Lentes intraoculares en pilotos aviadores: revisión del tema / Intraocular lenses in pilots: a review

Resumen Objetivo: Revisar en la literatura las diferentes posturas de las agencias reguladoras de la aviación sobre la implantación de lentes intraoculares multifocales (MIOLs) en pilotos aviadores civiles que han desarrollado catarata, además de evidencia científica que podría generar una revisión de los lineamientos vigentes. Resultados: Se encontraron el 50% (3 de 6) de agencias revisadas con postura en contra de los MIOLs. Además, se revisaron dos estudios a favor de los MIOLs, en el que implantarlos brinda una mayor independencia de lentes respecto a los monofocales para las tareas visuales dentro y fuera de la cabina, así como un rendimiento sin diferencias en simuladores de vuelo versus los pilotos con lentes intraoculares monofocales. Limitaciones: Existen pocos estudios de MIOLs en pilotos aviadores. Originalidad: No se ha reportado ninguna revisión de las agencias reguladoras respecto a la prohibición o permisión de los MIOLs en pilotos aviadores, tocando evidencia que pudiera consolidar una postura unánime respecto a este tema, como en su momento fue la cirugía refractiva con láser excimer que actualmente no está restringida.

Abstract Objective: To review the literature on the different stands of aviation regulatory agencies on the implantation of multifocal intraocular lenses (MIOLs) in civilian aviators who have developed cataract, as well as scientific evidence that could generate a revision of the current guidelines. Results: 50% (3 of 6) of agencies reviewed were found to be against MIOLs. In addition, two studies were reviewed in favour of MIOLs, in which implanting MIOLs provides greater lens independence from monofocals for visual tasks in and out of the cockpit, as well as no difference in performance in flight simulators versus pilots with monofocal intraocular lenses. Limitations: There are few studies of MIOLs in aviator pilots. Originality: No review of regulatory agencies regarding the prohibition or permission of MIOLs in airline pilots has been reported, touching on evidence that could consolidate a unanimous position on this issue, as was once the case with excimer laser refractive surgery, which is currently unrestricted.

Distúrbios do sono e estados de humor em pilotos civis / Sleep disorders and mood states in civilian pilots

Distúrbios do sono e as alterações do estado de humor, quando não tratados, estão associados à perda de produtividade e acidentes de trabalho, resultando em lesões e fatalidade. Esses distúrbios são subdiagnosticados e subtratados em contextos clínicos, porque podem ser assintomáticos e o exame de polissonografia tem custo elevado. Por isso, questionários são usados para realizar uma triagem e detectar profissionais com alto risco de síndrome da apneia obstrutiva do sono, de sonolência diurna excessiva e fadiga. Este estudo teve como objetivo aplicar questionários validados para triagem dos distúrbios do sono e do humor em pilotos civis e analisar os resultados obtidos com a aplicação desses instrumentos. Foram coletados dados de 44 pilotos civis por meio de quatro instrumentos: um questionário para a caracterização sociodemográfica e ocupacional da amostra, a Escala de Sonolência de Epworth para avaliar a presença de sonolência diurna excessiva, o Questionário de Berlim para avaliar a Síndrome da Apneia Obstrutiva do Sono e a Escala de Humor de Brunel para avaliar o estado de humor. A Escala de Sonolência de Epworth mostrou que 25% dos pilotos apresentaram pontuação para sonolência diurna excessiva. De acordo com o Questionário de Berlim, 29,5% apresentaram alto risco para a Síndrome da Apneia Obstrutiva do Sono e pela Escala de Humor de Brunel, o domínio vigor, teve a média mais alta (5,09 ±4,06). Portanto, a utilização dos questionários nos exames de admissão e nos periódicos, pode auxiliar na identificação precoce e no monitoramento de distúrbios do sono e dos estados de humor ao longo do tempo em pilotos civis, priorizando aqueles que deverão ser encaminhados para realizarem estudos do sono.

Sleep disorders and mood state changes, when untreated, are associated with loss of productivity and accidents at work, resulting in injuries and fatality. These disorders are underdiagnosed and undertreated in clinical contexts due to them being asymptomatic and the prohibitive cost of polysomnography exams. For this reason, questionnaires are used to screen and detect professionals at high risk for obstructive sleep apnea syndrome, excessive daytime sleepiness, and fatigue. This study aimed at applying validated questionnaires for screening sleep and mood disorders in civilian pilots and analyzing the results obtained with the application of these instruments. Data were collected from 44 civilian pilots using four instruments: a questionnaire for sociodemographic and occupational characterization of the sample; the Epworth Sleepiness Scale to assess the presence of excessive daytime sleepiness; the Berlin Questionnaire to assess Obstructive Sleep Apnea Syndrome; and the Brunel Mood Scale to assess the mood state. The Epworth Sleepiness Scale showed that 25% of the pilots presented scores for excessive daytime sleepiness. According to the Berlin Questionnaire, 29.5% were at high risk for Obstructive Sleep Apnea Syndrome, and according to the Brunel Mood Scale, the vigor domain presented the highest mean (5.09 ± 4.06). Therefore, the use of questionnaires in admission and periodic exams can assist in the early identification and monitoring of sleep disorders and mood states over time in civilian pilots, prioritizing those who should be referred to sleep studies.

The effect of sports health treatment on reducing the prevalence of hypertension / O efeito do tratamento de saúde esportiva na redução da prevalência de hipertensão / El efecto del tratamiento de salud deportiva en la reducción de la prevalencia de hipertensión

ABSTRACT Introduction Hypertension is a common clinical disease, which is not uncommon in the aviation industry. Pilots suffering from high blood pressure need to control high blood pressure to ensure flight safety. Exercise therapy is an effective way to control high blood pressure. Objective To design the clinical effects of exercise intervention in the treatment of hypertension in pilots. Method The article randomly assigned 41 pilot volunteers with hypertension to two groups: the treatment and control groups. Except for the different exercise intervention therapy, the other treatment methods are the same. After the expiration of the experiment, the volunteers were tested for their physiological and biochemical indicators. Results After one year of strict diet and exercise intervention, the two groups of physiological and biochemical indicators were significantly different. Conclusion Intervention of moderate-intensity exercise can reduce the body mass index, waist-to-hip ratio and blood pressure level of hypertensive patients, correct the disorder of blood lipid metabolism, and can help reduce the recurrence rate of hypertension. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução A hipertensão é uma doença clínica comum, o que não é incomum na indústria de aviação. Os pilotos que sofrem de pressão alta precisam controlar a pressão alta para garantir a segurança do vôo. A terapia com exercícios é uma forma eficaz de controlar a hipertensão. Objetivo Desenhar os efeitos clínicos da intervenção com exercícios no tratamento da hipertensão em pilotos. Método O artigo distribuiu aleatoriamente 41 voluntários pilotos com hipertensão em dois grupos: os grupos de tratamento e controle. Exceto pela terapia de intervenção com exercícios diferentes, os outros métodos de tratamento são os mesmos. Após o término do experimento, os voluntários foram testados quanto aos seus indicadores fisiológicos e bioquímicos. Resultados Após um ano de dieta estrita e intervenção com exercícios, os dois grupos de indicadores fisiológicos e bioquímicos foram significativamente diferentes. Conclusão A intervenção de exercícios de intensidade moderada pode reduzir o índice de massa corporal, a relação cintura-quadril e o nível de pressão arterial de pacientes hipertensos, corrigir o distúrbio do metabolismo dos lipídios do sangue e pode ajudar a reduzir a taxa de recorrência da hipertensão. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La hipertensión es una enfermedad clínica común, que no es infrecuente en la industria de la aviación. Los pilotos que sufren de presión arterial alta necesitan controlar la presión arterial alta para garantizar la seguridad del vuelo. La terapia con ejercicios es una forma eficaz de controlar la presión arterial alta. Objetivo Diseñar los efectos clínicos de la intervención con ejercicios en el tratamiento de la hipertensión en pilotos. Método El artículo asignó al azar a 41 voluntarios piloto con hipertensión a dos grupos: el de tratamiento y el de control. Excepto por las diferentes terapias de intervención con ejercicios, los otros métodos de tratamiento son los mismos. Después de la terminación del experimento, se evaluó a los voluntarios en cuanto a sus indicadores fisiológicos y bioquímicos. Resultados Después de un año de estricta intervención de dieta y ejercicio, los dos grupos de indicadores fisiológicos y bioquímicos fueron significativamente diferentes. Conclusión La intervención del ejercicio de intensidad moderada puede reducir el índice de masa corporal, la relación cintura-cadera y el nivel de presión arterial de los pacientes hipertensos, corregir el trastorno del metabolismo de los lípidos en sangre y puede ayudar a reducir la tasa de recurrencia de la hipertensión. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Aspects of work and sleep associated with work ability in regular aviation pilots / Aspectos do trabalho e do sono associados à capacidade para o trabalho entre pilotos

ABSTRACT OBJECTIVE: Analyze the association of work organization and sleep aspects with work ability in regular aviation pilots. METHODS: This is a cross-sectional epidemiological study with 1,234 regular aviation pilots who worked domestic and international flights, affiliated with the Brazilian Association of Civil Aviation Pilots. Data collection employed online questionnaire. We compared proportions using Pearson's Chi-squared or Fisher's exact hypothesis tests. Then, we conducted Poisson analysis, with robust variance, to test factors associated with moderate or low work ability. RESULTS: The prevalence of moderate or low work ability was 43.3%. We found that self-perception of insufficient sleep (PR = 1.29; 95%CI 1.06-1.57), increased perception for fatigue (PR = 1.51; 95%CI 1.24-1.84), more than 65 flight hours per month (PR = 1.22; 95%CI 1.01-1.46), less than 10 days of time off per month (PR = 1.27; 95%CI 1.04-1.55), and frequent operational delays (PR = 1.23; 95%CI 1.02-1.48) were factors associated with moderate or low work ability. CONCLUSIONS: Work organization was a determining factor for decreased work ability, especially concerning aspects related to rest and its influence on the sleep of pilots.

RESUMO OBJETIVO: Analisar a associação da organização do trabalho e dos aspectos do sono com a capacidade para o trabalho entre pilotos da aviação regular. MÉTODOS: Foi realizada uma pesquisa epidemiológica transversal, com 1.234 pilotos da aviação regular, que realizavam voos de rotas nacionais e internacionais, afiliados à Associação Brasileira de Pilotos da Aviação Civil. A coleta de dados foi feita através de questionário on-line. Para comparação entre as proporções foram realizados os testes de hipóteses qui-quadrado de Pearson ou Exato de Fisher. Posteriormente, foi efetuada a análise de Poisson, com variância robusta, para testar os fatores associados à capacidade moderada ou baixa para o trabalho. RESULTADOS: A prevalência de capacidade para o trabalho moderada ou baixa foi de 43,3%. Verificou-se que autopercepção de sono insuficiente (RP = 1,29; IC95% 1,06-1,57), maior percepção para fadiga (RP = 1,51; IC95% 1,24-1,84), jornada de voo maior que 65 horas por mês (RP = 1,22; IC95% 1,01-1,46), menos de 10 dias de folga por mês (RP = 1,27; IC95% 1,04-1,55) e atrasos operacionais frequentes (RP = 1,23; IC95% 1,02-1,48) foram fatores associados à capacidade moderada ou baixa para o trabalho. CONCLUSÕES: A organização do trabalho foi um fator determinante para a diminuição da capacidade para o trabalho, em especial quanto aos aspectos relacionados ao descanso e suas repercussões no sono de pilotos.

Study on the status and influencing factors of hypertension in civil aviation pilots / 中国职业医学

OBJECTIVE: To investigate the incidence and influencing factors of hypertension among civil aviation pilots. METHODS: A total of 1 169 civil aviation pilots in Northern China were selected into the study by the method of convenient sampling. Physical examination, laboratory test and questionnaire survey were conducted. RESULTS: The prevalence of hypertension in Northern China was 4.7%(55/1 169). Multivariate regression analysis showed that the relative risk factors ranking from high to low were, age over 30 years [odds ratio(OR)=6.81, 95% confidence interval(95%CI) 3.57-12.98)], total flight hours over 1 000 hours(OR=4.24, 95%CI 2.14-8.41), flight hours over 500 hours in the past year(OR=2.91, 95%CI 1.57-5.40), obesity(OR=2.50, 95%CI 1.08-5.81), fasting blood glucose(OR=2.24, 95%CI 1.21-4.13), and frequent long-distance flight(OR=2.38, 95%CI 1.24-4.58). These factors were the risk factors of hypertension in civil aviation pilots(P<0.05). CONCLUSION: Age, total flight hours, flight hours in the past year, obesity, fasting blood glucose, frequent long-distance flight are related to the prevalence of hypertension in civil aviation pilots.

Electroencephalographic Abnormalities in the Screening for Pilot Applicants in Korea

BACKGROUND AND PURPOSE: Electroencephalography (EEG) is often used as a screening tool for selecting pilots despite controversy regarding its contribution to aviation safety. We investigated EEG abnormalities in Korean commercial pilot applicants in order to identify the usefulness of EEG screening in this population. METHODS: We retrospectively analyzed the EEG results of 740 unselected pilot applicants who underwent waking EEG at Inha University Hospital from January 2013 to May 2017. EEG recording was performed for 30 minutes, which included 3 minutes of hyperventilation and intermittent photic stimulation. RESULTS: The pilot applicants were predominantly male (95.3%) and had a mean age of 27.8 years (range: 16–40 years). Nine of them (1.2%) exhibited EEG abnormalities; the most common abnormality (six applicants) was a small amount of generalized irregular slow activities, while the other three applicants (0.4%) exhibited epileptiform discharges, with two showing generalized spike-and-wave complexes and one showing a few spike-and-wave complexes in the left frontotemporal area. The two applicants with generalized spike-and-wave complexes were found to have experienced clinical seizures by a neurologist during detailed history-taking. CONCLUSIONS: This study found that 2 of 740 pilot applicants (0.3%) were diagnosed with epilepsy by routine EEG screening in an unselected population. Considering the low predictive value of EEG without the relevant clinical history in an unselected healthy young population, our findings raise questions regarding the cost-effectiveness of the current EEG screening protocol applied to pilot applicants. We suggest that a more-targeted and standardized EEG screening approach be applied to pilot applicants with epilepsy risk factors or a seizure history as determined by thorough medical history-taking.

Recognition of fatigue status of pilots based on deep contractive auto-encoding network / 生物医学工程学杂志

We proposed a new deep learning model by analyzing electroencephalogram signals to reduce the complexity of feature extraction and improve the accuracy of recognition of fatigue status of pilots. For one thing, we applied wavelet packet transform to decompose electroencephalogram signals of pilots to extract the δ wave (0.4-3 Hz), θ wave (4-7 Hz), α wave (8-13 Hz) and β wave (14-30 Hz), and the combination of them was used as de-nosing electroencephalogram signals. For another, we proposed a deep contractive auto-encoding network-Softmax model for identifying pilots' fatigue status. Its recognition results were also compared with other models. The experimental results showed that the proposed deep learning model had a nice recognition, and the accuracy of recognition was up to 91.67%. Therefore, recognition of fatigue status of pilots based on deep contractive auto-encoding network is of great significance.

Study on correlationship between fasting blood glucose level and coronary arterial vulnerable plaque in civil airline pilots / 重庆医学

Objective To investigate the relationship between fasting blood glucose(FBG) with coronary arterial vulnerable plaque in civil airline pilots and its risk factors.Methods One hundred and twenty civil airline pilots with coronary heart disease were divided into the vulnerable plaque group and non-vulnerable plaque group based on the virtual histology intravascular ultrasound(VH-IVUS) results.Then the clinical data were collected.Logistic regression analysis was used to analyze the risk factors of vulnerable plaque.Results The FBG level in the vulnerable plaque group was much higher(P＜0.05);FBG,high-sensitivity C-reactive protein and low density lipoprotein were the risk factors for vulnerable plaque;FBG was positively correlated with the plaque necrosis core constituent ratio(r=0.44,P＜0.05).The area under curve of ROC curve efficiency for diagnosing vulnerable plaque was 0.72(95％CI:0.66-0.81),at FBG cut-off value of 6.39,the sensitivity was 71.35％ and specificity was 76.15％.Conclusion The FBG level is an independent risk factor of coronary arterial vulnerable plaque,which can assist in the identification of vulnerable plaque in civil airline pilots.

Hearing Thresholds at Extended High Frequencies in Civilian Student Pilotswith Normal Hearing at Conventional Frequencies / 听力学及言语疾病杂志

Objective To study extended high frequency (EHF) audiometry for early detection of hearing loss in student pilots in civil aviation.Methods A total of 175 student pilots (all male,18~25 years old, mean 20.2±0.92 years) from a university flight academy were surveyed and underwent EHFA.All subjects had hearing thresholds ≤25 dB HL at conventional frequencies (0.25~8 kHz).The results were compared with the corresponding recommended standards in other countries.According to the use of personal listening devices, all the subjects were divided into the low risk group (non-use, 121 cases) and the high risk group (using>1 year, day>1 hour, 52 cases).The differences of hearing thresholds and detection rates at EHF between the two groups were compared.Results The hearing thresholds of 173 subjects (1 case of middle ear disease and 1 case with family history of hearing loss were excluded) at 9~20 kHz were slightly higher than the reference equivalent threshold sound pressure level (RETSPL) prescribed by American National Standardization Association and the age-matched thresholds recommended by a foreign literature (P<0.05 or P<0.01).The hearing thresholds in the high risk group elevated dramatically than that in the low risk group at 9,12.5,16 and 18 kHz(P<0.05 or P<0.01).As frequencies increased, the detection rate of hearing thresholds in the high risk group decreased gradually, and at 18 and 20 kHz it was significantly lower than that in the low risk group (P<0.01).Conclusion EHF audiometry is a helpful tool for early detection of noise-induced hearing loss in student pilots.Hearing health care should be emphasized in civilian student pilots.It is recommended to avoid the use of personal listening devices or reduce the use time of them.

Correlation between the plasma level of MIF and its related gene-173G/C polymorphism and risk factors of atherosclerosis in pilots / 解放军医学杂志

Objective To investigate the relationship between the plasma level of macrophage migration inhibiting factor (MIF) and its related gene-173G/C polymorphism and risk factors of atherosclerosis in pilots for reducing the risk of adverse cardiovascular events in early stage. Methods Four hundred and fifty-eight military pilots undergoing medical examination (pilot group), 51 patients with coronary heart disease (CHD group), and 194 persons undergoing routine health examination (control group) were selected as the subjects under investigation. Subjects in pilot group were further grouped according to the different aircraft type they were flying and their flight time. General clinical data of the three groups were collected. ELISA was used to determine the plasma levels of MIF. MIF-173 G/C (rs755622) was detected by Taqman probe method. The differences of genotype and allele frequencies among the three groups were analyzed. Results No significant difference was found in plasma levels of MIF between pilot group and CHD group (P>0.05), but the levels were significantly higher in the both groups than in the control group (P0.05). There was no significant difference in genotype and allele frequencies among the three group (P>0.05). There was no significant difference of plasma MIF, TC, TG concentrations in the pilots who were with CC, GG and CG genotypes, respectively (P>0.05). Conclusions MIF-173G/C polymorphism may have no significant correlation to the early susceptibility of atherosclerosis. Elevated plasma MIF levels may be associated with the development of coronary heart disease.

Regional distribution and aggregation analysis of risk factors for cardiovascular disease among active pilots aged 40-59 years / 解放军医学杂志

Objective To analyze the regional distribution and aggregation of risk factors for cardiovascular disease (CVD) among active China civil aviation pilots aged 40–59 years. Methods In 2011, 831 active pilots aged 40–59 years in Northern, Eastern and Southern China were investigated for risk factors of CVD. The regional distribution and aggregation of risk factors were analyzed. Results The mean hemoglobin A1c (HbA1c), mean total cholesterol (TC) and age standardized prevalence rate of high TC in Northern China (5.7%±0.5%, 5.6±1.1mmol/L and 23.6%, respectively) were significantly higher than in Eastern and Southern China. High density lipoprotein cholesterol (HDL-C), 1ow density lipoprotein cholesterol (LDL-C) and systolic blood pressure (SBP) were controlled poorer (1.1±0.2mmol/L, 3.6±0.7mmol/L and 125.7±9.4mmHg, respectively) in pilots from Eastern China, and their age standardized prevalence rates of low HDL-C and high LDL-C were 37.9% and 24.6%, respectively, which was obviously higher than that in pilots from other two regions. The mean fast plasma glucose (FPG, 5.5±0.5mmol/L) was significantly higher in pilots from Southern China than that in pilots from the other two regions. There was significant difference of 1 and 2 categories of risk factors for CVD among the three regions, and among 1, 2 and ≥3 kinds of CVD risk factors, combination of overweight and obesity, low HDL-C+ overweight and obesity, and high TG+ low HDL-C+ overweight and obesity ranked highest. Conclusions The regional distribution and aggregation of risk factors for CVD among active pilots aged 40–59 years old are significantly different. Prevention and control measures should be different among these three regions. Weight control is imperative for active pilots aged 40–59 years old.

Relationship between levels of serum gamma-glutamyltransferase and coronary heart disease in pilots / 实用医学杂志

Objective To investigate the correlation between serum level of gamma-glutamyl transferase (GGT) and coronary heart disease (CHD) in military pilots. Methods Sixty male military pilots hospitalized in Airforce General Hospital having coronary angiography examination(CAG) from March 2005 to May 2015 were involved then were divided into CHD group (n = 24) and control group (n = 36) according to the results of coronary angiography (CAG). The patients with CHD were divided into low score group (Gensini score ≤ 20) and high score group (Gensini score > 20) according to Gensini score. Results There were significant increase of the level of TG, GGT and decrease of the level of HDL-C in CHD group than those in control group(P 0.05); logistic regression analysis showed that serum GGT was an independent risk factor of CHD in military pilots (OR = 1.168, P < 0.01). Conclusion Serum GGT is associated with CHD in military pilots and is the independent risk factor of CHD in the pilots.

Study of the changes in contrast sensitivity of eyes after laser in situ keratomileuses surgery among pilots / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the changes in contrast sensitivity (CS) between emmetropic pilots, glasses wearing, and after laser in situ keratomileuses ( LASIK) surgery pilots, provide the basis for the physical examination standard after operation. METHODS:The CS of 13 emmetropic pilots (26 eyes), 12 glasses wearing pilots (24 eyes) and 10 with LASIK (20 eyes) , under photopic, scotopic and scotopic with glare environments at four different spatial frequencies ( 3, 6, 12 and 18cpd ) were measured and the resluts were analyzed by statistics. RESULTS:Under photopic environments, there was no significant difference in the low spatial frequency (3cpd) among the three groups (P>0. 05). The CS of emmetropic pilots was better than that of the myopic and with LASIK, and there was significant difference (P0. 05). Under scotopic environments, there was no significant difference in the low spatial frequency (3cpd)among the three groups (P>0. 05). The CS of emmetropic and with LASIK pilots were better than that of the myopic, and there was significant difference ( P0. 05). Under scotopic with glare environments, the CS of emmetropic and myopic pilots were better than that of the with LASIK, and there was significant difference (P0. 05). CONCLUSION: The CS after LASIK is decreased compare with emmetropic pilot, specially under scotopic with glare environments. A perfect identification standard should be set up.

Group sandplay characteristic and mental health status of 518 military pilots / 中华行为医学与脑科学杂志

Objective To analyse characteristics of military pilot group sandplay work and reveal their psychological status.Methods Using the self-reporting 90-item Symptom Checklist (SCL-90) to test the validity of group sandplay work made by 87 groups of military pilots.Statistical analysis was used to analyse the characteristics of code data in group sandplay work.Results Positive and negative themes in group sandplay work showed negative and positive correlations(r=-0.59,0.59) with symptom factors of SCL-90,respectively.Positive and negative themes scores were 5.37±2.25 and 2.36± 1.85 ,respectively.The secondary theme scores in the positive theme were entirely higher than those in the negative theme.Scores of energy, connection, cooperation, integration, relaxation, and spirituality in the positive theme and threat,limitation, and aggression in the negative theme were relatively high.The overall evaluations of the work include power, integration, enrichment, and fluency.The theme names of the work include life, military, natural and abstract.Conclusion Group sandplay is an effective method in the study of military pilots' psychological health and military pilots are in good mental health.These pilots have strong intrinsic energy,teamwork and communication.However,some pilots have symptoms of anxiety,tension and insecure.

Medical indexes for student pilots from different areas / 军事医学

Objective To evaluate the medical indexes for student pilots from different areas , to discover the major different indexes between different areas ,and to establish the space distribution model of military pilots .Methods A cross-section survey was conducted among student pilots , and 290 student pilots sampled as respondents were interviewed with questionnaires and subjected to a physical examination , involving distant vision , heart function , and pulmonary function , before a database was established , cleaned and analyzed by EpiData 3.02, SAS 9.13 with double checking .Results There was no difference between the medical indexes of student pilots from 7 areas, but the psychological selection performance record and the entrance examination record were different .Student pilots from area E had the highest psychological selection performance record while those from area D had the highest entrance examination record .Conclusion Student pilots have area difference ,so we should pay close attention to their birth place during recruitment of student pilots .

Comparison of antioxidant status between pilots and non-flight staff of the army force: pilots may need more vitamin C / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To compare the blood antioxidant levels and dietary antioxidant intakes between pilots and non-flight staff of the Army Force in The Islamic Republic of Iran.</p><p><b>METHODS</b>Thirty-seven helicopter pilots and 40 non-flight staff were included in this study. Their general characteristics were recorded and their weight, height, and waist circumference were measured. Their daily intake of energy and nutrients including antioxidants was assessed using a semi-quantitative food frequency questionnaire. Serum levels of total antioxidant capacity (TAC), malondialdehyde (MDA), and glutathione reductase (GR), glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT) in red blood cells were also measured.</p><p><b>RESULTS</b>The median erythrocytes SOD, serum MDA level and the mean serum level of TAC and erythrocytes GPx were significantly higher in pilots than in non-flight staff. The median vitamin C intake was significantly lower in pilots than in non-flight staff. The serum MDA levels were similar in non-flight staff and pilots when their vitamin C intake was ⋜168 mg and significantly lower in non-flight staff than in pilots when their vitamin C intake was >168 mg.</p><p><b>CONCLUSION</b>The serum MDA level is lower in non-flight staff than in pilots when their vitamin C intake level is high, indicating that pilots need more vitamin C than non-flight staff.</p>

Hypertension in Indonesian air force pilots.

Background: To investigate the association between aircraft noise and blood pressure. Methods: A nested case-control study was conducted on Indonesian Air Force pilots doing annual medical check-ups at the Saryanto Institute for Aviation and Aerospace Health (LAKESPRA) from 2003 – 2008. The data extracted from medical records were age, total flight hours, type of aircraft, fasting blood glucose and cholesterol levels, waist circumference, height and weight (Body Mass Index), and blood pressure. Results: There were 549 pilots, 49 were found to be hypertensive, with SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg. Helicopters pilots were at an almost 2 fold risk of hypertension compared to pilots of the fixed wing aircrafts. Pilots with more than 1400 hours of flight had more than 2 fold risk of being hypertensive compared to those with 1400 flight hours or less. Conclusion: The type of aircraft, which is related to the noise generated, may be a risk factor for developing hypertension in pilots. Increased total flight hours also increased the risk of hypertension.

Investigation and analysis on fatigue status of military pilots / 解放军医学杂志

Objective To investigate the fatigue status and its characteristics and influential factors of military pilots. Methods Questionnaire survey was conducted on 924 military pilots by using Fatigue Assessment Instrument (FAI) and Fatigue Scale (FS-14), χ2 test and Pearson correlation analysis were performed on the data results with SPSS 17.0 software. Results The findings of fatigue status indicated 343 subjects (37.1%) with positive fatigue symptoms and 581 subjects (62.9%) with negative fatigue symptoms. FAI factor 1 (severity of fatigue), factor 2 (mental fatigue factor), factor 3 (consequence of fatique) and the total score, FS-14 factor 1 (physical fatigue factor) and the total score in fatigue-positive group were all higher than those in fatiguenegative group, and the differences were all statistically significant (P0.05) in the possibility of developing fatigue symptoms between subjects with different aircraft types. Age and flight time were positively correlated with factor 1 and total score in FAI and factor 1, factor 2 and total score in FS-14. However, the aircraft type was associated with neither the individual factors and total score in FAI nor the individual factors and total score in FS-14. Conclusion It is common for military pilots to develop fatigue symptoms, characterized by obvious manifestations of severity, environmental specificity, consequences of fatigue and physical fatigue, and the possibilities of developing fatigue symptoms for different ages and flight time were different.

Two-dimensional and color Doppler ultrasound analysis of vertebral artery in pilot cadets / 解放军医学杂志

Objective To investigate the development of vertebral artery in the 2010 enrolled pilot cadets, and provide a foundation for introducing vertebral artery ultrasound examination into inclusion criteria. Methods The ultrasound findings of the vertebral artery in 722 pilot cadets, including its origin, shape, diameter and hemodynamic patterns, were retrospectively reviewed by two-dimensional and color Doppler ultrasound. The proportion of its congenital dysplasia was calculated and summarized. Results Among the 722 pilot cadets, both the inner diameter of the initial segment (D1) and the intervertebral segment (D2) of left vertebral artery were wider than the right one (3.624±0.017mm vs 3.489±0.018mm, 3.623±0.018mm vs 3.438±0.019 mm, P0.05). Among 5 persons showed both abnormal origin and shape, there were 2 cases in whom there was also small caliber. Conclusions Multiple congenital dysplasia of vertebral artery was found in pilot cadets. The ultrasonography examination of vertebral artery should be included in the selection criteria for pilot cadet enrollment as early as possible.

Management system reform of public hospital in 16 cities / 中华医院管理杂志

The paper covered key progress of the management system reform for China's public hospitals and analyzed main roadblocks in the reform.It proposed such policy recommendations as clearly separating the regulation and management affairs,concentrating management authorities to build an integrated management system,establishing a clear-cut appraisal criteria for accountability,and completing supportive reforms for effective management.