Commercial Pilots Research Articles

Effects of atmospheric pressure change during flight on insulin pump delivery and glycaemic control of pilots with insulin-treated diabetes: an in vitro simulation and a retrospective observational real-world study.

Glycaemic control and clinical outcomes in diabetes are improved by continuous subcutaneous insulin infusion (CSII). Atmospheric pressure changes during flights may affect insulin delivery from pumps and cause unintended metabolic consequences, including hypoglycaemia, in people with type 1 diabetes. The present report evaluates both hypobaric flight simulation and real-world data in pilots using insulin pumps while flying. In the flight simulation part of this study, an in vitro study of insulin pumps was conducted in a hypobaric chamber, de-pressurised to 550 mmHg to mimic the atmospheric pressure changes in airliner cabins during commercial flights. Insulin delivery rates and bubble formation were recorded for standard flight protocol. Insulin infusion sets, without pumps, were tested in a simulated rapid decompression scenario. The real-world observational study was a 7.5-year retrospective cohort study in which pre- and in-flight self-monitored blood glucose (SMBG) values were monitored in pilots with insulin-treated diabetes. Commercial and private pilots granted a medical certificate to fly within the European Union Aviation Safety Agency approved protocol and receiving insulin either by pump or multiple daily injections (MDI) were included. In the flight simulation study, full cartridges over-delivered 0.60 U of insulin during a 20 min ascent and under-delivered by 0.51 U during descent compared with ground-level performance. During emergency rapid decompression, 5.6 U of excess insulin was delivered. In the real-world study, seven pilots using CSII recorded 4656 SMBG values during 2345 h of flying across 1081 flights. Only 33 (0.7%) values were outside an acceptable safe range (5.0-15.0 mmol/l [90-270 mg/dl]). No clinically significant fall in the median SMBG concentration was observed after aircraft ascent and no in-flight SMBG values were within the hypoglycaemic range (<4.0 mmol/l [<72 mg/dl]). Compared with pilots receiving MDI therapy, pilots using CSII recorded more SMBG values within the acceptable range (99.3% vs 97.5%), fewer values in the low red range (0.02% vs 0.1%), fewer in-flight out-of-range values (0.2% vs 1.3%) and maintained stricter glycaemic control during flight. Ambient pressure reduction during simulated flights results in bubble formation and expansion within insulin cartridges. This causes unintended delivery of small insulin doses independent of pre-determined delivery rates and represents the maximum amount of insulin that could be delivered and retracted. However, in vivo, pilots using CSII in-flight did not experience a fall in blood glucose or episodes of hypoglycaemia during these atmospheric pressure changes and the use of insulin pumps can be endorsed in view of their clinical benefits.

Underreporting of Depression in Australian Commercial Pilots

INTRODUCTION: Undiagnosed depression in the aviation industry can have catastrophic consequences such as aircraft-assisted suicide. Depression is often underreported, especially when subjects are aware they are reporting on depression. The aim of the present study was to investigate whether scores on a depression screening tool would vary if it was disguised as a “life stress” questionnaire in a sample of Australian commercial pilots. METHODS: A total of 109 subjects were assigned into either a “Life Stress” survey or a “Depression” survey, both containing the Depression, Anxiety, Stress Scales depression screening tool among other questions relating to either depression or stress to determine any variation in depression scores. RESULTS: A statistically significant difference was found in which the covert group that completed a “life-stress” survey scored higher average depression scores than the control group completing an overt depression inventory. Prevalence of depression was consistent with the general population, with 25% of pilots meeting the threshold for depression within the control group, and this number increased to 41% when using a covert measure to assess depression. DISCUSSION: This research adds further weight to the potential underreporting of depression in pilots as a function of stigma and fear associated with the label “depression”. Regulators and organizations must proactively minimize exposure to psychological harm, negating the reliance on self-reporting to control psychological risk and recruitment methods must aim to reduce bias against those with disabilities. Nonpunitive environments for pilots to self-assess and report psychological issues will allow better outcomes from expedited treatment. Minnock SDT, Thomas MJW. Underreporting of depression in Australian commercial pilots. Aerosp Med Hum Perform. 2024; 95(11):821–825.

Dynamic Adaptive Charging Network Planning Under Deep Uncertainties

Charging infrastructure is the backbone of electromobility. Due to new charging behaviors and power distribution and charging space constraints, the energy demand and supply patterns of electromobility and the locations of current refueling stations are misaligned. Infrastructure developers (charging point operators, fleet operators, grid operators, vehicle manufacturers, and real-estate developers) need new methodologies and tools that help reduce the cost and risk of investments. To this extent we propose a transport-energy-demand-centric, dynamic adaptive planning approach and a data-driven Spatial Decision Support System (SDSS). In the SDSS, with the help of a realistic digital twin of an electrified road transport system, infrastructure developers can quickly and accurately estimate key performance measures (e.g., charging demand, Battery Electric Vehicle (BEV) enablement) of a candidate charging location or a network of locations under user-specified transport electrification scenarios and constraints and interactively and continuously calibrate and/or expand their network plans as facts about the deep uncertainties about the supply side of transport electrification (i.e., access to grid capacity and real-estate and presence of competition) are gradually discovered/observed. This paper describes the components and the planning support of the SDSS and how these can be used in competitive and collaborative settings. Qualitative user evaluations of the SDSS with 33 stakeholder organizations in commercial discussions and pilots have shown that both transport-energy-demand-centric and dynamic adaptive planning of charging infrastructure planning are useful.

Examining flight time, cognitive reflection, workload, stress and metacognition on decision making performance for pilots during flight simulation

Despite technological advancements, human decision errors still contribute to civil aviation accidents. This study investigated whether flight time, cognitive reflection, task-load, metacognition, and perceived stress predicted decision-making (DM) performance during two in-flight training simulations with 104 commercial pilots at Bogota International Airport. Hierarchical regression analysis revealed that the predictors accounted for 56% of the variance. Cognitive reflection, flight time and performance task load emerged as significant positive predictors. Cognitive reflection significantly moderated the relationship between flight time and DM performance, with pilots scoring lower on cognitive reflection showing improved DM with increased flight time, while controlling for performance task load. The study did not find significant relationships between stress metacognition and DM performance. The study emphasises the significance of advanced training methods in improving pilots’ DM, especially for those with low cognitive reflection. Future research should expand to multiple airlines, address gender balance, and incorporate direct measures of metacognitive monitoring.

Commercial Airline Pilots’ Stress Across the Travel Cycle: Multi-Level Stressors, Spillover Effects, and the Role of Resources

Commercial airline pilots (CAPs) are a key employee group within the travel industry who are exposed to multi-level institutional and organizational demands that impact their lived experience of stress potentially leading to accidents and incidents. This study explores CAPs’ lived experience of stress and draws on conservation of resources theory and context and travel stage frameworks to investigate unique stressors that CAPs face at different travel stages. Utilizing qualitative data from interviews with 28 CAPs combined with archival data, we surface a range of multi-level factors that impact their lived experience of stress at each travel stage. To cope with stressors, and in the absence of valuable contextual resources, CAPs utilized multiple personal resources. We additionally found evidence of significant spillover across the travel stages. Findings highlight the need to improve contextual resources available to pilots, strengthen their personal resources, and customize support to the requirements of the travel stage.

Understanding Pilots' Perceptions of Mental Health Issues: A Qualitative Phenomenological Investigation Among Airline Pilots in the United States.

Background and objective Although mental health is always a major concern, particularly for airline pilots, knowledge of and attitudes toward mental health have not always been emphasized for safe operations in the aviation industry. Fear of self-reporting, stigmas, and lack of knowledge about mental health conditions are prevalent in this industry. The purpose of our research was to examine pilots' perceptions of mental health issues, the resources available to them, and the reasons they may or may not report these issues. Methods We conducted a qualitative, phenomenological study in which 21 commercial pilots were interviewed to better understand their perceptions of mental health issues, available self-help resources, and rationale for failing to report mental health issues. Results The results of our analysis using NVivo softwareshowed that pilots neither reported the issues nor trusted the processes meant to address mental health issues. Three themes emerged from the research: (1) pilots avoid discussing mental health issues for fear of repercussions, (2) although resources exist, pilots generally distrust the confidentiality of reporting systems, and (3) pilots honestly believe that reporting any mental health issue will be devastating to their careers. Conclusions Airline companies and the Federal Aviation Administration (FAA) need to change processes and instill a sense of trust in reporting systems among pilots so that they feel safe reporting mental health concerns and receive improved treatment. This can lead to more accurate reporting of conditions andensure safe flight operations.

Cosmic Ionizing Radiation: A DNA Damaging Agent That May Underly Excess Cancer in Flight Crews.

In the United States, the Federal Aviation Administration has officially classified flight crews (FC) consisting of commercial pilots, cabin crew, or flight attendants as "radiation workers" since 1994 due to the potential for cosmic ionizing radiation (CIR) exposure at cruising altitudes originating from solar activity and galactic sources. Several epidemiological studies have documented elevated incidence and mortality for several cancers in FC, but it has not yet been possible to establish whether this is attributable to CIR. CIR and its constituents are known to cause a myriad of DNA lesions, which can lead to carcinogenesis unless DNA repair mechanisms remove them. But critical knowledge gaps exist with regard to the dosimetry of CIR, the role of other genotoxic exposures among FC, and whether possible biological mechanisms underlying higher cancer rates observed in FC exist. This review summarizes our understanding of the role of DNA damage and repair responses relevant to exposure to CIR in FC. We aimed to stimulate new research directions and provide information that will be useful for guiding regulatory, public health, and medical decision-making to protect and mitigate the risks for those who travel by air.

Carotid Intima-Media Thickness, Overweight, and Poor Sleep Quality in Commercial Airline Pilots: A Cross-Sectional Study.

Background Cardiovascular disease is a leading cause of premature career termination in commercial airline pilots (APs). In this cross-sectional study, we sought to investigate the relationship between intima-media thickness (IMT), a marker of subclinical atherosclerosis, and cardiovascular risk factors in APs, focusing on overweight status and sleep quality. Methods A total of 140 male APs were categorized into four groups based on body mass index (BMI) and Pittsburgh Sleep Quality Index (PSQI) score: overweight poor sleepers (OW-PS), overweight good sleepers (OW-GS), normal weight poor sleepers (NW-PS), and normal weight good sleepers (NW-GS). IMT was quantified in the common carotid artery (CCA) and carotid bulb using ultrasound, yielding a composite IMT (IMTcom) measure. Common cardiovascular risk factors were assessed in all participants. Results The prevalence of overweight and poor sleep quality was 43.6% and 32.9%, respectively. The OW-PS group had significantly higher age, heart rate, total cholesterol, and low-density lipoprotein (LDL) cholesterol compared to other groups (p<0.05). Overweight pilots, regardless of sleep quality, had increased IMTcom compared to normal-weight pilots (p<0.001). Age and LDL cholesterol were independent predictors of IMTcom in the OW-PS and OW-GS groups (p<0.05). Conclusions Overweight status, irrespective of sleep quality, is associated with increased IMT in APs, suggesting a higher burden of subclinical atherosclerosis. Interventions focused on reducing LDL cholesterol levels and managing age-related cardiovascular risk factors could be advantageous in mitigating the risk of atherosclerotic vascular disease in overweight pilots.

Reducing flight upset risk and startle response: A study of the wake vortex alert with licensed commercial pilots

The study aimed at investigating the impact of an innovative Wake Vortex Alert (WVA) avionics on pilots' operation and mental states, intending to improve aviation safety by mitigating the risks associated with wake vortex encounters (WVEs). Wake vortices, generated by jet aircraft, pose a significant hazard to trailing or crossing aircrafts. Despite existing separation rules, incidents involving WVEs continue to occur, especially affecting smaller aircrafts like business jets, resulting in aircraft upsets and occasional cabin injuries. To address these challenges, the study focused on developing and validating an alert system that can be presented to air traffic controllers, enabling them to warn flight crews. This empowers the flight crews to either avoid the wake vortex or secure the cabin to prevent injuries. The research employed a multidimensional approach including an analysis of human performance and human factors (HF) issues to determine the potential impact of the alert on pilots' roles, tasks, and mental states. It also utilizes Human Assurance Levels (HALs) to evaluate the necessary human factors support based on the safety criticality of the new system. Realistic flight simulations were conducted to collect data of pilots' behavioural, subjective and neurophysiological responses during WVEs. The data allowed for an objective evaluation of the WVA impact on pilots' operation, behaviour and mental states (mental workload, stress levels and arousal). In particular, the results highlighted the effectiveness of the alert system in facilitating pilots' preparation, awareness and crew resource management (CRM). The results also highlighted the importance of avionics able to enhance aviation safety and reducing risks associated with wake vortex encounters. In particular, we demonstrated how providing timely information and improving situational awareness, the WVA will minimize the occurrence of WVEs and contribute to safer aviation operations.

Practice effects of a breathing technique on pilots’ cognitive and stress associated heart rate variability during flight operations

Commercial pilots endure multiple stressors in their daily and occupational lives which are detrimental to psychological well-being and cognitive functioning. The Quick coherence technique (QCT) is an effective intervention tool to improve stress resilience and psychophysiological balance based on a five-minute paced breathing exercise with heart rate variability (HRV) biofeedback. The current research reports on the application of QCT training within an international airline to improve commercial pilots’ psychological health and support cognitive functions. Forty-four commercial pilots volunteered in a one-month training programme to practise self-regulated QCT in day-to-day life and flight operations. Pilots’ stress index, HRV time-domain and frequency-domain parameters were collected to examine the influence of QCT practice on the stress resilience process. The results demonstrated that the QCT improved psychophysiological indicators associated with stress resilience and cognitive functions, in both day-to-day life and flight operation settings. HRV fluctuations, as measured through changes in RMSSD and LF/HF, revealed that the resilience processes were primarily controlled by the sympathetic nervous system activities that are important in promoting pilots’ energy mobilization and cognitive functions, thus QCT has huge potential in facilitating flight performance and aviation safety. These findings provide scientific evidence for implementing QCT as an effective mental support programme and controlled rest strategy to improve pilots’ psychological health, stress management, and operational performance.

Factors associated with approaching Pilot Peer Support: a cross-sectional study

Abstract Background Pilot Peer Support Programs (PPSP) have been introduced in Europe as a measure to facilitate commercial pilots’ mental health help-seeking in a confidential and non-punitive manner. However, research is scarce regarding what promotes and prevents pilots from approaching PPSP. Aims To investigate if, and in which way, different organizational and individual factors are associated with pilots’ attitudes towards approaching PPSP, and to examine the prevalence of possible cases of depression and anxiety disorders among commercial pilots in Europe. Methods Data were collected using an anonymous web-based survey (n = 4494), covering pilots’ work conditions, health and flight safety. Logistic regression was used to determine the impact of objective and psychosocial work environment factors, mental health factors, and demographic factors. Results Key findings were that just culture (odds ratio [OR] = 2.65, 95% confidence interval [CI] 1.97, 3.56), type of employment (OR = 0.60, 95% CI 0.46, 0.78), minimum guaranteed pay (OR = 1.98, 95% CI 1.48, 2.65), and symptoms of depression (OR = 0.62, 95% CI 0.50, 0.76) and anxiety (OR = 0.66, 95% CI 0.54, 0.80) significantly predicted pilots’ attitude towards approaching PPSP. The prevalence of pilots scoring above threshold for possible depression (18%) and anxiety disorders (23%) were determined. Conclusions Pilot Peer Support in its current form appears to be an insufficient means to facilitate pilots’ mental health help-seeking, but could have an important preventive purpose. The findings could assist authorities and operators in developing measures to facilitate pilots’ help-seeking, and improve mental health and flight safety.

Post-Treatment Effects of Multiple Sclerosis (MS) on the Executive and Memory Functions ofCommercial Pilots in the UAE

Individuals with MS often face challenges in cognitive functioning, particularly in demanding occupations such as commercial flying. This study investigates the post-treatment impact of MS on the memory and executive functions of commercial pilots while working under a busy flying roster. The research aims to understand cognitive changes over time and their implications for onboard safety.Data was collected over two and a half years from a single pilot. Standard assessments were used to evaluate the pilot’s executive and memory functions. A two-way ANOVA table was used for statisticalanalysis. The analysis indicates that there is no significant decline in performance over time for the pilot (p = 0.106447, df = 3). However, there are notable variations among memory and executive function tasks (p &lt; 0.001, df = 7), highlighting specific areas of strength. The null hypothesis there is no decline in pilots’ neurocognitive functions, has been accepted. Additionally, the case study outcomes showed improvement in the pilot's executive and memory functions over two and a half years while maintaining stressful long-haul flight rosters. Future research should focus on understanding the factors driving these variations and exploring interventions to address cognitive weaknesses.

Ethnic Differences in the Prevalence of Compulsive and Histrionic Traits among Pilots in the UAE: A Comparative Study

This study aims to examine the prevalence rates of compulsive and histrionic characteristics among pilots from diverse demographic backgrounds such as South Asian, Middle Eastern, and Western pilots. The research aims to identify differences in personality traits and explore potential correlations within each ethnic group of commercial pilots. The data was provided by sixty pilots, equally representing three different ethnic groups, with twenty participants in each demographic. To collect the data, the researchers used a measuring tool designed to reveal signs of mental disorders, known as the Millon Clinical Multiaxial Inventory (MCMI). According to ANOVA results, there is a notable difference in prevalence rates for compulsive and histrionic traits among the three different ethnic groups (F (2,87) = 4.76, p =0.00057). Overall, the results showed that South Asian pilots had more compulsive traits than Middle Eastern and Western pilots. On the other hand, Middle Eastern pilots were found to have a higher occurrence of histrionic traits compared to their counterparts from South Asia and Westen pilots. The correlation analysis confirmed that there was a substantial link between histrionic and compulsive traits (r = 0.51, p &lt; 0.05). A similar trend was seen for Middle Eastern pilots, where a weakly positive link (r = 0.24, p &lt; 0.05) was visible. On the other hand, the Western pilots showed a weak, inverse correlation between compulsive and histrionic characteristics (r = - 0.14, p&lt;00), displaying unique profiles within this group in terms of their mutual interaction. These results offer a profound understanding of the relationship between ethnicity and personality traits in pilots.

Tactile transformation in flying airplanes: From hands-on to fingers-on aviation

Portable laptops, cell phones, touchscreen equipment and other mobile devices are changing the way commercial airplane pilots are handling information used for flying aircraft. Pilot expertise and skill are being transformed by a new approach in which fingertips are replacing traditional hands-on methods of controlling airplanes. Drawing on participatory and interview methods at a UK airbase, this article draws on ethnographic research with commercial pilots and pilot cadets, to trace the refashioning of cell phone media in an aviation context where touch-based computer screens replace traditional airplane technology. Drawing on Merleau-Ponty’s phenomenology, this article examines how the knowing, sensing and intuition through the hands allows for a particular sort of la prise (grip) which accustoms itself to the emergence of new tactile and human–computer interfaces.

Prevalence and network analysis of internet addiction, depression and their associations with sleep quality among commercial airline pilots: A national survey in China

ObjectiveAirline pilots are members of a unique occupational group that is often confronted with sleep routine disruptions, yet relatively few studies have examined their mental health status. This study assessed the prevalence and network structure of internet addiction, depression and sleep quality problems in commercial airline pilots. MethodA total of 7055 airline pilots were included in analyses. Internet addiction and depression were measured with the Internet Addiction Test (IAT) and 9-item Patient Health Questionnaire (PHQ-9), respectively. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). The network model was constructed based on an Ising model and its association with sleep quality was evaluated using a flow procedure. ResultsInternet addiction, depression and sleep quality were common among airline pilots. The prevalence of internet addiction was 8.0 % (95 % CI: 7.3–8.6 %), while the rates of depression and poor sleep quality were 23.3 % (95 % CI: 22.3–24.2 %) and 33.0 % (95 % CI: 31.9–34.1 %), respectively. In the depression and internet addiction network model, “Fatigue” (PHQ4; Expected Influence (EI): 2.04) and “Depressed/moody/nervous only while being offline” (IAT20; EI: 1.76) were most central symptoms while “Fatigue” (PHQ4; Bridge EI: 1.30) was also the most important bridge symptom. The flow network model of sleep quality with internet addiction and depression showed that “Appetite” (PHQ5) had the strongest positive association with poor sleep quality. ConclusionInternet addiction, depression and sleep quality were common among airline pilots and warrant regular screening and timely treatment. Strategies to improve sleep hygiene may be useful in preventing onsets or exacerbations in depression and internet addiction among airline pilots.

European and US Aeromedical Authority Guidance for Neurocognitive Evaluation of Airline Pilots With Mental Disorders

Abstract: Commercial airline pilots must exhibit specific neurocognitive skills and aptitudes to perform their safety-critical roles. This review addresses neuropsychological assessment in mental disorders derived from guidance developed by European and US aviation authorities as well as indications in the current literature in relation to major depression and suicidality, self-harm, attention-deficit/hyperactivity disorder, posttraumatic stress disorder, and bipolar disorder in aeromedical evaluations. Several studies show that cognitive functioning may be impaired during major depression. The results of neurocognitive assessments provide useful information about a pilot’s performance. Obstacles to referring crew for neuropsychological testing are the paucity of neuropsychological specialists to undertake assessments and aeromedical examiners’ varied training and experience in assessing mental health problems of pilots in general.

Development of a machine learning model for predicting abnormalities of commercial airplanes

Airplanes are a social necessity for movement of humans, goods, and other. They are generally safe modes of transportation; however, incidents and accidents occasionally occur. To prevent aviation accidents, it is necessary to develop a machine-learning model to detect and predict commercial flights using automatic dependent surveillance–broadcast data. This study combined data-quality detection, anomaly detection, and abnormality-classification-model development. The research methodology involved the following stages: problem statement, data selection and labeling, prediction-model development, deployment, and testing. The data labeling process was based on the rules framed by the international civil aviation organization for commercial, jet-engine flights and validated by expert commercial pilots. The results showed that the best prediction model, the quadratic-discriminant-analysis, was 93% accurate, indicating a “good fit”. Moreover, the model’s area-under-the-curve results for abnormal and normal detection were 0.97 and 0.96, respectively, thus confirming its “good fit”.

Commercial airline pilots' job satisfaction before and during the COVID-19 pandemic: A comparative study

The impact of the COVID-19 pandemic on the world's commercial aviation industry was unprecedented. National lockdowns and border closures effectively prohibited passenger air travel. Airlines responded by reducing operations, parking aircraft and making staff, including pilots, redundant. This research aims to examine the impact of COVID-19 on commercial airline pilots' job satisfaction before and during the pandemic and identify the workplace factors that affect it. Empirical data was gathered via an online survey which was distributed to members of three commercial airline pilot unions in Europe and Australasia in November 2021. 346 complete responses were received. Using Herzberg's 16 workplace factors as a theoretical frame for the survey and subsequent analysis, the findings showed that, overall, job satisfaction decreased during the pandemic. The largest effect sizes were observed for Salary, Job Security and Working Conditions while the smallest effect sizes were observed for Impacts on Personal Life, Responsibility and Recognition. The importance of effective communication between airline management and pilots was highlighted. The findings and recommendations regarding employee compensation, benefits and support packages are of relevance not only to airlines but also to other transport and economic sectors facing future disruptive events.

Probiotic Supplementation With Saccharomyces boulardii and Enterococcus faecium Improves Gastric Pain and Bloating in Airline Pilots With Chronic Non-atrophic Gastritis: An Open-Label Study.

Background Commercial airline pilots (APs) are prone to upper gastrointestinal symptoms, such as epigastric pain and bloating. These issues are often linked to occupational risk factors like irregular diet, sleep disruption, and circadian rhythm disturbance. The use of probiotics to enhance intestinal health is well established, but their efficacy in treating upper gastrointestinal diseases is still debated. This is primarily due to the stomach's small resident microbiota and its low pH, which is inhospitable to most microbes. However, emerging research suggests that specific probiotic strains, such as Enterococcus faecium, can withstand acidic environments. Moreover, certain yeast species, including Saccharomyces boulardii, can survive at a low pH. Consequently, we conducted a preliminary, three-arm, randomized, open-label, dose-finding, four-week study to compare the effects of watchful waiting (WW) with the administration of an oral probiotic supplement containing S. boulardii and E. faecium in APs diagnosed with Helicobacter pylori-negative chronic non-atrophic gastritis (CNG). Methods The study included 39 APs with CNG who were randomized into three groups with a 1:1:1 ratio. The low-dose group (n = 13) received one capsule of the probiotic supplement twice daily, before meals, for four weeks. The high-dose group (n = 13) was administered two capsules of the supplement on the same schedule. The third group (n = 13) underwent WW and served as the control arm. Blinding was maintained for the examining physicians and laboratory staff, but not for the patients. All participants self-rated their experiences of gastric pain and bloating at the beginning and conclusion of the four-week treatment period. Additionally, serum levels of pepsinogen I (PGI) and pepsinogen II (PGII) were measured at these time points. Results Supplementation with probiotics significantly outperformed WW in reducing subjective gastric pain and bloating. This effect was consistent across both tested dosages, with no significant differences observed. However, only high-dose probiotics led to a statistically significant decrease in PGII levels and an increase in the PGI/PGII ratio after the four-week study period, a result not observed with low-dose probiotics. Conclusions Oral administration of S. boulardii and E. faecium demonstrated potential efficacy in reducing gastric pain and bloating symptoms in APs with CNG, as evidenced by statistically significant symptom improvement compared to the control group that did not receive the probiotic supplementation. Notably, high-dose probiotics resulted in a significant increase in the PGI/PGII ratio, indicating potential long-term cytoprotective effects on the gastric mucosa.

The effect of job stress on the quality of life of commercial pilots: Testing the mediating effects of mindfulness and job satisfaction

AbstractThe commercial pilots responsible for aircraft and passenger safety are exposed to various environmental job stresses. This study investigates the relationship between job stress and the quality of life of commercial pilots, and examines the mediating effects of mindfulness and job satisfaction in the relationship between job stress and quality of life. The results show that the job stress aced by commercial pilots has a negative impact on quality of life, and that mindfulness and job satisfaction partially mediates this stress. However, despite the mediating effects of mindfulness and job satisfaction, there is a need for a way to reduce job stress more directly. These results indicate the need for various strategies, including direct and indirect methods, to reduce job stress among commercial pilots, as this is directly related to safety.