Aeromedical Implications of Long-Term COVID-19 Sequelae

BACKGROUND: While many COVID-19 studies focus on acute effects of the infection, few examine the intermediate and long-term sequelae of the illness. Studies have shown that a good portion of patients have chronic effects in several body systems for several months or longer. Such effects can potentially adversely impact pilot performance in flight. We sought to determine the long-term effects of COVID-19 infection, how such effects can affect pilot performance, and how to best evaluate pilots for aeromedical flight clearance.METHODS: We used the PubMed literature search engine to review peer-reviewed articles that focused on the intermediate and long-term effects of COVID-19 infection. Chronic signs and symptoms were subdivided based on the particular body organ system affected. Merging information obtained from case reviews, article reviews, and aeromedical standards, we created a risk stratification guide to assist with the aeromedical disposition of affected pilots.RESULTS: Long-term effects of COVID-19 infection can last for several months or longer. The most common effects are fatigue, weakness, pulmonary diffusion defects, depression, and anxiety.DISCUSSION: This review article focuses on the most common intermediate- and long-term COVID-19 conditions of aeromedical significance and the corresponding course of actions recommended for the aeromedical examiner. Aeromedical evaluation should take into consideration factors related to the pilot, aircraft type, and specific aviation environment. Such evaluation may include diagnostic testing, medical specialist consultation, preflight simulation in an altitude chamber, human centrifuge testing, and/or a flight simulator checkride.Ko SY, Nguyen NK, Lee CL, Lee LA, Nguyen KUT, Lee EC. Aeromedical implications of long-term COVID-19 sequelae. Aerosp Med Hum Perform. 2021; 92(11):898-907.

Situation Awareness Adaptive Alerting in an Aircraft Cockpit: A Simulator Study

The goal of this study was to develop an automated cockpit support system that is adaptive to the flight crew’s situation awareness (SA) estimated by online gaze analysis. Flight crew errors are often attributed to low SA. Online measurement of SA could be used to automatically guide the user’s attention for the sake of fewer errors and better performance.An eye-tracking based measure for SA was developed and used for the adaptive generation of alerts in a flight simulator. In an experiment, ten certified pilots conducted two trials with no and adaptive alerting. The experimental task involved tracking of flight parameters which were partially disturbed or changed at random times. Our online estimation of SA showed a strong correlation with observed pilot performance. With adaptive alerts, the average performance increased in those experimental tasks, where a situational change could not be predicted by participants. Also, adaptive alerts improved change detection and reduced the number of outliers, where a change was not noticed for an exceptionally long time. However, subjective rating was poor due to low transparency and false positives. SA-adaptive support can improve change detection performance in typical tasks on the flight deck. For a greater acceptance, pilots should be trained to understand the adaption policy.

292 Rest Schemes and Inflight Sleep Duration on Long Range and Ultra-Long Range Commercial Airline Routes

Introduction Pilots flying long range (LR; 8-16 hour) and ultra-long range (ULR; 16+ hour on 10% of trips) commercial airline routes use a variety of work/rest schedules during flights, resulting in a wide distribution of total inflight sleep time (TIFS) amounts. Since sleep is a strong predictor of performance, it is important to quantify TIFS and determine rest scheme patterns that optimize sleep opportunity and subsequent alertness and performance. Here we report rest schemes for pilots on LR and ULR routes and longer TIFS values than previously reported. These rest schemes can serve as templates to increase TIFS and improve pilot performance, particularly on ULR routes. Methods 427 commercial airline pilots provided data for this sub-study that was part of a larger study on Fatigue Risk Management System (FRMS) routes. Inflight sleep timing and duration were measured on 3 LR and 5 ULR routes. Inflight sleep times were self-reported in a sleep/work logbook and verified using actigraphy. Results Most outbound and inbound landing crews took one break during the second half of the flight (average LR TIFS=4.0 hr; average ULR TIFS=4.9 hr), while most outbound and inbound relief crews consequently took one break during the first half of the flight (average LR TIFS=3.5 hr; average ULR TIFS=4.5 hr). However, three of the five ULR routes used more complex split rest schemes for landing and relief crews, primarily on outbound flights (average TIFS=5.0 hr). Across all routes and both crews, the maximum average TIFS reached ~6 hours. Conclusion Our results indicate that pilots on average are sleeping inflight more than previous studies demonstrated. Additionally, we found that crews on some ULR flights used more complicated rest schemes, but still generally preferred 2 or 3 breaks. These findings have implications for airline procedures and aviation policies by showing that pilots may be sleeping longer than originally expected on LR and ULR flights. Recommending rest schemes that allow for the greatest inflight sleep opportunity may provide the best chance for inflight recuperation, especially before the Top of Descent critical phase of flight. Support (if any) United Airlines

Correlation Between Physiological and Performance-Based Metrics to Estimate Pilots' Cognitive Workload

This paper discusses the utilization of pilots' physiological indications such as electroencephalographic (EEG) signals, ocular parameters, and pilot performance-based quantitative metrics to estimate cognitive workload. The study aims to derive a non-invasive technique to estimate pilot's cognitive workload and study their correlation with standard physiological parameters. Initially, we conducted a set of user trials using well-established psychometric tests for evaluating the effectiveness of pupil and gaze-based ocular metrics for estimating cognitive workload at different levels of task difficulty and lighting conditions. Later, we conducted user trials with the NALSim flight simulator using a business class Learjet aircraft model. We analyzed participants' ocular parameters, power levels of different EEG frequency bands, and flight parameters for estimating variations in cognitive workload. Results indicate that introduction of secondary task increases pilot's cognitive workload significantly. The beta frequency band of EEG, nearest neighborhood index specifying distribution of gaze fixation, L1 Norm of power spectral density of pupil diameter, and the duty cycle metric indicated variations in cognitive workload.

Wireline Retrievable ESP Deployment: Observation, Challenges and Intervention

The Offshore Field X Project comprises of greenfield scope to expand the Waterflood scheme towards delivering the peak production levels similar to those achieved in the 1990s. Although various artificial lift systems have been successfully deployed in Brunei Shell Petroleum, offshore ESP installation, especially on this scale, is a first and a new journey for the company and its Offshore Assets in which gas lift was predominantly the artificial lift method. The first offshore ESP well was only installed and kicked off in 2017 as part of the Field X Project. As wells are located offshore, cost, resources and logistics remain a challenge for well interventions. With a high workover cost associated with conventional ESP change out, a technology trial was embarked upon to install wireline retrievable ESP systems. A total of 4 out of the 22 ESP wells were approved to be installed and completed with wireline retrievable ESP system on a pilot basis. The business goal was to prove the production deferment reduction and cost advantage for a failed ESP replacement. A critical selection process was followed as well as FAT/industry benchmarking in order to land on WRESP decision for the pilot. System installation and commissioning of the wells was completed by June 2019, however a series of start-up problems were encountered, leading to an intervention requirement to rectify 1 well. Job planning for this intervention was not straight forward and was classified as a high-risk job requiring regulator's approval. Rigorous logistics planning, integration of various vendors, detailed workflow analysis, intervention equipment stack up and modifications were among the planning scope conducted. This paper captures details of the deployment value proposition, case success definition and challenges faced in ensuring all the installed WRESPs are up and running to enable the pilot performance proper evaluation. As no full workover has been executed yet due to the limited operating period, a lifecycle comparison between WL retrievable and conventional ESPs has not been done yet. Once sufficient performance data is available, a detailed study will be conducted to assess the performance of the WRESP system. This analysis will then conclude the technology trial and may change the future of ESP wells in BSP and Shell global.

The effect of work environment and individual characteristics on pilot performance with professionalism as an intervening variable

This study aims to analyze the influence of the work environment on professionalism, analyzing the effect of individual characteristics on professionalism, analyzing the effect of professionalism on pilot performance, analyzing the influence of the work environment on pilot performance with professionalism as an intervening variable and analyzing the influence of individual characteristics on pilot performance in Lion Air with professionalism as an intervening variable. The number of samples in this study were 165 respondents. The data analysis technique used path analysis. The results of the analysis show that the work environment has an effect on professionalism. Individual characteristics affect professionalism. The work environment affects pilot performance. Individual characteristics have an effect on pilot performance. The work environment affects the pilot's performance with professionalism as an intervening variable. Individual characteristics affect pilot performance with professionalism as an intervening variable.