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Neck strength and myoelectric fatigue in fighter and helicopter pilots with a history of neck pain.

INTRODUCTION: Flight-induced neck pain at high Gz loads or during sustained rotary-wing missions may be caused by limitations in neck muscle function. A better understanding of the contributing factors of excessive external load and internal neck-stabilizing mechanisms would improve the ability to prevent and treat such pain. The aim of this single-blinded cross-sectional study was to evaluate neck neuromuscular function in fighter and helicopter pilots who suffered from frequent neck pain. METHODS: Subjects with pain were 16 fighter pilots (FP-P) and 15 helicopter pilots (HP-P) with frequent neck pain episodes who were compared with pain-free controls (FP-C and HP-C). In all groups, neck extensor and flexor muscles were studied by measuring 1) the strength of maximum voluntary contraction (MVC), and 2) fatigue due to a submaximal isometric contraction. The decline (slope) of the electromyogram (EMG) median frequency power spectra was used as an index of fatigue, while initial median frequency (fi) was taken from the intercept of the regression line. RESULTS: Two-way analysis of variance (ANOVA) revealed interaction effects for extensor MVC. Post hoc testing showed that FP-P had significantly lower extensor MVC (p = 0.03) than FP-C, while there was no such difference for the HP-P vs. HP-C or between the two control groups. There were no significant effects for MVC-balance (flexors/extensors); nor were there any fi or extensor EMG-slope effects. However, there were interaction effects for flexor EMG-slopes: HP-P showed lower slopes than did HP-C (p = 0.02). CONCLUSIONS: To protect and stabilize the head and neck in high Gz environments, higher neck muscle strength is needed; less muscle strength in FP-P may cause further pain and perhaps reduced mission effectiveness. Less localized steep slopes for HP-P might reflect impaired muscle functioning. Specific preventive and clinical attention may be warranted for different types of pilot.

Adult↗

Trans-femoral amputee pilots: criteria for return to the fighter cockpit.

Proximal lower limb amputations (trans-femoral) usually leave amputees with significant functional disturbances. This article contains information regarding three pilots with trans-femoral amputations that returned swiftly to continue their aeronautical careers despite their disabilities. Adaptations are needed in the limb prostheses to enable the amputees to access the minimally spaced cockpit.

Adult↗

Relationship between the stress of hyper-gravity and food intake and growth rate in mouse.

A new method was introduced to assess the effects of hyper-gravity on secretion of corticosterone, one of the major stress hormone, in mouse. The hormone was extracted from feces of the animal and measured by means of ELISA. The amount of corticosterone was high at the beginning of breeding under the hyper-gravity, 3 G. It decreased down to the level of the ground control within 2 weeks. Increases both in the growth rate of the body weight and the food intake were closely related to the decrease in the amount of corticosterone. It is likely that hyper-gravity affects the growth rate via internal secretion.

Adaptation, Physiological↗

Hemodynamics of graded water immersion in the baboon: +Gz protection potential.

INTRODUCTION: Fluid-filled anti-G suits depend on external fluid counterpressure to maintain near-normal hemodynamics during +Gz (head-to-foot inertial force). However, the relationship between external fluid level, hemodynamic events, and +Gz tolerance has not been determined. METHODS: Seven anesthetized male baboons (avg. wt. = 27.2 kg) were catheterized for measurement of left ventricular pressure (LVP), right ventricular pressure (RVP), aortic BP (ABP), central venous pressure (CVP), pulmonary artery pressure, cardiac output, and esophageal pressure. The animals were seated in a restraint chair and control data were collected, followed by six discrete steps of water immersion (WI): 1) knee; 2) hip; 3) xiphoid; 4) mid-chest; 5) neck; and 6) return to the xiphoid (data check). Each level was maintained until hemodynamic stabilization. Rectal temperature averaged 33.5 degrees C; water bath temperature was maintained at 34 degrees C. RESULTS: There was a significant (p < 0.05) increase in most hemodynamic parameters with WI to the xiphoid, mid-chest, and neck. With WI to the neck, CVP, LV, and RV end diastolic pressures increased by 8.7 mmHg, 19.6 mmHg, and 8.0 mmHg, respectively, suggesting a major passive increase in thoracic and cardiac blood volume, whereas mean ABP (MABP) increased by 18.6 mmHg and total peripheral resistance significantly decreased. Heart rate did not change significantly. CONCLUSION: The increase in MABP with WI to the neck would provide slightly more than +1 Gz relaxed protection. Additional +Gz would require pressure breathing to overcome the increased external hydrostatic pressure on the thorax. Water-filled anti-G suits filled to the xiphoid cannot provide adequate relaxed +Gz protection for current high performance aircraft without supplemental factors such as additional pressure in the suit or positive pressure breathing.

Adaptation, Physiological↗

Pressure breathing without a counter-pressure vest does not impair acceleration tolerance up to 9 G.

INTRODUCTION: This study was to determine whether safe and adequate G-protection by pressure breathing during G (PBG) could be maintained if the COMBAT EDGE counter-pressure vest were eliminated to ensure aircrew do not unnecessarily endure a possible in-flight discomfort or distraction. METHODS: Centrifuge exposures up to +9 Gz were completed by 11 subjects, including 5 F-15 aircrew, using PBG at 60 mmHg pressure with and without the counter-pressure vest. Additional G-exposures using pressures of 0, 30, and 45 mmHg were performed without the vest. RESULTS: Elimination of the COMBAT EDGE counter-pressure vest did not significantly reduce G-tolerance. During gradual onset G exposure, the mean G level reached with PBG was 8.4 G without the vest and 8.2 G with the vest. In comparison, 6.7 G was reached without PBG. Mean times at G with rapid onset G exposure were 59 and 60 s, respectively, compared with 49 s without PBG. PBG, with or without the vest, was preferred by all test subjects. PBG at 60 mmHg produced the highest G protection and was preferred by the test subjects over lesser pressures. Subjects reported no adverse effects from the use of PBG without chest counter-pressure. CONCLUSION: The use of PBG and the anti-G straining manuever (AGSM) together enhances G tolerance and comfort more than AGSM alone. Elimination of the counter-pressure vest during use of PBG does not hinder an individual's ability to reach +9 Gz or complete a short duration simulated aerial combat maneuver G exposure. Further research is needed to determine if use of PBG without chest counter-pressure increases fatigue during multiple sorties or produces other aeromedical problems in operational environments.

Acceleration↗

G-induced visual and cognitive disturbances in a survey of 65 operational fighter pilots.

INTRODUCTION: Only one previous study has assessed almost loss of consciousness (A-LOC) in operational fighter pilots, reporting an incidence rate of 14%. Research also indicates that 8-13% of pilots have experienced G-induced loss of consciousness (G-LOC). A-LOC can be as insidious as G-LOC due to the associated altered state of awareness and relative incapacitation time, making it a significant risk factor in the high +Gz environment. Royal Australian Air Force (RAAF) pilots currently fly the F/A-18 and Hawk 127, producing +Gz accelerations up to +7.5 Gz, which places these pilots at risk of both A-LOC and G-LOC. METHODS: A survey was administered to 100 active RAAF fighter pilots requesting information on G-induced visual and cognitive disturbances, A-LOC symptoms, and G-LOC. Details regarding type of aircraft, flying maneuvers performed and mission outcome were also sought. RESULTS: There were 65 RAAF fighter pilots who completed the survey (age 20-53 yr, height 168-193 cm, weight 64-110 kg, jet hours 30-5700 h). Of these pilots, 98% indicated they had experienced at least one visual or cognitive disturbance in the high G environment: gray-out 98%; black-out 29%; and A-LOC symptoms 52%, including abnormal sensation in limbs, disorientation, and confusion. There were 9% who indicated they had experienced G-LOC (50% were the pilot flying the aircraft). DISCUSSION: These findings indicate that RAAF fighter pilots are experiencing a similar rate of visual disturbances and G-LOC when compared with other air forces. However, RAAF pilots reported a much higher incidence of A-LOC compared with the only other study of operational fighter pilots.

Adult↗

[An experimental study on injury of hippocampus neurons in rats by simulated push-pull maneuver of different degrees].

OBJECTIVE: To explore the degree of injury and phase of push-pull effect induced by different degrees of push-pull maneuver on hippocampus neurons in rats. METHOD: Injury of push-pull maneuver on hippocampus neurons in rats after different degrees of push-pull maneuver were determined by general evaluation of animal model, pathologic examination and electronic microscopy. RESULT: 1) General evaluation of animal model: the apoplexy index and the pathological grading increased with the increase of intensity of the push-pull maneuver. 2) Routine HE: No abnormity was found in appearance and distribution of hippocampus neurons in the control rats and various groups of +/-2 Gz exposures, and 30 min groups of +/-6 Gz, +/-8 Gz exposures, but denatured necrosis of neurons were found in 6 h and 24 h groups of +/-6 Gz, +/-8 Gz exposures. 3) Examination of ultrastructure under electronic microscope: No significant change were found in hippocampus neurons of CA1 area in 30 min and 24 h after +/-2 Gz exposures as compared with the normal control group. But various degrees of denatured necrosis of neurons were found in some of the hippocampus neurons of CA1 area in 6 h after +/-2 Gz exposures, 6 h and 24 h after +/-6 Gz and +/-8 Gz exposures. CONCLUSION: +/-6 Gz and +/-8 Gz exposures may cause injury of hippocampus tissues and it is most severe at 6 h after the +/-8 Gz exposures.

Animals↗

[Myocardial ultrastructural changes in rats following different levels of acute +Gz exposure].

OBJECTIVE: To observe the effects of different levels of acute +Gz exposure on myocardial ultrastructure of rats and provide experimental basis for further development of anti-G measures. METHOD: Twenty male Wistar rats were randomly divided into 4 groups (n=5): normal control group, +20 Gz group, +10 Gz group and +5 Gz group. Profile of the centrifuge +Gz exposure was trapezoidal, in which +20 Gz lasted for 30 s, +10 Gz for 1.5 min. +5 Gz exposure was repeated for 3 times with 30 min interval and each for 1.5 min. Myocardial tissue of left ventricle was sampled for transmission electron microscopy 5 h after exposure. RESULT: +20 Gz and +10 Gz exposure caused obvious edema of myocardial and endothelial cells, myofibril disorder and injuries of mitochondria and nucleus. Breaks of myocardial fiber, formation of contraction bands and rupture of mitochondria were also observed in +20 Gz group. In +5 Gz group, there was still slight edema of myocardial and endothelial cells, while organic changes of myocardial ultrastructure were not observed. CONCLUSION: High +Gz exposure can cause myocardial ultrastructural injury in rats. Slight reversible injured response can also be observed in myocardial cell after repeated moderate level of +Gz exposure. This indicates that attention should be paid to the study of the effect of high +Gz on heart in pilots.

Acceleration↗

[A study on pathological changes of brain after high +Gx exposure in rhesus monkey].

OBJECTIVE: To study the pathological morphological changes of cerebral cortex and hippocampi in rhesus monkey caused by +Gx exposure, and to explore the relation between +Gx level and pathological changes. METHOD: Healthy rhesus monkeys were randomly divided into one control group and three experimental groups (+15 Gx, +18 Gx, +21 Gx). Monkeys in each group were exposed to the corresponding level of +Gx, after that, the required tissue was qualitatively studied on the basis of pathological morphology. RESULT: 1) Different morphology changes were observed in pyramidal neurons and astrocytes in the cerebral cortex and hippocampi by light microscopy. The higher the +Gx level, the more the changes were observed. In addition, the trauma was more serious in the hippocampi. 2) Chromatin marginating, karyotheca fold, apoptosis body and swollen mitochondria with blurred cristae were observed in pyramidal cell under electron microscope after +Gx exposure, and degenerative changes were also observed in some cases after higher +Gx. CONCLUSION: High level of +Gx causes acute pathological trauma of brain tissues in rhesus monkey, and consanguineous relationship exists between pathological changes and level of +Gx.

Acceleration↗

[Effects of centrifuge training on mRNA expression in different rat tissues].

OBJECTIVE: To demonstrate the tissue specific expression of five rat genes related to centrifuge training and the relationship between expression change and duration of training. METHOD: mRNA was extracted from hearts, brains, kidneys, lungs and intestines of rats after different durations of training. Five genes obtained by SSH from centrifuge-trained rats were labeled by Dig-11-dUTP as probes. The expression levels were measured by thin-line hybridization. Optical density (OD) values were obtained by scanning and treated with statistics. RESULT: As compared with control group, the new gene CH157 expression decreased in hearts and brains of rats trained for 6 d (P<0.05), but returned to control levels after 12 d training; the new gene CH244 expression depressed in rat hearts, brains, and intestines after 6 d or 12 d training, but it was not statistically significant owing to large individual differences; gene expression of protein inhibitor of neuronal nitric oxide syntheses (PIN) increased gradually and significantly in rat hearts (P<0.01 after 12 d training) and kidneys (P<0.05 after 12 d training); Cyt b gene expression in rat hearts and brains increased increasingly (P<0.01 after 12 d training), however, it increased obviously (P<0.05) in kidneys, lungs and intestines of rats trained for 6 d, while it returned back a little in rats trained for 12 d; enlongation factor 1-alpha expression levels in intestines of rats trained for 6 d increased significantly (P<0.05), but it became no significant in rats trained for 12 d, while the expression in brains increased gradually (P<0.01). CONCLUSION: It suggested that the change in gene expression in several tissues of rats caused by centrifuge training contribute in enhancing +Gz tolerance.

Acceleration↗

Motion sickness decreases arterial pressure and therefore acceleration tolerance.

BACKGROUND: Motion sickness is a common aeromedical problem that may occur in pilots exposed to increased gravitoinertial load in the head-to-foot direction (+Gz). Since motion sickness may affect autonomic nervous functions including cardiovascular control, it was hypothesized that it might interfere with cardiovascular responses to high +Gz, thereby decreasing G tolerance. METHODS: G tolerance and cardiovascular responses to increased G load were studied in nine subjects in a centrifuge environment under two conditions. In the motion sickness condition, the subject was exposed to a motion sickness provocation (MSP) comprising repeated rapid changes in G load in combination with a regimen of head movements. In the control condition the subject was exposed to similar cumulative G-time stress, but without the MSP. Mean arterial pressure (MAP) was measured. An index of peripheral vascular resistance was achieved by measuring the difference in skin temperature between the forearm and fingertip (deltaT(forearm-fingertip)). RESULTS: MSP decreased gradual-onset rate G tolerance from 5.1 +/- 1.0 G (mean +/- SD) to 4.6 +/- 0.9 G. There was no change in gradual-onset rate G tolerance in the control condition. Rapid-onset rate G tolerance was lower in the motion sickness (2.9 +/- 0.5 G) than in the control (3.4 +/- 0.3 G) condition. MSP reduced MAP by 11 mmHg and deltaT(forearm-fingertip) by 4.2 +/- 4.1 degrees C. In the control condition MAP and deltaT(forearm-fingertip) were unaffected. CONCLUSIONS: Motion sickness may reduce the arterial pressure response to the extent that the capacity of an individual to withstand increased G loads in the head-to-foot direction is significantly diminished.

Acceleration↗

Changes of hippocampus somatostatin and learning ability in rats after +Gz exposure.

OBJECTIVE: To investigate changes of learning ability and somatostatin (SS) changes after positive acceleration (+Gz) exposures. METHOD: Eighty male SD rats were randomly divided into 3 groups: control group (Con), +6 Gz/3 min group (+6 Gz), and +10 Gz/3 min group (+10 Gz), 8 rats in each group. Changes of learning ability in rats were observed at 0 d, 2 d, 4 d and 6 d after +Gz exposure. SS in hippocampus was measured by RIA at 0 d, 2 d and 4 d after +Gz exposures (there were 8 rats every time, in each group). RESULT: In Y-maze test, number of correct response decreased significantly (P<0.01), and total reaction time increased significantly (P<0.01) in +6 Gz and +10 Gz groups as compared with control group; number of correct response and total reaction time in +10 Gz group changed significantly at 0 d (P<0.01 or P<0.05) as compared with +6 Gz group. RIA showed that, content of SS in hippocampus declined at 0 d and 2 d (P<0.05 or P<0.01) in +6 Gz and +10 Gz groups as compared with control group. CONCLUSION: +Gz exposure could impair learning ability of rats, and inhibit expression of SS in hippocampus.

Acceleration↗

[Dynamic responses of human body and human surrogate to different impacts under 30 degrees supine position].

OBJECTIVE: To study the difference between the dynamic responses of human body and human surrogate under 30 degrees supine position, and to discuss impact probability of substituting human body with human surrogate in impact tests. METHOD: Five volunteers experienced half-sine impact pulses, averaged 4.76, 8.96, 11.33 G, lasting for 40-60 ms on an impact tower. The human surrogate was exposed to half-sine impact pulses, averaged 6.77, 10.39, 16.93, 21.11, 24.98, 31.11 G, lasting for 40-60 ms, two times for each G level. ECG changes of the volunteers were continuously monitored before, during and after each impact. RESULT: Output responses at forehead and chest of human body and human surrogate increased with input increments. But there was obvious difference of the dynamic responses between human body and the surrogate to impact of low G levels. Heart rate of each volunteer had temporary increase during the process of impact, and returned to normal level soon after the impact. CONCLUSION: There is difference in a certain extend between the dynamic responses of human body and human surrogate. The ECG changes are induced mainly by mental stress during process of impact.

Acceleration↗

[Changes of somatostatin (SS) in stomach and duodenum of rats after +Gz exposure].

OBJECTIVE: To study effects of +Gz exposure on the change of somatostatin (SS) in stomach and duodenum of rats. METHOD: Forty male Wistar rats were randomly divided into +1 Gz control group, +5 Gz x 5 min group, +10 Gz x 5 min group and repeated exposure [(+5 Gz x 2 min) + (+10 Gz x 2 min) + (+5 Gz x 2 min)] group. After +Gz exposure, the rats in each group were anesthesized by aether, and gastric and duodenal mucosa were taken immediately. Levels of SS were assayed using radioimmunoassay (RIA) methods. RESULTS: Gastric and duodenal mucosa of the control group and +5 Gz group were intact and smooth. Under naked eye and light microscope, scattered hemorrhagic spoto, small ulcers, submucosal hyperemia, and erosion of mucosa were found in gastric antrum and duodenum in +10 Gz group rats. Diffuse hyperemia, erosion and small ulcers were found in mucosa of gastric fundus, gastric antrum and duodenum of repeated exposure group. Exposure to +Gz can increase somatostatin content in gastric antrum and duodenum (P<0.01). CONCLUSION: Increase of SS content may play an important role in the prevention of pathogenesis of stomach and duodenum after +G exposure.

Acceleration↗

Computer modeling of acceleration effects on cerebral oxygen saturation.

INTRODUCTION: Failure to effectively regulate BP and cerebral perfusion during high-G aircraft maneuvering may contribute to reduced performance in pilots due to the fact that perfusion to the peripheral cerebral tissues may not be adequate to support the mental demands of flight. Therefore, a critical area of investigation is the study of cortical tissue oxygenation responses to +Gz acceleration. METHODS: Two experiments were used to build two sections of a cerebral oxygen saturation (rSo2) model. Experiment 1: Six subjects participated in the study. A cerebral oximeter (gold standard) provided rSo2. Acceleration profiles (subjects relaxed) included a 0.1 G x s(-1) G onset to central light loss (CLL) and a 3 G x s(-1) onset to a G level that was 1 Gz above CLL to an endpoint of G-LOC. Experiment 2: There were 12 subjects (with G protection) who participated in this study. The rSo2 data were collected during five different simulated aerial combat maneuvers. A model was created that read the Gz profile as input and calculated changes in rSo2. The correlation coefficient, linear best-fit slope, and mean percent error were calculated to determine agreement. RESULTS: The average value for the correlation coefficients, linear best-fit slopes, and mean percent errors for the unprotected subjects were 0.79, 0.87, and 6.08, respectively. These values for the protected subjects were 5 G (0.994, 1.011, 0.384), 6 G (0.994, 0.909, 0.811), 7 G (0.986, 1.061, 0.692), 8 G (0.969, 1.016, 1.300), and 9 G (0.994, 0.979, 0.558), respectively. DISCUSSION: The model is a good predictor of rSo2 values for protected and unprotected subjects under +Gz stress.

Adult↗

BIOLAB, EPU and EMCS for cell culture experiments on the ISS.

Two ESA facilities are under development for biological research on the International Space Station: BIOLAB as part of the European "Columbus" Laboratory and the European Modular Cultivation System (EMCS), foreseen for accommodation in the US Lab "Destiny". Both facilities have an incubator (18-40 degrees C) and use standard Experiment Containers, mounted on two centrifuge rotors providing either microgravity or variable g-levels from 0.001 x g to 2.0 x g. Standard interface plates supply each container with power and data lines, with gas (controlled CO2, O2 and water vapour concentration; trace gas removal), and--for EMCS only--with water. The degree of automation is higher in BIOLAB: it contains a robotic Handling Mechanism for automatic sampling and handling of liquids, which can be stored at cool or cold temperatures or injected for automatic on-board analysis into a microscope or a spectrophotometer. For analyses on the running centrifuge, small automatic microscopes can be installed in the Experiment Containers. Several designs for supporting cell culture experiments have been studied for BIOLAB and EMCS. BIOLAB has in addition a Bio-Glovebox, which can be sterilised and where new cell cultures may be prepared under 1 x g conditions from deep-frozen samples in the Experiment Preparation Unit (EPU): the cryo-protectant will be removed by automatic washing cycles. Both facilities, EMCS and BIOLAB (with EPU), have also provisions for telescience operations through video, data and command lines, either operated by the crew or by the experimenter on ground.

Automation↗