Integrating physiological monitoring systems in military aviation: a brief narrative review of its importance, opportunities, and risks

References

• Aebi, Mathias R., N. Bourdillon, A. Kunz, D. Bron, and G. P. Millet. 2020. “Specific Effect of Hypobaria on Cerebrovascular Hypercapnic Responses in Hypoxia.” Physiological Reports 8 (4): 1–13. doi:10.14814/phy2.14372.
   Web of Science ®Google Scholar
• Aebi, Mathias Roland, N. Bourdillon, D. Bron, and G.P. Millet. 2020. “Minimal Influence of Hypobaria on Heart Rate Variability in Hypoxia and Normoxia.” Frontiers in Physiology 11: 1072. doi:10.3389/fphys.2020.01072.
   PubMed Web of Science ®Google Scholar
• AFIC. 2022. AIR STD 3010 Aviation Medicine Physiological Training of Aircrew.
   Google Scholar
• Ainslie, P. N., R. L. Hoiland, and D. M. Bailey. 2016. “Lessons from the Laboratory; Integrated Regulation of Cerebral Blood Flow during Hypoxia.” Experimental Physiology 101 (9): 1160–1166. doi:10.1113/ep085671.
   PubMedGoogle Scholar
• Ånell, R., M. Grönkvist, M. Gennser, and O. Eiken. 2020. “Evolution and Preservation of Venous Gas Emboli at Alternating High and Moderate Altitude Exposures.” Aerospace Medicine and Human Performance 91 (1): 11–17. doi:10.3357/AMHP.5579.2020.
   PubMed Web of Science ®Google Scholar
• Ånell, R., M. Grönkvist, M. Gennser, and O. Eiken. 2021. “High-Altitude Decompression Strain Can Be Reduced by an Early Excursion to Moderate Altitude While Breathing Oxygen.” European Journal of Applied Physiology 121 (11): 3225–3232. doi:10.1007/s00421-021-04794-2.
   PubMed Web of Science ®Google Scholar
• Azizan, A., M. Fard, M. F. Azari, and R. Jazar. 2017. “Effects of Vibration on Occupant Driving Performance under Simulated Driving Conditions.” Applied Ergonomics 60: 348–355. doi:10.1016/j.apergo.2016.12.020.
   PubMed Web of Science ®Google Scholar
• Bak, Z., F. Sjöberg, A. Rousseau, I. Steinvall, and B. Janerot-Sjoberg. 2007. “Human Cardiovascular Dose-Response to Supplemental Oxygen.” Acta Physiologica 191 (1): 15–24. doi:10.1111/j.1748-1716.2007.01710.x.
   PubMed Web of Science ®Google Scholar
• Ballard, M. T., A. M. Madison, and V. C. Chancey. 2020. Human Response Effects to Whole-Body Vibration in Aviation: A Brief Review.
   Google Scholar
• Banks, R., J. Grissett, P. Saunders, and A. Mateczun. 1995. “The Effect of Varying Time at − Gz on Subsequent + Gz Physiological Tolerance (Push-Pull Effect).” Aviation, Space, and Environmental Medicine 66 (8): 723–727.
   PubMedGoogle Scholar
• Becker, H. F., O. Polo, S. G. Mcnamara, M. Berthon-Jones, and C.E. Sullivan. 1996. “Effect of Different Levels of Hyperoxia on Breathing in Healthy Subjects.” Journal of Applied Physiology 81 (4): 1683–1690. doi:10.1152/jappl.1996.81.4.1683.
   PubMed Web of Science ®Google Scholar
• Besch, E. L., P. M. Werchan, J. F. Wiegman, T. E. Nesthus, and A.R. Shahed. 1994. “Effect of Hypoxia and Hyperoxia on Human + G(z) Duration Tolerance.” Journal of Applied Physiology 76 (4): 1693–1700. doi:10.1152/jappl.1994.76.4.1693.
   PubMed Web of Science ®Google Scholar
• Bloch-Salisbury, E., R. Lansing, and S. A. Shea. 2000. “Acute Changes in Carbon Dioxide Levels Alter the Electroencephalogram without Affecting Cognitive Function.” Psychophysiology 37 (4): 418–426. doi:10.1017/S0048577200981198.
   PubMed Web of Science ®Google Scholar
• Borges, J. B., G. Hedenstierna, J. S. Bergman, M. B. P. Amato, J. Avenel, and S. Montmerle-Borgdorff. 2015. “First-Time Imaging of Effects of Inspired Oxygen Concentration on Regional Lung Volumes and Breathing Pattern during Hypergravity.” European Journal of Applied Physiology 115 (2): 353–363. doi:10.1007/s00421-014-3020-9.
   PubMed Web of Science ®Google Scholar
• Botek, M., J. Krejčí, S. De Smet, A. Gába, and A. J. McKune. 2015. “Heart Rate Variability and Arterial Oxygen Saturation Response during Extreme Normobaric Hypoxia.” Autonomic Neuroscience: Basic & Clinical 190: 40–45. doi:10.1016/j.autneu.2015.04.001.
   PubMed Web of Science ®Google Scholar
• Bovenzi, M., and C. T. J. Hulshof. 1999. “An Updated Review of Epidemiologic Studies on the Relationship between Exposure to Whole-Body Vibration and Low Back Pain (1986–1997).” International Archives of Occupational and Environmental Health 72 (6): 351–365. doi:10.1007/s004200050387.
   PubMed Web of Science ®Google Scholar
• Brothers, R. M., J. E. Wingo, K. A. Hubing, and C. G. Crandall. 2009. “The Effects of Reduced End-Tidal Carbon Dioxide Tension on Cerebral Blood Flow during Heat Stress.” The Journal of Physiology 587 (Pt 15): 3921–3927. doi:10.1113/jphysiol.2009.172023.
   PubMed Web of Science ®Google Scholar
• Brown, S., M. J. Barnes, and T. Mündel. 2014. “Effects of Hypoxia and Hypercapnia on Human HRV and Respiratory Sinus Arrhythmia.” Acta Physiologica Hungarica 101 (3): 263–272. doi:10.1556/APhysiol.101.2014.3.1.
   PubMedGoogle Scholar
• Bruce-Low, S. S., D. Cotterrell, and G. E. Jones. 2006. “Heart Rate Variability during High Ambient Heat Exposure.” Aviation, Space, and Environmental Medicine 77 (9): 915–920.
   PubMedGoogle Scholar
• Brunyé, T. T., K. Yau, K. Okano, G. Elliott, S. Olenich, G. E. Giles, E. Navarro, S. Elkin-Frankston, A. L. Young, and E. L. Miller. 2021. “Toward Predicting Human Performance Outcomes from Wearable Technologies: A Computational Modeling Approach.” Frontiers in Physiology 12: 738973. doi:10.3389/fphys.2021.738973.
   PubMed Web of Science ®Google Scholar
• Burrell, C., R. J. Love, S. Stergiopoulos, and D. T. R. Centre. 2016. Integrated Physiological Monitoring. Defence Research and Development Canada Scientific Report, DRDC-RDDC-2016-R207, 1–54. http://cradpdf.drdc-rddc.gc.ca/PDFS/unc256/p804911_A1b.pdf
   Google Scholar
• Caldwell, J. A., J. L. Caldwell, L. A. Thompson, and H. R. Lieberman. 2019. “Fatigue and Its Management in the Workplace.” Neuroscience and Biobehavioral Reviews 96: 272–289. doi:10.1016/j.neubiorev.2018.10.024.
   PubMed Web of Science ®Google Scholar
• Cable, G.G. 2003. “In-Flight Hypoxia Incidents in Military Aircraft: Causes and Implications for Training.” Aviation, space, and environmental medicine 74 (2):169–72
   Google Scholar
• Chen, H. 1991. “Effect of 30-h Sleep Loss on Cardiorespiratory Functions at Rest and in Exercise.” Medicine and Science in Sports and Exercise 23 (2): 193–198.
   PubMed Web of Science ®Google Scholar
• Cheng, H. L. M. 2012. “Effect of Hyperoxia and Hypercapnia on Tissue Oxygen and Perfusion Response in the Normal Liver and Kidney.” PLOS One 7 (7): e40485. doi:10.1371/journal.pone.0040485.
   PubMed Web of Science ®Google Scholar
• Connolly, D. M., V.M. Lee, A. S. McGown, and N. D. C. Green. 2021. “Hypoxia-Like Events in UK Typhoon Aircraft from 2008 to 2017.” Aerospace Medicine and Human Performance 92 (4): 257–264. doi:10.3357/AMHP.5719.2021.
   PubMed Web of Science ®Google Scholar
• Conway, G. E., J. L. Szalma, and P. A. Hancock. 2007. “A Quantitative Meta-Analytic Examination of Whole-Body Vibration Effects on Human Performance.” Ergonomics 50 (2): 228–245. doi:10.1080/00140130600980888.
   PubMed Web of Science ®Google Scholar
• Coppel, J., P. Hennis, E. Gilbert-Kawai, and M. P. Grocott. 2015. “The Physiological Effects of Hypobaric Hypoxia versus Normobaric Hypoxia: A Systematic Review of Crossover Trials.” Extreme Physiology & Medicine 4 (1): 2–20. doi:10.1186/s13728-014-0021-6.
   PubMedGoogle Scholar
• Costello, J. T., M. Wilkes, and M. J. Tipton. 2021. “From Pigeon Holes to Descending Spirals: A Paradigm of Physiology, Cognitive Performance and Behaviour in Extreme Environments.” Experimental Physiology 106 (9): 1863–1864. doi:10.1113/ep089938.
   PubMed Web of Science ®Google Scholar
• Damato, E. G., T. A. Flak, R. S. Mayes, K. P. Strohl, A. M. Ziganti, A. Abdollahifar, C. A. Flask, J. C. LaManna, and M. J. Decker. 2020. “Neurovascular and Cortical Responses to Hyperoxia: Enhanced Cognition and Electroencephalographic Activity despite Reduced Perfusion.” The Journal of Physiology 598 (18): 3941–3956. doi:10.1113/JP279453.
   PubMed Web of Science ®Google Scholar
• Dettoni, J. L., F. M. Consolim-Colombo, L. F. Drager, M. C. Rubira, S. B. P. C. De Souza, M. C. Irigoyen, C. Mostarda, S. Borile, E. M. Krieger, H. Moreno, and G. Lorenzi-Filho. 2012. “Cardiovascular Effects of Partial Sleep Deprivation in Healthy Volunteers.” Journal of Applied Physiology 113 (2): 232–236. doi:10.1152/japplphysiol.01604.2011.
   PubMed Web of Science ®Google Scholar
• Dongen, H. P. A. Van, G. Maislin, J. M. Mullington, and D. F. Dinges. 2003. “The Cumulative Cost of Additional Wakefulness: Dose-Response Effects on Neurobehavioral Functions and Sleep Physiology from Chronic Sleep Restriction and Total Sleep Deprivation.” Sleep 26 (2): 117–126. doi:10.1093/sleep/26.2.117.
   PubMed Web of Science ®Google Scholar
• Dussault, C., E. Gontier, C. Verret, M. Soret, A. Boussuges, G. Hedenstierna, and S. Montmerle-Borgdorff. 2016. “Hyperoxia and Hypergravity Are Independent Risk Factors of Atelectasis in Healthy Sitting Humans: A Pulmonary Ultrasound and SPECT/CT Study.” Journal of Applied Physiology 121 (1): 66–77. doi:10.1152/japplphysiol.00085.2016.
   PubMed Web of Science ®Google Scholar
• Eiken, O., E. Bergsten, and M. Grönkvist. 2011. “G-Protection Mechanisms Afforded by the Anti-G Suit Abdominal Bladder with and without Pressure Breathing.” Aviation, Space, and Environmental Medicine 82 (10): 972–977. doi:10.3357/asem.3058.2011.
   PubMedGoogle Scholar
• Eiken, O., and M. Grönkvist. 2013. “Signs and Symptoms during Supra-Tolerance + Gz Exposures, with Reference to G-Garment Failure.” Aviation, Space, and Environmental Medicine 84 (3): 196–205. doi:10.3357/asem.3436.2013.
   PubMedGoogle Scholar
• Eiken, O., M. E. Keramidas, N. A. S. Taylor, and M. Grönkvist. 2017. “Intraocular Pressure and Cerebral Oxygenation during Prolonged Headward Acceleration.” European Journal of Applied Physiology 117 (1): 61–72. doi:10.1007/s00421-016-3499-3.
   PubMed Web of Science ®Google Scholar
• Elliott, J. J., and D. R. Schmitt. 2019. “Unexplained Physiological Episodes.” Air & Space Power 15–32.
   Google Scholar
• Elvsåshagen, T., H. J. Mutsaerts, N. Zak, L. B. Norbom, S. H. Quraishi, P. Pedersen, U. F. Malt, L. T. Westlye, E. J. van Someren, A. Bjørnerud, and I.R. Groote. 2019. “Cerebral Blood Flow Changes after a Day of Wake, Sleep, and Sleep Deprivation.” NeuroImage 186: 497–509. doi:10.1016/j.neuroimage.2018.11.032.
   PubMed Web of Science ®Google Scholar
• Epstein, Y., A. Druyan, and Y. Heled. 2012. “Heat Injury Prevention – A Military Perspective.” Journal of Strength and Conditioning Research 26 (Supplement 2): S82–S86. doi:10.1519/JSC.0b013e31825cec4a.
   PubMedGoogle Scholar
• Friend, A. T., G. M. Balanos, and S. J. E. Lucas. 2019. “Isolating the Independent Effects of Hypoxia and Hyperventilation‐Induced Hypocapnia on Cerebral Haemodynamics and Cognitive Function.” Experimental Physiology 104 (10): 1482–1493. doi:10.1113/EP087602.
   PubMed Web of Science ®Google Scholar
• Gibb, R. W., and W. Olson. 2008. “Classification of Air Force Aviation Accidents: Mishap Trends and Prevention.” The International Journal of Aviation Psychology 18 (4): 305–325. doi:10.1080/10508410802346913.
   Web of Science ®Google Scholar
• Gole, Y., O. Gargne, M. Coulange, J.-G. Steinberg, M. Bouhaddi, Y. Jammes, J. Regnard, and A. Boussuges. 2011. “Hyperoxia-Induced Alterations in Cardiovascular Function and Autonomic Control during Return to Normoxic Breathing.” European Journal of Applied Physiology 111 (6): 937–946. doi:10.1007/s00421-010-1711-4.
   PubMed Web of Science ®Google Scholar
• Hayes, A. M., L. A. Temme, and P. M. S. Onge. 2020. Hyperoxia as a Cognitive Enhancement Tool: An Annotated Bibliography. United States Army Aeromedical Research Laboratory.
   Google Scholar
• Hill, J. R., and B. S. Caldwell. 2022. “Assessment of Physiological Responses during Field Science Task Performance: Feasibility and Future Needs.” Frontiers in Physiology 13: 779873. doi:10.3389/fphys.2022.779873.
   PubMed Web of Science ®Google Scholar
• Hoiland, R. L., A. R. Bain, M. G. Rieger, D. M. Bailey, and P. N. Ainslie. 2016. “Hypoxemia, Oxygen Content, and the Regulation of Cerebral Blood Flow.” American Journal of Physiology. Regulatory, Integrative and Comparative Physiology 310 (5): R398–R413. doi:10.1152/ajpregu.00270.2015.
   PubMed Web of Science ®Google Scholar
• Hood, W. B. Jr., R. H. Murray, C. W. Urschel, J. A. Bowers, and J. G. Clark. 1966. “Cardiopulmonary Effects of Whole-Body Vibration in Man.” Journal of Applied Physiology 21 (6): 1725–1731. doi:10.1152/jappl.1966.21.6.1725.
   PubMed Web of Science ®Google Scholar
• Hormeño-Holgado, A. J., and V. J. Clemente-Suárez. 2019. “Effect of Different Combat Jet Manoeuvres in the Psychophysiological Response of Professional Pilots.” Physiology & Behavior 208: 112559. doi:10.1016/j.physbeh.2019.112559.
   PubMed Web of Science ®Google Scholar
• Ito, H., I. Kanno, M. Ibaraki, J. Hatazawa, and S. Miura. 2003. “Changes in Human Cerebral Blood Flow and Cerebral Blood Volume during Hypercapnia and Hypocapnia Measured by Positron Emission Tomography.” Journal of Cerebral Blood Flow & Metabolism 23 (6): 665–670. doi:10.1097/01.WCB.0000067721.64998.F5.
   PubMed Web of Science ®Google Scholar
• Jiao, K., Z. Li, M. Chen, C. Wang, and S. Qi. 2004. “Effect of Different Vibration Frequencies on Heart Rate Variability and Driving Fatigue in Healthy Drivers.” International Archives of Occupational and Environmental Health 77 (3): 205–212. doi:10.1007/s00420-003-0493-y.
   PubMed Web of Science ®Google Scholar
• Johnson, J., A. Mannberg, J. Hendrikx, A. Hetland, and M. Stephensen. 2020. “Rethinking the Heuristic Traps Paradigm in Avalanche Education: Past, Present and Future.” Cogent Social Sciences 6 (1): 1–18. doi:10.1080/23311886.2020.1807111.
   Web of Science ®Google Scholar
• Kizuk, S. A. D., W. Vuong, J. E. MacLean, C. T. Dickson, and K.E. Mathewson. 2019. “Electrophysiological Correlates of Hyperoxia during Resting‐State EEG in Awake Human Subjects.” Psychophysiology 56 (10): e13401. doi:10.1111/psyp.13401.
   PubMed Web of Science ®Google Scholar
• Kjellberg, A., and B. O. Wikström. 1985. “Whole-Body Vibration: Exposure Time and Acute Effects–A Review.” Ergonomics 28 (3): 535–544. doi:10.1080/00140138508963168.
   PubMed Web of Science ®Google Scholar
• Kobayashi, A., A. Tong, and A. Kikukawa. 2002. “Pilot Cerebral Oxygen Status during Air-to-Air Combat Maneuvering.” Aviation Space and Environmental Medicine 73 (9): 919–924.
   PubMedGoogle Scholar
• Kraaier, V., A. C. Van Huffelen, and G. H. Wieneke. 1988. “Quantitative EEG Changes Due to Hypobaric Hypoxia in Normal Subjects.” Electroencephalography and Clinical Neurophysiology 69 (4): 303–312. doi:10.1016/0013-4694(88)90002-8.
   PubMedGoogle Scholar
• Krejčí, J., M. Botek, and A. J. McKune. 2018. “Dynamics of the Heart Rate Variability and Oxygen Saturation Response to Acute Normobaric Hypoxia within the First 10 Min of Exposure.” Clinical Physiology and Functional Imaging 38 (1): 56–62. doi:10.1111/cpf.12381.
   PubMed Web of Science ®Google Scholar
• Kutilek, P., P. Volf, J. Hejda, P. Smrcka, J. Adolf, V. Krivanek, L. Lhotska, K. Hana, R. Doskocil, J. Kacer, and L. Cicmanec. 2019. “Non-Contact Measurement Systems for Physiological Data Monitoring of Military Pilots during Training on Simulators: Review and Application.” 2019 International Conference on Military Technologies (ICMT), 1–6. doi:10.1109/miltechs.2019.8870115.
   Google Scholar
• Lamb, T. W., and S. M. Tenney. 1966. “Nature of Vibration Hyperventilation.” Journal of Applied Physiology 21 (2): 404–410. doi:10.1152/jappl.1966.21.2.404.
   PubMed Web of Science ®Google Scholar
• Lambert, L. L., M. B. Baldwin, C. V. Gonzalez, G. R. Lowe, and J. R. Willis. 2018. “Accuracy of Transcutaneous CO2 Values Compared with Arterial and Capillary Blood Gases.” Respiratory Care 63 (7): 907–912. doi:10.4187/respcare.05936.
   PubMed Web of Science ®Google Scholar
• Lambertsen, C. J., R. H. Kough, D. Y. Cooper, G. L. Emmel, H. H. Loeschcke, and C. F. Schmidt. 1953. “Oxygen Toxicity. Effects in Man of Oxygen Inhalation at 1 and 3.5 Atmospheres upon Blood Gas Transport, Cerebral Circulation and Cerebral Metabolism.” Journal of Applied Physiology 5 (9): 471–486. doi:10.5005/jp/books/12678_10.
   PubMed Web of Science ®Google Scholar
• Leonhardt, S., L. Leicht, and D. Teichmann. 2018. “Unobtrusive Vital Sign Monitoring in Automotive Environments—A Review.” Sensors 18 (9): 3080–3038. doi:10.3390/s18093080.
   PubMed Web of Science ®Google Scholar
• Lieberman, H. R. 2007. “Hydration and Cognition: A Critical Review and Recommendations for Future Research.” Journal of the American College of Nutrition 26 (sup5): 555S–561S. doi:10.1080/07315724.2007.10719658.
   PubMed Web of Science ®Google Scholar
• Lim, Y., A. Gardi, R. Sabatini, S. Ramasamy, T. Kistan, N. Ezer, J. Vince, and R. Bolia. 2018. “Avionics Human-Machine Interfaces and Interactions for Manned and Unmanned Aircraft.” Progress in Aerospace Sciences 102: 1–46. doi:10.1016/j.paerosci.2018.05.002.
   Web of Science ®Google Scholar
• Liu, J., A. Gardi, S. Ramasamy, Y. Lim, and R. Sabatini. 2016. “Cognitive Pilot-Aircraft Interface for Single-Pilot Operations.” Knowledge-Based Systems 112: 37–53. doi:10.1016/j.knosys.2016.08.031.
   Web of Science ®Google Scholar
• Lund, V. E., E. Kentala, H. Scheinin, J. Klossner, H. Helenius, K. Sariola-Heinonen, and J. Jalonen. 1999. “Heart Rate Variability in Healthy Volunteers during Normobaric and Hyperbaric Hyperoxia.” Acta Physiologica Scandinavica 167 (1): 29–35. doi:10.1046/j.1365-201x.1999.00581.x.
   PubMedGoogle Scholar
• Maikala, R. V., S. King, and Y. N. Bhambhani. 2005. “Cerebral Oxygenation and Blood Volume Responses to Seated Whole-Body Vibration.” European Journal of Applied Physiology 95 (5–6): 447–453. doi:10.1007/s00421-005-0013-8.
   PubMed Web of Science ®Google Scholar
• Maikala, R. V., S. King, and Y. N. Bhambhani. 2006. “Acute Physiological Responses in Healthy Men during Whole-Body Vibration.” International Archives of Occupational and Environmental Health 79 (2): 103–114. doi:10.1007/s00420-005-0029-8.
   PubMed Web of Science ®Google Scholar
• Marczak, M., and M. Pokorski. 2004. “Oxygen Breathing and Ventilation.” Journal of Physiology and Pharmacology 55 (1 I): 127–134.
   PubMed Web of Science ®Google Scholar
• Mattos, J. D., M. O. Campos, M. P. Rocha, D. E. Mansur, H. N. M. Rocha, V. P. Garcia, G. Batista, T. S. Alvares, G. V. Oliveira, M. V. Souza, R. L. R. Videira, N. G. Rocha, N. H. Secher, A. C. L. Nóbrega, and I. A. Fernandes. 2019. “Human Brain Blood Flow and Metabolism during Isocapnic Hyperoxia: The Role of Reactive Oxygen Species.” The Journal of Physiology 597 (3): 741–755. doi:10.1113/JP277122.
   PubMed Web of Science ®Google Scholar
• McSwain, S. D., D. S. Hamel, P. B. Smith, M. A. Gentile, S. Srinivasan, J. N. Meliones, and I. M. Cheifetz. 2010. “End-Tidal and Arterial Carbon Dioxide Measurements Correlate across All Levels of Physiologic Dead Space.” Respiratory Care 55 (3): 288–293.
   PubMed Web of Science ®Google Scholar
• Millet, G. Y., M. Muthalib, M. Jubeau, P. B. Laursen, and K. Nosaka. 2012. “Severe Hypoxia Affects Exercise Performance Independently of Afferent Feedback and Peripheral Fatigue.” Journal of Applied Physiology 112 (8): 1335–1344. doi:10.1152/japplphysiol.00804.2011.
   PubMed Web of Science ®Google Scholar
• Miyata, S., A. Noda, N. Ozaki, Y. Hara, M. Minoshima, K. Iwamoto, M. Takahashi, T. Iidaka, and Y. Koike. 2010. “Insufficient Sleep Impairs Driving Performance and Cognitive Function.” Neuroscience Letters 469 (2): 229–233. doi:10.1016/j.neulet.2009.12.001.
   PubMed Web of Science ®Google Scholar
• National Aeronautics and Space Administration. 2020. NASA Engineering and Safety Center Technical Assessment Report Volume I Pilot Breathing Assessment. https://www.nasa.gov/sites/default/files/atoms/files/nesc-rp-18-01320_v.1.2_nesc_pba_vol._1_11-19-20_nrb_rp_final-.pdf
   Google Scholar
• National Commission on Military Aviation Safety. 2020. Report to the President and the Congress of the United States.
   Google Scholar
• Nelson, M. D., M. J. Haykowsky, M. K. Stickland, L. A. Altamirano-Diaz, C. K. Willie, K. J. Smith, S. R. Petersen, and P. N. Ainslie. 2011. “Reductions in Cerebral Blood Flow during Passive Heat Stress in Humans: Partitioning the Mechanisms.” The Journal of Physiology 589 (16): 4053–4064. doi:10.1113/jphysiol.2011.212118.
   PubMed Web of Science ®Google Scholar
• Nishida, M., S. Kikuchi, F. Miwakeichi, and S. Suda. 2017. “Night Duty and Decreased Brain Activity of Medical Residents: A Wearable Optical Topography Study.” Medical Education Online 22 (1): 1379345. doi:10.1080/10872981.2017.1379345.
   PubMed Web of Science ®Google Scholar
• Nishida, Y., S. Maruyama, I. Shouji, T. Kemuriyama, A. Tashiro, H. Ohta, K. Hagisawa, M. Hiruma, and H. Yokoe. 2016. “Effects and Biological Limitations of + Gz Acceleration on the Autonomic Functions-Related Circulation in Rats.” The Journal of Physiological Sciences 66 (6): 447–462. doi:10.1007/s12576-016-0461-4.
   PubMed Web of Science ®Google Scholar
• NSO. 2018. STANAG 3114 Aeromedical Training of Flight Personnel.
   Google Scholar
• Nunneley, S. A., and R. F. Stribley. 1979. “Heat and Acute Dehydration Effects on Acceleration Response in Man.” Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology 47 (1): 197–200. doi:10.1152/jappl.1979.47.1.197.
   PubMed Web of Science ®Google Scholar
• Ogawa, T., N. Fujii, Y. Kurimoto, and T. Nishiyasu. 2019. “Effect of Hypobaria on Maximal Ventilation, Oxygen Uptake, and Exercise Performance during Running under Hypobaric Normoxic Conditions.” Physiological Reports 7 (3): e14002. doi:10.14814/phy2.14002.
   PubMed Web of Science ®Google Scholar
• Ogoh, S. 2019. “Interaction between the Respiratory System and Cerebral Blood Flow Regulation.” Journal of Applied Physiology 127 (5): 1197–1205. doi:10.1152/japplphysiol.00057.2019.
   PubMed Web of Science ®Google Scholar
• Ottestad, W., J. I. Kåsin, and L. Ø. Høiseth. 2018. “Arterial Oxygen Saturation, Pulse Oximetry, and Cerebral and Tissue Oximetry in Hypobaric Hypoxia.” Aerospace Medicine and Human Performance 89 (12): 1045–1049. doi:10.3357/amhp.5173.2018.
   PubMed Web of Science ®Google Scholar
• Parker Jr, J. F., and V. R. West. 1973. Bioastronautics Data Book: Nasa Sp-3006. NASA Special Publication 3006.
   Google Scholar
• Phillips, J. B. 2019. “In-Cockpit Measures of Operator State: Capabilities and Pitfalls.” IEEE Research and Applications of Photonics in Defense Conference (RAPID), 1–4. doi:10.1109/RAPID.2019.8864318.
   Google Scholar
• Phillips, J. B., R. G. Simmons, J. P. Florian, D. S. Horning, R. A. Lojewski, and J. Chandler. 2009. “Moderate Intermittent Hypoxia: Effect on Two-Choice Reaction Time Followed by a Significant Delay in Recovery.” Human Factors and Ergonomics Society Annual Meeting Proceedings, Vol. 53, 1564–1568. doi:10.1518/107118109x12524444080314.
   Google Scholar
• Pipraiya, R., K. Tripathi, and M. Dogra. 2005. “Effects of + Gz Acceleration on Indices of Heart Rate Variability.” Indian Journal of Aerospace Medicine 49 (1): 37–47.
   Google Scholar
• Pollock, R. D., S. D. Gates, J. A. Storey, J. J. Radcliffe, and A. T. Stevenson. 2021. “Indices of Acceleration Atelectasis and the Effect of Hypergravity Duration on Its Development.” Experimental Physiology 106 (1): 18–27. doi:10.1113/EP088495.
   PubMed Web of Science ®Google Scholar
• Pollock, R. D., P. D. Hodkinson, and T. G. Smith. 2021. “Oh G: The x, y and z of Human Physiological Responses to Acceleration.” Experimental Physiology 106 (12): 2367–2384. doi:10.1113/EP089712.
   PubMed Web of Science ®Google Scholar
• Pongsakornsathien, N., Y. Lim, A. Gardi, S. Hilton, L. Planke, R. Sabatini, T. Kistan, and N. Ezer. 2019. “Sensor Networks for Aerospace Human-Machine Systems.” Sensors 19 (16): 3465. doi:10.3390/s19163465.
   PubMed Web of Science ®Google Scholar
• Poudel, G. R., C. R. H. Innes, and R. D. Jones. 2012. “Cerebral Perfusion Differences between Drowsy and Nondrowsy Individuals after Acute Sleep Restriction.” Sleep 35 (8): 1085–1096. doi:10.5665/sleep.1994.
   PubMed Web of Science ®Google Scholar
• Pöyhönen, M., S. Syväoja, J. Hartikainen, E. Ruokonen, and J. Takala. 2004. “The Effect of Carbon Dioxide, Respiratory Rate and Tidal Volume on Human Heart Rate Variability.” Acta Anaesthesiologica Scandinavica 48 (1): 93–101. doi:10.1111/j.1399-6576.2004.00272.x.
   PubMed Web of Science ®Google Scholar
• Qian, S., Q. Jiang, K. Liu, B. Li, M. Li, L. Li, X. Yang, Z. Yang, and G. Sun. 2014. “Effects of Short-Term Environmental Hyperthermia on Patterns of Cerebral Blood Flow.” Physiology & Behavior 128: 99–107. doi:10.1016/j.physbeh.2014.01.028.
   PubMed Web of Science ®Google Scholar
• Regterschot, G. R. H., Heuvelen, M. J. G. Van Zeinstra, E. B. Fuermaier, A. B. M. Tucha, L. Koerts, J. Tucha, O. Zee, and E. A. Van Der. 2014. “Whole Body Vibration Improves Cognition in Healthy Young Adults.” PLOS One 9 (6): e100506. doi:10.1371/journal.pone.0100506.
   PubMed Web of Science ®Google Scholar
• Rice, G. M., D. Snider, S. Drollinger, C. Greil, F. Bogni, J. Phillips, A. Raj, K. Marco, and S. Linnville. 2019. “Dry-EEG Manifestations of Acute and Insidious Hypoxia during Simulated Flight.” Aerospace Medicine and Human Performance 90 (2): 92–100. doi:10.3357/AMHP.5228.2019.
   PubMed Web of Science ®Google Scholar
• Ring, C., A. Cooke, M. Kavussanu, D. McIntyre, and R. Masters. 2015. “Investigating the Efficacy of Neurofeedback Training for Expediting Expertise and Excellence in Sport.” Psychology of Sport and Exercise 16 (P1): 118–127. doi:10.1016/j.psychsport.2014.08.005.
   Web of Science ®Google Scholar
• Rutherford, J. J., T. H. Clutton-Brock, and M. J. Parkes. 2005. “Hypocapnia Reduces the T Wave of the Electrocardiogram in Normal Human Subjects.” American Journal of Physiology-Regulatory Integrative and Comparative Physiology 289 (1): R148–R155. doi:10.1152/ajpregu.00085.2005.
   PubMed Web of Science ®Google Scholar
• Savourey, G., J.-C. Launay, Y. Besnard, A. Guinet, and S. Travers. 2003. “Normo- and Hypobaric Hypoxia: are There Any Physiological Differences?” European Journal of Applied Physiology 89 (2): 122–126. doi:10.1007/s00421-002-0789-8.
   PubMed Web of Science ®Google Scholar
• Sawka, M. N., S. N. Cheuvront, and R. W. Kenefick. 2015. “Hypohydration and Human Performance: Impact of Environment and Physiological Mechanisms.” Sports Medicine 45 (S1): 51–60. doi:10.1007/s40279-015-0395-7.
   Web of Science ®Google Scholar
• Shaw, D. M., G. Cabre, and N. Gant. 2021. “Hypoxic Hypoxia and Brain Function in Military Aviation: Basic Physiology and Applied Perspectives.” Frontiers in Physiology 12: 665821. doi:10.3389/fphys.2021.665821.
   PubMed Web of Science ®Google Scholar
• Shender, B. S., E. M. Forster, L. Hrebien, H. C. Ryoo, and J. P. Cammarota Jr. 2003. “Acceleration-Induced near-Loss of Consciousness : The “A-LOC” Syndrome.” Aviation, Space, and Environmental Medicine 74 (10): 1021–1028.
   PubMedGoogle Scholar
• Shykoff, B. E., L. R. Lee, M. Gallo, and C. A. Griswold. 2021. “Transcutaneous and End-Tidal CO2 Measurements in Hypoxia and Hyperoxia.” Aerospace Medicine and Human Performance 92 (11): 864–872. doi:10.3357/AMHP.5856.2021.
   PubMed Web of Science ®Google Scholar
• Simmons, S. E., B. K. Saxby, F. P. McGlone, and D. A. Jones. 2008. “The Effect of Passive Heating and Head Cooling on Perception, Cardiovascular Function and Cognitive Performance in the Heat.” European Journal of Applied Physiology 104 (2): 271–280. doi:10.1007/s00421-008-0677-y.
   PubMed Web of Science ®Google Scholar
• Smith, C., N. Goswami, R. Robinson, M. Von Der Wiesche, and S. Schneider. 2013. “The Relationship between Brain Cortical Activity and Brain Oxygenation in the Prefrontal Cortex during Hypergravity Exposure.” Journal of Applied Physiology 114 (7): 905–910. doi:10.1152/japplphysiol.01426.2012.
   PubMed Web of Science ®Google Scholar
• Stepanek, J., R. A. Dunn, G. N. Pradhan, and M. J. Cevette. 2020. “Supplemental CO2 Improves Oxygen Saturation, Oxygen Tension, and Cerebral Oxygenation in Acutely Hypoxic Healthy Subjects.” Physiological Reports 8 (14): 6–11. doi:10.14814/phy2.14513.
   Web of Science ®Google Scholar
• Suda, M., T. Sato, M. Kameyama, M. Ito, T. Suto, Y. Yamagishi, T. Uehara, M. Fukuda, and M. Mikuni. 2008. “Decreased Cortical Reactivity Underlies Subjective Daytime Light Sleepiness in Healthy Subjects: A Multichannel near-Infrared Spectroscopy Study.” Neuroscience Research 60 (3): 319–326. doi:10.1016/j.neures.2007.12.001.
   PubMed Web of Science ®Google Scholar
• Suess, W. M., A.B. Alexander, D. D. Smith, H. W. Sweeney, and R.J. Marion. 1980. “The Effects of Psychological Stress on Respiration: A Preliminary Study of Anxiety and Hyperventilation.” Psychophysiology 17 (6): 535–540. doi:10.1111/j.1469-8986.1980.tb02293.x.
   PubMed Web of Science ®Google Scholar
• Tu, M.-Y., H. Chu, Y.-J. Lin, K.-T. Chiang, C.-M. Chen, H.-H. Chen, C.-S. Yang, and C.-Y. Lai. 2020. “Combined Effect of Heart Rate Responses and the Anti-G Straining Manoeuvre Effectiveness on G Tolerance in a Human Centrifuge.” Scientific Reports 10 (1): 21611. doi:10.1038/s41598-020-78687-3.
   PubMed Web of Science ®Google Scholar
• Ueda, K., Y. Ogawa, R. Yanagida, K. Aoki, and K. Iwasaki. 2015. “Dose-Effect Relationship between Mild Levels of Hypergravity and Autonomic Circulatory Regulation.” Aerospace Medicine and Human Performance 86 (6): 535–540. doi:10.3357/AMHP.4162.2015.
   PubMed Web of Science ®Google Scholar
• United States Department of Defence Inspector General. 2021. Audit of the Department of the Air Force’s Actions Taken to Mitigate Physiological Events.
   Google Scholar
• Vann, R. D., F. K. Butler, S. J. Mitchell, and R. E. Moon. 2011. “Decompression Illness.” The Lancet 377 (9760): 153–164. doi:10.1016/S0140-6736(10)61085-9.
   PubMed Web of Science ®Google Scholar
• Vicente-Rodríguez, M., D. I. Gallego, J. P. Fuentes-García, and V.J. Clemente-Suárez. 2020. “Portable Biosensors for Psychophysiological Stress Monitoring of a Helicopter Crew.” Sensors 20 (23): 6849–6813. doi:10.3390/s20236849.
   PubMed Web of Science ®Google Scholar
• Webb, J. T., and A. A. Pilmanis. 2011. “Fifty Years of Decompression Sickness Research at Brooks AFB, TX: 1960–2010.” Aviation, Space, and Environmental Medicine 82 (5 Suppl): A1–A25. doi:10.3357/asem.2576.2011.
   PubMedGoogle Scholar
• West, J. B. 2016. “Early History of High‐Altitude Physiology.” Annals of the New York Academy of Sciences 1365 (1): 33–42. doi:10.1111/nyas.12719.
   PubMed Web of Science ®Google Scholar
• Whinnery, T., and E. M. Forster. 2013. “The + Gz-Induced Loss of Consciousness Curve.” Extreme Physiology & Medicine 2 (1): 1–11. doi:10.1186/2046-7648-2-19.
   PubMedGoogle Scholar
• Williams, T. B., J. Corbett, T. McMorris, J. S. Young, M. Dicks, S. Ando, R. C. Thelwell, M. J. Tipton, and J. T. Costello. 2019. “Cognitive Performance is Associated with Cerebral Oxygenation and Peripheral Oxygen Saturation, but Not Plasma Catecholamines, during Graded Normobaric Hypoxia.” Experimental Physiology 104 (9): 1384–1397. doi:10.1113/ep087647.
   PubMed Web of Science ®Google Scholar
• Worley, M. L., E. L. Reed, J. A. Freemas, and C. L. Chapman. 2021. “Mode of Passive Heating Differentially Modifies Cerebral Hemodynamics: Potential Implications on Heat Therapy.” The Journal of Physiology 599 (11): 2789–2790. doi:10.1113/JP281536.
   PubMed Web of Science ®Google Scholar
• Xing, C., X. Wang, Y. Gao, J. Zhang, Y. Liu, Y. Guo, C. Wang, Y. Feng, Y. Lei, X. Zhang, J. Li, W. Hu, S. Zhang, L. Yuan, and F. Gao. 2020. “Lower Body Negative Pressure Protects Brain Perfusion in Aviation Gravitational Stress Induced by Push–Pull Manoeuvre.” The Journal of Physiology 598 (15): 3173–3186. doi:10.1113/JP279876.
   PubMed Web of Science ®Google Scholar
• Yamamoto, S., M. Iwamoto, M. Inoue, and N. Harada. 2007. “Evaluation of the Effect of Heat Exposure on the Autonomic Nervous System by Heart Rate Variability and Urinary Catecholamines.” Journal of Occupational Health 49 (3): 199–204. doi:10.1017/S0373463300028526.
   PubMed Web of Science ®Google Scholar
• Yeung, M. K., T. L. Lee, W. K. Cheung, and A. S. Chan. 2018. “Frontal Underactivation during Working Memory Processing in Adults with Acute Partial Sleep Deprivation: A near-Infrared Spectroscopy Study.” Frontiers in Psychology 9: 742. doi:10.3389/fpsyg.2018.00742.
   PubMed Web of Science ®Google Scholar
• Zhang, N., M. Fard, M. H. U. Bhuiyan, D. Verhagen, M. F. Azari, and S. R. Robinson. 2018. “The Effects of Physical Vibration on Heart Rate Variability as a Measure of Drowsiness.” Ergonomics 61 (9): 1259–1272. doi:10.1080/00140139.2018.1482373.
   PubMed Web of Science ®Google Scholar
• Zhou, F., M. Huang, L. Gu, S. Hong, J. Jiang, X. Zeng, and H. Gong. 2019. “Regional Cerebral Hypoperfusion after Acute Sleep Deprivation.” Medicine 98 (2): e14008. doi:10.1097/MD.0000000000014008.
   PubMed Web of Science ®Google Scholar