology is gravity-dependent and is likely to be affected, which may have clinical implications for medically susceptible individuals.METHODS During 2-min centrifuge exposures ranging up to 6 Gx, 11 healthy subjects were studied using advanced respiratory techniques. These sustained exposures were intended to allow characterization of the underlying pulmonary response and did not replicate actual suborbital G profiles. Regional distribution of ventilation in the lungs was determined using electrical impedance tomography. Neural respiratory drive (from diaphragm electromyography) and work of breathing (from transdiaphragmatic pressures) were obtained via nasoesophageal catheters. Arterial blood gases were measured in a subset of subjects. Measurements were conducted while breathing air and breathing 15 oxygen to simulate and G, Robbins PA, Ritchie GAD, Segal MJ, Stevenson AT, Tank HD, Smith TG. selleckchem Pulmonary effects of sustained periods of high-G acceleration relevant to suborbital spaceflight. Aerosp Med Hum Perform. 2021; 92(7)633641.AbstractBACKGROUND Based on posturography parameters during sleep deprivation (SD), a mental fatigue index (MFI) was constructed for healthy male cadets.METHODS There were 37 young male subjects who volunteered for two successive days of SD. Their posturography balance, profile of mood status (POMS), and heart rate variability (HRV) were measured at four different times (1000 and 2200 of day 1, 1000 and 2200 of day 2). According to the methods used in our previous research, similar MFIs based on posturography parameters were computed. Then, correlations of MFIs with POMS scores and HRV values were evaluated by linear and nonlinear methods including quadratic, S-curve, growth, and exponential analyses.RESULTS MFI continued to increase during SD and MFI as the independent variable had quadratic relationships with fluster (R² 0.057), depression (R² 0.067), and anger (R² 0.05) scores of POMS. A linear correlation was found between MFI and the depression score (R² 0.045) and MFI correlated linearly (R² 0.029) and nonlinearly (R² 0.03) with heart rate. Similarly, MFI reflected changes in the time and frequency domain parameters of HRV, with linear (R²range 0.0290.082) or nonlinear (R²range 0.0300.082) relationships.DISCUSSION The increase of MFI was linked with amplification of personal negative moods and an imbalance of autonomic nervous system activity. The findings suggest that MFI might be a potential indicator of mental fatigue and provide a method to prevent driving fatigue and human errors.Cheng S, Yang J, Su M, Sun J, Xiong K, Ma J, Hu W. Postural stability change under sleep deprivation and mental fatigue status. Aerosp Med Hum Perform. 2021; 92(8)627632.INTRODUCTION Aerobatic flight operations involve a higher level of risk than standard flight operations. Aerobatics imposes considerable stresses on both the aircraft and the pilot. The purpose of this study was to analyze civilian aerobatic aircraft accidents in Australia, with particular emphasis on the underlying accident causes and survival outcomes.METHODS The accident and incident database of the Australian Transport Safety Bureau was searched for all events involving aerobatic flight for the period 19802010.RESULTS A total of 51 accidents involving aircraft undertaking aerobatic operations were identified, with 71 aircraft occupants. Of the accidents, 27 (52.9) were fatal, resulting in a total of 36 fatalities. There were 24 nonfatal accidents. In terms of injury outcomes, there were 4 serious and 9 minor injuries, and 22 accidents in which no injuries were recorded. link2 Fatal accidents were mainly due to loss of control by the pilot (44.4), in-flight structural failure of the airframe (25.9), and terrain impact (25.9). G-LOC was considered a possible cause in 11.1 of fatal accidents. Nonfatal accidents were mainly due to powerplant failure (41.7) and noncatastrophic airframe damage (25). Accidents involving aerobatic maneuvering have a significantly increased risk of a fatal outcome (odds ratio 26).DISCUSSION The results of this study highlight the risks involved in aerobatic flight. Exceeding the operational limits of the maneuver and the design limits of the aircraft are major factors contributing to a fatal aerobatic aircraft accident. Improved awareness of G physiology and better operational decision-making while undertaking aerobatic flight may help prevent further accidents.Newman DG. Factors contributing to accidents during aerobatic flight operations. Aerosp Med Hum Perform. 2021; 92(8)612618.

Israel serves as a case study for understanding the importance of undergraduate palliative care (PC) education in implementing, developing, and enabling access to palliative care services. This article presents the findings collected from the five medical schools.

This qualitative study supported by a survey explores and describes the state of undergraduate PC education at medical schools in Israel. The survey included questions on voluntary and mandatory courses, allocation of different course models, teaching methods, time frame, content, institutions involved, and examinations. Semi-structured interviews with teaching faculty were conducted at the same locations.

Eleven expert interviews and five surveys demonstrate that PC is taught as a mandatory subject at only two out of the five Israeli universities. To enhance PC in Israel, it needs to become a mandatory subject for all undergraduate medical students. To teach communication, cultural safety, and other basic competencies, new interactive teachintically lead to a better practical implementation for the benefit of people. Medical schools should cooperate, as the formation of expertise exchange across medical schools would automatically lead to better PC education.While metabolic disorders such as obesity and diabetes are costly and deadly to the current population, they are also extremely detrimental to the next generation. Much of the current literature focuses on the negative impact of poor maternal choices on offspring disease, while there is little work examining maternal behaviors that may improve offspring health. Research has shown that voluntary maternal exercise in mouse models improves metabolic function in offspring. In this study, we hypothesized that controlled maternal exercise in a mouse model will effect positive change on offspring obesity and glucose homeostasis. Female mice were separated into three groups home cage, sedentary, and exercise. The sedentary home cage group was not removed from the home cage, while the sedentary wheel group was removed from the cage and placed in an immobile wheel apparatus. The exercise group was removed from the home cage and run on the same wheel apparatus but with the motor activated at 5-10 m/min for 1 h/d prior to and during pregnancy. Offspring were subjected to oral glucose tolerance testing and body composition analysis. There was no significant difference in offspring glucose tolerance or body composition as a consequence of the maternal exercise intervention compared to the sedentary wheel group. There were no marked negative consequences of the maternal controlled exercise intervention. Further research should clarify the potential advantages of the controlled exercise model and improve experimental techniques to facilitate translation of this research to human applications.The field of epigenetics is currently one of the most rapidly expanding in biology and has resulted in increasing public interest in its applications to human health. link3 Epigenetics provides a promising avenue for both targeted individual intervention and public health messaging. However, to develop effective strategies for engagement, it is important to understand the public's understanding of the relevant concepts. While there has been some research exploring the public's understanding of genetic and environmental susceptibility to disease, limited research exists on public opinion and understanding of epigenetics and epigenetic concepts. Using an online questionnaire, this study investigated the Australian public's understanding, views, and opinions of epigenetics and related concepts, including the concepts of the developmental origins of health and disease (DOHaD) and the first 1000 days. Over 600 questionnaires were completed, with 391 included in the analysis. The survey included questions on knowledge of epigenetics and perceptions of epigenetic concepts for self and for children.