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    <title>Transport Research International Documentation (TRID)</title>
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    <language>en-us</language>
    <copyright>Copyright © 2026. National Academy of Sciences. All rights reserved.</copyright>
    <docs>http://blogs.law.harvard.edu/tech/rss</docs>
    <managingEditor>tris-trb@nas.edu (Bill McLeod)</managingEditor>
    <webMaster>tris-trb@nas.edu (Bill McLeod)</webMaster>
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      <title>Transport Research International Documentation (TRID)</title>
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      <link>https://trid.trb.org/</link>
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    <item>
      <title>2021 FAA Aerospace Medical Certification Services Airman Customer Satisfaction Survey </title>
      <link>https://trid.trb.org/View/2431641</link>
      <description><![CDATA[The Civil Aerospace Medical Institute (CAMI) of the Federal Aviation Administration (FAA) surveys airmen who recently sought medical certification approximately every two years since 2006. The survey examines satisfaction with Aerospace Medical Certification Services provided by Aviation Medical Examiners (AME), FAA Regional Flight Surgeons (RFS), and the FAA Aerospace Medical Certification Division (AMCD) in Oklahoma City. Each survey aims to evaluate the degree of customer satisfaction with Aerospace Medical Certification Services (AMCS), identify areas in which the FAA may improve, and assess change in customer satisfaction as a result of improvements from previous iterations of the process. Survey results are used by the Office of Aerospace Medicine (OAM) to improve the process in which pilots apply and are evaluated for medical certificates to receive their license to fly. Administration of the survey meets federal requirements set forth initially by Executive Order No. 12862, “Setting Customer Service Standards,” and the Government Performance and Results Act of 1993.]]></description>
      <pubDate>Thu, 19 Sep 2024 12:10:42 GMT</pubDate>
      <guid>https://trid.trb.org/View/2431641</guid>
    </item>
    <item>
      <title>Medical Events Encountered at a Major International Airport and Health Services Provided</title>
      <link>https://trid.trb.org/View/2377944</link>
      <description><![CDATA[Travel by airline starts and ends at airports. Thousands of people consisting of passengers, relatives of passengers, and employees gather at airports every day. In this study, medical events (MEs) encountered at Istanbul Atatürk Airport (IAA) and health services provided were analyzed. The MEs encountered in IAA between January 1, 2016, and December 31, 2018, and health services provided by the private medical clinic in the airport terminal building were retrospectively analyzed. During the study period, 192,500,930 passengers traveled from the IAA and a total of 11,799 patients were seen at the clinic. There were 4898 (41.5%) male patients. The median age of the 9466 (80.2%) patients whose age was recorded was 34 (28–51) yr. Of 11,799 patients included in the present study, 9228 (78.21%) patients had medical complaints, 1122 (9.5%) patients had trauma complaints, 1180 patients (10%) were transferred to the hospital, and 269 (2.27%) patients required a certificate of preflight fitness. The most common medical complaint was gastrointestinal (1515 patients, 12.84%). The most common trauma was soft tissue injury (345 patients, 2.92%). MEs in airports can be as various and also critical as health conditions seen in emergency departments. It is important to provide medical services with an experienced medical team trained in aviation medicine and adequate medical equipment at airports.]]></description>
      <pubDate>Wed, 15 May 2024 10:11:33 GMT</pubDate>
      <guid>https://trid.trb.org/View/2377944</guid>
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    <item>
      <title>Assessing Pilot Aeromedical Risk Using Commercial Healthcare Data</title>
      <link>https://trid.trb.org/View/2286383</link>
      <description><![CDATA[The Federal Aviation Administration (FAA) Office of Aerospace Medicine is responsible for the medical certification of pilots such that the risk of pilot acute incapacitation is below a target risk threshold. This study sought to design a repeatable method of using commercial healthcare datasets to segment pilots with existing chronic conditions into acute incapacitation risk groups for the purpose of informing medical standards and certification policy guidance. Based on availability to the researchers, Merative’s Explorys electronic health record dataset, comprising 11-years of data, was used for method development. In collaboration with FAA medical officers, researchers operationalized pilot acute incapacitation as a composite outcome of 16 medical conditions and their associated diagnostic codes. These conditions were identified based on the scenario that a pilot is medically qualified to fly, conducts an adequate preflight self-assessment, and during flight experiences the acute onset of a state incompatible with active aircraft control such that orderly transfer of control to another pilot or automation is unlikely. Approaches to developing quantitative risk models for the outcome of pilot acute incapacitation were explored for four chronic conditions: diabetes, obstructive sleep apnea, chronic obstructive pulmonary disease, and atrial fibrillation. Three general approaches were explored: whole-population risk, disease severity models, and a de novo method. Using whole-population risk resulted in over- and - under estimation of pilot acute incapacitation risk for a significant portion of the population. Using existing disease severity scores produced poor risk stratification for pilot acute incapacitation. The de novo method was designed to be broadly applicable to any condition of interest. The method was comprised of the following steps: (1) define the cohort for the condition of interest; (2) use a clinical reference tool (DynaMed, UpToDate, etc.) to produce relevant clinical factors; (3) use a clinical mapping tool (e.g., Unified Medical Language System) to link clinical factors to medical codes; (4) use information gain to select risk factors (relevant to both the chronic condition of interest and the outcome) from clinical factors for inclusion in pilot acute incapacitation risk models; (5) compute stratified incidence rates for pilot acute incapacitation; and (5) compare incident rates to the target risk threshold.]]></description>
      <pubDate>Mon, 13 Nov 2023 09:00:34 GMT</pubDate>
      <guid>https://trid.trb.org/View/2286383</guid>
    </item>
    <item>
      <title>Aeromedical Collaboration Outreach</title>
      <link>https://trid.trb.org/View/2286382</link>
      <description><![CDATA[The Federal Aviation Administration (FAA) Office of Aerospace Medicine (AAM) tasked MITRE's Center for Advanced Aviation System Development to conduct outreach and dialogue with the FAA and industry about an Aeromedical Partnership focusing on enabling sharing of pilot and operational data for analyses that can inform collaborative discussions on technological and policy changes as they relate to recognition and mitigation of pilot medical-related human factor hazards. In particular, the research focused on identifying potential stakeholders, their interests and potential contributions, as well as governance principles. MITRE gathered observations from sources including: internal MITRE subject matter experts; sponsor contacts at the FAA; FAA/AAM; commercial and general aviation pilots; mainline, regional, cargo, and other airlines; pilots’ unions; Aviation Medical Examiners (AME) and others involved in pilot health issues; and union and trade associations. MITRE researchers also applied tools and methods from the public-private partnership (PPP) Toolkit that encourage prospective partners to be active in exploring common challenges and co-designing the solution. This approach yielded essential insights into stakeholders’ motivators and concerns that inform the potential for collaboration with industry (including data sharing), notably the need for a compelling benefit that outweighs the costs and risks. The impact of this work is that FAA can: (1) initiate informed and productive collaboration with industry to take a fresh look at aeromedical certifications and the role of pilot health in aviation safety, which can then (2) enhance the collection and proper use of sensitive data providing realworld insight into the primary drivers of and mitigations for aviation safety risk associated with pilot health, which (3) allows FAA to better calibrate related safety risk management activities (e.g., regulations, mitigations, enforcement) to maximize public trust in aviation safety and minimize cost and burden on pilots and other parties.]]></description>
      <pubDate>Thu, 09 Nov 2023 17:10:42 GMT</pubDate>
      <guid>https://trid.trb.org/View/2286382</guid>
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    <item>
      <title>Gene Expression Biomarkers of the Response to Sleep Loss With and Without Modafinil</title>
      <link>https://trid.trb.org/View/2278487</link>
      <description><![CDATA[Sleep disruption presents a substantial risk to health and safety, particularly due to the risks of performance degradation in safety-critical operations that can result in catastrophic injuries or mortality. Federal regulations exist to minimize the risks of fatigue with limitations on hours worked and requirements for fatigue risk management plans. Yet, even with workload controls and scheduled opportunities for rest, fatigue may be caused by factors such as personal and lifestyle choices, illness, and circadian disruption from travel across multiple time zones. Complicating risk mitigation is the challenge of identifying and measuring fatigue. Here, the authors report on gene expression biomarkers (biological indicators) for cognitive impairment during sleep loss. The authors observe hundreds of genes whose expression is associated with attention changes during one night of sleep loss. Several genes are identified that the authors previously associated with attention impairment in a separate study of sleep loss. The reproducibility of findings may indicate the robustness of these candidate fatigue impairment biomarkers. However, some biomarker genes only associate with certain tests of impairment (e.g., attention lapses but not self-reported fatigue), suggesting that different biomarker panels may be developed to assess the particular cognitive domains that need monitoring for a given safety critical operation. The authors also find that using a drug countermeasure (modafinil) not only helps mitigate impairment on tests of attention lapses, but also disrupts gene expression associations with attention lapses. Further research is needed to confirm whether this represents a unique effect of modafinil administration, or emphasizes the need to ensure biomarker validation occurs both in the presence and absence of countermeasures.]]></description>
      <pubDate>Mon, 06 Nov 2023 08:39:26 GMT</pubDate>
      <guid>https://trid.trb.org/View/2278487</guid>
    </item>
    <item>
      <title>Exploring Industry Medical Risk Management Best Practices for Application to Aerospace Medicine</title>
      <link>https://trid.trb.org/View/2270025</link>
      <description><![CDATA[The Federal Aviation Administration (FAA) Office of Aerospace Medicine tasked MITRE’s Center for Advanced Aviation System Development to investigate relevant industry best practices applicable to the forecasting and managing pilot medical risks. In particular, the research focused on the insurance industry for risk assessment expertise. MITRE gathered observations from sources including internal MITRE subject matter experts, insurance brokers, insurance companies, technology vendors, and trade associations. The research also applied TRIZ—the theory of inventive problem-solving. TRIZ proposes that narrow problems can be abstracted to broad problems for which broad solutions already exist. MITRE mapped key elements from the insurance industry process model to the elements of FAA’s Safety Risk Management / Safety Assurance process of Order 8040.4B. This juxtaposition yielded a novel finding of the research: a unified process model with common elements. MITRE identified actions that can be adopted from the insurance domain best practices for each step of this unified process model.]]></description>
      <pubDate>Mon, 30 Oct 2023 08:52:35 GMT</pubDate>
      <guid>https://trid.trb.org/View/2270025</guid>
    </item>
    <item>
      <title>Improving Computational Usability of Unstructured Pilot Medical Certification Data</title>
      <link>https://trid.trb.org/View/2256585</link>
      <description><![CDATA[Current Federal Aviation Administration's Office of Aerospace Medicine (AAM) operations include scanning paper documents received from various third‑party medical providers to support individual pilot medical certification decision-related matters. These operations lack analytic tools, resulting in a time-intensive effort by subject matter experts to manually search through document sets to find relevant information. MITRE applied human language technologies to a sample set of AAM documents containing unstructured pilot medical certification data. MITRE demonstrated that third-party documents received and scanned by AAM could be automatically classified through a combination of computer vision and human language technologies; demonstrated that these documents can have their content extracted with sufficient accuracy to enable fundamental automation and human support tasks including summarization, search, and de-identification; identified aspects of the documents that present risk to future systems development; and produced a prototypical integrated document processing software pipeline capable of automatic ingest, classification, content extraction, and indexing to support basic search as an initial application.]]></description>
      <pubDate>Fri, 06 Oct 2023 13:40:14 GMT</pubDate>
      <guid>https://trid.trb.org/View/2256585</guid>
    </item>
    <item>
      <title>Technological Feasibility Assessment of Conducting Aeromedical Certification Exams using Telemedicine During Public Health Emergencies</title>
      <link>https://trid.trb.org/View/2237371</link>
      <description><![CDATA[During the Public Health Emergency (PHE) caused by the SARS-CoV-2 virus, airmen could not schedule medical exams with Aviation Medical Examiners (AMEs), necessitating the Federal Aviation Administration (FAA) to extend the duration of medical certification for several months. This situation was undesirable because it removed one of the safeguards for ensuring human reliability in aerospace operations. Accordingly, the Federal Aviation Administration's Office of Aerospace Medicine requested MITRE evaluate the feasibility of telemedicine for aeromedical certification exams in a future PHE, with the main objective of identifying validated technologies for elements of the exam. Based on interviews with senior AMEs, a telemedicine innovation challenge, and an assessment of marketplace best practices, mature telemedicine technology was identified to accomplish 19 and partially complete 10 elements of the FAA's aeromedical certification exam. Elements that can be completed via telemedicine include medical history, height, weight, ear, nose, throat, ocular motility, lungs, heart, vascular, skin, musculoskeletal extremities, spine, identifying body marks/scars/tattoos, neurologic, psychiatric, general systemic, hearing, blood pressure, pulse. Additionally, the electrocardiogram and urinalysis testing can be accomplished remotely. Elements that can be only partially assessed in the home via telemedicine include the retina, pupils, abdomen/viscera, genitourinary, vision (distant, near, intermediate), color vision, field of vision, and heterophoria. Elements that cannot be accomplished remotely include an exam of the anus and lymphatics.]]></description>
      <pubDate>Mon, 11 Sep 2023 11:39:32 GMT</pubDate>
      <guid>https://trid.trb.org/View/2237371</guid>
    </item>
    <item>
      <title>Cerebral Blood Flow Based Computer Modeling of Gz-Induced Effects</title>
      <link>https://trid.trb.org/View/2201930</link>
      <description><![CDATA[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. 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. 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. 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.]]></description>
      <pubDate>Thu, 27 Jul 2023 16:55:29 GMT</pubDate>
      <guid>https://trid.trb.org/View/2201930</guid>
    </item>
    <item>
      <title>Transient Facial Nerve Palsy in Aviation</title>
      <link>https://trid.trb.org/View/2201929</link>
      <description><![CDATA[Facial nerve palsy has been observed sporadically by aviation medicine doctors in recent years. The authors present two case reports of patients with the rare condition of facial nerve palsy occurring during aviation, along with a review of the literature, an overview of the phenomenon and the described symptoms of the cases. PubMed® including Medline® was searched using the terms nerve palsy and aviation with no restriction. In addition, two new cases of recurrent nerve palsy are described. The authors describe two case reports: A 20-yr-old woman reported recurrent transient left-sided facial nerve palsy with increased duration and intensity on four subsequent flights, and a 35-yr-old woman who reported a left-sided transient facial nerve palsy 20 min after ascent. Included in the systematic review were 17 studies. Only case report studies were found. Including the two cases of facial nerve palsy described in this article, the reviewed studies represent 23 cases of peer-reviewed facial baro-palsy in aviation (ages 10 to 62 yr old). Having baro-palsy symptoms during flight is a rare condition, and the mechanism is not well understood. Some typical characteristics and possible mechanisms are discussed. PE tube insertion of the tympanic membrane has been found to be an effective treatment; however, further studies are needed.]]></description>
      <pubDate>Thu, 27 Jul 2023 16:55:29 GMT</pubDate>
      <guid>https://trid.trb.org/View/2201929</guid>
    </item>
    <item>
      <title>Assessment of RNA-seq Sample Preparation Methodology [Data Management Plan]</title>
      <link>https://trid.trb.org/View/2215828</link>
      <description><![CDATA[This study was designed to address concerns regarding effects of lab processing techniques on downstream results and also to determine an optimal combination of software programs to use to align genetic data and assess differential expression. Homogeneous lab samples were tested using two different purification methods and compared to unpurified samples to determine if either purification method had any impact on differential expression. Genetic data was also simulated with a known rate of differential expression. All samples were aligned and analyzed for differential expression using combinations of seven different alignment programs and nine different differential expression programs. Results were compared to determine which alignment program(s) and which differential expression program(s) provided optimal results in terms of accuracy, time required for processing and data storage footprint.]]></description>
      <pubDate>Wed, 26 Jul 2023 11:01:26 GMT</pubDate>
      <guid>https://trid.trb.org/View/2215828</guid>
    </item>
    <item>
      <title>RNA-Seq Alignment and Differential Expression Software Comparison</title>
      <link>https://trid.trb.org/View/2135271</link>
      <description><![CDATA[The twofold goals for this study were to determine an optimum choice for ribonucleic acid sequencing (RNA-Seq) alignment software and to determine which differential expression software packages produced consistent and accurate results. RNA was extracted from blood and pooled to produce homogenous sample material to ensure that any differential expression between samples was attributable to characteristics of downstream processing or software choice. Also, simulated sequence data were produced with a known rate of differential expression. After RNA-Seq, all datasets had alignments (or pseudoalignments) performed by Bowtie2, HISAT2, kallisto, RSEM, Rsubread, Salmon, and STAR. Feature counts were tabulated and analyzed for differential expression using ALDEx2, baySeq, DEGseq, DESeq2, edgeR, limma, NOISeq, PoissonSeq, and SAMseq (samr), and results were compared. Findings indicated that kallisto, Salmon, and STAR provided superior mapping performance, were quickest, and had the smallest output file size compared to the others tested. The differential expression software DESeq2, edgeR, and limma had the most accurate true positive rate with simulated data and consistently performed as expected with real datasets.]]></description>
      <pubDate>Mon, 20 Mar 2023 09:35:40 GMT</pubDate>
      <guid>https://trid.trb.org/View/2135271</guid>
    </item>
    <item>
      <title>An Evaluation of the Downstream Effects of Purification Methods on RNA-Seq Differential Expression</title>
      <link>https://trid.trb.org/View/2135269</link>
      <description><![CDATA[Ribonucleic acid sequencing (RNA-Seq) is a valuable and commonly used technique to quantify the number of individual RNA transcripts within a sample. RNA-Seq typically requires a small amount of pure and concentrated RNA, which can necessitate additional concentration or purification of previously isolated RNA samples. Magnetic beads and silica-based columns are often used to concentrate and/or purify RNA samples, but little is known about how these techniques influence downstream analyses. In this study, the authors collected blood from volunteer human subjects and pooled those samples during RNA extraction to minimize variance due to input material. The authors then purified aliquots of that sample pool to evaluate how sample purification and concentration influenced gene expression observations. Extracted RNA was sequenced, and the resulting RNA-Seq files were evaluated to determine the degree of differential expression between methods. Differential expression was detected in roughly half of the comparisons made and appeared attributable at least partly to differences in sample concentration and purification techniques.]]></description>
      <pubDate>Mon, 20 Mar 2023 09:35:40 GMT</pubDate>
      <guid>https://trid.trb.org/View/2135269</guid>
    </item>
    <item>
      <title>SMS – Validating simplifying assumptions for estimating pilot incapacitation risk 17.7</title>
      <link>https://trid.trb.org/View/2114826</link>
      <description><![CDATA[This research project will leverage existing aerospace, medical claims and mortality datasets to validate the following proposed simplifying assumptions for estimating pilot incapacitation risk: (1) the cardiovascular death rate can be taken to approximate the cardiovascular incapacitation rate, and (2) cardiovascular mortality data alone provides a reasonable approximation for all-cause sudden in-flight incapacitations.
]]></description>
      <pubDate>Wed, 08 Feb 2023 16:03:26 GMT</pubDate>
      <guid>https://trid.trb.org/View/2114826</guid>
    </item>
    <item>
      <title>SMS – Determining if there is a medical vs. human factors/experience risk tradeoff in pilots operating under Basic Med 17.6</title>
      <link>https://trid.trb.org/View/2114825</link>
      <description><![CDATA[This research project will compare pilot human factors vs. medically caused mishap rates across age deciles between pilots operating under BasicMed vs. a 3rd class medical certificate.  The purpose of this comparison is to determine whether the likely experience gained by age for older pilots can serve as a tradeoff for the likely increased risk due to medical factors associated with increased age.]]></description>
      <pubDate>Wed, 08 Feb 2023 15:59:58 GMT</pubDate>
      <guid>https://trid.trb.org/View/2114825</guid>
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