Limited evaluation of an F-14A airplane utilizing an aileron-rudder interconnect control system in the landing configuration

A flight test was conducted for preliminary evaluation of an aileron-rudder interconnect (ARI) control system for the F-14A airplane in the landing configuration. Two ARI configurations were tested in addition to the standard F-14 flight control system. Results of the flight test showed marked improvement in handling qualities when the ARI systems were used. Sideslip due to adverse yaw was considerably reduced, and airplane turn rate was more responsive to pilot lateral control inputs. Pilot comments substantiated the flight data and indicated that the ARI systems were superior to the standard control system in terms of pilot capability to make lateral offset corrections and heading changes on final approach

Pilot Human Factors in Stall/Spin Accidents of Supersonic Fighter Aircraft

A study has been made of pilot human factors related to stall/spin accidents of supersonic fighter aircraft. The military specifications for flight at high angles of attack are examined. Several pilot human factors problems related to stall/spin are discussed. These problems include (1) unsatisfactory nonvisual warning cues; (2) the inability of the pilot to quickly determine if the aircraft is spinning out of control, or to recognize the type of spin; (3) the inability of the pilot to decide on and implement the correct spin recovery technique; (4) the inability of the pilot to move, caused by high angular rotation; and (5) the tendency of pilots to wait too long in deciding to abandon the irrecoverable aircraft. Psycho-physiological phenomena influencing pilot's behavior in stall/spin situations include (1) channelization of sensory inputs, (2) limitations in precisely controlling several muscular inputs, (3) inaccurate judgment of elapsed time, and (4) disorientation of vestibulo-ocular inputs. Results are given of pilot responses to all these problems in the F14A, F16/AB, and F/A-18A aircraft. The use of departure spin resistance and automatic spin prevention systems incorporated on recent supersonic fighters are discussed. These systems should help to improve the stall/spin accident record with some compromise in maneuverability

Flight evaluation of advanced control systems and displays on a general aviation airplane

A flight-test program was conducted to determine the effect of advanced flight control systems and displays on the handling qualities of a light twin-engined airplane. A flight-director display and an attitude-command control system, used separately and in combination, transformed a vehicle with poor handling qualities during ILS approaches in turbulent air into a vehicle with good handling qualities. The attitude-command control system also improved the ride qualities of the airplane. A rate-command control system made only small improvements to the airplane's ILS handling qualities in turbulence. Both the rate- and the attitude-command control systems reduced stall warning in the test airplane, increasing the likelihood of inadvertent stalls. The final approach to the point of flare was improved by both the rate- and the attitude-command control systems. However, the small control wheel deflections necessary to flare were unnatural and tended to cause overcontrolling during flare. Airplane handling qualities are summarized for each control-system and display configuration

Flight test evaluation of an RAF high altitude partial pressure protective assembly

A partial pressure suit was evaluated during tests in an F-104 and F-15 as a protective garment for emergency descents. The garment is an pressure jerkin and modified anti-g suit combined with an oronasal mask. The garment can be donned and doffed at the aircraft to minimize thermal buildup. The oronasal mask was favored by the pilots due to its immobility on the face during high g-loading. The garment was chosen to provide optimum dexterity for the pilot, which is not available in a full pressure suit, while protecting the pilot at altitudes up to 18,288 meters, during a cabin decompression, and subsequent aircraft descent. During cabin decompressions in the F-104 and F-15, cabin pressure altitude was measured at various aircraft angles of attack, Mach numbers, and altitudes to determine the effect of the aerodynamic slipstream on the cabin altitude

Length of carotid stenosis predicts peri-procedural stroke or death and restenosis in patients randomized to endovascular treatment or endarterectomy.

BACKGROUND: The anatomy of carotid stenosis may influence the outcome of endovascular treatment or carotid endarterectomy. Whether anatomy favors one treatment over the other in terms of safety or efficacy has not been investigated in randomized trials. METHODS: In 414 patients with mostly symptomatic carotid stenosis randomized to endovascular treatment (angioplasty or stenting; n = 213) or carotid endarterectomy (n = 211) in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS), the degree and length of stenosis and plaque surface irregularity were assessed on baseline intraarterial angiography. Outcome measures were stroke or death occurring between randomization and 30 days after treatment, and ipsilateral stroke and restenosis ≥50% during follow-up. RESULTS: Carotid stenosis longer than 0.65 times the common carotid artery diameter was associated with increased risk of peri-procedural stroke or death after both endovascular treatment [odds ratio 2.79 (1.17-6.65), P = 0.02] and carotid endarterectomy [2.43 (1.03-5.73), P = 0.04], and with increased long-term risk of restenosis in endovascular treatment [hazard ratio 1.68 (1.12-2.53), P = 0.01]. The excess in restenosis after endovascular treatment compared with carotid endarterectomy was significantly greater in patients with long stenosis than with short stenosis at baseline (interaction P = 0.003). Results remained significant after multivariate adjustment. No associations were found for degree of stenosis and plaque surface. CONCLUSIONS: Increasing stenosis length is an independent risk factor for peri-procedural stroke or death in endovascular treatment and carotid endarterectomy, without favoring one treatment over the other. However, the excess restenosis rate after endovascular treatment compared with carotid endarterectomy increases with longer stenosis at baseline. Stenosis length merits further investigation in carotid revascularisation trials

Status Update and Interim Results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2)

Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362. © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved

Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy

Background: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91–1·32; p=0·21). Interpretation: Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable. Funding: UK Medical Research Council and Health Technology Assessment Programme