Experts call for AED placement on every commercial aircraft to boost in-flight cardiac arrest survival rates from 6% to up to 70%

An article in the Canadian Journal of Cardiology outlines recommendations for improved safety standards at 30,000 feet

Elsevier

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A new comprehensive literature review in the Canadian Journal of Cardiology highlights systemic and policy shortcomings of current aviation safety standards, and recommends regulated and mandated automated external defibrillators (AEDs), standardized cardiopulmonary resuscitation (CPR) protocols, and integration of telemedicine.

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Credit: Credit: Canadian Journal of Cardiology / Bassi et al.

December 3, 2025 – In-flight cardiac arrest is extremely rare, yet catastrophic, and responsible for up to 86% of all deaths in the air. A new comprehensive literature review highlights systemic and policy shortcomings of current aviation safety standards, calling for global alignment. Recommendations include regulated and mandated automated external defibrillators (AEDs) on board, standardized cardiopulmonary resuscitation (CPR) protocols training, and integration of telemedicine. The article in the Canadian Journal of Cardiology, published by Elsevier, aims to inform policy regulators, airlines, and international aviation bodies to improve in-flight medical emergency preparedness and response protocols.

In-flight medical emergencies are an expected challenge, given the global air travel passenger volume of nearly four billion passengers annually. The most prominent risk factors for in-flight cardiac arrest include male sex, age, pre-existing cardiac disease, and duration of flight time. With an aging global passenger population and increasing flight durations due to advancing aircraft technology, the risk and frequency of in-flight cardiac arrest are expected to rise.

“Improving survival rates following a flight passenger’s cardiac arrest hinges on several critical considerations,” states senior author Adrian Baranchuk, MD, Queens University, Canada. “The cabin environment poses a unique challenge, including the confined space of the fuselage, limitations to equipment accessibility, and inconsistent crew CPR and AED training. Currently, only the US legally mandates defibrillators on commercial flights, whereas Canada only federally recommends it and leaves it to the discretion of the airline itself to include them.”

Prompt defibrillation is crucial

AED utilization has a significant impact on survival outcomes in multiple environments. The likelihood of survival for shockable sudden cardiac arrest decreases by 7–10% per minute without defibrillation. Due to the narrow intervention window, diverting a plane for an emergency landing is often unattainable, as it often takes longer than 20 minutes from cruising altitude to a safe landing.

The disparities in AED implementation may hinder swift emergency responses. Without an onboard AED, only approximately 6% of in-flight cardiac arrest patients survive to hospital. Further projections suggest that equipping all commercial aircraft with AEDs could save 35–93 lives annually worldwide.

First author Mario D. Bassi, MD, University of Ottawa, Canada, points out, “Currently, the data show that AEDs are consistently reliable, sensitive to detecting and treating in-flight cardiac arrest, and cost-effective to airlines. AEDs are proven to be safe, with no evidence of detriment or reduced functionality emerging in the compromised environment of the aircraft cabin, such as turbulence. While prompt recognition of a cardiac arrest and CPR initiation are vital, the chances of survival jump from 6% to up to 70% when an AED is used. However, up to one third of EU aircraft were found to not have an AED available in-flight.”

Based on their comprehensive review of the existing literature, the authors recommend:

• Universal implementation of easily accessible onboard AEDs to reduce time to defibrillation
• Standardized airline-specific CPR training for crew
• Integration of telemedicine for real-time guidance and triage (e.g., CPR coaching)

“The primary determinant impacting sudden cardiac arrest survival is the time to defibrillation,” concludes Dr. Baranchuk. “We believe our recommendations and appropriate measures must be strongly considered by policymakers and airlines alike to improve passenger safety and survival rates.”

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Journal

Canadian Journal of Cardiology

DOI

10.1016/j.cjca.2025.10.010 

Method of Research

Literature review

Subject of Research

People

Article Title

Is There a Doctor on Board?: In-Flight Sudden Cardiac Arrest and Automated External Defibrillator Use

Article Publication Date

3-Dec-2025

 

Death may suggest we belong to a broader whole

AI could change our view of death, but its inevitability remains

Kyoto University

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Shisei Tei, a researcher at Kyoto University, stresses the importance of accepting death.

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Credit: KyotoU / Shisei Tei

Kyoto, Japan -- Shisei Tei claims he is clumsy with technology and doesn't even own a smartphone, yet he has found himself thinking a lot about what we call generative AI.

Tei is cautiously optimistic about AI. As a researcher, he uses it to help with analyzing psychiatric data, and outside work it helps him plan personalized hikes. But Tei is concerned that AI will change how we think about death, which he discusses in a chapter he wrote for the book SecondDeath: Experiences of Death Across Technologies.

"Today, I often see how AI reframes grief and remembrance," says Tei. Though he thinks mental health chatbots have the potential to lower barriers to care, maladaptive use of chatbots that reconstruct deceased individuals can distort our perceptions of death and existence.

"AI-induced virtual continuations of the deceased can comfort the living and extend memory to some extent," says Tei, "but they can also blur presence and absence, potentially hindering our capacity to accept impermanence."

In our conversation, Tei explained that historically, many cultures and philosophical traditions have considered the mind and body to be separate entities, supporting the belief that the mind is eternal. This idea has penetrated modern society, which often treats death as something to overcome or delay rather than an essential part of life. It has also been reinforced by attempts to use AI to preserve the human mind.

Tei, who is from Taiwan and works at Kyoto University, has dedicated his research to bridging psychiatry, religious philosophy, and neurophenomenology, a framework proposed by biologist Francisco Varela. In this book chapter, the author explores death through the lens of selfless selves, a term introduced by Varela, who was influenced by Tibetan Buddhism. It describes how living systems sustain themselves through the mutual interdependence of their parts, like cells in a body.

"Selfless selves refers to being both altruistic and autonomous -- maintaining one's individuality while remaining in harmony with others and the wider world," says Tei. "In this sense, like cells in a larger body, people can be viewed as simultaneously distinct yet co-creating a collective life, with the self understood as fluid and shaped through interaction to serve biological and social needs."

Tei writes that this concept also describes characteristics of AI agents, as they present artificial identities while lacking a fixed selfhood, along with our interconnectedness and anonymity online. However, while traditional belief systems and modern mental health care emphasize the importance of accepting uncertainty, AI can make us reliant on quick, straightforward answers, most of which we will never obtain, thus flattening complex experiences and reinforcing cost-benefit reasoning.

"Outsourcing decision-making or emotional support to machines risks weakening the very wisdom we aim to cultivate," Tei says. For humans, empathy formed through face-to-face and nonverbal communication enhances a sense of belonging, showing how it feels and what it means to be alive, while loneliness and solitude can nurture hope. Perceptions of death arise from these interactions. Dying can evoke a sense of connection to something broader -- we may die, but part of ourselves may live on in our communities.

Tei stresses that incorporating these ideas into end-of-life care and engaging with these ideas ourselves and in our communities can help us to both treat the dying with dignity and accept death's inevitability.

"Death becomes certain once life begins," Tei writes in the book, "and denying its anticipation risks denying life itself."

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The chapter "Death in the Cybernetic Era: AI, Virtual Agents, and Selfless Selves" appeared on 16 October 2025 in SecondDeath: Experiences of Death Across Technologies, with doi: 10.1007/978-3-031-98808-0_16

About Kyoto University

Kyoto University is one of Japan and Asia's premier research institutions, founded in 1897 and responsible for producing numerous Nobel laureates and winners of other prestigious international prizes. A broad curriculum across the arts and sciences at undergraduate and graduate levels complements several research centers, facilities, and offices around Japan and the world. For more information, please see: http://www.kyoto-u.ac.jp/en

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DOI

10.1007/978-3-031-98808-0_16 

How Ramanujan’s formulae for pi connect to modern high energy physics

Indian Institute of Science (IISc)

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Most of us first hear about the irrational number π (pi) – rounded off as 3.14, with an infinite number of decimal digits – in school, where we learn about its use in the context of a circle. More recently, scientists have developed supercomputers that can estimate up to trillions of its digits.

Now, physicists at the Centre for High Energy Physics (CHEP), Indian Institute of Science (IISc) have found that pure mathematical formulae used to calculate the value of pi 100 years ago has connections to fundamental physics of today – showing up in theoretical models of percolation, turbulence, and certain aspects of black holes.

In 1914, just before he sailed from Madras to Cambridge, the famous Indian mathematician Srinivasa Ramanujan published a paper listing 17 mathematical formulae to calculate pi. They were highly efficient and helped compute pi faster than other methods at the time. Even with very few mathematical terms in them, the formulae still yielded many correct decimal digits of pi. The formulae were so foundational that they form the basis for modern computational and mathematical techniques – even the ones used by supercomputers – to compute digits of pi.  “Scientists have computed pi up to 200 trillion digits using an algorithm called the Chudnovsky algorithm,” says Aninda Sinha, Professor at CHEP and senior author of the new study. “These algorithms are actually based on Ramanujan's work.”

The question that Sinha and Faizan Bhat, first author and former IISc PhD student, asked was: Why should such astonishing formulae exist at all? In their work, they looked for a physics-based answer. “We wanted to see whether the starting point of his formulae fit naturally into some physics,” says Sinha. “In other words, is there a physical world where Ramanujan’s mathematics appears on its own?”

They found that Ramanujan’s formulae naturally come up within a broad class of theories called conformal field theories, specifically within logarithmic conformal field theories. Conformal field theories describe systems with scale invariance symmetry – essentially systems that look identical no matter how deep you zoom in, like fractals. In a physical context, this can be seen at the critical point of water – a special temperature and pressure at which both liquid and vapour forms of water become indistinguishable from the other. At this point, water shows scale invariance symmetry and its properties can be described using conformal field theory. Critical behaviour also comes up in percolation (how things spread through a medium), at the onset of turbulence in fluids, and certain descriptions of black holes – phenomena that can be explained by the more specific logarithmic conformal field theories.

The researchers found that the mathematical structure underlying the starting point of Ramanujan's formulae also comes up in the mathematics underlying these logarithmic conformal field theories. Using this connection, they could efficiently calculate certain quantities in these theories – ones that could potentially help them understand phenomena like turbulence or percolation better. This is similar to Ramanujan going from the starting point of his formulae and efficiently deriving pi. “[In] any piece of beautiful mathematics, you almost always find that there is a physical system which actually mirrors the mathematics,” says Bhat. “Ramanujan’s motivation might have been very mathematical, but without his knowledge, he was also studying black holes, turbulence, percolation, all sorts of things.”

The study shows that Ramanujan’s century-old formulae have a hitherto hidden application in making current high-energy physics calculations faster and more tractable. Even without this, however, Sinha and Bhat say they were just baffled by the beauty of Ramanujan’s mathematics. “We were simply fascinated by the way a genius working in early 20th century India, with almost no contact with modern physics, anticipated structures that are now central to our understanding of the universe,” says Sinha.

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Journal

Physical Review Letters

DOI

10.1103/c38g-fd2v 

Article Title

Ramanujan’s 1/𝜋 Series and Conformal Field Theories

Article Publication Date

2-Dec-2025

East China Normal University team unveils “Chinese approach” to STEM education framework

Researchers outline a uniquely Chinese STEM model that blends engineering, AI integration, and hands-on learning with national curriculum goals

ECNU Review of Education

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A newly proposed framework outlines how China can develop a localized model of STEM education that aligns with national curriculum while preserving the core principles of STEM. This Chinese-style approach emphasizes engineering-based learning, hands-on practice, and digital empowerment, while integrating cultural values and national priorities. It recommends integrating AI across school curricula, developing local STEM programs, and expanding extracurricular opportunities to foster innovation within the Chinese educational context.

Science, technology, engineering, and mathematics (STEM) education has emerged globally as a key driver of national competitiveness, yet China requires a localized approach beyond transplanting foreign models to align with its national conditions, traditional culture, and the digital intelligence era. Amid President Xi Jinping's 2025 call to strengthen education's role in sci-tech advancement and talent development, plus the new curriculum's focus on competency-oriented reforms, a core question arises: How can China construct a systematic STEM framework emphasizing engineering-based, integrative, practice-oriented learning empowered by AI?

In a study published online on November 25, 2025 in ECNU Review of Education, a team led by Professor Yunhuo Cui of East China Normal University, working with colleagues from Hangzhou Normal University, introduces a systematic framework for building a distinctly “Chinese approach” to STEM education. The authors argue that while STEM has become a global engine of national competitiveness, China’s own STEM development needs deeper localization, stronger theoretical grounding, and more structural innovation.

“STEM education must move beyond simple transplantation of foreign models,” said Prof. Cui and his co-authors. “Our approach anchors STEM in China’s new curriculum reform, embedding AI across all school subjects and leveraging local and school-based curricula to reflect regional strengths and values.”

Their framework is built on four core principles: engineering-based learning, interdisciplinary integration, hands-on practice, and digital-intelligence empowerment. With these foundations in place, the paper lays out a multi-level strategy for implementation—adding mandated interdisciplinary learning time to the national curriculum, expanding localized school-based STEM programs, growing extracurricular clubs and makerspaces, and deepening partnerships with museums, laboratories, and universities. Together, these layers aim to create STEM learning that is more coherent, more authentic, and more equitable for students across China.

“This is not just a curriculum upgrade,” Prof. Cui added. “It represents a strategic effort to enhance China’s capacity for technological self-reliance and to nurture a new generation with creativity, civic awareness, and a strong sense of social responsibility.”

The publication also comes at a notable moment: the launch of UNESCO’s International Institute for STEM Education in Shanghai in 2025, which the authors say highlights China’s expanding role in contributing localized perspectives to global conversations about the future of STEM education.

 

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Journal

ECNU Review of Education

DOI

10.1177/20965311251394054 

Method of Research

Literature review

Subject of Research

Not applicable

Article Title

A “Chinese Approach” to STEM Education Innovation and Development