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1.
Sensors (Basel) ; 24(9)2024 Apr 29.
Article in English | MEDLINE | ID: mdl-38732940

ABSTRACT

Future airspace is expected to become more congested with additional in-service cargo and commercial flights. Pilots will face additional burdens in such an environment, given the increasing number of factors that they must simultaneously consider while completing their work activities. Therefore, care and attention must be paid to the mental workload (MWL) experienced by operating pilots. If left unaddressed, a state of mental overload could affect the pilot's ability to complete his or her work activities in a safe and correct manner. This study examines the impact of two different cockpit display interfaces (CDIs), the Steam Gauge panel and the G1000 Glass panel, on novice pilots' MWL and situational awareness (SA) in a flight simulator-based setting. A combination of objective (EEG and HRV) and subjective (NASA-TLX) assessments is used to assess novice pilots' cognitive states during this study. Our results indicate that the gauge design of the CDI affects novice pilots' SA and MWL, with the G1000 Glass panel being more effective in reducing the MWL and improving SA compared with the Steam Gauge panel. The results of this study have implications for the design of future flight deck interfaces and the training of future pilots.


Subject(s)
Awareness , Pilots , Workload , Humans , Workload/psychology , Pilots/psychology , Male , Awareness/physiology , Adult , Aircraft , Aviation , Electroencephalography/methods , Female , Young Adult
2.
Environ Health ; 23(1): 46, 2024 May 04.
Article in English | MEDLINE | ID: mdl-38702725

ABSTRACT

BACKGROUND: Long-term exposure to transportation noise is related to cardio-metabolic diseases, with more recent evidence also showing associations with diabetes mellitus (DM) incidence. This study aimed to evaluate the association between transportation noise and DM mortality within the Swiss National Cohort. METHODS: During 15 years of follow-up (2001-2015; 4.14 million adults), over 72,000 DM deaths were accrued. Source-specific noise was calculated at residential locations, considering moving history. Multi-exposure, time-varying Cox regression was used to derive hazard ratios (HR, and 95%-confidence intervals). Models included road traffic, railway and aircraft noise, air pollution, and individual and area-level covariates including socio-economic position. Analyses included exposure-response modelling, effect modification, and a subset analysis around airports. The main findings were integrated into meta-analyses with published studies on mortality and incidence (separately and combined). RESULTS: HRs were 1.06 (1.05, 1.07), 1.02 (1.01, 1.03) and 1.01 (0.99, 1.02) per 10 dB day evening-night level (Lden) road traffic, railway and aircraft noise, respectively (adjusted model, including NO2). Splines suggested a threshold for road traffic noise (~ 46 dB Lden, well below the 53 dB Lden WHO guideline level), but not railway noise. Substituting for PM2.5, or including deaths with type 1 DM hardly changed the associations. HRs were higher for males compared to females, and in younger compared to older adults. Focusing only on type 1 DM showed an independent association with road traffic noise. Meta-analysis was only possible for road traffic noise in relation to mortality (1.08 [0.99, 1.18] per 10 dB, n = 4), with the point estimate broadly similar to that for incidence (1.07 [1.05, 1.09] per 10 dB, n = 10). Combining incidence and mortality studies indicated positive associations for each source, strongest for road traffic noise (1.07 [1.05, 1.08], 1.02 [1.01, 1.03], and 1.02 [1.00, 1.03] per 10 dB road traffic [n = 14], railway [n = 5] and aircraft noise [n = 5], respectively). CONCLUSIONS: This study provides new evidence that transportation noise is associated with diabetes mortality. With the growing evidence and large disease burden, DM should be viewed as an important outcome in the noise and health discussion.


Subject(s)
Diabetes Mellitus , Environmental Exposure , Noise, Transportation , Noise, Transportation/adverse effects , Humans , Switzerland/epidemiology , Diabetes Mellitus/epidemiology , Diabetes Mellitus/mortality , Male , Female , Environmental Exposure/adverse effects , Cohort Studies , Middle Aged , Adult , Aged , Aircraft
3.
Aerosp Med Hum Perform ; 95(5): 254-258, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38715275

ABSTRACT

INTRODUCTION: Although an unintended aircraft landing on water (referred to as ditching) is a rare event, the potential for occupant injury/fatality increases immediately following the event due to adverse conditions. However, to date, few studies have addressed the subject. Herein, ditching events and post-ditching survival were investigated.METHODS: Ditchings (1982-2022) in the United States were identified from the National Transportation Safety Board database. Occupant injury severity, aircraft type, pilot experience, flight conditions, and number of occupants were extracted. Poisson distribution, the Chi-squared test (2-tailed), Mann-Whitney U test, and Kruskal-Wallis one-way analysis of variance were employed.RESULTS: A total of 96 ditchings were identified. A systematic survey was hampered by the lack of a standardized reporting matrix in the reports. In total, 77 reports were included in the analysis. Across all ditchings, 128 of 169 (76%) occupants survived ditching and were rescued. Importantly, the initial ditching event was survived by 95% of all occupants. However, 32 (19%) occupants died post-ditching by drowning (21/32 cases) or for undetermined reasons. Considering probability per ditching event, in 26 (34%) of all ditchings, one or more occupants was/were fatally injured.DISCUSSION: Initial survival of the emergency ditching is high. Drowning was the leading cause of death after ditching and reduced the overall survival to 76%. Further investigation is needed to identify risk factors for fatal outcomes and/or improve probability of survival after ditching.Schick VC, Boyd DD, Hippler C, Hinkelbein J. Survival after ditching in motorized aircraft, 1989-2022. Aerosp Med Hum Perform. 2024; 95(5):254-258.


Subject(s)
Accidents, Aviation , Aircraft , Humans , Accidents, Aviation/mortality , Accidents, Aviation/statistics & numerical data , United States/epidemiology , Drowning/mortality , Male , Databases, Factual , Pilots/statistics & numerical data
4.
BMC Anesthesiol ; 24(1): 140, 2024 Apr 12.
Article in English | MEDLINE | ID: mdl-38609864

ABSTRACT

BACKGROUND: Aneurysmal subarachnoid hemorrhage (aSAH) is preferentially treated by prompt endovascular coiling, which is not available in Guadeloupe. Subsequently, patients are transferred to Paris, France mainland, by commercial airplane (6751 km flight) after being managed according to guidelines. This study describes the characteristics, management and outcomes related to these patients. METHODS: Retrospective observational cohort study of 148 patients admitted in intensive care unit for a suspected aSAH and transferred by airplane over a 10-year period (2010-2019). RESULTS: The median [interquartile range] age was 53 [45-64] years and 61% were female. On admission, Glasgow coma scale was 15 [13-15], World Federation of Neurological Surgeons (WFNS) grading scale was 1 [1-3] and Fisher scale was 4 [2-4]. External ventricular drainage and mechanical ventilation were performed prior to the flight respectively in 42% and 47% of patients. One-year mortality was 16% over the study period. By COX logistic regression analysis, acute hydrocephalus (hazard ratio [HR] 2.34, 95% confidence interval [CI] 0.98-5.58) prior to airplane transfer, WFNS grading scale on admission (HR 1.53, 95% CI 1.16-2.02) and age (OR 1.03, 95% 1.00-1.07) were associated with one-year mortality. CONCLUSION: When necessary, transatlantic air transfer of patients with suspected aSAH after management according to local guidelines seems feasible and safe.


Subject(s)
Subarachnoid Hemorrhage , Humans , Female , Middle Aged , Male , Retrospective Studies , Subarachnoid Hemorrhage/surgery , Aircraft , Drainage , France
5.
Environ Sci Technol ; 58(15): 6575-6585, 2024 Apr 16.
Article in English | MEDLINE | ID: mdl-38564483

ABSTRACT

Wide-area aerial methods provide comprehensive screening of methane emissions from oil and gas (O & G) facilities in production basins. Emission detections ("plumes") from these studies are also frequently scaled to the basin level, but little is known regarding the uncertainties during scaling. This study analyzed an aircraft field study in the Denver-Julesburg basin to quantify how often plumes identified maintenance events, using a geospatial inventory of 12,629 O & G facilities. Study partners (7 midstream and production operators) provided the timing and location of 5910 maintenance events during the 6 week study period. Results indicated three substantial uncertainties with potential bias that were unaddressed in prior studies. First, plumes often detect maintenance events, which are large, short-duration, and poorly estimated by aircraft methods: 9.2 to 46% (38 to 52%) of plumes on production were likely known maintenance events. Second, plumes on midstream facilities were both infrequent and unpredictable, calling into question whether these estimates were representative of midstream emissions. Finally, 4 plumes attributed to O & G (19% of emissions detected by aircraft) were not aligned with any O & G location, indicating that the emissions had drifted downwind of some source. It is unclear how accurately aircraft methods estimate this type of plume; in this study, it had material impact on emission estimates. While aircraft surveys remain a powerful tool for identifying methane emissions on O & G facilities, this study indicates that additional data inputs, e.g., detailed GIS data, a more nuanced analysis of emission persistence and frequency, and improved sampling strategies are required to accurately scale plume estimates to basin emissions.


Subject(s)
Air Pollutants , Air Pollutants/analysis , Aircraft , Methane/analysis , Natural Gas/analysis
6.
Neurol Clin ; 42(2): 521-542, 2024 May.
Article in English | MEDLINE | ID: mdl-38575264

ABSTRACT

Headaches attributed to disorders of homeostasis include those different headache types associated with metabolic and systemic diseases. These are headache disorders occurring in temporal relation to a disorder of homeostasis including hypoxia, high altitude, airplane travel, diving, sleep apnea, dialysis, autonomic dysreflexia, hypothyroidism, fasting, cardiac cephalalgia, hypertension and other hypertensive disorders like pheochromocytoma, hypertensive crisis, and encephalopathy, as well as preeclampsia or eclampsia. The proposed mechanism behind the causation of these headache subtypes including diagnostic criteria, evaluation, treatment, and overall management will be discussed.


Subject(s)
Brain Diseases , Hypertensive Crisis , Female , Pregnancy , Humans , Headache/etiology , Headache/therapy , Headache/diagnosis , Homeostasis , Aircraft , Brain Diseases/complications
7.
Sci Eng Ethics ; 30(2): 14, 2024 Apr 11.
Article in English | MEDLINE | ID: mdl-38605283

ABSTRACT

Two Boeing 737-MAX passenger planes crashed in October 2018 and March 2019, suspending all 737-MAX aircraft. The crashes put Boeing's corporate practices and culture under the spotlight. The main objective of this paper is to use the case of Boeing to highlight the importance of efficient employee grievance redressal mechanisms and an independent external regulator. The methodology adopted is a qualitative analysis of statements of various whistleblowers and Boeing and the Federal Aviation Administration (FAA) stakeholders. It suggests that employee feedback flowing up the chain of command should be more flexible and dealt with more seriousness. It recommends that companies adopt a cooling-off period or a lifetime restriction for employees who have gone through the revolving door between regulators and the industry. The Boeing 737-MAX case, which emphasizes the ethical obligations of the job, can offer value to engineers, engineering educators, managers, ombudsmen, and human resource professionals.


Subject(s)
Accidents, Traffic , Employee Grievances , Humans , Aircraft , Organizations , Industry
8.
Eur J Psychotraumatol ; 15(1): 2337509, 2024.
Article in English | MEDLINE | ID: mdl-38626195

ABSTRACT

Background: Previous research has indicated that continuous exposure to disaster-related information through social media can lead to vicarious trauma. However, scholars have recognized the need for further in-depth research into the underlying mechanisms influencing this relationship.Objective: The purpose of this study is to investigate the impact mechanism of social media usage on vicarious traumatization in users and analyze the roles of recommendation systems and peer communication.Methods: This study was conducted with college students in China, focusing on the context of the MU5735 aircraft flight accident in China in which 123 passengers and 9 crew members died. Data were collected through an online questionnaire. The partial least square structural equation modelling (PLS-SEM) method was used to test the data and model.Results: This study obtained valid responses from 1317 participants. The study findings revealed a significant positive correlation between social media usage(ß = 0.180,P < .001), recommendation systems usage (ß = 0.172, P < .001), peer communication (ß = 0.303, P < .001), and the development of vicarious traumatization. Recommendation systems usage (specific indirect effect = 0.063, P < .001) and peer communication (specific indirect effect = 0.138, P < .001) mediated the relationship between social media use and vicarious trauma. Additionally, the impact of peer communication on vicarious trauma was found to be higher compared to the effects of continuous social media use and recommendation system use.Conclusion: The study found that the use of social media to obtain information about accidents, the frequent pushing of accident information by recommender systems, and the frequent discussion of accidents among peers during unexpected accidents contribute to vicarious traumatization. The study suggests that users' reduced retrieval of accident information via social media, as well as reduced peer-to-peer discussions about accidents, and social media platforms' adjustment of recommender system algorithm rules to reduce accident information pushes, may help reduce the likelihood of users experiencing vicarious traumatization.


Social media usage significantly affected college users to develop vicarious traumatization.Recommendation systems usage and peer communication significantly affected the development of vicarious traumatization.Recommendation systems usage and peer communication mediated the relationship of social media usage and vicarious traumatization.


Subject(s)
Compassion Fatigue , Social Media , Humans , Surveys and Questionnaires , Communication , Aircraft
9.
Scand J Trauma Resusc Emerg Med ; 32(1): 29, 2024 Apr 16.
Article in English | MEDLINE | ID: mdl-38627817

ABSTRACT

BACKGROUND: Helicopter Emergency Medical Services (HEMS) provide rapid and specialized care to critically ill or injured patients. Norwegian HEMS in Central Norway serves an important role in pre-hospital emergency medical care. To grade the severity of patients, HEMS uses the National Advisory Committee for Aeronautics' (NACA) severity score. The objective of this study was to describe the short- and long term mortality overall and in each NACA-group for patients transported by HEMS Trondheim using linkage of HEMS and hospital data. METHODS: The study used a retrospective cohort design, aligning with the STROBE recommendations. Patient data from Trondheim HEMS between 01.01.2017 and 31.12.2019 was linked to mortality data from a hospital database and analyzed. Kaplan Meier plots and cumulative mortality rates were calculated for each NACA group at day one, day 30, and one year and three years after the incident. RESULTS: Trondheim HEMS responded to 2224 alarms in the included time period, with 1431 patients meeting inclusion criteria for the study. Overall mortality rates at respective time points were 10.1% at day one, 13.4% at 30 days, 18.5% at one year, and 22.3% at three years. The one-year cumulative mortality rates for each NACA group were as follows: 0% for NACA 1 and 2, 2.9% for NACA 3, 10.1% for NACA 4, 24.7% for NACA 5 and 49.5% for NACA 6. Statistical analysis with a global log-rank test indicated a significant difference in survival outcomes among the groups (p < 2⋅10- 16). CONCLUSION: Among patients transported by Trondheim HEMS, we observed an incremental rise in mortality rates with increasing NACA scores. The study further suggests that a one-year follow-up may be sufficient for future investigations into HEMS outcomes.


Subject(s)
Air Ambulances , Emergency Medical Services , Humans , Retrospective Studies , Aircraft , Norway/epidemiology
10.
BMC Vet Res ; 20(1): 158, 2024 Apr 26.
Article in English | MEDLINE | ID: mdl-38671444

ABSTRACT

BACKGROUND: Studies on equine air transport practices and consequences are scarce. This prospective study aimed to describe horse and air journey details and practices, document how horse behavior and health changed during the air transport phases, quantify the occurrence of welfare issues, and identify possible associations between horse and journey details, air transport practices, and welfare issues. RESULTS: Data were collected from before departure to five days after arrival on 118/597 horses traveling on 32 commercial air journeys on different routes, varying in duration and conditions. Most horses were middle-aged warmblood females, 26% of which were pregnant, and being moved by air for sales. Before flying, most were quarantined (median: 18; IQR: 9-53 days), and their fitness for travel was certified by veterinarians. At the departure airports, external temperatures varied from - 6 °C to 33 °C, and horses were loaded by experienced flight grooms (median: 35; IQR: 15-40 years) into jet stalls (three-horse: 87%, two-horse: 13%). During the flights, horses were regularly watered (water intake median: 14 L) and fed ad libitum (feed consumption median: 8 kg). At the arrival airport, horses were unloaded from the jet stalls, and external temperatures ranged from - 5 °C to 32 °C. Then, all horses were transported to arrival quarantine by road. Air transport phases affected horses' health status and behavior; increased heart and respiratory rates and behaviors, such as pawing, head tossing, and vocalization, were mainly identified at departure and arrival. Horse interaction, nasal discharge, increased capillary refill time (CRT), and abnormal demeanor were observed more often one hour before landing while resting and normal capillary refill time were more often displayed five days after arrival (all P < 0.01). One hour before landing, horses with bad temperament and horses of unknown temperament were more likely to develop nasal discharge when transported in winter and autumn (P < 0.001). The likelihood of an increased CRT was associated with shorter flights in horses of unknown travel experience (P < 0.001). Ten horses were injured, and 11 developed pleuropneumonias (i.e., shipping fever). CONCLUSIONS: Air transport is a complex procedure with several different phases affecting horse health and behavior. Therefore, experienced staff should carefully manage each horse before, during, and after air journeys to minimize welfare hazards.


Subject(s)
Animal Welfare , Transportation , Animals , Horses/physiology , Female , Male , Prospective Studies , Aircraft , Pregnancy
11.
Biomolecules ; 14(4)2024 Apr 15.
Article in English | MEDLINE | ID: mdl-38672497

ABSTRACT

BACKGROUND: In military flight operations, during flights, fighter pilots constantly work under hyperoxic breathing conditions with supplemental oxygen in varying hypobaric environments. These conditions are suspected to cause oxidative stress to neuronal organ tissues. For civilian flight operations, the Federal Aviation Administration (FAA) also recommends supplemental oxygen for flying under hypobaric conditions equivalent to higher than 3048 m altitude, and has made it mandatory for conditions equivalent to more than 3657 m altitude. AIM: We hypothesized that hypobaric-hyperoxic civilian commercial and private flight conditions with supplemental oxygen in a flight simulation in a hypobaric chamber at 2500 m and 4500 m equivalent altitude would cause significant oxidative stress in healthy individuals. METHODS: Twelve healthy, COVID-19-vaccinated (third portion of vaccination 15 months before study onset) subjects (six male, six female, mean age 35.7 years) from a larger cohort were selected to perform a 3 h flight simulation in a hypobaric chamber with increasing supplemental oxygen levels (35%, 50%, 60%, and 100% fraction of inspired oxygen, FiO2, via venturi valve-equipped face mask), switching back and forth between simulated altitudes of 2500 m and 4500 m. Arterial blood pressure and oxygen saturation were constantly measured via radial catheter and blood samples for blood gases taken from the catheter at each altitude and oxygen level. Additional blood samples from the arterial catheter at baseline and 60% oxygen at both altitudes were centrifuged inside the chamber and the serum was frozen instantly at -21 °C for later analysis of the oxidative stress markers malondialdehyde low-density lipoprotein (M-LDL) and glutathione-peroxidase 1 (GPX1) via the ELISA test. RESULTS: Eleven subjects finished the study without adverse events. Whereas the partial pressure of oxygen (PO2) levels increased in the mean with increasing oxygen levels from baseline 96.2 mm mercury (mmHg) to 160.9 mmHg at 2500 m altitude and 60% FiO2 and 113.2 mmHg at 4500 m altitude and 60% FiO2, there was no significant increase in both oxidative markers from baseline to 60% FiO2 at these simulated altitudes. Some individuals had a slight increase, whereas some showed no increase at all or even a slight decrease. A moderate correlation (Pearson correlation coefficient 0.55) existed between subject age and glutathione peroxidase levels at 60% FiO2 at 4500 m altitude. CONCLUSION: Supplemental oxygen of 60% FiO2 in a flight simulation, compared to flying in cabin pressure levels equivalent to 2500 m-4500 m altitude, does not lead to a significant increase or decrease in the oxidative stress markers M-LDL and GPX1 in the serum of arterial blood.


Subject(s)
Altitude , Oxidative Stress , Oxygen , Humans , Male , Female , Adult , Oxygen/metabolism , COVID-19 , Hyperoxia/blood , Aircraft , Hyperbaric Oxygenation
12.
Appl Ergon ; 118: 104288, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38636348

ABSTRACT

Humans working in modern work systems are increasingly required to supervise task automation. We examined whether manual aircraft conflict detection skill predicted participants' ability to respond to conflict detection automation failures in simulated air traffic control. In a conflict discrimination task (to assess manual skill), participants determined whether pairs of aircraft were in conflict or not by judging their relative-arrival time at common intersection points. Then in a simulated air traffic control task, participants supervised automation which either partially or fully detected and resolved conflicts on their behalf. Automation supervision required participants to detect when automation may have failed and effectively intervene. When automation failed, participants who had better manual conflict detection skill were faster and more accurate to intervene. However, a substantial proportion of variance in failure intervention was not explained by manual conflict detection skill, potentially reflecting that future research should consider other cognitive skills underlying automation supervision.


Subject(s)
Automation , Aviation , Man-Machine Systems , Task Performance and Analysis , Humans , Male , Female , Adult , Young Adult , Aircraft , Personnel Selection/methods
13.
Radiat Environ Biophys ; 63(2): 263-269, 2024 May.
Article in English | MEDLINE | ID: mdl-38668870

ABSTRACT

This work investigates the impact on cosmic ray exposures to aircrew due to changing flight routes operated in the context of the recent conflict between Ukraine and the Russian Federation. All analyses were done based on Paris-Tokyo and Tokyo-Paris flights taken as examples, and differences in radiation exposures were quantified by comparing the situation before and after the beginning of the conflict. Regarding space weather scenarios, a quiet solar period and an extreme solar event (ground level enhancement (GLE) 5) were considered in the study. Analyses showed that the new Paris-Tokyo flight route established after the beginning of the conflict results in a smaller radiation dose to aircrew than that operated before the conflict, particularly during solar events. In contrast, for Tokyo-Paris flights the new high-latitude route crossing the Atlantic Ocean and North America increases the dose significantly (+ 50% in the worst case). Although this analysis is limited only to flights connecting Paris and Tokyo, it allowed for an evaluation of the consequences of new routes (particularly polar ones) on ambient dose equivalent values.


Subject(s)
Cosmic Radiation , Ukraine , Russia , Humans , Occupational Exposure/analysis , Aircraft , Armed Conflicts , Radiation Dosage , Radiation Monitoring
14.
Environ Int ; 187: 108660, 2024 May.
Article in English | MEDLINE | ID: mdl-38677085

ABSTRACT

OBJECTIVE: Aircraft noise exposure is linked to cardiovascular disease risk. One understudied candidate pathway is obesity. This study investigates the association between aircraft noise and obesity among female participants in two prospective Nurses' Health Study (NHS and NHSII) cohorts. METHODS: Aircraft day-night average sound levels (DNL) were estimated at participant residential addresses from modeled 1 dB (dB) noise contours above 44 dB for 90 United States (U.S.) airports in 5-year intervals 1995-2010. Biennial surveys (1994-2017) provided information on body mass index (BMI; dichotomized, categorical) and other individual characteristics. Change in BMI from age 18 (BMI18; tertiles) was also calculated. Aircraft noise exposures were dichotomized (45, 55 dB), categorized (<45, 45-54, ≥55 dB) or continuous for exposure ≥45 dB. Multivariable multinomial logistic regression using generalized estimating equations were adjusted for individual characteristics and neighborhood socioeconomic status, greenness, population density, and environmental noise. Effect modification was assessed by U.S. Census region, climate boundary, airline hub type, hearing loss, and smoking status. RESULTS: At baseline, the 74,848 female participants averaged 50.1 years old, with 83.0%, 14.8%, and 2.2% exposed to <45, 45-54, and ≥55 dB of aircraft noise, respectively. In fully adjusted models, exposure ≥55 dB was associated with 11% higher odds (95% confidence interval [95%CI]: -1%, 24%) of BMIs ≥30.0, and 15% higher odds (95%CI: 3%, 29%) of membership in the highest tertile of BMI18 (ΔBMI 6.7 to 71.6). Less-pronounced associations were observed for the 2nd tertile of BMI18 (ΔBMI 2.9 to 6.6) and BMI 25.0-29.9 as well as exposures ≥45 versus <45 dB. There was evidence of DNL-BMI trends (ptrends ≤ 0.02). Stronger associations were observed among participants living in the West, arid climate areas, and among former smokers. DISCUSSION: In two nationwide cohorts of female nurses, higher aircraft noise exposure was associated with higher BMI, adding evidence to an aircraft noise-obesity-disease pathway.


Subject(s)
Aircraft , Airports , Body Mass Index , Environmental Exposure , Humans , Female , United States , Prospective Studies , Middle Aged , Adult , Environmental Exposure/statistics & numerical data , Noise, Transportation/adverse effects , Noise, Transportation/statistics & numerical data , Obesity/epidemiology , Nurses/statistics & numerical data
15.
BMC Emerg Med ; 24(1): 60, 2024 Apr 13.
Article in English | MEDLINE | ID: mdl-38614978

ABSTRACT

BACKGROUND: Recent research has indicated that sex is an important determinant of emergency medical response in patients with possible serious injuries. Men were found to receive more advanced prehospital treatment and more helicopter transportation and trauma centre destinations and were more often received by an activated trauma team, even when adjusted for injury mechanism. Emergency medical dispatchers choose initial resources when serious injury is suspected after a call to the emergency medical communication centre. This study aimed to assess how dispatchers evaluate primary responses in trauma victims, with a special focus on the sex of the victim. METHODS: Emergency medical dispatchers were interviewed using focus groups and a semistructured interview guide developed specifically for this study. Two vignettes describing typical and realistic injury scenarios were discussed. Verbatim transcripts of the conversations were analysed via systematic text condensation. The findings were reported in accordance with the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist. RESULTS: The analysis resulted in the main category "Tailoring the right response to the patient", supported by three categories "Get an overview of location and scene safety", "Patient condition" and "Injury mechanism and special concerns". The informants consistently maintained that sex was not a relevant variable when deciding emergency medical response during dispatch and claimed that they rarely knew the sex of the patient before a response was implemented. Some of the participants also raised the question of whether the Norwegian trauma criteria reliably detect serious injury in women. CONCLUSIONS: The results indicate that the emergency medical response is largely based on the national trauma criteria and that sex is of little or no importance during dispatch. The observed sex differences in the emergency medical response seems to be caused by other factors during the emergency medical response phase.


Subject(s)
Emergency Medical Dispatcher , Humans , Female , Male , Qualitative Research , Focus Groups , Aircraft , Checklist
16.
JMIR Hum Factors ; 11: e51587, 2024 Apr 30.
Article in English | MEDLINE | ID: mdl-38687589

ABSTRACT

BACKGROUND: The use of drones in the health care sector is increasingly being discussed against the background of the aging population and the growing shortage of skilled workers. In particular, the use of drones to provide medication in rural areas could bring advantages for the care of people with and without a need for care. However, there are hardly any data available that focus on the interaction between humans and drones. OBJECTIVE: This study aims to disclose and analyze factors associated with user acceptance of drone-based medication delivery to derive practice-relevant guidance points for participatory technology development (for apps and drones). METHODS: A controlled mixed methods study was conducted that supports the technical development process of an app design for drone-assisted drug delivery based on a participatory research design. For the quantitative analysis, established and standardized survey instruments to capture technology acceptance, such as the System Usability Scale; Technology Usage Inventory (TUI); and the Motivation, Engagement, and Thriving in User Experience model, were used. To avoid possible biasing effects from a continuous user development (eg, response shifts and learning effects), an ad hoc group was formed at each of the 3 iterative development steps and was subsequently compared with the consisting core group, which went through all 3 iterations. RESULTS: The study found a positive correlation between the usability of a pharmacy drone app and participants' willingness to use it (r=0.833). Participants' perception of usefulness positively influenced their willingness to use the app (r=0.487; TUI). Skepticism had a negative impact on perceived usability and willingness to use it (r=-0.542; System Usability Scale and r=-0.446; TUI). The study found that usefulness, skepticism, and curiosity explained most of the intention to use the app (F3,17=21.12; P<.001; R2=0.788; adjusted R2=0.751). The core group showed higher ratings on the intention to use the pharmacy drone app than the ad hoc groups. Results of the 2-tailed t tests showed a higher rating on usability for the third iteration of the core group compared with the first iteration. CONCLUSIONS: With the help of the participatory design, important aspects of acceptance could be revealed by the people involved in relation to drone-assisted drug delivery. For example, the length of time spent using the technology is an important factor for the intention to use the app. Technology-specific factors such as user-friendliness or curiosity are directly related to the use acceptance of the drone app. Results of this study showed that the more participants perceived their own competence in handling the app, the more they were willing to use the technology and the more they rated the app as usable.


Subject(s)
Aircraft , Medication Systems , Mobile Applications , User-Centered Design , Adult , Female , Humans , Male , Middle Aged , Surveys and Questionnaires
17.
Environ Sci Technol ; 58(16): 6934-6944, 2024 Apr 23.
Article in English | MEDLINE | ID: mdl-38651174

ABSTRACT

Stratospheric aerosol injection (SAI) is proposed as a means of reducing global warming and climate change impacts. Similar to aerosol enhancements produced by volcanic eruptions, introducing particles into the stratosphere would reflect sunlight and reduce the level of warming. However, uncertainties remain about the roles of nucleation mechanisms, ionized molecules, impurities (unevaporated residuals of injected precursors), and ambient conditions in the generation of SAI particles optimally sized to reflect sunlight. Here, we use a kinetic ion-mediated and homogeneous nucleation model to study the formation of H2SO4 particles in aircraft exhaust plumes with direct injection of H2SO4 vapor. We find that under the conditions that produce particles of desired sizes (diameter ∼200-300 nm), nucleation occurs in the nascent (t < 0.01 s), hot (T = 360-445 K), and dry (RH = 0.01-0.1%) plume and is predominantly unary. Nucleation on chemiions occurs first, followed by neutral new particle formation, which converts most of the injected H2SO4 vapor to particles. Coagulation in the aging and diluting plumes governs the subsequent evolution to a narrow (σg = 1.3) particle size distribution. Scavenging by exhaust soot is negligible, but scavenging by acid impurities or incomplete H2SO4 evaporation in the hot exhaust plume and enhanced background aerosols can matter. This research highlights the need to obtain laboratory and/or real-world experiment data to verify the model prediction.


Subject(s)
Aerosols , Aircraft , Particle Size , Vehicle Emissions , Atmosphere/chemistry , Air Pollutants/chemistry
18.
PLoS One ; 19(3): e0290648, 2024.
Article in English | MEDLINE | ID: mdl-38446803

ABSTRACT

Under the repeated action of aircraft taxiing load, the subgrade plastic deformation becomes the key factor affecting the service performance of the airfields when salinized silt is used to fill the subgrade. In this study, the dynamic triaxial tests were carried out on a region in the northern part of China to study the effects of different salt contents on the dynamic characteristics of silt under cyclic loading. A prediction model for the salinized silt dynamic strength with a plastic strain of 4% as the failure criterion for the subgrade was thus proposed. It is found that with the increase of dynamic stress amplitude, the salinized silt plastic deformation transforms gradually from plastic deformation to incremental failure. The salt contents significantly influence the plastic strain and critical dynamic stress of silt. The strength of the salinized silt specimen is related to the ion concentration in the soil pores and the arrangement pattern of soil particles, as indicated by the progressive strength increase of the salinized silt at the low salt content of 1% and a further gradual decrease at high salt content.


Subject(s)
Sodium Chloride, Dietary , Sodium Chloride , Aircraft , Automobiles , Soil
19.
PLoS One ; 19(3): e0298160, 2024.
Article in English | MEDLINE | ID: mdl-38442105

ABSTRACT

Contrails are line-shaped clouds formed in the exhaust of aircraft engines that significantly contribute to global warming. This paper confidently proposes integrating advanced image segmentation techniques to identify and monitor aircraft contrails to address the challenges associated with climate change. We propose the SegX-Net architecture, a highly efficient and lightweight model that combines the DeepLabV3+, upgraded, and ResNet-101 architectures to achieve superior segmentation accuracy. We evaluated the performance of our model on a comprehensive dataset from Google research and rigorously measured its efficacy with metrics such as IoU, F1 score, Sensitivity and Dice Coefficient. Our results demonstrate that our enhancements have significantly improved the efficacy of the SegX-Net model, with an outstanding IoU score of 98.86% and an impressive F1 score of 99.47%. These results unequivocally demonstrate the potential of image segmentation methods to effectively address and mitigate the impact of air conflict on global warming. Using our proposed SegX-Net architecture, stakeholders in the aviation industry can confidently monitor and mitigate the impact of aircraft shrinkage on the environment, significantly contributing to the global fight against climate change.


Subject(s)
Aviation , Deep Learning , Aircraft , Benchmarking , Climate Change
20.
Scand J Trauma Resusc Emerg Med ; 32(1): 20, 2024 Mar 12.
Article in English | MEDLINE | ID: mdl-38475832

ABSTRACT

BACKGROUND: Accurate haemodynamic monitoring in the prehospital setting is essential. Non-invasive blood pressure measurement is susceptible to vibration and motion artefact, especially at extremes of hypotension and hypertension: invasive arterial blood pressure (IABP) monitoring is a potential solution. This study describes the largest series to date of cases of IABP monitoring being initiated prehospital. METHODS: This retrospective observational study was conducted at East Anglian Air Ambulance (EAAA), a UK helicopter emergency medical service (HEMS). It included all patients attended by EAAA who underwent arterial catheterisation and initiation of IABP monitoring between 1st February 2015 and 20th April 2023. The following data were retrieved for all patients: sex; age; aetiology (medical cardiac arrest, other medical emergency, trauma); site of arterial cannulation; operator role (doctor/paramedic); time of insertion and, where applicable, times of pre-hospital emergency anaesthesia, and return of spontaneous circulation following cardiac arrest. Descriptive analyses were performed to characterise the sample. RESULTS: 13,556 patients were attended: IABP monitoring was initiated in 1083 (8.0%) cases, with a median age 59 years, of which 70.8% were male. 546 cases were of medical cardiac arrest: in 22.4% of these IABP monitoring was initiated during cardiopulmonary resuscitation. 322 were trauma cases, and the remaining 215 were medical emergencies. The patients were critically unwell: 981 required intubation, of which 789 underwent prehospital emergency anaesthesia; 609 received vasoactive medication. In 424 cases IABP monitoring was instituted en route to hospital. CONCLUSION: This study describes over 1000 cases of prehospital arterial catheterisation and IABP monitoring in a UK HEMS system and has demonstrated feasibility at scale. The high-fidelity of invasive arterial blood pressure monitoring with the additional benefit of arterial blood gas analysis presents an attractive translation of in-hospital critical care to the prehospital setting.


Subject(s)
Air Ambulances , Emergency Medical Services , Heart Arrest , Hemodynamic Monitoring , Humans , Male , Middle Aged , Female , Blood Pressure , Arterial Pressure , Retrospective Studies , Critical Illness , Aircraft , United Kingdom
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