Air Force Pilots Research Articles

Fitness to fly: assessing cardiac disease among Air Force pilots

Abstract Introduction Aviation is a risk activity, particularly in pilots with cardiovascular (CV) disease. The occurrence of acute clinical events during flight may have catastrophic implications, justifying the relevance of cardiologic evaluation in Aviation Medicine. However, the evidence about the impact of CV diseases in this population is scarce. Aim To study the cardiac causes of incapacitation among pilot candidates and pilots of the Portuguese Air Force (PoAF) over a period of 20 years. Methods and results A retrospective analysis of cardiac causes of incapacitation between January 1999 and December 2018 was performed, both in PoAF candidates and pilots. In this period, the overall number of candidates was 2529 and the number of PoAF pilots was 760. Among the candidates, 41% (N=1086) were considered unfit, of which 4% (N=39) due to cardiac causes (all men aged 17-25), namely valvular diseases (N=27) and conduction/heart rhythm disturbances (N=12). Among the pilots, 2% (N=18) were considered unfit, mainly due to cardiac disease (50%; N=9). These pilots considered unfit pilots due to cardiac disease were men with mean age of 47±9 (30-60) years old, all unfit due to acute myocardial infarction, none occurring during flight. Conclusion Cardiac diseases were an uncommon cause of incapacitation among the pilot aviator candidates, but it was the main cause among the pilots of the PoAF during two decades, all due to acute myocardial infarction. Cardiac evaluation in Aviation Medicine is essential, focusing on CV risk stratification and preclinical detection of coronary artery disease.Figure 1

Ensuring High-Quality Professional Training for Future Tactical Air Force Pilots in Combat Flight through the Pedagogical System's Effectiveness Justification

This article presents an in-depth analysis of the efficacy of the pedagogical system in providing high-quality professional training for prospective tactical air force pilots. The study encompasses the evaluation of cognitive, operational, motivational and conative, and physical components of professional training for combat flights through an extensive pedagogical experiment. Two distinct groups, namely the experimental group (EG) and the control group (CG), comprising a total of 190 participants, were established for the experiment. The assessment of professional readiness among KNAFU student pilots for combat flights involved the examination of criteria, indicators, and levels associated with each component. The experimental process entailed both quantitative measurement and qualitative interpretation of the outcomes. The study uncovered noteworthy enhancements in professional training for future tactical air force pilots, encompassing intellectual domain, simulator training quality, operational proficiency, motivational and conative aspects, physical capabilities, and psychophysiological elements. These findings contribute to the progression of military pilot education and carry positive implications for public health. By refining the training programs and pedagogical approaches for military pilots, the implemented measures can indirectly impact public health by ensuring the deployment of highly skilled and mentally resilient pilots to safeguard national security. This study underscores the interdependence between professional training for tactical air force pilots and broader public health objectives, underscoring the significance of holistic education and training approaches in the military domain.

Analysis of the relationship between body imbalance characteristics and physical ability in air force cadets: physical function and gravity acceleration resistance

Air Force pilots and some athletes (e.g., in sledding sports) are frequently exposed to high G-forces. High-intensity physical activity is essential to withstand gravitational acceleration, and morphological symmetry and functional movement are directly related to injury in those who perform these activities. However, the relationship between G-endurance and physical imbalance and the effect on physical performance is poorly understood. This study aimed to analyze the physical performance of those exposed to a high load of G-tolerance and who performed high-intensity physical activity. A total of 363 male cadets from the Korean Air Force Academy underwent functional movement screen tests, anatomical structure measurements, G-tests (fourth grade), and body composition and physical fitness tests. Participants were classified into the G-test-pass and -fail groups depending on the G-test results. The pass group showed significantly different bilateral imbalance in active straight leg raises (p < 0.05), while the fail group showed a significant difference in deep squats (p < 0.05), shoulder mobility (p < 0.01), rotary stability (p < 0.05), and functional leg length (p < 0.05). Leg length was significantly correlated with the hurdle step (p < 0.01), inline lunge (p < 0.01), and active straight leg raise (p < 0.01). Functional leg lengths on both sides and structural leg lengths were also significantly correlated (p < 0.01). High body balance positively affects gravitational acceleration and exercise performance. Therefore, functional movement and physical imbalance affect performance in pilots affected by gravitational acceleration. This study can also be applied to strengthen the performance of winter sports athletes affected by gravitational acceleration.

Prevalence of barodontalgia in military pilots of the Brazilian Air Force

Introduction: Barodontalgia refers to the painful condition affecting previously asymptomatic teeth and periodontal tissues, caused by changes in atmospheric pressure during flight. This study aimed to evaluate the prevalence of barodontalgia in Brazilian Air Force (FAB) pilots. Materials and Methods: An exploratory study was carried out, with a convenience sample, made up of military pilots, regardless of age group and type of aircraft, using a structured questionnaire and descriptive analysis of the data. Results: 141 pilots participated; men; 37.3 ± 3.6 years; 40.6% were transport pilots, 14.1% fighter, 9.4% rotary wing, and 35.8% Instruction/Demonstration. The prevalence of barodontalgia was 12.8% (18 occurrences). Three missions were interrupted. Regarding knowledge of barodontalgia, 56 (39.7%) reported regular knowledge and 21 (15%) declared they had no knowledge on the subject. Conclusions: It is concluded that the prevalence of barodontalgia in Brazilian military pilots is higher than the values reported by some air forces of developed countries, already indicating the need for a more in-depth look at the oral health of FAB military personnel.

NEW APPROACH TO MILITARY PILOT EDUCATION AND TRAINING IN THE NEW SECURITY ENVIRONMENT

Military pilot education, including flight training, is a long, expensive, and complex process. The main goal is to produce as many skilled professionals as possible ready to perform flight tasks on the front-line aircraft and push them to their workload limits with complete control. To achieve this goal, it is necessary to select and educate young people with the aptitude and abilities to perform the most demanding military flight tasks. The creation of a model for the education and training of military pilots depends on the requirements of the Czech Air Force Command and the teaching capacities of the University of Defence and the Aviation Training Centre in Pardubice. Rearmament of the Czech Air Force and the required number of pilots requires a change in the new military pilot training model. This contribution describes a new approach to Czech Air Force pilot education and training in the current security conditions in the world.

Factors That Influence Health Care-Seeking Behavior and Health Information Disclosure Among U.S. Air Force Pilots.

The reality of pilot health care avoidance behavior is often common knowledge to both pilots and aeromedical physicians, but the underlying factors leading to this behavior are less understood. In the current study, we conducted a qualitative assessment of a sample of U.S. Air Force (USAF) pilots to gather firsthand perceptions of the factors that encourage and discourage disclosure during aeromedical screening and use of mental and physical health care services, as well as recommendations to improve the USAF aeromedical health care system. We conducted interviews with 21 USAF pilots on their perceptions of seeking medical care to identify factors that uniquely discourage or encourage disclosure and health care utilization to understand factors that aid the aeromedical provider/aviator relationship and to elicit interventions that could be prospectively researched. This work was reviewed by the Air Force Research Laboratory Institutional Review Board at Wright-Patterson Air Force Base and designated as exempt research, FWR20220103E. The most reported factors that discourage military pilot health care disclosure and health care utilization overall were medical revocation, stigma, and lack of trust in providers. Unit-embedded services, ease of access, and severity of condition were the most reported factors encouraging disclosure and utilization. Factor descriptions and exemplary quotes from pilots and pilot recommendations to encourage health care utilization and disclosure are provided. Results from firsthand interviews with pilots provide valuable information for flight surgeons to focus on building trust with their pilots to reduce health care avoidance.

Flexible ureteroscopy in Chinese air force pilots with renal calculi: a cohort study at a single medical centre

IntroductionRenal calculi are the predominant urological ailment in air force pilots. Flexible ureteroscopy (FURS) constitutes a valuable approach for renal calculi treatment. This study presents a decade-long exploration of using...

Evaluating the impact of a combined aerobic and strength training intervention on the physical performance of male Chinese People's Liberation Army air force pilots

This study aimed to assess the impact of a 16-week combined training program on the physical performance of 20 male Air Force pilots, with an average age of 31.87 ± 2.75 years, body mass of 76.33 ± 0.79 kg, and height of 175.55 ± 3.65 cm. This intervention encompassed both aerobic and strength training, involving six weekly training sessions. The participants were categorized into two groups based on their initial physical performance levels to explore potential baseline influences on post-intervention adaptations. The study measured changes in estimated maximal oxygen uptake (VO2 max), maximal strength, muscular endurance, and long jump performance before and after the training program. Repeated measures ANOVA revealed significant differences over time in the V˙O2 max (F = 86.898; p < 0.001; ηp2 = 0.821), handgrip strength right hand (F = 160.480; p < 0.001; ηp2 = 0.894), handgrip strength left hand (F = 102.196; p < 0.001; ηp2 = 0.843), squat maximal strength (F = 525.725; p < 0.001; ηp2 = 0.965), push-ups (F = 337.197; p < 0.001; ηp2 = 0.974), sit up (F = 252.500; p < 0.001; ηp2 = 0.930) and standing long jump (F = 521.714; p < 0.001; ηp2 = 0.965). In conclusion, the 16-week combined training regimen significantly enhanced the physical performance of Air Force pilots, regardless of their initial performance levels.

Metabolic flexibility associated with flight time among combat pilots of the Brazilian air force.

Fighter pilots must support the effects of many stressors, including physical and psychological exertion, circadian disturbance, jet lag, and environmental stress. Despite the rigorous selection of military pilots, those factors predispose to failures in physiological compensatory mechanisms and metabolic flexibility. We compared through NMR-based metabolomics the metabolic profile of Brazilian F5 fighter pilots with different flight experiences vs. the control group of non-pilots. We hypothesized that combat pilots have metabolic flexibility associated with combat flight time. We evaluated for the first time 34 Brazilian fighter pilots from Santa Cruz Air Base (Rio de Janeiro, RJ) allocated into three groups: pilots with lower total accumulated flight experience < 1,100h (PC1, n = 7); pilots with higher total accumulated flight experience ≥ 1,100h (PC2, n = 6); military non-pilots (CONT, n = 21). Data collection included anthropometric measurements, total blood count, lipidogram, markers of oxidative stress, and serum NMR-based metabolomics. In comparison with controls (p < 0.05), pilots exhibited decreased levels of white blood cells (-13%), neutrophils (-15%), lymphocytes (-20%), alfa-glucose (-13%), lactate (-26%), glutamine (-11%), histidine (-20%), and tyrosine (-11%), but higher isobutyrate (+ 10%) concentrations. Significant correlations were found between lactate vs. amino acids in CONT (r = 0.55-0.68, p < 0.001), and vs. glutamine in PC2 (r = 0.94, p = 0.01). Fighter pilots with lower experience showed a dysregulation in immune-metabolic function in comparison with controls, which seemed to be counteracted by the accumulation of flight hours. Those findings might have implications for the health preservation and operational training of fighter pilots.

The effect of Ashtanga-Vinyasa Yoga method on air force pilots' operational performance.

In today's military landscape, optimizing performance and bolstering physical health and mental resilience are critical objectives. Introducing a 12-week Ashtanga Vinyasa Yoga Supta Method (AVYSM) to the training protocol of military trained Airforce pilots, we aim to assesses the feasibility and impact of the method. Borg Scale assesses the intensity level of physical activity during the intervention. Flight simulator data gauges operational performance responses. Postural control responses are measured using a force platform, stress responses are monitored via heart monitor, and handgrip dynamometry will measure strength. Respiratory capacity is assessed using a spirometer, body composition is evaluated using impedance balance, and aviation-related questionnaires are administered before and after the intervention period. In a randomized controlled trial, the totality of pilots from the "Masters in Military Aeronautics: aviator pilot specialist" course at the Portuguese Air Force Academy (PAA) were randomly assigned to the yoga intervention or the waiting list control groups, with participants providing written informed consent. The control group followed protocolized course classes for 12 weeks, while the intervention group integrated two weekly one-hour yoga sessions into their course. The PAA has approved the implementation of this intervention protocol at Airbase 11 in Beja, highlighting its significance for the organization's policy makers. We hypothesize that this method will enhance operational performance and, subsequently, elevate flight safety. This research's potential extends beyond the PAA, as it can be adapted for use in Airforce departments of other nations and various military contexts. Évora University research ethics committee-approval number 21050. Study registered on ClinicalTrials.gov under identifier NCT05821270, registered on April 19, 2023.

Re-evaluating the Need for Routine Maximal Aerobic Capacity Testing within Fighter Pilots.

INTRODUCTION: There is a current belief in aviation suggesting that aerobic training may reduce G-tolerance due to potential negative impacts on arterial pressure response. Studies indicate that increasing maximal aerobic capacity (<mml:math id="ie1" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂ max) through aerobic training does not hinder G-tolerance. Moreover, sustained centrifuge training programs revealed no instances where excessive aerobic exercise compromised a trainee's ability to complete target profiles. The purpose of this review article is to examine the current research in the hope of establishing the need for routine <mml:math id="ie2" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂-max testing in air force pilot protocols.METHODS: A systematic search of electronic databases including Google Scholar, PubMed, the Aerospace Medical Association, and Military Medicine was conducted. Keywords related to "human performance," "Air Force fighter pilots," "aerobic function," and "maximal aerobic capacity" were used in various combinations. Articles addressing exercise physiology, G-tolerance, physical training, and fighter pilot maneuvers related to human performance were considered. No primary data collection involving human subjects was conducted; therefore, ethical approval was not required.RESULTS: The <mml:math id="ie3" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂-max test provides essential information regarding a pilot's ability to handle increased Gz-load. It assists in predicting G-induced loss of consciousness by assessing anti-G straining maneuver performance and heart rate variables during increased G-load.DISCUSSION: <mml:math id="ie4" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂-max testing guides tailored exercise plans, optimizes cardiovascular health, and disproves the notion that aerobic training hampers G-tolerance. Its inclusion in air force protocols could boost readiness, reduce health risks, and refine training for fighter pilots' safety and performance. This evidence-backed approach supports integrating <mml:math id="ie5" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂-max testing for insights into fitness, risks, and tailored exercise.Zeigler Z, Acevedo AM. Re-evaluating the need for routine maximal aerobic capacity testing within fighter pilots. Aerosp Med Hum Perform. 2024; 95(5):273-277.

Effects of a mat Pilates-based exercise program for low back pain in helicopter pilots of the Brazilian Air Force: Randomized controlled trial

IntroductionHelicopter pilots may present chronic low back pain due to vibration exposure and asymmetric posture during flight. ObjectivesTo analyze the effects of a Pilates-based exercise program on low back pain of helicopter pilots of the Brazilian Air Force. MethodsThis is a randomized controlled trial with fifteen helicopter pilots of the Brazilian Air Force, who were assessed for pain intensity (Numerical Pain Rating Scale), disability associated with low back pain, and spine muscle endurance in three positions: trunk extension (Ito test) and left and right lateral bridge. Individuals were randomly distributed into the regular exercises group (REG) (n = 7), oriented to maintain their exercise routine, and Pilates group (PG) (n = 8), which performed an exercise program based on Pilates method twice a week for 12 weeks. Reassessments occurred after 6 and 12 weeks. Data were analyzed on SPSS 20.0 software using a significance level of 5%. ResultsPG showed a significant reduction in low back pain after 12 weeks of training compared with REG (mean difference of 3.5 points, p < 0.0001). We also observed increased endurance of trunk extensors (p = 0.002) and right (p = 0.001) and left lateral muscles (p = 0.001) in the PG compared with REG. However, the indexes of disability did not change between groups. ConclusionPain intensity was significantly reduced while spine muscle endurance increased in PG compared with REG after intervention; thus, Pilates-based exercises should be considered in physical conditioning programs for helicopter pilots.

Responsible machine learning for United States Air Force pilot candidate selection

The United States Air Force (USAF) continues to be plagued by a chronic pilot shortage, one that could be exacerbated by an accompanying shortfall in the commercial airlines. As a result, efforts have increased to alleviate this shortage by finding methods to reduce pilot training attrition. We contribute to these efforts by setting forth a decision support system (DSS) for pilot candidate selection using modern machine learning techniques. In view of the recent Responsible Artificial Intelligence Strategy published by the United States Department of Defense, this research leverages interpretable and explainable machine learning methods to create traceable and equitable models that may be responsibly and reliably governed. These models are used to regress candidates’ average merit assignment selection system scores based on information available for selection and prior to training. More specifically, using data provided by the USAF from 2010 to 2018, this paper develops and analyzes multiple interpretable models based on Gaussian Bayesian networks, as well as multiple black-box models rendered explainable by SHAP values and conformal prediction. A preferred pair of interpretable and explainable models is selected and embedded within a DSS for USAF pilot candidate selection boards: the Air Force Pilot Applicant Selection System. The utilization of this DSS is explored, the analyses it enables are discussed, and relevant USAF policymaking issues are examined.

Subjective versus objective refraction in healthy young adults

PurposeTo evaluate objective and subjective refraction differences in healthy young adults.MethodsData concerning candidates for the Israeli Air Force Flight Academy, as well as active air force pilots in all stages of service who underwent a routine health checkup between the years 2018 and 2019 were retrospectively analyzed. Objective refraction measured using a single autorefractometer was compared with subjective refraction measured by an experienced military optometrist during the same visit. The results were converted to power vectors (spherical equivalent [SE], J0, and J45). To interpret astigmatism using power vector values, the cylinder power (Cp) was determined.ResultsThis study included 1,395 young adult participants. The average age was 22.17 years (range, 17–39, 84.8% males). The average SE was − 0.65 ± 1.19 diopter (D) compared with − 0.71 ± 0.91D in the auto- and subjective refraction, respectively (p = 0.001). Cp was 0.91 ± 0.52D and 0.67 ± 0.40D, respectively (p < 0.001). This difference was more common in older participants (p < 0.001). J0 and J45 value differences were not significant. The absolute SE value of subjective refraction was lower in the myopic (p < 0.001) and hyperopic (p < 0.001) patients.ConclusionsYoung hyperopic participants tended to prefer “less plus” in subjective refraction compared with autorefraction. Young myopic participants tended to prefer “less minus” in subjective refraction compared with autorefraction. All participants, but mainly older participants, preferred slightly “less Cp” than that measured using autorefraction; The astigmatic axis did not differ significantly between the methods.

The Conceptual View of the Department of Combat use of Communication Units on the Creation of a Training Game Complex for Training Military Specialists on the Basis of Leadership

Today’s cadet leader is tomorrow’s officer, a professional capable of integrating knowledge and solving complex problems in a full-scale war with incomplete information, being a leader and authority for the personnel. Most of the time, cadets study in study groups using traditional technology, which is not enough to form a professional cadet leader. With the advent of computer technology, students’ and cadets’ motivation to learn using traditional teaching methods has paradoxically begun to decline rapidly. The problem of the quality of training of military specialists for the needs of communication and cybersecurity units is not reflected in the publications reviewed. However, significant progress has been made in the use of computer technology as the basis of training tools for ground forces units. Similar training complexes are actively used in NATO member states in the military education system in the training of air force pilots (navigators). Therefore, the author chose the improvement of the educational process at the Department of Combat Use of Communication Units in combination with the methodology of professional-business game for the development of a cadet leader in professional training courses (L-1B) of the tactical level of military education as the direction of research. The purpose of the study and the article is to substantiate the conceptual view of the department in the need to build a computerized training complex for training officers of leaders in professional training courses (L-1B) of the tactical level of military education, capable of using communication units based on computer games. Fragments of the game mechanics of stimulating the interest and motivation of cadets to study, for example, electronic shooting range, and learning Morse code, are considered. Game mechanics is a proof of a professional business game in the course of the discipline: Combat use of military communication systems and complexes of the course of professional military education (professional course of tactical level L1B).

ALPHA THALASSEMIA IN A PILOT FLYING HELICOPTERS: FITNESS TO FLY A CONSIDERED DECISION: A CASE REPORT

Introduction: The disease/disability Alpha-Thalassemia is a rare genetic disorder wherein there is reduced production of haemoglobin. An individual suffering from this may sugffer from easy fatiguability, fluctuating anemias, leg ulcers, all depending upon the severity of the condition. It is an aerospace safety concern in case an aircrew member is diagnosed with Alpha Thalassemia. The pilot being discussed in this case study presented with complaints of easy fatigability and anemia. The paper discusses the aeromedical disposal dilemma in the first and only case of Alpha Thalassemia documented in military aviation across the globe. Case report: This is a case of an Indian Air Force pilot who has been flying helicopters in the forces and was diagnosed as a case of alpha-thalassemia. The pilot was extensively evaluated, including aeromedical stresses, and was declared fit for flying under waiver after due consideration. Discussion: A literature review of a case report on disposal of cases of alpha-thalassemia in military flying did not reveal any results. However, based on the observation on the ground, simulated aviation stressors, haemoglobin and haematocrit values and international best practices, the pilot was awarded a flying category under waiver. The pilot has been asymptomatic and is currently flying without compromising aerospace safety.

Aeromedical Transportation in an Area Intensive Care Unit: Experimental Study of Aircraft Pilots Undergoing Non-Invasive in-Flight Intracranial Pressure Measurement

Introduction: In certain emergency situations, a patient admitted to a hospital with fewer resources needs to be transferred quickly to a unit better prepared to deal with them. This is when the aeromedical transport service is needed. For this, the aircraft must be staffed by specialized health professionals and have a variety of resources to provide the best care for the patient. Objectives: 1) The general objective of this article was to analyze changes in intracranial pressure (ICP) in Brazilian Air Force pilots undergoing a level straight flight. 2) To help collect data for the development of a non-invasive sensor for monitoring ICP in flight. 3). To verify whether the equipment for measuring non-invasive Intracranial Pressure can be used in air ICUs. Materials and Methods: The work evaluated the presence of morphological changes in non-invasive ICP during level straight flight lasting 30 min among 10 (ten) pilots who volunteered for the collection. Results: It was observed that the ICP pulse waveform did not change during straight level flight, when compared to normal resting situations of an individual in a collection in a terrestrial environment, demonstrating the reliability of the equipment and the research. Final considerations: This study has helped to understand not only the need for rapid diagnosis of non-invasive ICP, but also the possible suitability of this equipment in aircraft prepared for rapid diagnosis and tratament.

A Study on the Effect of ROK Air Force Pilots' Working Conditions and Job Satisfaction on Turnover Intention

A Study on the Effect of ROK Air Force Pilots' Working Conditions and Job Satisfaction on Turnover Intention

Autonomous systems, superior orders and manifest unlawfulness: is there a duty to disobey?

The recent development of the next generation of ‘drones’ featuring some form of artificial intelligence or machine learning – the autonomous military system or AMS – has fuelled speculation about who the law ought to hold responsible for any negligence or malfeasance in their use. In a scenario recently posted by the Australian War College, an Air Force pilot relies on sensor information and artificial intelligence assessments provided by AMS which led to an (ultimately unlawful) order to attack a target. If that story played out in real life, what disciplinary liability should that ADF member face for their actions: do AMS fundamentally challenge the circumstances in which Defence Force members should disobey unlawful orders? Would disciplinary liability be assigned differently if the pilot was from another host jurisdiction? This article comparatively examines the superior orders defence in the domestic law, with a view to identifying the application of the duty to disobey in relation to orders involving AMS.

Cerebral Blood Flow Based Computer Modeling of Gz-Induced Effects

BACKGROUND: There is continued interest in acceleration (G) effects in civil aviation, as G-induced loss of consciousness (G-LOC), impaired consciousness, and visual effects play a role in aerobatic, agricultural, and military aviation accidents.METHODS: A software model [the Civil Aerospace Medical Institute G-Effects Model (CGEM)] based on physical and physiological variables related to in-flight tissue resupply and using oxygen flow as a proxy for supply availability, was developed to evaluate risk of G-LOC and related phenomena in aeronauts. Aeronauts were modeled using several parameters, including sex, cardiovascular fitness, and other common modifiers such as G-suits, positive pressure breathing gear, anti-G straining, and other muscle tensing. The software was validated by comparison with experimental data from the peer-reviewed literature.RESULTS: CGEM predicted physiological effects of Gz exposure accurately, particularly for rapid onset rates. Predicted times to G-LOC and absolute incapacitation periods were consistently within 1 SD of pooled results obtained during centrifuge experiments using U.S. Navy (USN) and U.S. Air Force (USAF) pilots. Predictions of G tolerance based on visual effects onset also compared well with published data, as did evaluation of symptoms expected during a difficult aerobatic maneuver.DISCUSSION: CGEM is a new tool for civil and military aviation. Rather than providing a simple G tolerance number, flight surgeons, pilots, and accident investigators can gain insight into changes in risk-from factors such fatigue, medications, dehydration, and anti-G countermeasures used-through proper selection of parameters.Copeland K, Whinnery JE. Cerebral blood flow based computer modeling of Gz-induced effects. Aerosp Med Hum Perform. 2023; 94(5):409-414.