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Sample records for moderate altitude residence

  1. Hemoglobin mass and peak oxygen uptake in untrained and trained residents of moderate altitude.

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    Böning, D; Rojas, J; Serrato, M; Ulloa, C; Coy, L; Mora, M; Gomez, J; Hütler, M

    2001-11-01

    Blood composition, hemoglobin mass (CO rebreathing method) and VO2peak were measured in 15 untrained (UT-Bogotá) and 14 trained males (TR-Bogotá) living at 2600 m of altitude, and in 14 untrained lowlanders (UT-Berlin). [Hb] amounted to 15.3 + 0.2(SE) g/dl in UT-Berlin, 17.4 + 0.2 g/dl in UT-Bogotá and 16.0 + 0.2 g/dl in TR-Bogotá. Hb mass was significantly higher in UT-Bogotá (13.2 + 0.4 g/kg, P < 0.01) and in TR-Bogotá (14.7 + 0.5 g/kg, P < 0.001) than in UT-Berlin (11.7 + 0.2 g/kg). In TR-Bogotá also plasma volume was expanded. Erythropoietin concentrations in UT-Bogotá and TR-Bogotá were not significantly increased. There was a positive correlation between blood volume and VO2peak for the pooled values of all subjects, if the oxygen uptake of UT-Berlin was corrected for an ascent to 2600 m. For the Hb mass - VO2peak relation two groups are indicated pointing to two types of altitude acclimatization with different Hb mass increases but similar distribution of aerobic performance capacity. We suggest that different genetic properties in a population of mixed ethnic origin might play a role.

  2. Hemoglobin values for pregnant women residing at middle altitude

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    Mercedes Jatziri Gaitán-González

    2013-07-01

    Full Text Available Objective. To determine maternal hemoglobin behavior during pregnancy for middle altitude residents and to compare it with that reported in other populations with or without iron supplementation. Materials and methods. Hematological values from 227 pregnant women residing at 2 240 m altitude (Mexico City, with low obstetric and perinatal risk, and receiving supplementary iron, were compared with reference values obtained from other populations of pregnant women residing at different altitudes, after correcting for altitude. Results. While the hemoglobin values for the first and second trimester of pregnancy in our studied population were similar to those reported for iron-supplemented populations (p mayor que 0.05, the third trimester values were similar to those reported for a population without this supplement (p mayor que 0.05. Conclusions. Despite receiving supplementary iron, hemoglobin values during pregnancy from women residing at middle altitude show similar behavior to that reported for pregnant women without iron supplementation.

  3. Sildenafil and Exercise Capacity in the Elderly at Moderate Altitude.

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    Rodway, George W; Lovelace, Anne J; Lanspa, Michael J; McIntosh, Scott E; Bell, James; Briggs, Ben; Weaver, Lindell K; Yanowitz, Frank; Grissom, Colin K

    2016-06-01

    Hypobaric hypoxia decreases exercise capacity and causes hypoxic pulmonary vasoconstriction and pulmonary hypertension. The phosphodiesterase-5 inhibitor sildenafil is a pulmonary vasodilator that may improve exercise capacity at altitude. We aimed to determine whether sildenafil improves exercise capacity, measured as maximal oxygen consumption (peak V̇o2), at moderate altitude in adults 60 years or older. The design was a randomized, double-blind, placebo-controlled, crossover study. After baseline cardiopulmonary exercise testing at 1400 m, 12 healthy participants (4 women) aged 60 years or older, who reside permanently at approximately 1400 m and are regularly active in self-propelled mountain recreation above 2000 m, performed maximal cardiopulmonary cycle exercise tests in a hypobaric chamber at a simulated altitude of 2750 m after ingesting sildenafil and after ingesting a placebo. After placebo, mean peak V̇o2 was significantly lower at 2750 m than 1400 m: 37.0 mL · kg(-1) · min(-1) (95% CI, 32.7 to 41.3) vs 39.1 mL · kg(-1) · min(-1) (95% CI, 33.5 to 44.7; P = .020). After placebo, there was no difference in heart rate (HR) or maximal workload at either altitude (z = 0.182; P = .668, respectively). There was no difference between sildenafil and placebo at 2750 m in peak V̇o2 (P = .668), O2 pulse (P = .476), cardiac index (P = .143), stroke volume index (z = 0.108), HR (z = 0.919), or maximal workload (P = .773). Transthoracic echocardiography immediately after peak exercise at 2750 m showed tricuspid annular plane systolic velocity was significantly higher after sildenafil than after placebo (P = .019), but showed no difference in tricuspid annular plane systolic excursion (P = .720). Sildenafil (50 mg) did not improve exercise capacity in adults 60 years or older at moderate altitude in our study. This might be explained by a "dosing effect" or insufficiently high altitude. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc

  4. Preparation for football competition at moderate to high altitude.

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    Gore, C J; McSharry, P E; Hewitt, A J; Saunders, P U

    2008-08-01

    Analysis of approximately 100 years of home-and-away South American World Cup matches illustrate that football competition at moderate/high altitude (>2000 m) favors the home team, although this is more than compensated by the likelihood of sea-level teams winning at home against the same opponents who have descended from altitude. Nevertheless, the home team advantage at altitudes above approximately 2000 m may reflect that traditionally, teams from sea level or low altitude have not spent 1-2 weeks acclimatizing at altitude. Despite large differences between individuals, in the first few days at high altitude (e.g. La Paz, 3600 m) some players experience symptoms of acute mountain sickness (AMS) such as headache and disrupted sleep, and their maximum aerobic power (VO2max) is approximately 25% reduced while their ventilation, heart rate and blood lactate during submaximal exercise are elevated. Simulated altitude for a few weeks before competition at altitude can be used to attain partial ventilatory acclimation and ameliorated symptoms of AMS. The variety of simulated altitude exposures usually created with enriched nitrogen mixtures of air include resting or exercising for a few hours per day or sleeping approximately 8 h/night in hypoxia. Preparation for competition at moderate/high altitude by training at altitude is probably superior to simulated exposure; however, the optimal duration at moderate/high altitude is unclear. Preparing for 1-2 weeks at moderate/high altitude is a reasonable compromise between the benefits associated with overcoming AMS and partial restoration of VO2max vs the likelihood of detraining.

  5. The body weight loss during acute exposure to high-altitude hypoxia in sea level residents.

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    Ge, Ri-Li; Wood, Helen; Yang, Hui-Huang; Liu, Yi-Ning; Wang, Xiu-Juan; Babb, Tony

    2010-12-25

    Weight loss is frequently observed after acute exposure to high altitude. However, the magnitude and rate of weight loss during acute exposure to high altitude has not been clarified in a controlled prospective study. The present study was performed to evaluate weight loss at high altitude. A group of 120 male subjects [aged (32±6) years] who worked on the construction of the Golmud-Lhasa Railway at Kunlun Mountain (altitude of 4 678 m) served as volunteer subjects for this study. Eighty-five workers normally resided at sea level (sea level group) and 35 normally resided at an altitude of 2 200 m (moderate altitude group). Body weight, body mass index (BMI), and waist circumference were measured in all subjects after a 7-day stay at Golmud (altitude of 2 800 m, baseline measurements). Measurements were repeated after 33-day working on Kunlun Mountain. In order to examine the daily rate of weight loss at high altitude, body weight was measured in 20 subjects from the sea level group (sea level subset group) each morning before breakfast for 33 d at Kunlun Mountain. According to guidelines established by the Lake Louise acute mountain sickness (AMS) consensus report, each subject completed an AMS self-report questionnaire two days after arriving at Kunlun Mountain. After 33-day stay at an altitude of 4 678 m, the average weight loss for the sea level group was 10.4% (range 6.5% to 29%), while the average for the moderate altitude group was 2.2% (-2% to 9.1%). The degree of weight loss (Δ weight loss) after a 33-day stay at an altitude of 4 678 m was significantly correlated with baseline body weight in the sea level group (r=0.677, P0.05). In the sea level subset group, a significant weight loss was observed within 20 d, but the weight remained stable thereafter. AMS-score at high altitude was significantly higher in the sea level group (4.69±2.48) than that in the moderate altitude group (2.97±1.38), and was significantly correlated with baseline body weight

  6. How can acute mountain sickness be quantified at moderate altitude?

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    Roeggla, G; Roeggla, M; Podolsky, A.; Wagner, A; Laggner, A N

    1996-01-01

    Reports of acute mountain sickness (AMS) at moderate altitude show a wide variability, possibly because of different investigation methods. The aim of our study was to investigate the impact of investigation methods on AMS incidence. Hackett's established AMS score (a structured interview and physical examination), the new Lake Louise AMS score (a self-reported questionnaire) and oxygen saturation were determined in 99 alpinists after ascent to 2.94 km altitude. AMS incidence was 8% in Hacket...

  7. Role of the altitude level on cerebral autoregulation in residents at high altitude.

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    Jansen, Gerard F A; Krins, Anne; Basnyat, Buddha; Odoom, Joseph A; Ince, Can

    2007-08-01

    Cerebral autoregulation is impaired in Himalayan high-altitude residents who live above 4,200 m. This study was undertaken to determine the altitude at which this impairment of autoregulation occurs. A second aim of the study was to test the hypothesis that administration of oxygen can reverse this impairment in autoregulation at high altitudes. In four groups of 10 Himalayan high-altitude dwellers residing at 1,330, 2,650, 3,440, and 4,243 m, arterial oxygen saturation (Sa(O(2))), blood pressure, and middle cerebral artery blood velocity were monitored during infusion of phenylephrine to determine static cerebral autoregulation. On the basis of these measurements, the cerebral autoregulation index (AI) was calculated. Normally, AI is between zero and 1. AI of 0 implies absent autoregulation, and AI of 1 implies intact autoregulation. At 1,330 m (Sa(O(2)) = 97%), 2,650 m (Sa(O(2)) = 96%), and 3,440 m (Sa(O(2)) = 93%), AI values (mean +/- SD) were, respectively, 0.63 +/- 0.27, 0.57 +/- 0.22, and 0.57 +/- 0.15. At 4,243 m (Sa(O(2)) = 88%), AI was 0.22 +/- 0.18 (P < 0.0005, compared with AI at the lower altitudes) and increased to 0.49 +/- 0.23 (P = 0.008, paired t-test) when oxygen was administered (Sa(O(2)) = 98%). In conclusion, high-altitude residents living at 4,243 m have almost total loss of cerebral autoregulation, which improved during oxygen administration. Those people living at 3,440 m and lower have still functioning cerebral autoregulation. This study showed that the altitude region between 3,440 and 4,243 m, marked by Sa(O(2)) in the high-altitude dwellers of 93% and 88%, is a transitional zone, above which cerebral autoregulation becomes critically impaired.

  8. QT interval changes in term pregnant women living at moderately high altitude.

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    Batmaz, G; Aksoy, A N; Aydın, S; Ay, N K; Dane, B

    2016-01-01

    This study aimed to compare the QT interval changes in women with term pregnancy living at moderately high altitude (1890 m in Erzurum, Turkey) with those of women living at sea level (31 m in İstanbul, Turkey). One-hundred ten women (n = 55, for each group) with full-term and single child pregnancies. Two different locations in that state were selected: İstanbul, Turkey, which is at 31 m above sea level (Group 1) and Erzurum, Turkey, at 1890 m above sea level (Group 2). Physicians from the two locations participated in the study. We estimated QTc, QTc Max, QTc Min, QT, and QTcd intervals. Moderately high altitude group had significantly longer QT parameters (QTc, QTc Max, QTc Min, QT, and QTcd intervals) compared with sea level group (P anges occur in term pregnant women living moderately high altitude. These changes may be associated with pregnancy-related cardiovascular complications in moderately high altitude.

  9. Hypoxic Hypoxia at Moderate Altitudes: State of the Science

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    2011-05-01

    indicating more O2 unloading, leading to more rapid desaturation of hemoglobin. 6 Conditions such as anemia or high altitude, cause an increase of 2,3...yielded 32 articles, 5 technical reports, 1 master’s thesis , 2 abstracts, and 2 manuals. Excluded from the Dialog search were 17 articles, 2...technical reports, and 2 manuals. Additionally, 52 articles, 1 master’s thesis , and 16 abstracts were obtained for review from references of original

  10. Changes in physical performance parameters during and after moderate altitude training in elite cross country skiers

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    Jensen, Kurt; Höög, Martina; Willis, Sarah

    2013-01-01

    INTRODUCTION: The Olympic cross country skiing competitions in 2014 will be held in Sochi, Russia at an altitude of approximately 1500m. Although moderate, this altitude is known to reduce performance in highly trained endurance athletes. It is also known that individuals react differently during...... moderate altitude training seems not to be related to any single parameter. One should not ignore individual differences in adaptation. REFERENCES 1. Ainegren, M. et al Engineering of Sport 7, Vol 2, 2008: p. 393-400. 2. Medbo, J.I.et al J.Appl.Physiol., 1988. 64: p. 50-60.......INTRODUCTION: The Olympic cross country skiing competitions in 2014 will be held in Sochi, Russia at an altitude of approximately 1500m. Although moderate, this altitude is known to reduce performance in highly trained endurance athletes. It is also known that individuals react differently during...... altitude exposure. The purpose of this study was to evaluate performance changes during and after three weeks of training in moderate altitude in elite skiers. METHOD: Four male and three female skiers were tested on a roller skiing treadmill using the classic technique at sea level (NORM1), after 3 and 20...

  11. Quantitative changes in the sleep EEG at moderate altitude (1630 m and 2590 m.

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    Katrin Stadelmann

    Full Text Available BACKGROUND: Previous studies have observed an altitude-dependent increase in central apneas and a shift towards lighter sleep at altitudes >4000 m. Whether altitude-dependent changes in the sleep EEG are also prevalent at moderate altitudes of 1600 m and 2600 m remains largely unknown. Furthermore, the relationship between sleep EEG variables and central apneas and oxygen saturation are of great interest to understand the impact of hypoxia at moderate altitude on sleep. METHODS: Fourty-four healthy men (mean age 25.0 ± 5.5 years underwent polysomnographic recordings during a baseline night at 490 m and four consecutive nights at 1630 m and 2590 m (two nights each in a randomized cross-over design. RESULTS: Comparison of sleep EEG power density spectra of frontal (F3A2 and central (C3A2 derivations at altitudes compared to baseline revealed that slow-wave activity (SWA, 0.8-4.6 Hz in non-REM sleep was reduced in an altitude-dependent manner (~4% at 1630 m and 15% at 2590 m, while theta activity (4.6-8 Hz was reduced only at the highest altitude (10% at 2590 m. In addition, spindle peak height and frequency showed a modest increase in the second night at 2590 m. SWA and theta activity were also reduced in REM sleep. Correlations between spectral power and central apnea/hypopnea index (AHI, oxygen desaturation index (ODI, and oxygen saturation revealed that distinct frequency bands were correlated with oxygen saturation (6.4-8 Hz and 13-14.4 Hz and breathing variables (AHI, ODI; 0.8-4.6 Hz. CONCLUSIONS: The correlation between SWA and AHI/ODI suggests that respiratory disturbances contribute to the reduction in SWA at altitude. Since SWA is a marker of sleep homeostasis, this might be indicative of an inability to efficiently dissipate sleep pressure.

  12. Quantitative Changes in the Sleep EEG at Moderate Altitude (1630 m and 2590 m)

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    Stadelmann, Katrin; Latshang, Tsogyal D.; Lo Cascio, Christian M.; Tesler, Noemi; Stoewhas, Anne-Christin; Kohler, Malcolm; Bloch, Konrad E.; Huber, Reto; Achermann, Peter

    2013-01-01

    Background Previous studies have observed an altitude-dependent increase in central apneas and a shift towards lighter sleep at altitudes >4000 m. Whether altitude-dependent changes in the sleep EEG are also prevalent at moderate altitudes of 1600 m and 2600 m remains largely unknown. Furthermore, the relationship between sleep EEG variables and central apneas and oxygen saturation are of great interest to understand the impact of hypoxia at moderate altitude on sleep. Methods Fourty-four healthy men (mean age 25.0±5.5 years) underwent polysomnographic recordings during a baseline night at 490 m and four consecutive nights at 1630 m and 2590 m (two nights each) in a randomized cross-over design. Results Comparison of sleep EEG power density spectra of frontal (F3A2) and central (C3A2) derivations at altitudes compared to baseline revealed that slow-wave activity (SWA, 0.8–4.6 Hz) in non-REM sleep was reduced in an altitude-dependent manner (∼4% at 1630 m and 15% at 2590 m), while theta activity (4.6–8 Hz) was reduced only at the highest altitude (10% at 2590 m). In addition, spindle peak height and frequency showed a modest increase in the second night at 2590 m. SWA and theta activity were also reduced in REM sleep. Correlations between spectral power and central apnea/hypopnea index (AHI), oxygen desaturation index (ODI), and oxygen saturation revealed that distinct frequency bands were correlated with oxygen saturation (6.4–8 Hz and 13–14.4 Hz) and breathing variables (AHI, ODI; 0.8–4.6 Hz). Conclusions The correlation between SWA and AHI/ODI suggests that respiratory disturbances contribute to the reduction in SWA at altitude. Since SWA is a marker of sleep homeostasis, this might be indicative of an inability to efficiently dissipate sleep pressure. PMID:24167552

  13. [Geographic Altitude of Residence and Alcohol Dependence in a Peruvian Population].

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    Quiñones-Laveriano, Dante Manuel; Espinoza-Chiong, César; Scarsi-Mejia, Ottavia; Rojas-Camayo, José; Mejia, Christian Richard

    2016-01-01

    The aim of this study was to determine the association between alcohol dependence and altitude of residence in 11 villages in two high altitude areas of Peru. An analytical cross-sectional study was performed using a survey conducted by physicians in primary health care in 11 villages until 2013, that were divided into low altitude (≤2500m asl (above sea level)), and high altitude (>2500m asl) areas. The CAGE test for alcoholism (cut point, ≥2) was applied to those who responded positively when asked if they consumed alcohol. Statistical associations were obtained with generalised linear models Of the 737 participants, 51% were women and the median age was 36 years [interquartile range, 25-50], 334 (45%) lived at low altitude, and 113 (15%) had alcohol dependence. The highest frequency of alcoholism was positively associated with being a village considered extremely poor (Likelihood Ratio (LP)=2.42; 95%CI, 1.40-4.19), while being female (LP=0.44; 95%CI, 0.23-0.89) and residing at high altitude (LP=0.15; 95%CI, 0.07-0.31) were negatively associated. These were adjusted for nine socio-occupational and pathological variables. According to these data, there is a higher frequency of alcohol dependence in being, male, extremely poor, and residing at low altitude. These results should be taken into account by professionals who work in primary care and those involved in mental health care, because of their implications in society. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  14. Changes in maximal double poling performance during and after moderate altitude training in elite cross country skiers

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    Höög, Martina; Jensen, Kurt; Willis, Sarah;

    2013-01-01

    INTRODUCTION: In 2014, the Olympic cross-country ski competitions will be held in Sochi, Russia at approximately 1500m altitude. Even moderate altitude can have negative effects on performance in highly trained endurance athletes and individuals may adapt and react differently to altitude exposure...

  15. A Novel Approach to Critical Congenital Heart Disease (CCHD Screening at Moderate Altitude

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    Erin Lueth

    2016-07-01

    Full Text Available The American Academy of Pediatrics (AAP has endorsed Critical Congenital Heart Disease (CCHD screening using pulse oximetry nationwide, but, however, acknowledges that altitude may impact failure rates and alternative algorithms may be required at high altitudes. We therefore evaluated a modified screening protocol at an altitude of 6200 feet with the hypothesis that modifications could decrease failure rates. We evaluated 2001 well, newborn infants ≥35 weeks gestation using a modified protocol, which included a lower saturation cutoff for the first screen (85% instead of the AAP recommended 90% and an oxygen hood intervention between the first two screens. Using our modified screening algorithm, we found a 0.3% failure rate, which was similar to the 0.2% sea-level rate and statistically different from the 1.1% rate identified in a recent study at similar altitude. Had the AAP protocol been used, the failure rate would have increased to 0.8%, which is similar to prior reports near this altitude. Echocardiograms were performed on failing newborns with no CCHD identified. A Birth Defects Registry Database review demonstrated one newborn with CCHD was missed after meeting AAP passing criteria. Overall, this study demonstrates that an alternative algorithm can be implemented at moderate altitude with decreased failure rate and comparable false negative rate.

  16. Sleep respiratory disturbances and arousals at moderate altitude have overlapping electroencephalogram spectral signatures.

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    Stadelmann, Katrin; Latshang, Tsogyal D; Tarokh, Leila; Lo Cascio, Christian M; Tesler, Noemi; Stoewhas, Anne-Christin; Kohler, Malcolm; Bloch, Konrad E; Huber, Reto; Achermann, Peter

    2014-08-01

    An ascent to altitude has been shown to result in more central apneas and a shift towards lighter sleep in healthy individuals. This study employs spectral analysis to investigate the impact of respiratory disturbances (central/obstructive apnea and hypopnea or periodic breathing) at moderate altitude on the sleep electroencephalogram (EEG) and to compare EEG changes resulting from respiratory disturbances and arousals. Data were collected from 51 healthy male subjects who spent 1 night at moderate altitude (2590 m). Power density spectra of Stage 2 sleep were calculated in a subset (20) of these participants with sufficient artefact-free data for (a) epochs with respiratory events without an accompanying arousal, (b) epochs containing an arousal and (c) epochs of undisturbed Stage 2 sleep containing neither arousal nor respiratory events. Both arousals and respiratory disturbances resulted in reduced power in the delta, theta and spindle frequency range and increased beta power compared to undisturbed sleep. The similarity of the EEG changes resulting from altitude-induced respiratory disturbances and arousals indicates that central apneas are associated with micro-arousals, not apparent by visual inspection of the EEG. Our findings may have implications for sleep in patients and mountain tourists with central apneas and suggest that respiratory disturbances not accompanied by an arousal may, none the less, impact sleep quality and impair recuperative processes associated with sleep more than previously believed.

  17. Effects of Acute Exposure to Moderate Altitude on Vascular Function, Metabolism and Systemic Inflammation

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    Stöwhas, Anne-Christin; Latshang, Tsogyal D.; Lo Cascio, Christian M.; Lautwein, Sina; Stadelmann, Katrin; Tesler, Noemi; Ayers, Lisa; Berneis, Kaspar; Gerber, Philipp A.; Huber, Reto; Achermann, Peter; Bloch, Konrad E.; Kohler, Malcolm

    2013-01-01

    Background Travel to mountain areas is popular. However, the effects of acute exposure to moderate altitude on the cardiovascular system and metabolism are largely unknown. Objectives To investigate the effects of acute exposure to moderate altitude on vascular function, metabolism and systemic inflammation. Methods In 51 healthy male subjects with a mean (SD) age of 26.9 (9.3) years, oxygen saturation, blood pressure, heart rate, arterial stiffness, lipid profiles, low density lipoprotein (LDL) particle size, insulin resistance (HOMA-index), highly-sensitive C-reactive protein and pro-inflammatory cytokines were measured at 490 m (Zurich) and during two days at 2590 m, (Davos Jakobshorn, Switzerland) in randomized order. The largest differences in outcomes between the two altitudes are reported. Results Mean (SD) oxygen saturation was significantly lower at 2590 m, 91.0 (2.0)%, compared to 490 m, 96.0 (1.0)%, p<0.001. Mean blood pressure (mean difference +4.8 mmHg, p<0.001) and heart rate (mean difference +3.3 bpm, p<0.001) were significantly higher at 2590 m, compared to 490 m, but this was not associated with increased arterial stiffness. At 2590 m, lipid profiles improved (median difference triglycerides −0.14 mmol/l, p = 0.012, HDL +0.08 mmol/l, p<0.001, total cholesterol/HDL-ratio −0.25, p = 0.001), LDL particle size increased (median difference +0.45 nm, p = 0.048) and hsCRP decreased (median difference −0.18 mg/l, p = 0.024) compared to 490 m. No significant change in pro-inflammatory cytokines or insulin resistance was observed upon ascent to 2590 m. Conclusions Short-term stay at moderate altitude is associated with increased blood pressure and heart rate likely due to augmented sympathetic activity. Exposure to moderate altitude improves the lipid profile and systemic inflammation, but seems to have no significant effect on glucose metabolism. Trial Registration ClinicalTrials.gov NCT01130948 PMID:23936377

  18. Effects of acute exposure to moderate altitude on vascular function, metabolism and systemic inflammation.

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    Anne-Christin Stöwhas

    Full Text Available BACKGROUND: Travel to mountain areas is popular. However, the effects of acute exposure to moderate altitude on the cardiovascular system and metabolism are largely unknown. OBJECTIVES: To investigate the effects of acute exposure to moderate altitude on vascular function, metabolism and systemic inflammation. METHODS: In 51 healthy male subjects with a mean (SD age of 26.9 (9.3 years, oxygen saturation, blood pressure, heart rate, arterial stiffness, lipid profiles, low density lipoprotein (LDL particle size, insulin resistance (HOMA-index, highly-sensitive C-reactive protein and pro-inflammatory cytokines were measured at 490 m (Zurich and during two days at 2590 m, (Davos Jakobshorn, Switzerland in randomized order. The largest differences in outcomes between the two altitudes are reported. RESULTS: Mean (SD oxygen saturation was significantly lower at 2590 m, 91.0 (2.0%, compared to 490 m, 96.0 (1.0%, p<0.001. Mean blood pressure (mean difference +4.8 mmHg, p<0.001 and heart rate (mean difference +3.3 bpm, p<0.001 were significantly higher at 2590 m, compared to 490 m, but this was not associated with increased arterial stiffness. At 2590 m, lipid profiles improved (median difference triglycerides -0.14 mmol/l, p=0.012, HDL +0.08 mmol/l, p<0.001, total cholesterol/HDL-ratio -0.25, p=0.001, LDL particle size increased (median difference +0.45 nm, p=0.048 and hsCRP decreased (median difference -0.18 mg/l, p=0.024 compared to 490 m. No significant change in pro-inflammatory cytokines or insulin resistance was observed upon ascent to 2590 m. CONCLUSIONS: Short-term stay at moderate altitude is associated with increased blood pressure and heart rate likely due to augmented sympathetic activity. Exposure to moderate altitude improves the lipid profile and systemic inflammation, but seems to have no significant effect on glucose metabolism. TRIAL REGISTRATION: ClinicalTrials.gov NCT01130948.

  19. Cerebrovascular reactivity among native-raised high altitude residents: an fMRI study

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    Zhang Jiaxing

    2011-09-01

    Full Text Available Abstract Background The impact of long term residence on high altitude (HA on human brain has raised concern among researchers in recent years. This study investigated the cerebrovascular reactivity among native-born high altitude (HA residents as compared to native sea level (SL residents. The two groups were matched on the ancestral line, ages, gender ratios, and education levels. A visual cue guided maximum inspiration task with brief breath holding was performed by all the subjects while Blood-Oxygenation-Level-Dependent (BOLD functional Magnetic Resonance Imaging (fMRI data were acquired from them. Results Compared to SL controls, the HA group showed generally decreased cerebrovascular reactivity and longer delay in hemodynamic response. Clusters showing significant differences in the former aspect were located at the bilateral primary motor cortex, the right somatosensory association cortex, the right thalamus and the right caudate, the bilateral precuneus, the right cingulate gyrus and the right posterior cingulate cortex, as well as the left fusiform gyrus and the right lingual cortex; clusters showing significant differences in the latter aspect were located at the precuneus, the insula, the superior frontal and temporal gyrus, the somatosensory cortex (the postcentral gyrus and the cerebellar tonsil. Inspiratory reserve volume (IRV, which is an important aspect of pulmonary function, demonstrated significant correlation with the amount of BOLD signal change in multiple brain regions, particularly at the bilateral insula among the HA group. Conclusions Native-born HA residents generally showed reduced cerebrovascular reactivity as demonstrated in the hemodynamic response during a visual cue guided maximum inspiration task conducted with BOLD-fMRI. This effect was particularly manifested among brain regions that are typically involved in cerebral modulation of respiration.

  20. Verification Testing to Confirm VO2max in Altitude-Residing, Endurance-Trained Runners.

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    Weatherwax, R M; Richardson, T B; Beltz, N M; Nolan, P B; Dalleck, L

    2016-06-01

    We sought to explore the utility of the verification trial to confirm individual attainment of 'true' VO2max in altitude-residing, endurance-trained runners during treadmill exercise. 24 elite endurance-trained men and women runners (age=21.5±3.3 yr, ht=174.8±9.3 cm, body mass=60.5±6.7 kg, PR 800 m 127.5±13.1 s) completed a graded exercise test (GXT) trial (VO2max=60.0±5.8 mL·kg(-1)·min(-1)), and returned 20 min after incremental exercise to complete a verification trial (VO2max=59.6±5.7 mL·kg(-1)·min(-1)) of constant load, supramaximal exercise. The incidence of 'true' VO2max confirmation using the verification trial was 24/24 (100%) with all participants revealing differences in VO2max≤3% (the technical error of our equipment) between the GXT and verification trials. These findings support use of the verification trial to confirm VO2max attainment in altitude-residing, endurance-trained runners. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Neonatal variables, altitude of residence and Aymara ancestry in northern Chile.

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    Francisco Rothhammer

    Full Text Available Studies performed in the Andean plateau, one of the highest inhabited areas in the world, have reported that reduced availability of oxygen is associated to fetal growth retardation and lower birth weight, which are established predictors of morbidity and mortality during the first year of life. To test this hypothesis, perinatal variables of neonates born at the Juan Noé Hospital of Arica, Chile, were analyzed in relation to altitude of residence and Aymara ancestry of their mothers. The study population comprised the offspring of 5,295 mothers born between February 2004 and August 2010. Information included birth weight, height, head circumference, gestational age, altitude of residence and socioeconomic status, and was obtained from medical records. Mother´s ancestry was assessed based on surnames which were linked to percentages of Aymara admixture estimates relying on 40 selected ancestry informative markers. After correcting for the effect of multicollinearity among predictor variables, neonates born to mothers with an increased component of Aymara ancestry showed significantly higher birth weight and height at sea level, a marginally significant (p-value 0.06 decrease of birth weight and a significant decrease of height with altitude in comparison with the offspring of mothers with low Aymara ancestry. Since observed tendencies are suggestive of a possible genetic adaptation to hypoxia of the Chilean Aymara, we discuss briefly preliminary evidence related to fetal oxygen transport, particularly polymorphisms in the promoters of the HBG1 and HBG2 genes that are modulators of HbF synthesis, obtained in this ethnic group.

  2. Ion density and temperature variations at altitude of 500 km during moderate seismic activity

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    Bardhan, Ananna; Khurana, M. S.; Bahal, B. M.; Aggarwal, Malini; Sharma, D. K.

    2017-02-01

    Ionospheric ions (O+ and H+) and temperature (Ti) as precursory parameters to seismic activity have been analysed from year 1995 till 1998, using SROSS-C2 (average altitude range of ∼500 km) satellite measurements for moderate magnitude earthquakes. The details of seismic events during this period are downloaded from United State Geological Survey (USGS) and National Earthquake Information Centre (NEIC) website. 13 seismic events of moderate magnitude (M = 4-5.5) from 1995 to 1998, using SROSS-C2 satellite measurements have been analysed. During seismic affected period, considerable decrease in the density of heavier ion - O+ and increase in the ion temperature (Ti) is observed during all the selected events. Lighter ion - H+ doesn't show any significant change. Electric field and electromagnetic emissions generated due to seismogenic activity could be the plausible initializing agents responsible for change in ion concentration and temperature values during these events.

  3. Hemoglobin mass and peak oxygen uptake in untrained and trained female altitude residents.

    Science.gov (United States)

    Böning, D; Cristancho, E; Serrato, M; Reyes, O; Mora, M; Coy, L; Rojas, J

    2004-11-01

    Total hemoglobin mass has not been systematically investigated in females at altitude. We measured this quantity (CO-rebreathing method) as well as peak oxygen uptake in 54 young women (age 22.5 +/- 0.6 SE years) with differing physical fitness living in Bogota (2600 m) and compared the results with those of 19 subjects from 964 m in Colombia and 75 subjects from 35 m in Germany. In spite of an increased hemoglobin concentration the hemoglobin mass was not changed in highlanders (means 9.0 to 9.5 g . kg (-1) in untrained subjects at all altitude levels). Endurance trained athletes, however, showed a rise in hemoglobin mass by 2 - 3 g . kg (-1) at all sites. Erythropoietin was little increased in Bogota; iron stores were within the normal range. Aerobic performance capacity was lower at high altitude than at sea level and remained so also after correction for the hypoxic deterioration in untrained and moderately trained subjects but not in athletes; possibly the cause was reduced daily physical activity in non-athletic Bogotanians compared to lowlanders. After exclusion of the factor V.O(2peak) by analysis of covariance a mean rise of 6.6 % in hemoglobin mass at 2600 m was calculated being smaller than in males (> 12 %). The attenuated increase of hemoglobin mass in female highlanders possibly results from stimulation of ventilation improving arterial oxygen saturation or from an increased hypoxia tolerance of cellular metabolism both caused by female sexual hormones.

  4. Hypoxic hypoxia at moderate altitudes: review of the state of the science.

    Science.gov (United States)

    Petrassi, Frank A; Hodkinson, Peter D; Walters, P Lynne; Gaydos, Steven J

    2012-10-01

    Unpressurized aircraft routinely operate at altitudes where hypoxia may be of concern. A systematic literature review was conducted regarding hypoxic impairment, including mental functions, sensory deficits, and other pertinent research findings that may affect aviation-related duties at moderate altitude (8000 to 15,000 ft/2438 to 4572 m). The results of this review suggest that cognitive and psychomotor deficits may include learning, reaction time, decision-making, and certain types of memory. However, results are difficult to quantify and reliably reproduce. Inconsistency of results may be related to the subtlety of deficits compared to high altitude, differences among individual compensatory mechanisms, variation in methodology or sensitivity of metrics, presence or absence of exercise, heterogeneous neuronal central nervous system (CNS) response, and interindividual variation. Literature regarding hypoxic visual decrements is more consistent. Rod photoreceptors are more susceptible to hypoxia; visual degradation has been demonstrated at 4000 to 5000 ft (1219 to 1524 m) under scotopic and 10,000 ft (3048 m) under photopic conditions. Augmented night vision goggle resolution demonstrates more resilience to mild hypoxic effects than the unaided eye under starlight conditions. Hypocapnia enhances visual sensitivity and contrast discrimination. Hyperventilation with resulting respiratory alkalosis and cerebral vasoconstriction may confound both cognitive/ psychomotor and visual experimental results. Future research should include augmentation of validated neuropsychological metrics (surrogate investigational end points) with actual flight metrics, investigation of mixed gas formulations, contribution of hypocapnic vasoconstrictive effects on hypoxic performance, and further investigation into cellular- and systems-level approaches for heterogeneous CNS response. Research is also required into the contribution of mild-moderate hypoxia in human factors- and spatial

  5. Arterial oxygen saturation and hemoglobin mass in postmenopausal untrained and trained altitude residents.

    Science.gov (United States)

    Cristancho, Edgar; Reyes, Orlando; Serrato, Mauricio; Mora, María Mercedes; Rojas, Joel Alberto; Robinson, Yohan; Böning, Dieter

    2007-01-01

    Because of lacking ventilatory stimulation by sex hormones in postmenopausal women (PW), one might expect a lowered arterial oxygen saturation (S(O(2))) in hypoxia and therefore a stronger erythropoietic reaction than in young women (YW). Nine untrained (UTRPW) and 11 trained (TRPW) postmenopausal altitude residents (2600 m) were compared to 16 untrained (UTRYW) and 16 trained young women (TRYW) to check this hypothesis and to study the combined response to hypoxia and training. S(O(2)) was decreased in PW (89.2% +/- 2.2 vs. 93.6 +/- 0.7% in YW, p < 0.01). Hb mass, however, was similar in UT (UTRYW: 9.2 +/- 0.9 g/kg(1), UTRPW: 8.7 +/- 1.0 g/kg). But if body fat rise with age was excluded by relation to fat-free mass, Hb mass was increased in UTRPW (+1.2 g/kg, p < 0.05) compared to UTRYW. Training caused a similar rise of Hb mass in PW and YW (0.3 g/kg per mL/kg x min(1) rise in V(O(2peak))). There was no difference in erythropoietin among the groups. Ferritin was higher in PW than YW. The results show that female hormones and fitness level have to be considered in studies on erythropoiesis at altitude. The role of erythropoietin during chronic hypoxia still has to be clarified.

  6. Reconstructing Ion Spectra from Low-Altitude ENAs: Moderate to Large Storms.

    Science.gov (United States)

    LLera, K.; Goldstein, J.; McComas, D. J.; Valek, P. W.

    2015-12-01

    Two Wide-angle Imaging Neutral-atom Spectrometers (TWINS) Energetic neutral atom (ENA) imagers regularly observe Low-altitude Emission (LAE) intensifications during geomagnetic storm intervals. Since LAEs are produced by the interaction between ions and the near-Earth exosphere (altitudes ~200-800 km), they are a global signature of how the ring current decays in response to solar wind conditions. In this "optically thick" region, an ENA readily becomes reionized, and an ion is readily neutralized. Therefore, emerging ENAs that contribute to the LAE signal (detectable several RE away) have undergone multiple charge exchange and electron stripping interactions. Accounting for the ~36 eV energy loss per interaction, we developed a model to quantify the total energy lost by emergent LAEs. The analytical tool is applied to an ensemble of moderate to large storms (including the recent 17 March and 23 June storms in 2015) to reconstruct the parent ion spectra from TWINS ENA images. We examine the ion spectra energy characteristics among the various storm events.

  7. Effect of acute exposure to moderate altitude on muscle power: hypobaric hypoxia vs. normobaric hypoxia.

    Science.gov (United States)

    Feriche, Belén; García-Ramos, Amador; Calderón-Soto, Carmen; Drobnic, Franchek; Bonitch-Góngora, Juan G; Galilea, Pedro A; Riera, Joan; Padial, Paulino

    2014-01-01

    When ascending to a higher altitude, changes in air density and oxygen levels affect the way in which explosive actions are executed. This study was designed to compare the effects of acute exposure to real or simulated moderate hypoxia on the dynamics of the force-velocity relationship observed in bench press exercise. Twenty-eight combat sports athletes were assigned to two groups and assessed on two separate occasions: G1 (n = 17) in conditions of normoxia (N1) and hypobaric hypoxia (HH) and G2 (n = 11) in conditions of normoxia (N2) and normobaric hypoxia (NH). Individual and complete force-velocity relationships in bench press were determined on each assessment day. For each exercise repetition, we obtained the mean and peak velocity and power shown by the athletes. Maximum power (Pmax) was recorded as the highest P(mean) obtained across the complete force-velocity curve. Our findings indicate a significantly higher absolute load linked to P(max) (∼ 3%) and maximal strength (1 RM) (∼ 6%) in G1 attributable to the climb to altitude (Ppress.

  8. Physical Growth, Biological Age, and Nutritional Transitions of Adolescents Living at Moderate Altitudes in Peru

    Science.gov (United States)

    Cossio-Bolaños, Marco; Gómez Campos, Rossana; Andruske, Cynthia Lee; Flores, Antonio Viveros; Luarte-Rocha, Cristian; Olivares, Pedro R.; Garcia-Rubio, Javier; de Arruda, Miguel

    2015-01-01

    Background: Peru is experiencing a stage of nutritional transition where the principal characteristics are typical of countries undergoing development. Objectives: The objectives of this study were the following: (a) compare physical growth patterns with an international standard; (b) determine biological age; and (c) analyze the double nutritional burden of adolescents living at a moderate altitude in Peru. Design: Weight, standing height, and sitting height were measured in 551 adolescents of both sexes (12.0 to 17.9 years old) from an urban area of Arequipa, Peru (2328 m). Physical growth was compared with the international standard of the CDC-2000. Biological age was determined by using a non-invasive transversal technique based on years from age at peak height velocity (APHV). Nutritional state was determined by means of weight for age and height for age. Z scores were calculated using international standards from the CDC-2000. Results: Body weight for both sexes was similar to the CDC-2000 international standards. At all ages, the girls’ height (p < 0.05) was below the standards. However, the boys’ height (p < 0.05) was less at ages, 15, 16, and 17. Biological age showed up in girls at age 12.7 years and for boys at 15.2 years. Stunted growth (8.7% boys and 18.0% girls) and over weight (11.3% boys and 8.8% girls) occurred in both groups. A relationship existed in both sexes between the categories of weight for the age and stunted growth by sex. Conclusions: Adolescents living at a moderate altitude exhibited stunted linear growth and biological maturation. Furthermore, adolescents of both sexes showed the presence of the double nutritional burden (stunted growth and excessive weight). PMID:26404334

  9. Physical Growth, Biological Age, and Nutritional Transitions of Adolescents Living at Moderate Altitudes in Peru

    Directory of Open Access Journals (Sweden)

    Marco Cossio-Bolaños

    2015-09-01

    Full Text Available Background: Peru is experiencing a stage of nutritional transition where the principal characteristics are typical of countries undergoing development. Objectives: The objectives of this study were the following: (a compare physical growth patterns with an international standard; (b determine biological age; and (c analyze the double nutritional burden of adolescents living at a moderate altitude in Peru. Design: Weight, standing height, and sitting height were measured in 551 adolescents of both sexes (12.0 to 17.9 years old from an urban area of Arequipa, Peru (2328 m. Physical growth was compared with the international standard of the CDC-2000. Biological age was determined by using a non-invasive transversal technique based on years from age at peak height velocity (APHV. Nutritional state was determined by means of weight for age and height for age. Z scores were calculated using international standards from the CDC-2000. Results: Body weight for both sexes was similar to the CDC-2000 international standards. At all ages, the girls’ height (p < 0.05 was below the standards. However, the boys’ height (p < 0.05 was less at ages, 15, 16, and 17. Biological age showed up in girls at age 12.7 years and for boys at 15.2 years. Stunted growth (8.7% boys and 18.0% girls and over weight (11.3% boys and 8.8% girls occurred in both groups. A relationship existed in both sexes between the categories of weight for the age and stunted growth by sex. Conclusions: Adolescents living at a moderate altitude exhibited stunted linear growth and biological maturation. Furthermore, adolescents of both sexes showed the presence of the double nutritional burden (stunted growth and excessive weight.

  10. Fluid distribution and tissue thickness changes in 29 men during 1 week at moderate altitude (2,315 m).

    Science.gov (United States)

    Gunga, H C; Kirsch, K; Baartz, F; Steiner, H J; Wittels, P; Röcker, L

    1995-01-01

    To quantify fluid distribution at a moderate altitude (2,315 m) 29 male subjects were studied with respect to tissue thickness changes [front (forehead), sternum, tibia], changes of total body water, changes of plasma volume, total protein concentrations (TPC), colloid osmotic pressure (COP), and electrolytes. Tissue thickness at the forehead showed a significant increase from 4.14 mm to 4.41 mm 48 h after ascent to the Rudolfshuette (2,315 m) (P Rudolf-shuette in Saalfelden (744 m) COP was back to the control values. The TPC also showed an initial drop from 7.75 g.dl-1 to 7.48 g.dl-1 after 48 h at altitude and remained below the control value during the whole week (P < 0.01). It seems from our study that even with exposure to moderate altitude measurable fluid shifts to the upper part of the body occurred which were detected by our ultrasound method.

  11. Impaired postural control in healthy men at moderate altitude (1630 m and 2590 m: data from a randomized trial.

    Directory of Open Access Journals (Sweden)

    Katrin Stadelmann

    Full Text Available Intact postural control is essential for safe performance of mountain sports, operation of machinery at altitude, and for piloting airplanes. We tested whether exposure to hypobaric hypoxia at moderate altitude impairs the static postural control of healthy subjects.In 51 healthy men, median age 24 y (quartiles 20;28, static control was evaluated on a balance platform in Zurich, 490 m, and during a 4-day sojourn in Swiss mountain villages at 1630 m and 2590 m, 2 days each. The order of altitude exposure was randomized. Total center of pressure path length (COPL and sway amplitude measured in two directions by a balance platform, and pulse oximetry were recorded. Data were compared between altitudes.Median (quartiles COPL during standing on both legs with eyes open at 490 m and in the evenings on the first and second days at 1630 and 2590 m, respectively were: 50 (45;57, 55 (48;62, 56 (49;61, 53 (47;59, 54 (48;60 cm, P<0.001 ANOVA. Corresponding arterial oxygen saturation was 97% (96;97, 95% (94;96, 95%(94;96, 92%(90;93, 93%(91;93, P<0.001. Anterior-posterior sway amplitudes were larger at 1630 and 2590 m compared to 490 m, P<0.001. Multiple logistic regression analysis confirmed that higher altitudes (1630 and 2590m were independently associated with increased COPL when controlled for the order of altitude exposure and age (P=0.001.Exposure to 1630 and 2590m was associated with impaired static postural control even when visual references were available.ClinicalTrials.gov NCT01130948.

  12. Impaired Postural Control in Healthy Men at Moderate Altitude (1630 M and 2590 M): Data from a Randomized Trial

    Science.gov (United States)

    Stadelmann, Katrin; Latshang, Tsogyal D.; Lo Cascio, Christian M.; Clark, Ross A.; Huber, Reto; Kohler, Malcolm

    2015-01-01

    Objectives Intact postural control is essential for safe performance of mountain sports, operation of machinery at altitude, and for piloting airplanes. We tested whether exposure to hypobaric hypoxia at moderate altitude impairs the static postural control of healthy subjects. Methods In 51 healthy men, median age 24 y (quartiles 20;28), static control was evaluated on a balance platform in Zurich, 490 m, and during a 4-day sojourn in Swiss mountain villages at 1630 m and 2590 m, 2 days each. The order of altitude exposure was randomized. Total center of pressure path length (COPL) and sway amplitude measured in two directions by a balance platform, and pulse oximetry were recorded. Data were compared between altitudes. Results Median (quartiles) COPL during standing on both legs with eyes open at 490 m and in the evenings on the first and second days at 1630 and 2590 m, respectively were: 50 (45;57), 55 (48;62), 56 (49;61), 53 (47;59), 54 (48;60) cm, P<0.001 ANOVA. Corresponding arterial oxygen saturation was 97% (96;97), 95% (94;96), 95%(94;96), 92%(90;93), 93%(91;93), P<0.001. Anterior-posterior sway amplitudes were larger at 1630 and 2590 m compared to 490 m, P<0.001. Multiple logistic regression analysis confirmed that higher altitudes (1630 and 2590m) were independently associated with increased COPL when controlled for the order of altitude exposure and age (P=0.001). Conclusions Exposure to 1630 and 2590m was associated with impaired static postural control even when visual references were available. Trial Registration ClinicalTrials.gov NCT01130948. PMID:25723529

  13. Does altitude moderate the impact of lithium on suicide? : The case of Austria

    NARCIS (Netherlands)

    Helbich, M.; Blüml, V.; Leitner, M.; Kapusta, N.

    2013-01-01

    Suicide, the tenth leading cause of death worldwide, is a complex phenomenon. Models aiming to explain the interaction of ambient variables such as socioeconomic factors, lithium content of drinking water and altitude are poorly developed. While controlling for several risk factors, this research

  14. Are Nocturnal Breathing, Sleep, and Cognitive Performance Impaired at Moderate Altitude (1,630-2,590 m)?

    Science.gov (United States)

    Latshang, Tsogyal D.; Lo Cascio, Christian M.; Stöwhas, Anne-Christin; Grimm, Mirjam; Stadelmann, Katrin; Tesler, Noemi; Achermann, Peter; Huber, Reto; Kohler, Malcolm; Bloch, Konrad E.

    2013-01-01

    Study Objectives: Newcomers at high altitude (> 3,000 m) experience periodic breathing, sleep disturbances, and impaired cognitive performance. Whether similar adverse effects occur at lower elevations is uncertain, although numerous lowlanders travel to moderate altitude for professional or recreational activities. We evaluated the hypothesis that nocturnal breathing, sleep, and cognitive performance of lowlanders are impaired at moderate altitude. Design: Randomized crossover trial. Setting: University hospital at 490 m, Swiss mountain villages at 1,630 m and 2,590 m. Participants: Fifty-one healthy men, median (quartiles) age 24 y (20-28 y), living below 800 m. Interventions: Studies at Zurich (490 m) and during 4 consecutive days at 1,630 m and 2,590 m, respectively, 2 days each. The order of altitude exposure was randomized. Polysomnography, psychomotor vigilance tests (PVT), the number back test, several other tests of cognitive performance, and questionnaires were evaluated. Measurements and Results: The median (quartiles) apnea-hypopnea index at 490 m was 4.6/h (2.3; 7.9), values at 1,630 and 2,590 m, day 1 and 2, respectively, were 7.0/h (4.1; 12.6), 5.4/h (3.5; 10.5), 13.1/h (6.7; 32.1), and 8.0/h (4.4; 23.1); corresponding values of mean nocturnal oxygen saturation were 96% (95; 96), 94% (93; 95), 94% (93; 95), 90% (89; 91), 91% (90; 92), P < 0.05 versus 490 m, all instances. Slow wave sleep on the first night at 2,590 m was 21% (18; 25) versus 24% (20; 27) at 490 m (P < 0.05). Psychomotor vigilance and various other measures of cognitive performance did not change significantly. Conclusions: Healthy men acutely exposed during 4 days to hypoxemia at 1,630 m and 2,590 m reveal a considerable amount of periodic breathing and sleep disturbances. However, no significant effects on psychomotor reaction speed or cognitive performance were observed. Clinical Trials Registration: Clinicaltrials.gov: NCT01130948. Citation: Latshang TD; Lo Cascio CM; Stöwhas AC

  15. Under-detection of pain in elderly nursing home residents with moderate to severe dementia

    Directory of Open Access Journals (Sweden)

    D.K.Y. Miu, MBBS (HK MRCP (UK MPH (CUHK FRCP (Glasgow and Edinburgh

    2014-03-01

    Conclusion: Pain is highly prevalent among nursing home residents with moderate to severe dementia and is associated with the use of restraints. However, only half of the patients in this study were treated with analgesic drugs. An improvement in the caregivers' knowledge of pain assessment together with the provision of adequate treatment for pain is necessary in the care of these groups of patients with dementia.

  16. Extracellular pH defense against lactic acid in untrained and trained altitude residents.

    Science.gov (United States)

    Böning, D; Rojas, J; Serrato, M; Reyes, O; Coy, L; Mora, M

    2008-05-01

    The assumption that buffering at altitude is deteriorated by bicarbonate (bi) reduction was investigated. Extracellular pH defense against lactic acidosis was estimated from changes (Delta) in lactic acid ([La]), [HCO3-], pH and PCO2 in plasma, which equilibrates with interstitial fluid. These quantities were measured in earlobe blood during and after incremental bicycle exercise in 10 untrained (UT) and 11 endurance-trained (TR) highlanders (2,600 m). During exercise the capacity of non-bicarbonate buffers (betanbi=-Delta[La]. DeltapH(-1)-Delta[HCO3-]. DeltapH(-1)) amounted to 40+/-2 (SEM) and 28+/-2 mmol l(-1) in UT and TR, respectively (P<0.01). During recovery beta (nbi) decreased to 20 (UT) and 16 (TR) mmol l(-1) (P<0.001) corresponding to values expected from hemoglobin, dissolved protein and phosphate concentrations related to extracellular fluid (ecf). This was accompanied by a larger decrease of base excess after than during exercise for a given Delta[La]. betabi amounted to 37-41 mmol l(-1) being lower than at sea level. The large exercise betanbi was mainly caused by increasing concentrations of buffers due to temporary shrinking of ecf. Tr has lower betanbi in spite of an increased Hb mass mainly because of an expanded ecf compared to UT. In highlanders betanbi is higher than in lowlanders because of larger Hb mass and reduced ecf and counteracts the decrease in [HCO3-]. The amount of bicarbonate is probably reduced by reduction of the ecf at altitude but this is compensated by lower maximal [La] and more effective hyperventilation resulting in attenuated exercise acidosis at exhaustion.

  17. Prevalence of Vitamin B12 and Folate Deficiency in School Children Residing at High Altitude Regions in India.

    Science.gov (United States)

    Gupta, Aakriti; Kapil, Umesh; Ramakrishnan, Lakshmy; Pandey, Ravindra Mohan; Yadav, Chander Prakash

    2017-04-01

    To assess the prevalence of vitamin B12 and folate deficiencies among children residing at high altitude regions of Himachal Pradesh, India. A total of 215 school children in the age group of 6-18 y were included. Biochemical estimation of serum vitamin B12 and folate levels was undertaken using chemiluminescence immunoassay method. The consumption pattern of foods high in dietary vitamin B12 and folate was recorded using Food Frequency Questionnaire. The median levels (interquartile range) of serum vitamin B12 and folate were 326 (259-395) pg/ml and 7.7 (6-10) ng/ml respectively. The prevalence of vitamin B12 and folate deficiency amongst school age children was found as 7.4% and 1.5% respectively. A low prevalence of vitamin B12 and folate deficiencies was found amongst children aged 6-18 y living at high altitude regions in India. This is possibly due to high frequency of consumption of foods rich in vitamin B12 and folate.

  18. [Applicability of BMI in adolescent students living at moderate altitude of Perú].

    Science.gov (United States)

    Cossio Bolaños, Marco Antonio; Viveros Flores, Antonio; Eduardo Hespanhol, Jefferson; Camargo, Cristiane; Gomez Campos, Rossana

    2014-11-01

    Introducción y objetivos: El uso del IMC es muy cuestionado, sobretodo, en poblaciones en fase de crecimiento que se caracterizan por presentar baja estatura para su edad. El objetivo es verificar si el IMC es aplicable a una muestra de escolares adolescentes que viven en una región de moderada altitud del Perú. Material y Métodos: Estudio descriptivo transversal realizado en 319 adolescentes escolares (181 hombres y 138 mujeres) de 12,0 a 17,9 años de edad. Se evaluó las variables antropométricas del peso y la estatura. Se calculó el Índice de Masa Corporal (IMC). Se utilizó la referencia del CDC-2000 para comparar el peso y estatura a partir del Z-score y el IMC por medio de diferencia de medias. Resultados: El Z-score para el peso corporal mostró pequeñas variaciones (entre -0,3 a 0,3 kg). En la estatura se observa valores negativos para ambos sexos (hombres entre -0,3 a -1,3 cm y mujeres entre -0,5 a 1,3 cm). Respecto al IMC, hubo diferencias significativas en todas la edades y en ambos sexos (p.

  19. Body fluid alterations during head-down bed rest in men at moderate altitude

    Science.gov (United States)

    Loeppky, J. A.; Roach, R. C.; Selland, M. A.; Scotto, P.; Luft, F. C.; Luft, U. C.

    1993-01-01

    To determine the effects of hypoxia on fluid balance responses to simulated zero-gravity, measurements were made in six subjects before and during -5 deg continuous head-down bed rest (HDBR) over 8 d at 10,678 ft. The same subjects were studied again at this altitude without HDBR as a control (CON) using a cross-over design. During this time, they maintained normal upright day-time activities, sleeping in the horizontal position at night. Fluid balance changes during HDBR in hypoxia were more pronounced than similar measurements previously reported from HDBR studies at sea level. Plasma volume loss was slightly greater and the diuresis and natriuresis were doubled in magnitude as compared to previous studies in normoxia and sustained for 4 d during hypoxia. These changes were associated with an immediate but transient rise in plasma atrial natriuretic peptide (ANP) to day 4 of 140 percent in HDBR and 41 percent in CON (p less than 0.005), followed by a decline towards baseline. Differences were less striking between HDBR and CON for plasma antidiuretic hormone and aldosterone, which were transiently reduced by HDBR. Plasma catecholamines showed a similar pattern to ANP in both HDBR and CON, suggesting that elevated ANP and catecholamines together accounted for the enhanced fluid shifts with HDBR during hypoxia.

  20. Lower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation.

    Directory of Open Access Journals (Sweden)

    Jameson D Voss

    Full Text Available We sought to evaluate whether residence at high altitude is associated with the development of obesity among those at increased risk of becoming obese. Obesity, a leading global health priority, is often refractory to care. A potentially novel intervention is hypoxia, which has demonstrated positive long-term metabolic effects in rats. Whether or not high altitude residence confers benefit in humans, however, remains unknown. Using a quasi-experimental, retrospective study design, we observed all outpatient medical encounters for overweight active component enlisted service members in the U.S. Army or Air Force from January 2006 to December 2012 who were stationed in the United States. We compared high altitude (>1.96 kilometers above sea level duty assignment with low altitude (<0.98 kilometers. The outcome of interest was obesity related ICD-9 codes (278.00-01, V85.3x-V85.54 by Cox regression. We found service members had a lower hazard ratio (HR of incident obesity diagnosis if stationed at high altitude as compared to low altitude (HR 0.59, 95% confidence interval [CI] 0.54-0.65; p<0.001. Using geographic distribution of obesity prevalence among civilians throughout the U.S. as a covariate (as measured by the Centers for Disease Control and Prevention and the REGARDS study also predicted obesity onset among service members. In conclusion, high altitude residence predicts lower rates of new obesity diagnoses among overweight service members in the U.S. Army and Air Force. Future studies should assign exposure using randomization, clarify the mechanism(s of this relationship, and assess the net balance of harms and benefits of high altitude on obesity prevention.

  1. Family cohesion moderates the relationship between acculturative stress and depression in Japanese adolescent temporary residents.

    Science.gov (United States)

    Roley, Michelle E; Kawakami, Ryoko; Baker, Jessica; Hurtado, Gabriela; Chin, Andrew; Hovey, Joseph D

    2014-12-01

    Acculturative stress is a risk factor for depression, and may be important in the risk for depression among acculturating Japanese adolescents. However, little to no research has been published on the mental health of acculturating Japanese adolescents. Further, although family cohesion has been shown to be protective against depression across ethnic groups, no prior research has examined family cohesion as a protective factor for Japanese adolescents. To examine these relationships, 26 Japanese temporary resident adolescents and 76 parents in the Midwest were recruited to participate. Moderate to strong correlations between acculturative stress, depression, likelihood for and seriousness of family conflict were found. A regression analysis found that likelihood for family conflict moderated the relationship between acculturative stress and depression. Findings broaden our understanding of the role of acculturative stress and family conflict on depression risk for Japanese adolescent immigrants.

  2. Improved running economy and increased hemoglobin mass in elite runners after extended moderate altitude exposure.

    Science.gov (United States)

    Saunders, P U; Telford, R D; Pyne, D B; Hahn, A G; Gore, C J

    2009-01-01

    There is conflicting evidence whether hypoxia improves running economy (RE), maximal O(2) uptake (V(O)(2max)), haemoglobin mass (Hb(mass)) and performance, and what total accumulated dose is necessary for effective adaptation. The aim of this study was to determine the effect of an extended hypoxic exposure on these physiological and performance measures. Nine elite middle distance runners were randomly assigned to a live high-train low simulated altitude group (ALT) and spent 46+/-8 nights (mean+/-S.D.) at 2860+/-41m. A matched control group (CON, n=9) lived and trained near sea level ( approximately 600m). ALT decreased submaximal V(O)(2) (Lmin(-1)) (-3.2%, 90% confidence intervals, -1.0% to -5.2%, p=0.02), increased Hb(mass) (4.9%, 2.3-7.6%, p=0.01), decreased submaximal heart rate (-3.1%, -1.8% to -4.4%, p=0.00) and had a trivial increase in V(O)(2max) (1.5%, -1.6 to 4.8; p=0.41) compared with CON. There was a trivial correlation between change in Hb(mass) and change in V(O)(2max) (r=0.04, p=0.93). Hypoxic exposure of approximately 400h was sufficient to improve Hb(mass), a response not observed with shorter exposures. Although total O(2) carrying capacity was improved, the mechanism(s) to explain the lack of proportionate increase in V(O)(2max) were not identified.

  3. A cross-sectional study of differences in 6-min walk distance in healthy adults residing at high altitude versus sea level

    Science.gov (United States)

    2014-01-01

    Background We sought to determine if adult residents living at high altitude have developed sufficient adaptation to a hypoxic environment to match the functional capacity of a similar population at sea level. To test this hypothesis, we compared the 6-min walk test distance (6MWD) in 334 residents living at sea level vs. at high altitude. Methods We enrolled 168 healthy adults aged ≥35 years residing at sea level in Lima and 166 individuals residing at 3,825 m above sea level in Puno, Peru. Participants completed a 6-min walk test, answered a sociodemographics and clinical questionnaire, underwent spirometry, and a blood test. Results Average age was 54.0 vs. 53.8 years, 48% vs. 43% were male, average height was 155 vs. 158 cm, average blood oxygen saturation was 98% vs. 90%, and average resting heart rate was 67 vs. 72 beats/min in Lima vs. Puno. In multivariable regression, participants in Puno walked 47.6 m less (95% CI -81.7 to -13.6 m; p < 0.01) than those in Lima. Other variables besides age and height that were associated with 6MWD include change in heart rate (4.0 m per beats/min increase above resting heart rate; p < 0.001) and percent body fat (-1.4 m per % increase; p = 0.02). Conclusions The 6-min walk test predicted a lowered functional capacity among Andean high altitude vs. sea level natives at their altitude of residence, which could be explained by an incomplete adaptation or a protective mechanism favoring neuro- and cardioprotection over psychomotor activity. PMID:24484777

  4. Prevalence and determinants of hyperlipidemia in moderate altitude areas of the Yunnan-Kweichow plateau in Southwestern China.

    Science.gov (United States)

    Deng, Bingjun; Luo, Tingguang; Huang, Yanfei; Shen, Tianhang; Ma, Jing

    2012-03-01

    The objective of the current study was to determine the prevalence and determinants of hyperlipidemia among the populations living at moderate altitude on the Yunnan-Kweichow Plateau in Southwestern China. We randomly recruited 1415 people for this study. These subjects underwent a physical examination and a comprehensive questionnaire regarding their daily habits and diets. Furthermore, blood samples from the participants were collected for assessing the lipid profile. We found that 49.3% of participants (95% CI: 46.7-51.9%) suffered from hyperlipidemia. The prevalence in men was significantly higher than that in women (53.6% vs. 44.7%, pdine out often and consume more animal-based foods and alcohol. In addition, the hyperlipidemic men in our cohort consumed more salted food then their normolipidemic counterparts (pdining out, and BMI were found to be the main determinants of hyperlipidemia in women, whereas a prevalence of salted food was observed to be related to hyperlipidemia in men from the Yunnan-Kweichow Plateau subpopulation under study (p<0.05). The average daily energy, and protein and fat intakes of the sampled subjects were also higher than the levels set by the Chinese Recommendation Nutrient Intakes (RNI), while hyperlipidemic subjects had an even higher average daily intake of total fat, cholesterol, and lower dietary fiber compared with the normolipidemic subjects in the study group (p<0.05). In conclusion, this study reveals a higher prevalence of hyperlipidemia, hypercholesterolemia, hypertriglyceridemia, increased BMI and WHR values in men, as well as a slightly higher prevalence of low HDL-C and high LDL-C in women from Yunnan-Kweichow Plateau. The incidence of hyperlipidemia also increased with age, as did the prevalence of an abnormal TC, TG, LDL-C, and WHR in our study cohort. A high BMI, and less healthy living habits and dietary preferences thus play significant roles in the onset of hyperlipidemia.

  5. Anatomical and hemodynamic evaluations of the heart and pulmonary arterial pressure in healthy children residing at high altitude in China

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    Hai-Ying Qi

    2015-06-01

    Conclusions: Children living at high altitude in China have significantly higher mPAP, dilated right heart and slower regression of right ventricular hypertrophy in the first 14 years of life. Systolic and diastolic functions of both ventricles were reduced with a paradoxically higher CI. There was no significant difference in these features between the Hans and the Tibetans. These values provide references for the care of healthy children and the sick ones with cardiopulmonary diseases at high altitude.

  6. Sildenafil does not improve steady state cardiovascular hemodynamics, peak power, or 15-km time trial cycling performance at simulated moderate or high altitudes in men and women.

    Science.gov (United States)

    Kressler, Jochen; Stoutenberg, Mark; Roos, Bernard A; Friedlander, Anne L; Perry, Arlette C; Signorile, Joseph F; Jacobs, Kevin A

    2011-12-01

    Sildenafil improves oxygen delivery and maximal exercise capacity at very high altitudes (≥ 4,350 m), but it is unknown whether sildenafil improves these variables and longer-duration exercise performance at moderate and high altitudes where competitions are more common. The purpose of this study was to determine the effects of sildenafil on cardiovascular hemodynamics, arterial oxygen saturation (SaO(2)), peak exercise capacity (W (peak)), and 15-km time trial performance in endurance-trained subjects at simulated moderate (MA; ~2,100 m, 16.2% F(I)O(2)) and high (HA; ~3,900 m, 12.8% F(I)O(2)) altitudes. Eleven men and ten women completed two HA W (peak) trials after ingesting placebo or 50 mg sildenafil. Subjects then completed four exercise trials (30 min at 55% of altitude-specific W (peak) + 15-km time trial) at MA and HA after ingesting placebo or 50 mg sildenafil. All trials were performed in randomized, counterbalanced, and double-blind fashion. Sildenafil had little influence on cardiovascular hemodynamics at MA or HA, but did result in higher SaO(2) values (+3%, p < 0.05) compared to placebo during steady state and time trial exercise at HA. W (peak) at HA was 19% lower than SL (p < 0.001) and was not significantly affected by sildenafil. Similarly, the significantly slower time trial performance at MA (28.1 ± 0.5 min, p = 0.016) and HA (30.3 ± 0.6 min, p < 0.001) compared to SL (27.5 ± 0.6 min) was unaffected by sildenafil. We conclude that sildenafil is unlikely to exert beneficial effects at altitudes <4,000 m for a majority of the population.

  7. Prevalence of Vitamin D deficiency and associated risk factors among children residing at high altitude in Shimla district, Himachal Pradesh, India

    Science.gov (United States)

    Kapil, Umesh; Pandey, Ravindra Mohan; Goswami, Ravinder; Sharma, Brij; Sharma, Neetu; Ramakrishnan, Lakshmy; Singh, Gajendra; Sareen, Neha; Sati, Hem Chandra; Gupta, Aakriti; Sofi, Nighat Yaseen

    2017-01-01

    Introduction: Vitamin D is important for bone development in children. A high prevalence of Vitamin D deficiency (VDD) has been documented from different parts of India. However, limited data are available on VDD among children residing at high altitude region of country. Objectives: To assess the prevalence of VDD and associated risk factors among children in the age group of 6–18 years in Shimla, Himachal Pradesh. Methods: A community-based cross-sectional study was conducted in the year 2014–2015. A total of 626 children in the age group of 6–18 years were enrolled from 30 clusters which were identified using population proportionate to size sampling method. A minimum of 20 children in the age group of 6–18 years per cluster were selected using random number tables. The data on socioeconomic status, physical activity, sunlight exposure, and biochemical parameters of bone and mineral metabolism were assessed. Results: Ninety-three percent of school-age children were found Vitamin D deficient as per serum 25(OH) D levels of <20 ng/ml. The prevalence was significantly higher among females. Conclusion: A high prevalence of VDD was found in children residing in high altitude region. PMID:28217519

  8. Physical Performance and Quality of Life of Nursing-Home Residents with Mild and Moderate Dementia

    Directory of Open Access Journals (Sweden)

    Elisabeth Wiken Telenius

    2013-12-01

    Full Text Available Introduction: The aims of this study were to describe the quality of life (QoL of nursing-home residents with dementia and their balance, mobility, muscle strength and daily life activity, as well as to examine the associations between QoL and levels of balance, mobility, muscle strength and daily life activity. Methods: The study is cross sectional, and 170 nursing-home residents with dementia were included. Tests: “The quality of life in late-stage dementia scale” (QUALID, Berg Balance Scale, comfortable walking speed, maximum walking speed, 30-s sit-to-stand, Barthel Index, Clinical Dementia Rating Scale, the Clock Drawing Test and the Mini-Mental State Examination (MMSE were used. Results: Our study showed that nursing-home residents with dementia are a heterogeneous group regarding registrations of QUALID and physical function measures. The scores on the QUALID ranged from 11 to 41 points. Higher scores on the 30-s sit-to-stand and Berg Balance Scale were associated with a better QUALID. For comfortable, as well as maximum, walking speed there was a trend towards better QUALID results for those participants with higher walking speed. Conclusions: Good muscle strength and balance were the most important physical performance variables significantly associated with a good QUALID score.

  9. Effect of low altitude at the Dead Sea on exercise capacity and cardiopulmonary response to exercise in cystic fibrosis patients with moderate to severe lung disease.

    Science.gov (United States)

    Falk, Bareket; Nini, Asaph; Zigel, Levana; Yahav, Yaacov; Aviram, Micha; Rivlin, Joseph; Bentur, Lea; Avital, Avraham; Dotan, Raffy; Blau, Hannah

    2006-03-01

    Oxygen supplementation may improve exercise tolerance and the physiological response to exercise in cystic fibrosis (CF) patients. Elevated barometric pressure at low altitude is a simple means of increasing the quantity of inspired oxygen. Our objectives were to examine the effect of natural oxygen enrichment (at the Dead Sea, 396 m below sea level) on exercise capacity, and the physiological responses to maximal and submaximal exercise in CF patients. Patients were tested twice: at sea level (barometric pressure, 754 +/- 6 mmHg, mean +/- SD), and at the Dead Sea (barometric pressure, 791 +/- 3 mmHg), in a randomized crossover design. We studied 14 CF patients (6 females, 8 males), aged 15-45 years, with moderate to severe lung disease (mean forced expired volume in 1 sec = 50.0 +/- 11.2% predicted). Tests at each site included resting spirometry, anthropometry, a graded submaximal exercise test, a maximal exercise test on a treadmill, and a 6-min walk test. Tests were performed in identical order at both sites. Tests at the Dead Sea were performed 72 hr after arrival. No differences between sites were observed in lung function at rest. Peak oxygen consumption was significantly improved at the Dead Sea compared with sea level (1.68 +/- 0.73 vs. 1.57 +/- 0.74 l/min, respectively, P = 0.05), along with an improvement in the ventilatory equivalent for oxygen (41.2 +/- 6.3 vs. 46.1 +/- 7.1, respectively, P Dead Sea compared with sea level at all exercise intensities (P Dead Sea area may have physiological benefits for CF patients with moderate to severe lung disease.

  10. Place of Residence Moderates the Risk of Infant Death in Kenya: Evidence from the Most Recent Census 2009.

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    Oliver Gruebner

    Full Text Available Substantial progress has been made in reducing childhood mortality worldwide from 1990-2015 (Millennium Development Goal, target 4. Achieving target goals on this however remains a challenge in Sub-Saharan Africa. Kenya's infant mortality rates are higher than the global average and are more pronounced in urban areas as compared to rural areas. Only limited knowledge exists about the differences in individual level risk factors for infant death among rural, non-slum urban, and slum areas in Kenya. Therefore, this paper aims at 1 assess individual and socio-ecological risk factors for infant death in Kenya, and at 2 identify whether living in rural, non-slum urban, or slum areas moderated individual or socio-ecological risk factors for infant death in Kenya.We used a cross-sectional study design based on the most recent Kenya Population and Housing Census of 2009 and extracted the records of all females who had their last child born in 12 months preceding the survey (N = 1,120,960. Multivariable regression analyses were used to identify risk factors that accounted for the risk of dying before the age of one at the individual level in Kenya. Place of residence (rural, non-slum urban, slum was used as an interaction term to account for moderating effects in individual and socio-ecological risk factors.Individual characteristics of mothers and children (older age, less previously born children that died, better education, girl infants and household contexts (better structural quality of housing, improved water and sanitation, married household head were associated with lower risk for infant death in Kenya. Living in non-slum urban areas was associated with significantly lower infant death as compared to living in rural or slum areas, when all predictors were held at their reference levels. Moreover, place of residence was significantly moderating individual level predictors: As compared to rural areas, living in urban areas was a protective factor

  11. Gender, age, and place of residence as moderators of the internalized homophobia-depressive symptoms relation among Australian gay men and lesbians.

    Science.gov (United States)

    McLaren, Suzanne

    2015-01-01

    Internalized homophobia is a risk factor for depression among gay men and lesbians. The aim of the study was to test whether the internalized homophobia-depression relation was moderated by gender (stronger among gay men compared with lesbians), age (stronger among younger compared with older gay men and lesbians), and place of residence (stronger among gay men and lesbians who live in rural areas compared with those who live in urban areas). An Australian sample of 311 self-identified gay men and 570 self-identified lesbians, aged 18 to 70 years, completed the Internalized Homophobia Scale and the Centre for Epidemiological Studies Depression Scale. Results indicated that age and gender did not moderate the internalized homophobia-depressive symptoms relation. Place of residence was a significant moderator for gay men but not lesbians. In contrast to the hypothesis, the internalized homophobia-depression relation was significant only among gay men who resided in urban areas. Those who work with gay men should be particularly aware of the significant relationship between internalized homophobia and depressive symptoms among gay men who reside in urban areas.

  12. Benefits of high altitude allergen avoidance in atopic adolescents with moderate to severe asthma, over and above treatment with high dose inhaled steroids

    NARCIS (Netherlands)

    Grootendorst, DC; Dahlen, SE; Van den Bos, JW; Duiverman, EJ; Veselic-Charvat, M; Vrijlandt, EJLE; O'Sullivan, S; Kumlin, M; Sterk, PJ; Roldaan, AC

    2001-01-01

    Background Some patients with severe asthma cannot be controlled with high doses of inhaled steroids (ICS), which may be related to ongoing environmental allergen exposure. Objective We investigated whether 10 weeks of high altitude allergen avoidance leads to sustained benefits regarding clinical a

  13. Assessment of physical growth through body proportionality in Peruvian children living at moderately elevated altitudes. http://dx.doi.org/10.5007/1980-0037.2012v14n6p690

    Directory of Open Access Journals (Sweden)

    Maria Fargueta

    2012-11-01

    Full Text Available The strategy of our approach involves the use of an instrument for measuring body proportionality for the purpose of comparing growth of segments to body dimensions. The objective of this descriptive transversal study is to assess physical growth through body proportionality of school children, aged 6 to 12 years, living at moderately elevated altitudes. Study participants included 482 females and 473 males ranging in ages from 6 to 12 years and possessing middle socioeconomic status. The students were selected from a stratified probability segment of 6,659 students. In all, we evaluated: anthropometric measurements of weight (kg, height (m, five skinfolds (mm, four body perimeters and four body-bone diameters. Proportionality analyses were performed using the Phantom theoretical model proposed by Ross and Wilson (1974. The results of the Phantom Z-scores for both genders show generally negative values for body weight (-3.7 to -1.7, skinfold thickness (0.5 to -1.5, and body circumference (-0.9 to -1.3. In turn, bone diameters show positive values in all ages as well as in both genders (1.0 to 3.2. The results suggest that school children living at moderately elevated altitudes are characterized by slow growth correlated to body weight; on the other hand, skinfold thicknesses and body circumferences in relation to bone diameters exhibit a tendency to robustness.

  14. Efficacy of Residence at Moderate Versus Low Altitude on Reducing Acute Mountain Sickness in Men Following Rapid Ascent to 4300 m

    Science.gov (United States)

    2013-01-01

    AL, Rock PB, Muza SR, and Cymerman A. (2005). Carbohydrate supplementation im- proves cycle time-trial performance during energy deficit at 4,300-m...Heinicke K, Rojas J, Manuel J, Serrato GM, Mora M, Wolfarth B, Schmid A, and Keul J. (2002). Blood volume and hemoglobin mass in endurance athletes from

  15. Brain Food at High Altitude.

    Science.gov (United States)

    Jain, Vishal

    2016-01-01

    Scenic view at high altitude is a pleasure to the eyes, but it has some shortcoming effects as well. High altitude can be divided into different categories, i.e., high altitude (3000-5000 ft), very high altitude (5000-8000 ft), and extreme altitude (above 8000 ft). Much of the population resides at high altitude, and others go there for tourism. Military personnel are also posted there to defend boundaries. As we ascent to high altitude, partial pressure of oxygen reduces, whereas concentration remains the same; this reduces the availability of oxygen to different body parts. This pathophysiological condition is known as hypobaric hypoxia (HH) which leads to oxidative stress and further causes cognitive dysfunction in some cases. Hypoxia causes neurodegeneration in different brain regions; however, the hippocampus is found to be more prone in comparison to other brain regions. As the hippocampus is affected most, therefore, spatial memory is impaired most during such condition. This chapter will give a brief review of the damaging effect of high altitude on cognition and also throw light on possible herbal interventions at high altitude, which can improve cognitive performance as well as provide protection against the deteriorating effect of hypobaric hypoxia at high altitude.

  16. Comparing high altitude treatment with current best care in Dutch children with moderate to severe atopic dermatitis (and asthma): study protocol for a pragmatic randomized controlled trial (DAVOS trial).

    Science.gov (United States)

    Fieten, Karin B; Zijlstra, Wieneke T; van Os-Medendorp, Harmieke; Meijer, Yolanda; Venema, Monica Uniken; Rijssenbeek-Nouwens, Lous; l'Hoir, Monique P; Bruijnzeel-Koomen, Carla A; Pasmans, Suzanne G M A

    2014-03-26

    About 10 to 20% of children in West European countries have atopic dermatitis (AD), often as part of the atopic syndrome. The full atopic syndrome also consists of allergic asthma, allergic rhinitis and food allergy. Treatment approaches for atopic dermatitis and asthma include intermittent anti-inflammatory therapy with corticosteroids, health education and self-management training. However, symptoms persist in a subgroup of patients. Several observational studies have shown significant improvement in clinical symptoms in children and adults with atopic dermatitis or asthma after treatment at high altitude, but evidence on the efficacy when compared to treatment at sea level is still lacking. This study is a pragmatic randomized controlled trial for children with moderate to severe AD within the atopic syndrome. Patients are eligible for enrolment in the study if they are: diagnosed with moderate to severe AD within the atopic syndrome, aged between 8 and 18 years, fluent in the Dutch language, have internet access at home, able to use the digital patient system Digital Eczema Center Utrecht (DECU), willing and able to stay in Davos for a six week treatment period. All data are collected at the Wilhelmina Children's Hospital and DECU. Patients are randomized over two groups. The first group receives multidisciplinary inpatient treatment during six weeks at the Dutch Asthma Center in Davos, Switzerland. The second group receives multidisciplinary treatment during six weeks at the outpatient clinic of the Wilhelmina Children's Hospital, Utrecht, the Netherlands. The trial is not conducted as a blind trial. The trial is designed with three components: psychosocial, clinical and translational. Primary outcomes are coping with itch, quality of life and disease activity. Secondary outcomes include asthma control, medication use, parental quality of life, social and emotional wellbeing of the child and translational parameters. The results of this trial will provide

  17. Altitude headache.

    Science.gov (United States)

    Lopez, J Ivan; Holdridge, Ashley; Mendizabal, Jorge E

    2013-12-01

    High altitude headache (HAH) has been defined by the International Headache Society as a headache that appears within 24 hours after ascent to 2,500 m or higher [1••]. The headache can appear in isolation or as part of acute mountain sickness (AMS), which has more dramatic symptoms than the headache alone. If symptoms are ignored, more serious conditions such as high altitude cerebral edema (HACE), high altitude pulmonary edema (HAPE), or even death may ensue. While there is no definitive understanding of the underlying pathophysiologic mechanism, it is speculated that HAH occurs from the combination of hypoxemia-induced intracranial vasodilation and subsequent cerebral edema. There are a number of preventive measures that can be adopted prior to ascending, including acclimatization and various medications. A variety of pharmacological interventions are also available to clinicians to treat this extremely widespread condition.

  18. Soccer activity profile of altitude versus sea-level natives during acclimatisation to 3600 m (ISA3600)

    Science.gov (United States)

    Aughey, Robert J; Hammond, Kristal; Varley, Matthew C; Schmidt, Walter F; Bourdon, Pitre C; Buchheit, Martin; Simpson, Ben; Garvican-Lewis, Laura A; Kley, Marlen; Soria, Rudy; Sargent, Charli; Roach, Gregory D; Claros, Jesus C Jimenez; Wachsmuth, Nadine; Gore, Christopher J

    2013-01-01

    Objectives We investigated the effect of high altitude on the match activity profile of elite youth high altitude and sea level residents. Methods Twenty Sea Level (Australian) and 19 Altitude-resident (Bolivian) soccer players played five games, two near sea level (430 m) and three in La Paz (3600 m). Match activity profile was quantified via global positioning system with the peak 5 min period for distance ((D5peak)) and high velocity running (>4.17 m/s, HIVR5peak); as well as the 5 min period immediately subsequent to the peak for both distance (D5sub) and high-velocity running (HIVR5sub) identified using a rolling 5 min epoch. The games at 3600 m were compared with the average of the two near sea-level games. Results The total distance per minute was reduced by a small magnitude in the first match at altitude in both teams, without any change in low-velocity running. There were variable changes in HiVR, D5peak and HiVR5peak from match to match for each team. There were within-team reductions in D5peak in each game at altitude compared with those at near sea level, and this reduction was greater by a small magnitude in Australians than Bolivians in game 4. The effect of altitude on HiVR5peak was moderately lower in Australians compared with Bolivians in game 3. There was no clear difference in the effect of altitude on maximal accelerations between teams. Conclusions High altitude reduces the distance covered by elite youth soccer players during matches. Neither 13 days of acclimatisation nor lifelong residence at high altitude protects against detrimental effects of altitude on match activity profile. PMID:24282196

  19. De-adaptation change in cardiac function of laborers engaged in physical labor at high altitude after returning to lower altitude

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    En-zhi FENG

    2012-09-01

    Full Text Available Objective To assess the effects of physical labor on cardiac function of laborers at high altitude and changes in cardiac function after returning to lower altitude. Methods According to symptomatic scores on Chinese acute high altitude reaction (AHAR, 96 male officers and soldiers, who rapidly entered high altitude areas (3700m altitude,and engaged in heavy physical work for 50 days, were be scored and graded. Levels of creatine kinase isoenzymes -MB (CK-MB and lactic dehydrogenase isoenzyme -1 (LDH-1 in the serum, Tei index, left ventricular ejection fraction (LVEF, and left ventricular fractional shortening (LVFS were measured in the 96 servicemen at the 50th day of residing at high altitude, and the 2nd and 15th day after returning to lower altitude (1500m altitude, and the results were compared with that of 50 healthy controls residing at 1500m. Results  Among the 96 male servicemen, 71 developed AHAR, and 24 of them had severe AHAR, 47 mild to moderate AHAR, and the rest 25 had no AHAR. Levels of serum CK-MB, LDH-1 and Tei index were higher in the severe AHAR group than in the mild to moderate AHAR group, higher in the mild to moderate AHAR group than in the no AHAR group and higher in the no AHAR group than in the healthy group. As far as the values of LVEF and LVFS were concerned, the severe AHAR group < mild to moderate AHAR group < no AHAR group < control group. Significant difference was found in these levels between every two successive groups (P < 0.01. Linear correlation analysis showed that levels of CK-MB and LDH-1 of persons staying at 3700m altitude for 50 days were positively correlated with Tei index (r= 0.625, 0.598, respectively, P<0.01, and negatively correlated with LVEF(r=-0.716, -0.658, respectively, P<0.01, and also negatively correlated with LVFS (r=-0.639, -0.727, respectively, P<0.01. Level of serum CK-MB, LDH-1 and Tei index at 3700m altitude for 50 days were significantly higher than those 2

  20. Economy of Adaptation to High Altitude

    Institute of Scientific and Technical Information of China (English)

    Jean-Paul Richalet

    2004-01-01

    @@ The international meeting that will be held in Xining and Lhasa in August 2004 will be a wonderful occasion to share facts and concepts dealing with adaptation to high altitude. Life at high altitude is a challenge for thousands of animal species and millions of humans residing or visiting high altitude regions of the world. To try to understand the physiological mechanisms involved in the adaptation processes to high altitude hypoxia, it is convenient to start by defining what is "extreme" from a biological point of view.

  1. O uso das curvas de crescimento da Organização Mundial da Saúde em crianças e adolescentes que vivem em regiões de altitude moderada El uso de curvas de crecimiento de la Organización Mundial de la Salud en niños y adolescentes que viven en regiones de altitud moderada The use of World Health Organization growth curves in children and adolescents that live in regions of moderate altitude

    Directory of Open Access Journals (Sweden)

    Marco Antonio Cossio-Bolaños

    2012-09-01

    Full Text Available OBJETIVO: Determinar a aplicabilidade do uso das curvas de crescimento da Organização Mundial da Saúde (OMS em escolares que vivem em regiões de altitude moderada. MÉTODOS: Estudo transversal cuja população foi constituída por uma amostra probabilística estratificada com 955 crianças e adolescentes de seis a 12 anos, sendo 473 meninos e 482 meninas que frequentavam escolas públicas da área urbana da Região de Arequipa (Peru. As variáveis avaliadas envolveram medidas de massa corpórea (kg e estatura (m e índice de massa corporal. Para as comparações, utilizou-se o escore Z e o teste t para medidas pareadas. RESULTADOS: Os meninos apresentaram valores similares de massa corpórea quando comparados com a referência. No entanto, as meninas mostraram valores superiores à referência nas idades de seis, sete e dez anos (pOBJETIVO: Determinar la aplicabilidad del uso de curvas de crecimiento de la Organización Mundial de la Salud en escolares que viven en regiones de altitud moderada. MÉTODOS: Estudio transversal, cuya población fue constituida por una muestra probabilística estratificada con 955 niños y adolescentes de seis a 12 años de edad, siendo 473 muchachos y 482 muchachas, que frecuentaban escuelas públicas de área urbana de la Región de Arequipa (Perú. Las variables evaluadas implicaron medidas de masa corporal (kg y estatura (m y el índice de masa corporal. Para las comparaciones, se utilizó el escore Z y la prueba t para medidas pareadas. RESULTADOS: Los muchachos presentaron valores similares de masa corporal cuando comparados con la referencia. Sin embargo, las muchachas mostraron valores superiores a la referencia en las edades de seis, siete y diez años (pOBJECTIVE: To determine the applicability of the World Health Organization growth curves in school children that live in areas of moderate altitude. METHODS: A cross-sectional study, using a stratified random sample of 955 children and adolescents aged 6

  2. [Prevalence of moderate and excessive alcohol consumption and associated factors among residents of Quilombo Communities (hinterland settlements founded by people of African origin) of Vitória da Conquista, Bahia, Brazil].

    Science.gov (United States)

    Cardoso, Luiz Gustavo Vieira; Melo, Ana Paula Souto; Cesar, Cibele Comini

    2015-03-01

    The scope of the study was to assess moderate and excessive alcohol consumption and associated factors among residents of Quilombola Communities in Vitória da Conquista in the State of Bahia. It involved a cross-sectional study among 750 individuals aged ≥ 18 years interviewed in 2011 using an adapted version of the National Survey of Health Questionnaire. Alcohol consumption was classified into abstemious, moderate and heavy drinking categories and was analyzed using the multinomial regression model. Consumption was observed among 41.5% of participants (95% CI [37.8, 44.98]); 10.7% being identified in the excessive consumption category and 30.8% in the moderate consumption category. Moderate consumption was inversely associated with age and is more common among whites and mulattoes, the better educated, the gainfully employed and among smokers. Heavy consumption increased with level of education, being more prevalent among those who had at least 8 years of schooling, smokers and the gainfully employed. The study shows that in these communities there are differences in the sociodemographic characteristics among the profiles of alcohol drinkers and these differences should be taken into account when drawing up proposals for the promotion of healthy habits.

  3. Adaptation to High Altitude

    OpenAIRE

    1984-01-01

    Hypoxia is inconsequential for physiologically fit persons below an effective altitude of 2640 metres. At higher altitudes, the adaptation is brought about by four main factors, viz., hyperventilation, increased diffusion of oxygen across alveolar membrane, erythrocythemia and maintenance of body hydration. Carbon dioxide sensitivity is markedly elevated at high altitude, both in sojourners and acclimatized low-landers. The greater pulmonary diffusing capacity observed in high altitude native...

  4. Sleep of Andean high altitude natives.

    Science.gov (United States)

    Coote, J H; Stone, B M; Tsang, G

    1992-01-01

    The structure of sleep in lowland visitors to altitudes greater than 4000 m is grossly disturbed. There are no data on sleep in long-term residents of high altitudes. This paper describes an electroencephalographic study of sleep in high altitude dwellers who were born in and are permanent residents of Cerro de Pasco in the Peruvian Andes, situated at 4330 m. Eight healthy male volunteers aged between 18 and 69 years were studied. Sleep was measured on three consecutive nights for each subject. Electroencephalographs, submental electromyographs and electro-oculograms were recorded. Only data from the third night were used in the analysis. The sleep patterns of these subjects resembled the normal sleep patterns described by others in lowlanders at sea level. There were significant amounts of slow wave sleep in the younger subjects and rapid eye movement sleep seemed unimpaired.

  5. Increased oxidative stress following acute and chronic high altitude exposure.

    Science.gov (United States)

    Jefferson, J Ashley; Simoni, Jan; Escudero, Elizabeth; Hurtado, Maria-Elena; Swenson, Erik R; Wesson, Donald E; Schreiner, George F; Schoene, Robert B; Johnson, Richard J; Hurtado, Abdias

    2004-01-01

    The generation of reactive oxygen species is typically associated with hyperoxia and ischemia reperfusion. Recent evidence has suggested that increased oxidative stress may occur with hypoxia. We hypothesized that oxidative stress would be increased in subjects exposed to high altitude hypoxia. We studied 28 control subjects living in Lima, Peru (sea level), at baseline and following 48 h exposure to high altitude (4300 m). To assess the effects of chronic altitude exposure, we studied 25 adult males resident in Cerro de Pasco, Peru (altitude 4300 m). We also studied 27 subjects living in Cerro de Pasco who develop excessive erythrocytosis (hematocrit > 65%) and chronic mountain sickness. Acute high altitude exposure led to increased urinary F(2)-isoprostane, 8-iso PGF(2 alpha) (1.31 +/- 0.8 microg/g creatinine versus 2.15 +/- 1.1, p = 0.001) and plasma total glutathione (1.29 +/- 0.10 micromol versus 1.37 +/- 0.09, p = 0.002), with a trend to increased plasma thiobarbituric acid reactive substance (TBARS) (59.7 +/- 36 pmol/mg protein versus 63.8 +/- 27, p = NS). High altitude residents had significantly elevated levels of urinary 8-iso PGF(2 alpha) (1.3 +/- 0.8 microg/g creatinine versus 4.1 +/- 3.4, p = 0.007), plasma TBARS (59.7 +/- 36 pmol/mg protein versus 85 +/- 28, p = 0.008), and plasma total glutathione (1.29 +/- 0.10 micromol versus 1.55 +/- 0.19, p < 0.0001) compared to sea level. High altitude residents with excessive erythrocytosis had higher levels of oxidative stress compared to high altitude residents with normal hematological adaptation. In conclusion, oxidative stress is increased following both acute exposure to high altitude without exercise and with chronic residence at high altitude.

  6. Sleep at high altitude: guesses and facts.

    Science.gov (United States)

    Bloch, Konrad E; Buenzli, Jana C; Latshang, Tsogyal D; Ulrich, Silvia

    2015-12-15

    Lowlanders commonly report a poor sleep quality during the first few nights after arriving at high altitude. Polysomnographic studies reveal that reductions in slow wave sleep are the most consistent altitude-induced changes in sleep structure identified by visual scoring. Quantitative spectral analyses of the sleep electroencephalogram have confirmed an altitude-related reduction in the low-frequency power (0.8-4.6 Hz). Although some studies suggest an increase in arousals from sleep at high altitude, this is not a consistent finding. Whether sleep instability at high altitude is triggered by periodic breathing or vice versa is still uncertain. Overnight changes in slow wave-derived encephalographic measures of neuronal synchronization in healthy subjects were less pronounced at moderately high (2,590 m) compared with low altitude (490 m), and this was associated with a decline in sleep-related memory consolidation. Correspondingly, exacerbation of breathing and sleep disturbances experienced by lowlanders with obstructive sleep apnea during a stay at 2,590 m was associated with poor performance in driving simulator tests. These findings suggest that altitude-related alterations in sleep may adversely affect daytime performance. Despite recent advances in our understanding of sleep at altitude, further research is required to better establish the role of gender and age in alterations of sleep at different altitudes, to determine the influence of acclimatization and of altitude-related illness, and to uncover the characteristics of sleep in highlanders that may serve as a study paradigm of sleep in patients exposed to chronic hypoxia due to cardiorespiratory disease.

  7. Developmental functional adaptation to high altitude: review.

    Science.gov (United States)

    Frisancho, A Roberto

    2013-01-01

    Various approaches have been used to understand the origins of the functional traits that characterize the Andean high-altitude native. Based on the conceptual framework of developmental functional adaptation which postulates that environmental influences during the period of growth and development have long lasting effects that may be expressed during adulthood, we initiated a series of studies addressed at determining the pattern of physical growth and the contribution of growth and development to the attainment of full functional adaptation to high-altitude of low and high altitude natives living under rural and urban conditions. Current research indicate that: (a) the pattern of growth at high altitude due to limited nutritional resources, physical growth in body size is delayed but growth in lung volumes is accelerated because of hypoxic stress); (b) low-altitude male and female urban natives can attain a full functional adaptation to high altitude by exposure to high-altitude hypoxia during the period of growth and development; (c) both experimental studies on animals and comparative human studies indicate that exposure to high altitude during the period of growth and development results in the attainment of a large residual lung volume; (d) this developmentally acquired enlarged residual lung volume and its associated increase in alveolar area when combined with the increased tissue capillarization and moderate increase in red blood cells and hemoglobin concentration contributes to the successful functional adaptation of the Andean high-altitude native to hypoxia; and (e) any specific genetic traits that are related to the successful functional adaptation of Andean high-altitude natives have yet to be identified.

  8. Adaptation to High Altitude

    Directory of Open Access Journals (Sweden)

    H. S. Nayar

    1984-10-01

    Full Text Available Hypoxia is inconsequential for physiologically fit persons below an effective altitude of 2640 metres. At higher altitudes, the adaptation is brought about by four main factors, viz., hyperventilation, increased diffusion of oxygen across alveolar membrane, erythrocythemia and maintenance of body hydration. Carbon dioxide sensitivity is markedly elevated at high altitude, both in sojourners and acclimatized low-landers. The greater pulmonary diffusing capacity observed in high altitude natives is well documented. RBC count, haemoglobin and haematocrit increase whereas arterial oxyhaemoglobin saturation percentage decreases at high altitude. Diuretics (Furosemide have no role in adaptation to high altitude and adequate body hydration must be maintained.The ultimate adaptive mechanisms occur at tissue level which facilitate the diffusion of oxygen from blood to tissue and its utilization. The work capacity decreases at high altitude and a relationship between load carried and speed of marching has been determined at various altitudes. Although altitude has an adverse effect on process of cold acclimatization, yet it is possible to induce cold acclimatization by exposing subjects to a temperature of 0° to -5°C for a period of three hours daily for three weeks. The caloric requirements increase at high altitudes and are 4,286 K Cal and 4,380 K Cal at 13000 feet (3950 m and 17000 feet (5170 m, respectively.

  9. Effects of ascent to high altitude on human antimycobacterial immunity.

    Directory of Open Access Journals (Sweden)

    Sarah Eisen

    Full Text Available Tuberculosis infection, disease and mortality are all less common at high than low altitude and ascent to high altitude was historically recommended for treatment. The immunological and mycobacterial mechanisms underlying the association between altitude and tuberculosis are unclear. We studied the effects of altitude on mycobacteria and antimycobacterial immunity.Antimycobacterial immunity was assayed in 15 healthy adults residing at low altitude before and after they ascended to 3400 meters; and in 47 long-term high-altitude residents. Antimycobacterial immunity was assessed as the extent to which participants' whole blood supported or restricted growth of genetically modified luminescent Bacille Calmette-Guérin (BCG mycobacteria during 96 hours incubation. We developed a simplified whole blood assay that could be used by a technician in a low-technology setting. We used this to compare mycobacterial growth in participants' whole blood versus positive-control culture broth and versus negative-control plasma.Measurements of mycobacterial luminescence predicted the number of mycobacterial colonies cultured six weeks later. At low altitude, mycobacteria grew in blood at similar rates to positive-control culture broth whereas ascent to high altitude was associated with restriction (p ≤ 0.002 of mycobacterial growth to be 4-times less than in culture broth. At low altitude, mycobacteria grew in blood 25-times more than negative-control plasma whereas ascent to high altitude was associated with restriction (p ≤ 0.01 of mycobacterial growth to be only 6-times more than in plasma. There was no evidence of differences in antimycobacterial immunity at high altitude between people who had recently ascended to high altitude versus long-term high-altitude residents.An assay of luminescent mycobacterial growth in whole blood was adapted and found to be feasible in low-resource settings. This demonstrated that ascent to or residence at high altitude was

  10. Effects of Ascent to High Altitude on Human Antimycobacterial Immunity

    Science.gov (United States)

    Aldridge, Robert W.; Siedner, Mark J.; Necochea, Alejandro; Leybell, Inna; Valencia, Teresa; Herrera, Beatriz; Wiles, Siouxsie; Friedland, Jon S.; Gilman, Robert H.; Evans, Carlton A.

    2013-01-01

    Background Tuberculosis infection, disease and mortality are all less common at high than low altitude and ascent to high altitude was historically recommended for treatment. The immunological and mycobacterial mechanisms underlying the association between altitude and tuberculosis are unclear. We studied the effects of altitude on mycobacteria and antimycobacterial immunity. Methods Antimycobacterial immunity was assayed in 15 healthy adults residing at low altitude before and after they ascended to 3400 meters; and in 47 long-term high-altitude residents. Antimycobacterial immunity was assessed as the extent to which participants’ whole blood supported or restricted growth of genetically modified luminescent Bacille Calmette-Guérin (BCG) mycobacteria during 96 hours incubation. We developed a simplified whole blood assay that could be used by a technician in a low-technology setting. We used this to compare mycobacterial growth in participants’ whole blood versus positive-control culture broth and versus negative-control plasma. Results Measurements of mycobacterial luminescence predicted the number of mycobacterial colonies cultured six weeks later. At low altitude, mycobacteria grew in blood at similar rates to positive-control culture broth whereas ascent to high altitude was associated with restriction (p≤0.002) of mycobacterial growth to be 4-times less than in culture broth. At low altitude, mycobacteria grew in blood 25-times more than negative-control plasma whereas ascent to high altitude was associated with restriction (p≤0.01) of mycobacterial growth to be only 6-times more than in plasma. There was no evidence of differences in antimycobacterial immunity at high altitude between people who had recently ascended to high altitude versus long-term high-altitude residents. Conclusions An assay of luminescent mycobacterial growth in whole blood was adapted and found to be feasible in low-resource settings. This demonstrated that ascent to or

  11. HIGH-ALTITUDE ILLNESS

    Directory of Open Access Journals (Sweden)

    Dwitya Elvira

    2015-05-01

    Full Text Available AbstrakHigh-altitude illness (HAI merupakan sekumpulan gejala paru dan otak yang terjadi pada orang yang baru pertama kali mendaki ke ketinggian. HAI terdiri dari acute mountain sickness (AMS, high-altitude cerebral edema (HACE dan high-altitude pulmonary edema (HAPE. Tujuan tinjauan pustaka ini adalah agar dokter dan wisatawan memahami risiko, tanda, gejala, dan pengobatan high-altitude illness. Perhatian banyak diberikan terhadap penyakit ini seiring dengan meningkatnya popularitas olahraga ekstrim (mendaki gunung tinggi, ski dan snowboarding dan adanya kemudahan serta ketersediaan perjalanan sehingga jutaan orang dapat terpapar bahaya HAI. Di Pherice, Nepal (ketinggian 4343 m, 43% pendaki mengalami gejala AMS. Pada studi yang dilakukan pada tempat wisata di resort ski Colorado, Honigman menggambarkan kejadian AMS 22% pada ketinggian 1850 m sampai 2750 m, sementara Dean menunjukkan 42% memiliki gejala pada ketinggian 3000 m. Aklimatisasi merupakan salah satu tindakan pencegahan yang dapat dilakukan sebelum pendakian, selain beberapa pengobatan seperti asetazolamid, dexamethasone, phosopodiestrase inhibitor, dan ginko biloba.Kata kunci: high-altitude illness, acute mountain sickness, edema cerebral, pulmonary edema AbstractHigh-altitude illness (HAI is symptoms of lung and brain that occurs in people who first climb to altitude. HAI includes acute mountain sickness (AMS, high-altitude cerebral edema (HACE and high altitude pulmonary edema (HAPE. The objective of this review was to understand the risks, signs, symptoms, and treatment of high-altitude illness. The attention was given to this disease due to the rising popularity of extreme sports (high mountain climbing, skiing and snowboarding and the ease and availability of the current travelling, almost each year, millions of people could be exposed to the danger of HAI. In Pherice, Nepal (altitude 4343 m, 43% of climbers have symptoms of AMS. Furthermore, in a study conducted at sites in

  12. Tibetans at extreme altitude.

    Science.gov (United States)

    Wu, Tianyi; Li, Shupin; Ward, Michal P

    2005-01-01

    Between 1960 and 2003, 13 Chinese expeditions successfully reached the summit of Chomolungma (Mt Everest or Sagarmatha). Forty-five of the 80 summiteers were Tibetan highlanders. During these and other high-altitude expeditions in Tibet, a series of medical and physiological investigations were carried out on the Tibetan mountaineers. The results suggest that these individuals are better adapted to high altitude and that, at altitude, they have a greater physical capacity than Han (ethnic Chinese) lowland newcomers. They have higher maximal oxygen uptake, greater ventilation, more brisk hypoxic ventilatory responses, larger lung volumes, greater diffusing capacities, and a better quality of sleep. Tibetans also have a lower incidence of acute mountain sickness and less body weight loss. These differences appear to represent genetic adaptations and are obviously significant for humans at extreme altitude. This paper reviews what is known about the physiologic responses of Tibetans at extreme altitudes.

  13. Predictive Models of Acute Mountain Sickness after Rapid Ascent to Various Altitudes

    Science.gov (United States)

    2013-01-01

    severity but not prevalence of AMS. Key Words: HYPOXIA , HYPOBARIC HYPOXIA , MIXED MODELS, ALTITUDE, ALTITUDE SICKNESS, UNACCLIMATIZED LOWLANDERS W hen...Beidleman BA, Muza SR, Fulco CS, et al. Intermittent altitude exposures reduce acute mountain sickness at 4300 m. Clin Sci. 2004;106(3):321–8. 4. Beidleman...Wood H, Yang HH, et al. The body weight loss during acute exposure to high-altitude hypoxia in sea level residents. Acta Physiologica Sinica

  14. Pre-Altitude Serum Ferritin Levels and Daily Oral Iron Supplement Dose Mediate Iron Parameter and Hemoglobin Mass Responses to Altitude Exposure

    OpenAIRE

    Govus, Andrew D.; Garvican-Lewis, Laura A; Chris R Abbiss; Peter Peeling; Gore, Christopher J

    2015-01-01

    Purpose To investigate the influence of daily oral iron supplementation on changes in hemoglobin mass (Hbmass) and iron parameters after 2–4 weeks of moderate altitude exposure. Methods Hematological data collected from 178 athletes (98 males, 80 females) exposed to moderate altitude (1,350–3,000 m) were analysed using linear regression to determine how altitude exposure combined with oral iron supplementation influenced Hbmass, total iron incorporation (TII) and blood iron parameters [ferrit...

  15. Mediated, moderated and direct effects of country of residence, age, and gender on the cognitive and social determinants of adolescent smoking in Spain and the UK: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Markham Wolfgang A

    2009-06-01

    Full Text Available Abstract Background European trans-national adolescent smoking prevention interventions based on social influences approaches have had limited success. The attitudes-social influences-efficacy (ASE model is a social cognition model that states smoking behaviour is determined by smoking intention which, in turn, is predicted by seven ASE determinants; disadvantages, advantages, social acceptance, social norms, modelling, perceived pressure, self-efficacy. Distal factors such as country of residence, age and gender are external to the model. The ASE model is, thus, closely related to the Theory of Planned Behaviour. This study assessed the utility of the ASE model using cross-sectional data from Spanish and UK adolescents. Methods In 1997, questionnaires were simultaneously administered to Spanish (n = 3716 and UK adolescents (n = 3715 who were considered at high risk of smoking. Participants' age, gender, smoking intentions and ASE determinant scores were identified and linear regression analysis was used to examine the mediated, moderated and direct effects of country of residence, age and gender on participants' smoking intentions. Results All UK participants were aged 12 or 13 and most Spanish participants were aged between 12 and 14 (range 12–16 years. Amongst 12 and 13 year olds, regular smoking was more common in Spain. Almost half the participants were female (47.2% in Spain; 49.9% in the UK. Gender did not vary significantly according to age. The distribution of ASE determinant scores varied by country and predicted intention. The influence of each ASE determinant on intention was moderated by country. Country had a large direct influence on intention (1.72 points on a 7 point scale but the effects of age and gender were mediated by the ASE determinants. The findings suggest resisting peer pressure interventions could potentially influence smoking amongst UK adolescents but not Spanish adolescents. Interventions that promote self

  16. Can High Altitude Influence Cytokines and Sleep?

    Directory of Open Access Journals (Sweden)

    Valdir de Aquino Lemos

    2013-01-01

    Full Text Available The number of persons who relocate to regions of high altitude for work, pleasure, sport, or residence increases every year. It is known that the reduced supply of oxygen (O2 induced by acute or chronic increases in altitude stimulates the body to adapt to new metabolic challenges imposed by hypoxia. Sleep can suffer partial fragmentation because of the exposure to high altitudes, and these changes have been described as one of the responsible factors for the many consequences at high altitudes. We conducted a review of the literature during the period from 1987 to 2012. This work explored the relationships among inflammation, hypoxia and sleep in the period of adaptation and examined a novel mechanism that might explain the harmful effects of altitude on sleep, involving increased Interleukin-1 beta (IL-1β, Interleukin-6 (IL-6, and tumor necrosis factor-alpha (TNF-α production from several tissues and cells, such as leukocytes and cells from skeletal muscle and brain.

  17. Can High Altitude Influence Cytokines and Sleep?

    Science.gov (United States)

    de Aquino Lemos, Valdir; dos Santos, Ronaldo Vagner Thomatieli; Lira, Fabio Santos; Rodrigues, Bruno; Tufik, Sergio; de Mello, Marco Tulio

    2013-01-01

    The number of persons who relocate to regions of high altitude for work, pleasure, sport, or residence increases every year. It is known that the reduced supply of oxygen (O2) induced by acute or chronic increases in altitude stimulates the body to adapt to new metabolic challenges imposed by hypoxia. Sleep can suffer partial fragmentation because of the exposure to high altitudes, and these changes have been described as one of the responsible factors for the many consequences at high altitudes. We conducted a review of the literature during the period from 1987 to 2012. This work explored the relationships among inflammation, hypoxia and sleep in the period of adaptation and examined a novel mechanism that might explain the harmful effects of altitude on sleep, involving increased Interleukin-1 beta (IL-1β), Interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) production from several tissues and cells, such as leukocytes and cells from skeletal muscle and brain. PMID:23690660

  18. High Altitude Cerebral Edema

    Science.gov (United States)

    1986-03-01

    such enzyme inhibition would favor the creation of a metabolic acidosis to offset the hypoxic respiratory alkalosis of high altitude hyperventilation...that some of their symptoms might be due to the early respiratory alkalosis seen upon arrival at high altitude. Unfortunately 23 out of the 30 subjects...i I Hamilton-16 was negative in all cases and normal respiratory excursions were seen. CSF chemistries and cell counts were normal. Houston and

  19. Altitude acclimatization and blood volume: effects of exogenous erythrocyte volume expansion

    DEFF Research Database (Denmark)

    Sawka, M N; Young, Jette Feveile; Rock, P B;

    1996-01-01

    We studied sea-level residents during 13 days of altitude acclimatization to determine 1) altitude acclimatization effects on erythrocyte volume and plasma volume, 2) if exogenous erythrocyte volume expansion alters subsequent erythrocyte volume and plasma volume adaptations, 3) if an increased...... blood oxygen content alters erythropoietin responses during altitude acclimatization, and 4) mechanisms responsible for plasma loss at altitude. Sixteen healthy men had a series of hematologic measurements made at sea level, on the first and ninth days of altitude (4,300 m) residence, and after...... had no effect; in addition, initially at altitude, blood oxygen content was 8% higher in erythrocyte-infused than in saline-infused subjects. The new findings regarding altitude acclimatization are summarized as follows: 1) erythrocyte volume does not change during the first 13 days...

  20. High Altitude and Heart

    Directory of Open Access Journals (Sweden)

    Murat Yalcin

    2011-04-01

    Full Text Available Nowadays, situations associated with high altitude such as mountaineering, aviation increasingly draw the attention of people. Gas pressure decreases and hypoxia is encountered when climbing higher. Physiological and pathological responses of human body to different heights are different. Therefore, physiological and pathological changes that may occur together with height and to know the clinical outcomes of these are important . Acute mountain sickness caused by high altitude and high altitude cerebral edema are preventable diseases with appropriate precautions. Atmospheric oxygen decreasing with height, initiates many adaptive mechanisms. These adaptation mechanisms and acclimatization vary widely among individuals because of reasons such as environmental factors, exercise and cold. High altitude causes different changes in the cardiovascular system with various mechanisms. Although normal individuals easily adapt to these changes, this situation can lead to undesirable results in people with heart disease. For this reason, it should be known the effective evaluation of the people with known heart disease before traveling to high altitude and the complications due to the changes with height and the recommendations can be made to these patients. [TAF Prev Med Bull 2011; 10(2.000: 211-222

  1. Resident resistance.

    Science.gov (United States)

    Price, J L; Cleary, B

    1999-01-01

    Clearly, faculty must work hard with residents to explore the nature of their resistance to a program's learning and growth opportunities. Initial steps to a deeper, more effective, and longer-lasting change process must be pursued. If resident resistance is mishandled or misunderstood, then learning and professional growth may be sidetracked and the purposes of residency training defeated. Listening to the whole person of the resident and avoiding the trap of getting caught up in merely responding to select resident behaviors that irritate us is critical. Every faculty member in the family practice residency program must recognize resistance as a form of defense that cannot immediately be torn down or taken away. Resident defenses have important purposes to play in stress reduction even if they are not always healthy. Residents, especially interns, use resistance to avoid a deeper and more truthful look at themselves as physicians. A family practice residency program that sees whole persons in their residents and that respects resident defenses will effectively manage the stress and disharmony inherent to the resistant resident.

  2. Altitude and endurance training.

    Science.gov (United States)

    Rusko, Heikki K; Tikkanen, Heikki O; Peltonen, Juha E

    2004-10-01

    The benefits of living and training at altitude (HiHi) for an improved altitude performance of athletes are clear, but controlled studies for an improved sea-level performance are controversial. The reasons for not having a positive effect of HiHi include: (1) the acclimatization effect may have been insufficient for elite athletes to stimulate an increase in red cell mass/haemoglobin mass because of too low an altitude (stress with possible overtraining symptoms and an increased frequency of infections. Moreover, the effects of hypoxia in the brain may influence both training intensity and physiological responses during training at altitude. Thus, interrupting hypoxic exposure by training in normoxia may be a key factor in avoiding or minimizing the noxious effects that are known to occur in chronic hypoxia. When comparing HiHi and HiLo (living high and training low), it is obvious that both can induce a positive acclimatization effect and increase the oxygen transport capacity of blood, at least in 'responders', if certain prerequisites are met. The minimum dose to attain a haematological acclimatization effect is > 12 h a day for at least 3 weeks at an altitude or simulated altitude of 2100-2500 m. Exposure to hypoxia appears to have some positive transfer effects on subsequent training in normoxia during and after HiLo. The increased oxygen transport capacity of blood allows training at higher intensity during and after HiLo in subsequent normoxia, thereby increasing the potential to improve some neuromuscular and cardiovascular determinants of endurance performance. The effects of hypoxic training and intermittent short-term severe hypoxia at rest are not yet clear and they require further study.

  3. Analysis of Guiyang residents basic pension insurance moderate security level%贵阳市居民基本养老保险适度保障水平分析

    Institute of Scientific and Technical Information of China (English)

    武学丽; 韦璞

    2012-01-01

      Sustainable development is an important target to the construction of social endowment insurance system. In this paper, the application of welfare economics and the theory of income distribution, and appropriate security level model, Guiyang urban and rural residents social endowment insurance of the moderate to system analysis and prediction, results reveal Guiyang City social basic pension system can not meet the old man the lowest survival need, city home security level is lower than the new agricultural insurance, local finance strength to undertake measurable future pension level pay, on the basis of this, put forward to perfect suggestion and the countermeasure for rural social old age pension insurance system.%  可持续是社会养老保险制度建设的重要目标。本文应用福利经济学和收入分配理论,及适度保障水平模型,对贵阳市城乡居民社会养老保险的适度性进行了系统分析和预测,结果揭示贵阳市社会基础养老金无法满足老人最低生存需要,城居保保障水平低于新农保,未来地方财政有实力承担适度养老水平的支付,在此基础上,提出完善城乡社会老保险制度的建议和对策。

  4. Low altitude remote sensing

    NARCIS (Netherlands)

    Pérez Calero, D.; Peyaud, A.; Van der Wal, D.; van 't Hof, J.; Hakkesteegt, H.; Vink, R.; Bovenkamp, E.G.P.; van Antwerpen, G.; Meynart, R.; Neeck, S.P.; Shimoda, H.; Habib, S.

    2008-01-01

    In 2007 TNO started to fly some sensors on an unmanned helicopter platform. These sensors included RGB, B/W and thermal infrared cameras. In 2008 a spectrometer was added. The goal for 2010 is to be able to offer a low altitude flying platform including several sensors. Development of these sensors

  5. Impact of Altitude on Power Output during Cycling Stage Racing.

    Science.gov (United States)

    Garvican-Lewis, Laura A; Clark, Bradley; Martin, David T; Schumacher, Yorck Olaf; McDonald, Warren; Stephens, Brian; Ma, Fuhai; Thompson, Kevin G; Gore, Christopher J; Menaspà, Paolo

    2015-01-01

    The purpose of this study was to quantify the effects of moderate-high altitude on power output, cadence, speed and heart rate during a multi-day cycling tour. Power output, heart rate, speed and cadence were collected from elite male road cyclists during maximal efforts of 5, 15, 30, 60, 240 and 600 s. The efforts were completed in a laboratory power-profile assessment, and spontaneously during a cycling race simulation near sea-level and an international cycling race at moderate-high altitude. Matched data from the laboratory power-profile and the highest maximal mean power output (MMP) and corresponding speed and heart rate recorded during the cycling race simulation and cycling race at moderate-high altitude were compared using paired t-tests. Additionally, all MMP and corresponding speeds and heart rates were binned per 1000 m (3000 m) according to the average altitude of each ride. Mixed linear modelling was used to compare cycling performance data from each altitude bin. Power output was similar between the laboratory power-profile and the race simulation, however MMPs for 5-600 s and 15, 60, 240 and 600 s were lower (p ≤ 0.005) during the race at altitude compared with the laboratory power-profile and race simulation, respectively. Furthermore, peak power output and all MMPs were lower (≥ 11.7%, p ≤ 0.001) while racing >3000 m compared with rides completed near sea-level. However, speed associated with MMP 60 and 240 s was greater (p sea-level. A reduction in oxygen availability as altitude increases leads to attenuation of cycling power output during competition. Decrement in cycling power output at altitude does not seem to affect speed which tended to be greater at higher altitudes.

  6. [Effect of altitude on iron absorption].

    Science.gov (United States)

    Pizarro, F; Zavaleta, N; Hertrampf, E; Berlanga, R; Camborda, L; Olivares, M

    1998-03-01

    Iron bioavailability was evaluated in people living in high altitudes. Absorption was estimated from a reference dose of ferrous ascorbate and from a standard diet of wheat flour, using extrinsic tag radioisotope technique of 55Fe and 59Fe. Twenty four volunteers, healthy women, with ages ranging from 28 to 45 years, participated. Of those, eleven lived at 3450 meters above sea level (m.a.s.l.) in Huancayo city-Peru (study group), and 13 lived in Santiago de Chile at 630 m.a.s.l. (control group). Iron absorption from reference dose of ferrous ascorbate was 32.0% and 31.1% in the study and control groups respectively. The geometric mean of iron absorption from the standard diet, corrected to 40% of absorption of reference dose, was 9.0% and 6.9% in the study and control groups respectively (NS). The results suggest that altitude does not produce a high iron absorption in highlander residents.

  7. Ear - blocked at high altitudes

    Science.gov (United States)

    High altitudes and blocked ears; Flying and blocked ears; Eustachian tube dysfunction - high altitude ... eustachian tube is a connection between the middle ear (the space deep to the eardrum) and the ...

  8. Dietary Recommendations for Cyclists during Altitude Training.

    Science.gov (United States)

    Michalczyk, Małgorzata; Czuba, Miłosz; Zydek, Grzegorz; Zając, Adam; Langfort, Józef

    2016-06-18

    The concept of altitude or hypoxic training is a common practice in cycling. However, several strategies for training regimens have been proposed, like "live high, train high" (LH-TH), "live high, train low" (LH-TL) or "intermittent hypoxic training" (IHT). Each of them combines the effect of acclimatization and different training protocols that require specific nutrition. An appropriate nutrition strategy and adequate hydration can help athletes achieve their fitness and performance goals in this unfriendly environment. In this review, the physiological stress of altitude exposure and training will be discussed, with specific nutrition recommendations for athletes training under such conditions. However, there is little research about the nutrition demands of athletes who train at moderate altitude. Our review considers energetic demands and body mass or body composition changes due to altitude training, including respiratory and urinary water loss under these conditions. Carbohydrate intake recommendations and hydration status are discussed in detail, while iron storage and metabolism is also considered. Last, but not least the risk of increased oxidative stress under hypoxic conditions and antioxidant supplementation suggestions are presented.

  9. Dietary Recommendations for Cyclists during Altitude Training

    Directory of Open Access Journals (Sweden)

    Małgorzata Michalczyk

    2016-06-01

    Full Text Available The concept of altitude or hypoxic training is a common practice in cycling. However, several strategies for training regimens have been proposed, like “live high, train high” (LH-TH, “live high, train low” (LH-TL or “intermittent hypoxic training” (IHT. Each of them combines the effect of acclimatization and different training protocols that require specific nutrition. An appropriate nutrition strategy and adequate hydration can help athletes achieve their fitness and performance goals in this unfriendly environment. In this review, the physiological stress of altitude exposure and training will be discussed, with specific nutrition recommendations for athletes training under such conditions. However, there is little research about the nutrition demands of athletes who train at moderate altitude. Our review considers energetic demands and body mass or body composition changes due to altitude training, including respiratory and urinary water loss under these conditions. Carbohydrate intake recommendations and hydration status are discussed in detail, while iron storage and metabolism is also considered. Last, but not least the risk of increased oxidative stress under hypoxic conditions and antioxidant supplementation suggestions are presented.

  10. The Effect on Moderate Altitude UPON Human Gastric Emptying Time

    Science.gov (United States)

    1952-03-01

    physiological aliment . The emptying time, therefore, of a mixture of barium and food may perhaps differ somewhat from that of food alone. Determination of the... psychological stresses a vigorous program of preven- tive psychology had been undertaken as described above. The day prior to his first run each subject was

  11. 农村居民收入差距适度性问卷调查%The Questionnaire Survey Research on the Moderation of Rural Residents'Income Gap

    Institute of Scientific and Technical Information of China (English)

    孙敬水; 于思源

    2014-01-01

    Based on the 2852 rural residents questionnaires from 31 provinces across China ,this paper measured the present situation of the rural income gap by Gini coefficient and other indicators ;analyzed the statistical estimates of rural income gap and its main influencing factors in terms of basic characteristics of peasant household ,physical capital ,human capital ,political capital ,the geographical environment and regional differences , and rural household incomes per capita ;conducted a questionnaire survey on the moderation of rural income gap related issues at the present stage of China .T he results indicated that rural income gap in China was wide .Different basic characteristics of peasant household ,physical capital , human capital ,political capital ,the geographical environment and regional differences led to different rural income and rural income gap .T he rural residents'income gap at the present stage in China has gone beyond reasonable limits .‘Rural labor lack of employment skills’ and ‘the lack of agricultural technology and capital’ were the main reasons of the difficulties in increasing the income of farmers .Rural residents’ affordability of the widening income gap was weak ,they were not content with the current situation of income distribution ,but satisfied with the policies of agriculture farmer and village .‘Social security’ ,‘education’ and‘public infrastructure’ were the main performance of the unfair to rural residents .‘The gap between rich and poor is too big’ was the main risk hindered economic efficiency .‘To improve the urban‐rural dual structure’ ,‘to improve the whole quality of rural labor force’ and ‘to build a balanced urban‐rural social security system’ were the main ways to narrow the income gap between urban and rural areas .%基于中国31个省份2852份农村居民家庭问卷调查数据,运用Gini系数等指标,对中国农村居民收入差距现状进行统计测算;从

  12. The Impact of Moderate-Altitude Staging on Pulmonary Arterial Hemodynamics after Ascent to High Altitude

    Science.gov (United States)

    2010-01-01

    pressure ( Pao2 ) and arterial oxygenation saturation (Sao2) were measured at each time point. Compared to mean PAP at SL (mean SD, 14 3 mmHg), mean PAP...increased after DA to 37 8 mmHg (D¼ 24 10 mmHg, p< 0.001) and was negatively correlated with both Pao2 (r 2¼ 0.57, p¼ 0.011) and Sao2 (r2¼ 0.64, p...subcostal view. Assessment of oxygenation The primary indexes of oxygenation in this study were alveolar oxygen pressure ( Pao2 ) and arterial oxygen

  13. Permanent resident.

    Science.gov (United States)

    Fisher, John F

    2016-01-01

    The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  14. Permanent resident

    Directory of Open Access Journals (Sweden)

    John F. Fisher

    2016-05-01

    Full Text Available The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  15. Pilot study on the differences of young male's sleep structure and quality between indigenous Tibetans and longtime Han residents in high altitude area%高原地区世居藏族与久居汉族青年男性睡眠结构及质量差异的初步研究

    Institute of Scientific and Technical Information of China (English)

    李玉红; 乌仁塔娜; 嘎琴; 关巍; 格日力

    2015-01-01

    目的 比较高原地区世居藏族与久居汉族青年男性睡眠结构及睡眠质量的差异.方法 选择海拔3 780 m地区的14名世居藏族青年男性[年龄(32.0±9.1)岁]为藏族组,出生并生活于此地区的11名久居汉族青年男性[年龄(36.6±7.6)岁]为汉族组,均进行夜间多导睡眠监测,并按照国际标准对两组之间的睡眠结构及睡眠质量进行分析与比较.结果 藏族组睡眠效率和夜间血氧饱和度均显著高于汉族组(93.1%±3.9%比85.7%±4.2%和89.4%±2.0%比84.6%±4.3%,均P <0.05),而觉醒指数[(1.9±0.8)比(4.1±1.3)次/h]、微觉醒指数[(23.4±5.8)比(28.7±4.1)次/h]、氧减指数[(11.7±4.8)比(16.3±7.5)次/h]、呼吸暂停低通气指数[(5.8±2.3)比(9.6±4.2)次/h]、夜间平均心率[(66.9±8.3)比(79.9±6.7)次/min]均显著低于汉族组(均P<0.05);藏族组深睡眠时间比例较高(20.1%±7.2%比8.8%±3.3%),而汉族组非快速眼动(NREM)2期和浅睡眠时间比例较高(31.1%±11.9%比18.4%±6.7%和76.1%±11.7%比70.8%±11.2%,均P<0.05).结论 高原地区世居藏族与久居汉族比较,有更好的睡眠结构和睡眠质量.%Objective To compare young males' sleep quality and structure between native Tibetans and longtime Han residents.Methods A total of 14 male Tibetans and 11 male Hans at an altitude of 3 780 m were enrolled in this study.Tibetans were native highlanders with a mean age of (32.0 ± 9.1) years.Han subjects were born and living in high altitude with a mean age of (36.6 ± 7.6) years.All subjects were monitored by Polysomnography (PSG),and the differences of sleep structure and quality between the two groups were compared according to the international standard.Results The sleep efficiency (93.1% ± 3.9% vs 85.7% ± 4.2%) and nocturnal oxygen saturation (SpO2) (89.4% ±-2.0% vs 84.6% ± 4.3%) in Tibetans was significantly higher than those in Hans (both P < 0.05).The number of

  16. Shilajit: A panacea for high-altitude problems.

    Science.gov (United States)

    Meena, Harsahay; Pandey, H K; Arya, M C; Ahmed, Zakwan

    2010-01-01

    High altitude problems like hypoxia, acute mountain sickness, high altitude cerebral edema, pulmonary edema, insomnia, tiredness, lethargy, lack of appetite, body pain, dementia, and depression may occur when a person or a soldier residing in a lower altitude ascends to high-altitude areas. These problems arise due to low atmospheric pressure, severe cold, high intensity of solar radiation, high wind velocity, and very high fluctuation of day and night temperatures in these regions. These problems may escalate rapidly and may sometimes become life-threatening. Shilajit is a herbomineral drug which is pale-brown to blackish-brown, is composed of a gummy exudate that oozes from the rocks of the Himalayas in the summer months. It contains humus, organic plant materials, and fulvic acid as the main carrier molecules. It actively takes part in the transportation of nutrients into deep tissues and helps to overcome tiredness, lethargy, and chronic fatigue. Shilajit improves the ability to handle high altitudinal stresses and stimulates the immune system. Thus, Shilajit can be given as a supplement to people ascending to high-altitude areas so that it can act as a "health rejuvenator" and help to overcome high-altitude related problems.

  17. Ascent schedules, acute altitude illness, and altitude acclimatization: Observations on the Yushu Earthquake

    Institute of Scientific and Technical Information of China (English)

    Wu Tianyi; Hou Shike; Li Shuzhi; Li Wenxiang; Gen Deng

    2013-01-01

    During the Yushu Earthquake on April 14,2010,a large number of rescuers from sea level or lowlands ascended to the quake areas very rapidly or rapidly less than 24 h.However,Yushu Earthquake is the highest quake in the world at altitudes between 3750 m and 4878 m where is a serious hypoxic environment.A high incidence of acute altitude illness was found in the unacclimatized rescuers; the mountain rescue operation changed as "rescue the rescuers".Lesson from the Yushu Earthquake is that the occurrence of acute altitude illness may be closely related to the ascent schedules.This prompted us to study the relationship between ascent rate and the incidence and severity of acute altitude illness; five different groups were compared.The first group was 42 sea level male young soldiers who ascended to quake area very rapidly within 8 h at 4000 m; the second group was 48 sea level male young soldiers who ascended to 4000 m rapidly less than 18 h; the third group was 66 acclimatized medical workers from 2261 m who ascended to 4000 m rapidly within 12 h; the fourth group was 56 Tibetan medical workers from 2800 m who ascended to 4000 m rapidly within 8 h; the fifth group was 50 male sea level workers who ascended to 4000 m gradually over a period of 4 d.The results showed that the sea level rescuers ascended to 4000 m very rapidly or rapidly had the highest incidence of acute mountain sickness (AMS) with the greatest AMS scores and the lowest arterial oxygen saturation (SaO2) ; the sea level workers ascended to 4000 m gradually had moderate incidence of AMS with moderate AMS scores and SaO2 values; whereas the acclimatized and adapted rescuers had the lowest incidence of AMS,lowest AMS scores and higher SaO2; especially none AMS occurred in Tibetan rescuers.AMS score is inversely related to the ascent rate (r=-0.24,p<0.001).Additionally,acute altitude illness is significantly influenced by altitude acclimatization.The ascent rate is inversely related to

  18. Cardiovascular physiology at high altitude.

    Science.gov (United States)

    Hooper, T; Mellor, A

    2011-03-01

    The role of the cardiovascular system is to deliver oxygenated blood to the tissues and remove metabolic effluent. It is clear that this complex system will have to adapt to maintain oxygen deliver in the profound hypoxia of high altitude. The literature on the adaptation of both the systemic and pulmonary circulations to high altitude is reviewed.

  19. Energy at high altitude.

    Science.gov (United States)

    Hill, N E; Stacey, M J; Woods, D R

    2011-03-01

    For the military doctor, an understanding of the metabolic effects of high altitude (HA) exposure is highly relevant. This review examines the acute metabolic challenge and subsequent changes in nutritional homeostasis that occur when troops deploy rapidly to HA. Key factors that impact on metabolism include the hypoxic-hypobaric environment, physical exercise and diet. Expected metabolic changes include augmentation of basal metabolic rate (BMR), decreased availability of oxygen in peripheral metabolic tissues, reduction in VO2 max, increased glucose dependency and lactate accumulation during exercise. The metabolic demands of exercise at HA are crucial. Equivalent activity requires greater effort and more energy than it does at sea level. Soldiers working at HA show high energy expenditure and this may exceed energy intake significantly. Energy intake at HA is affected adversely by reduced availability, reduced appetite and changes in endocrine parameters. Energy imbalance and loss of body water result in weight loss, which is extremely common at HA. Loss of fat predominates over loss of fat-free mass. This state resembles starvation and the preferential primary fuel source shifts from carbohydrate towards fat, reducing performance efficiency. However, these adverse effects can be mitigated by increasing energy intake in association with a high carbohydrate ration. Commanders must ensure that individuals are motivated, educated, strongly encouraged and empowered to meet their energy needs in order to maximise mission-effectiveness.

  20. High Altitude Dermatology

    Science.gov (United States)

    Singh, Lt. Col. G K

    2017-01-01

    Approximately, 140 million people worldwide live permanently at high altitudes (HAs) and approximately another 40 million people travel to HA area (HAA) every year for reasons of occupation, sports or recreation. In India, whole of Ladakh region, part of Northwest Kashmir, Northern part of Sikkim and Tenga valley of Arunachal are considered inhabited areas of HAA. The low quantity of oxygen, high exposure of ultraviolet (UV) light, very low humidity, extreme subzero temperature in winter, high wind velocity, make this region difficult for lowlanders as well as for tourists. Acute mountain sickness, HA pulmonary edema, HA cerebral edema, and thromboembolic conditions are known to occur in HA. However, enough knowledge has not been shared on dermatoses peculiar to this region. Xerosis, UV-related skin disorders (tanning, photomelanosis, acute and chronic sunburn, polymorphic light eruption, chronic actinic dermatitis, actinic cheilitis, etc.), cold injuries (frostbite, chilblains, acrocyanosis, erythrocyanosis, etc.) nail changes (koilonychias), airborne contact dermatitis, insect bite reaction, and skin carcinoma (basal cell carcinomas, squamous cell carcinomas, and also rarely malignant melanoma) are the dermatoses seen in HAAs. Early diagnosis and knowledge of HA dermatoses may prevent serious consequences of disease and improve the quality of life for the visitors as well as for native of the place. PMID:28216727

  1. High altitude dermatology

    Directory of Open Access Journals (Sweden)

    G K Singh

    2017-01-01

    Full Text Available Approximately, 140 million people worldwide live permanently at high altitudes (HAs and approximately another 40 million people travel to HA area (HAA every year for reasons of occupation, sports or recreation. In India, whole of Ladakh region, part of Northwest Kashmir, Northern part of Sikkim and Tenga valley of Arunachal are considered inhabited areas of HAA. The low quantity of oxygen, high exposure of ultraviolet (UV light, very low humidity, extreme subzero temperature in winter, high wind velocity, make this region difficult for lowlanders as well as for tourists. Acute mountain sickness, HA pulmonary edema, HA cerebral edema, and thromboembolic conditions are known to occur in HA. However, enough knowledge has not been shared on dermatoses peculiar to this region. Xerosis, UV-related skin disorders (tanning, photomelanosis, acute and chronic sunburn, polymorphic light eruption, chronic actinic dermatitis, actinic cheilitis, etc., cold injuries (frostbite, chilblains, acrocyanosis, erythrocyanosis, etc. nail changes (koilonychias, airborne contact dermatitis, insect bite reaction, and skin carcinoma (basal cell carcinomas, squamous cell carcinomas, and also rarely malignant melanoma are the dermatoses seen in HAAs. Early diagnosis and knowledge of HA dermatoses may prevent serious consequences of disease and improve the quality of life for the visitors as well as for native of the place.

  2. Barcroft's bold assertion: All dwellers at high altitudes are persons of impaired physical and mental powers.

    Science.gov (United States)

    West, John B

    2016-03-01

    Barcroft's bold assertion that everyone at high altitude has physical and mental impairment compared with sea level was very provocative. It was a result of the expedition that he led to Cerro de Pasco in Peru, altitude 4300 m. Although it is clear that newcomers to high altitude have reduced physical powers, some people believe that this does not apply to permanent residents who have been at high altitude for generations. The best evidence supports Barcroft's contention, although permanent residents often perform better than acclimatized lowlanders. Turning to neuropsychological function, newcomers to high altitude certainly have some impairment, and there is evidence that the same applies to highlanders. However the notion that permanent residents are impaired is anathema to many people. For example the eminent Peruvian physician Carlos Monge took great exception to Barcroft's remark and even attributed it to the fact that Barcroft was suffering from acute mountain sickness when he made it! Monge referred to 'climatic aggression', by which he meant the negative consequences of the inevitable hypoxia of high altitude. Recent technological advances such as oxygen enrichment of room air can overcome this 'aggression'. This might be useful in some settings at high altitude such as a nursery where newborn babies are cared for, and possibly operating rooms where the surgeon's dexterity may be enhanced. Other situations might be dormitories, conference rooms, and perhaps some school rooms. These constitute possible ways by which the effects of Barcroft's assertion might be countered.

  3. Altitude effects on growth of indigenous children in Oaxaca, Southern Mexico.

    Science.gov (United States)

    Little, Bertis B; Malina, Robert M; Pena Reyes, Maria Eugenia; Bali Chavez, Guillermo

    2013-09-01

    The effect of altitude of residence on the growth status of 11,454 indigenous school children 6-14 years of age in Oaxaca, southern Mexico, was examined. Indicators of living conditions (human development index [HDI], index of community nutritional risk [INR], index of marginalization [IM], index of relative isolation [II]) were regressed on z-scores for height, weight and BMI, and the residuals were regressed on altitude of residence (km). Independent of other environmental conditions, altitude negatively affected height by approximately -0.07 z-scores per kilometer altitude above sea level. The estimated average decrease in stature was 0.92 cm per kilometer elevation. BMI was significantly increased, 1.2 units per kilometer elevation, consistent with earlier studies of growth status and altitude. In contrast, weight was not affected by altitude of residence. Approximately 36% of the reduction in height and 54% of the increase in BMI were due to altitude effects; the remaining changes in height and BMI were associated with environmental factors reflected in the indices of community well-being considered.

  4. Timing the arrival at 2340m altitude for aerobic performance

    DEFF Research Database (Denmark)

    Schuler, B; Thomsen, JJ; Gassmann, M

    2007-01-01

    This study tested the hypothesis that maximal oxygen uptake (VO2max) and performance increase upon altitude acclimatization at moderate altitude. Eight elite cyclists were studied at sea level, and after 1 (Day 1), 7 (Day 7), 14 (Day 14) and 21 (Day 21) days of exposure to 2340 m. Capillary blood...... samples were taken on these days before performing two consecutive maximal exercise trials. Acclimatization reased hemoglobin concentration and arterial oxygen content. On Day 1, VO2max and time to exhaustion (at 80% of sea-level maximal power output) decreased by 12.8% (P

  5. Body Structure and Respiratory Efficiency among High Altitude Himalayan Populations

    OpenAIRE

    2005-01-01

    To understand the morphological and physiological variations among the temporary and permanent residents of high altitude, this study was undertaken at Leh, Ladakh. It is situated at 3500 m (11500 feet) above sea level, the mean barometric pressure was 500 tors and air temperature varied from 2 °C to 20 °C. The highland Tibetans showed broadest chest and most developed musculature closely followed by Ladakhi Bods. These high altude natives also displayed significantly higher value of vital ca...

  6. Enhancing team-sport athlete performance: is altitude training relevant?

    Science.gov (United States)

    Billaut, François; Gore, Christopher J; Aughey, Robert J

    2012-09-01

    Field-based team sport matches are composed of short, high-intensity efforts, interspersed with intervals of rest or submaximal exercise, repeated over a period of 60-120 minutes. Matches may also be played at moderate altitude where the lower oxygen partial pressure exerts a detrimental effect on performance. To enhance run-based performance, team-sport athletes use varied training strategies focusing on different aspects of team-sport physiology, including aerobic, sprint, repeated-sprint and resistance training. Interestingly, 'altitude' training (i.e. living and/or training in O(2)-reduced environments) has only been empirically employed by athletes and coaches to improve the basic characteristics of speed and endurance necessary to excel in team sports. Hypoxia, as an additional stimulus to training, is typically used by endurance athletes to enhance performance at sea level and to prepare for competition at altitude. Several approaches have evolved in the last few decades, which are known to enhance aerobic power and, thus, endurance performance. Altitude training can also promote an increased anaerobic fitness, and may enhance sprint capacity. Therefore, altitude training may confer potentially-beneficial adaptations to team-sport athletes, which have been overlooked in contemporary sport physiology research. Here, we review the current knowledge on the established benefits of altitude training on physiological systems relevant to team-sport performance, and conclude that current evidence supports implementation of altitude training modalities to enhance match physical performances at both sea level and altitude. We hope that this will guide the practice of many athletes and stimulate future research to better refine training programmes.

  7. Altitude transitions in energy climbs

    Science.gov (United States)

    Weston, A. R.; Cliff, E. M.; Kelley, H. J.

    1982-01-01

    The aircraft energy-climb trajectory for configurations with a sharp transonic drag rise is well known to possess two branches in the altitude/Mach-number plane. Transition in altitude between the two branches occurs instantaneously, a 'corner' in the minimum-time solution obtained with the energy-state model. If the initial and final values of altitude do not lie on the energy-climb trajectory, then additional jumps (crude approximations to dives and zooms) are required at the initial and terminal points. With a singular-perturbation approach, a 'boundary-layer' correction is obtained for each altitude jump, the transonic jump being a so-called 'internal' boundary layer, different in character from the initial and terminal layers. The determination of this internal boundary layer is examined and some computational results for an example presented.

  8. Venus Altitude Cycling Balloon Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The ISTAR Group ( IG) and team mate Thin Red Line Aerospace (TRLA) propose a Venus altitude cycling balloon (Venus ACB), an innovative superpressure balloon...

  9. A3 Altitude Test Facility

    Science.gov (United States)

    Dulreix, Lionel J.

    2009-01-01

    This slide presentation shows drawings, diagrams and photographs of the A3 Altitude Test Facility. It includes a review of the A3 Facility requirements, and drawings of the various sections of the facility including Engine Deck and Superstructure, Test Cell and Thrust Takeout, Structure and Altitude Support Systems, Chemical Steam generators, and the subscale diffuser. There are also pictures of the construction site, and the facility under construction. A Diagram of the A3 Steam system schematic is also shown

  10. Health-Related Conditions and Depression in Elderly Mexican American and Non-Hispanic White Residents of a United States-Mexico Border County: Moderating Effects of Educational Attainment

    Directory of Open Access Journals (Sweden)

    David F. Briones

    2011-01-01

    Full Text Available We investigated the prevalence of “high” levels of depressive symptomatology and 13 health-related medical conditions in elderly Mexican American (MA and non-Hispanic white (NHW residents of El Paso County, Texas. We analyzed the extent to which depressive symptoms in this population are associated with these conditions. Elderly MA residents possessed a higher prevalence of current depression, a relatively unique health-related condition profile, and were more likely to experience a set of conditions that impede participation in daily life—conditions that we found to be strongly associated with high depressive symptomatology in the elderly. After adjusting for educational attainment, using multiple regression analyses, depression was not associated with ethnicity and only six of the health related conditions showed significant differences between MA and NHW subjects. We believe these results provide an important insight into the mechanism of health-related conditions and depressive symptomatology in a large sample of elderly MAs; and how conditions typically attributed to MA ethnicity may in actuality be an artifact of socioeconomic status variables such as educational-attainment.

  11. Moderate Bravery

    DEFF Research Database (Denmark)

    Majgaard, Klaus

    2016-01-01

    Purpose: The ability to act in a purposeful and effective way amid institutional tensions and paradoxes is, right now, a highly prized quality in public leadership. The purpose of this chapter is to qualify moderately brave acts as a learning format that combines the analytical and performative...... skills implied in this kind of agency. Design/methodology/approach: The chapter explores the engagement with paradoxes as a narrative praxis. From existing literature, it sums up an understanding of agency as a social process of mediating paradoxes in order to make action possible. Drawing on Northrop...

  12. Application of altitude control techniques for low altitude earth satellites

    Science.gov (United States)

    Nickerson, K. G.; Herder, R. W.; Glass, A. B.; Cooley, J. L.

    1977-01-01

    The applications sensors of many low altitude earth satellites designed for recording surface or atmospheric data require near zero orbital eccentricities for maximum usefulness. Coverage patterns and altitude profiles require specified values of orbit semimajor axis. Certain initial combinations of semimajor axis, eccentricity, and argument of perigee can produce a so called 'frozen orbit' and minimum altitude variation which enhances sensor coverage. This paper develops information on frozen orbits and minimum altitude variation for all inclinations, generalizing previous results. In the altitude regions where most of these satellites function (between 200 and 1000 kilometers) strong atmospheric drag effects influence the evolution of the initial orbits. Active orbital maneuver control techniques to correct evolution of orbit parameters while minimizing the frequency of maneuvers are presented. The paper presents the application of theoretical techniques for control of near frozen orbits and expands upon the methods useful for simultaneously targeting several inplane orbital parameters. The applications of these techniques are illustrated by performance results from the Atmosphere Explorer (AE-3 and -5) missions and in preflight maneuver analysis and plans for the Seasat Oceanographic Satellite.

  13. Analysis of mitochondrial DNA in Tibetan gastric cancer patients at high altitude

    OpenAIRE

    Jiang, Jun; Zhao, Jun-Hui; Wang, Xue-Lian; DI, JI; Liu, Zhi-Bo; Li, Guo-Yuan; WANG, MIAO-ZHOU; Li, Yan; Chen, Rong; Ge, Ri-Li

    2015-01-01

    The highest risk areas of gastric cancer are currently Japan, Korea and China; Qinghai, a high-altitude area, has one of the highest gastric cancer rates in China. The incidence of gastric cancer is higher in the Tibetan ethnic group compared to that in the Han ethnic group in Qinghai. This study was conducted to determine the clinical characteristics of mitochondrial DNA (mtDNA) mutations and copy numbers among Tibetans with gastric cancer residing at high altitudes and investigate the assoc...

  14. 我国个人所得税对城镇居民收入的调节效应研究%Research of the Moderating Effect of the Personal Income Tax on the Income of the Urban Residents in China

    Institute of Scientific and Technical Information of China (English)

    黄凤羽; 王一如

    2012-01-01

    个人所得税对城镇居民收入的再分配效应可以分别从总量和结构的角度进行考察。对不同口径“税前收入”与“税后收入”的研究均发现.我国个人所得税有助于缩小城镇居民的基尼系数.但社会保障缴款显示了一定的逆向调节作用。通过结构分析发现.高收入居民的纳税比重、平均税率、税收累进程度均高于低收入组,但差别不大。同时,各收入组间收入结构、赡养人口的差别。影响了税收的再分配效应。%This paper analyzes the redistribution effect of the personal income tax on the income of the urban residents from the perspectives of the total amount and structure respectively. The studies of "pre-tax income" and "after-tax income" based on different statistical standards show that China's personal income tax contributes to reduce the Gini coefficient of the urban residents, but the social security contribution plays a reverse role. The structure analysis finds that the proportion of tax payment, average rate of tax and tax progressivity are slightly higher in the high income group than those in the low income group. Also, different income structures and family dependents between groups also influence the redistribution effect of taxation.

  15. Circulatory adaptation to long-term high altitude exposure in Aymaras and Caucasians.

    Science.gov (United States)

    Stuber, Thomas; Scherrer, Urs

    2010-01-01

    About 30 million people live above 2500 m in the Andean Mountains of South America. Among them are 5.5 million Aymaras, an ethnic group with its own language, living on the altiplano of Bolivia, Peru, and northern Chile at altitudes of up to 4400 m. In this high altitude region traces of human population go back for more than 2000 years with constant evolutionary pressure on its residents for genetic adaptation to high altitude. Aymaras as the assumed direct descendents of the ancient cultures living in this region were the focus of much research interest during the last decades and several distinctive adaptation patterns to life at high altitude have been described in this ethnic group. The aim of this article was to review the physiology and pathophysiology of circulatory adaptation and maladaptation to longtime altitude exposure in Aymaras and Caucasians.

  16. High altitude headache occurs frequently among construction workers in Yushu

    Institute of Scientific and Technical Information of China (English)

    Wu Tianyi; Li Shuzhi; Jin Xinhui; Zhang Jianqing

    2013-01-01

    The aim was to measure the incidence of high altitude headache (HAH) and to determine clinical features,as well as the relation between acute mountain sickness (AMS) and HAH through a prospective study.We conducted a questionnaire-based study among construction workers in Yushu after a serious earthquake; they were under reconstruction using a structured questionnaire incorporating International Headache Society (IHS) and AMS Lake Louise Scoring System.A total of 608 workers were enrolled after their first ascent to altitudes of 3 750~4528 m.The results showed that 96 % reported at least 1 HAH(median 3.8,range from 1 to 10) in workers at a mean altitude of 4250 m.The magnitude of headache was divided as mild (38 %),moderate (44 %) and severe (18 %).This study indicates that HAH is the most common symptom of acute altitude exposure and closely correlated with altitude (r=0.165,p<0.001).However,52 % of headache was one of the main symptoms of AMS,while the other 48 % was the sole symptom of HAH.On the contrary we found that 2 % of AMS without headache,thus the "painless AMS" actually existed.The clinical features of HAH are presented,and the relationship between AMS and HAH is discussed.

  17. Asteroid airburst altitude vs. strength

    Science.gov (United States)

    Robertson, Darrel; Wheeler, Lorien; Mathias, Donovan

    2016-10-01

    Small NEO asteroids (<Ø140m) may not be a threat on a national or global level but can still cause a significant amount of local damage as demonstrated by the Chelyabinsk event where there was over $33 million worth of damage (1 billion roubles) and 1500 were injured, mostly due to broken glass. The ground damage from a small asteroid depends strongly on the altitude at which they "burst" where most of the energy is deposited in the atmosphere. The ability to accurately predict ground damage is useful in determining appropriate evacuation or shelter plans and emergency management.Strong asteroids, such as a monolithic boulder, fail and create peak energy deposition close to the altitude at which ram dynamic pressure exceeds the material cohesive strength. Weaker asteroids, such as a rubble pile, structurally fail at higher altitude, but it requires the increased aerodynamic pressure at lower altitude to disrupt and disperse the rubble. Consequently the resulting airbursts have a peak energy deposition at similar altitudes.In this study hydrocode simulations of the entry and break-up of small asteroids were performed to examine the effect of strength, size, composition, entry angle, and speed on the resulting airburst. This presentation will show movies of the simulations, the results of peak burst height, and the comparison to semi-analytical models.

  18. Altitude Stress During Participation of Medical Congress

    OpenAIRE

    Kim, Soon Bae; Kim, Jong Sung; Kim, Sang Jun; Cho, Su Hee; Suh, Dae Chul

    2016-01-01

    Medical congresses often held in highlands. We reviewed several medical issues associated with altitude stress especially while physicians have participated medical congress held in high altitude. Altitude stress, also known as an acute mountain sickness (AMS), is caused by acute exposure to low oxygen level at high altitude which is defined as elevations at or above 1,200 m and AMS commonly occurs above 2,500 m. Altitude stress with various symptoms including insomnia can also be experienced...

  19. Pre-Altitude Serum Ferritin Levels and Daily Oral Iron Supplement Dose Mediate Iron Parameter and Hemoglobin Mass Responses to Altitude Exposure.

    Directory of Open Access Journals (Sweden)

    Andrew D Govus

    Full Text Available To investigate the influence of daily oral iron supplementation on changes in hemoglobin mass (Hbmass and iron parameters after 2-4 weeks of moderate altitude exposure.Hematological data collected from 178 athletes (98 males, 80 females exposed to moderate altitude (1,350-3,000 m were analysed using linear regression to determine how altitude exposure combined with oral iron supplementation influenced Hbmass, total iron incorporation (TII and blood iron parameters [ferritin and transferrin saturation (TSAT].Altitude exposure (mean ± s: 21 ± 3 days increased Hbmass by 1.1% [-0.4, 2.6], 3.3% [1.7, 4.8], and 4.0% [2.0, 6.1] from pre-altitude levels in athletes who ingested nil, 105 mg and 210 mg respectively, of oral iron supplement daily. Serum ferritin levels decreased by -33.2% [-46.9, -15.9] and 13.8% [-32.2, 9.7] from pre-altitude levels in athletes who supplemented with nil and 105 mg of oral iron supplement daily, but increased by 36.8% [1.3, 84.8] in athletes supplemented with 210 mg of oral iron daily. Finally, athletes who ingested either 105 mg or 210 mg of oral iron supplement daily had a greater TII compared with non-supplemented athletes (0 versus 105 mg: effect size (d = -1.88 [-2.56, -1.17]; 0 versus 210 mg: effect size (d = -2.87 [-3.88, -1.66].Oral iron supplementation during 2-4 weeks of moderate altitude exposure may enhance Hbmass production and assist the maintenance of iron balance in some athletes with low pre-altitude iron stores.

  20. The genetic architecture of adaptations to high altitude in Ethiopia.

    Science.gov (United States)

    Alkorta-Aranburu, Gorka; Beall, Cynthia M; Witonsky, David B; Gebremedhin, Amha; Pritchard, Jonathan K; Di Rienzo, Anna

    2012-01-01

    Although hypoxia is a major stress on physiological processes, several human populations have survived for millennia at high altitudes, suggesting that they have adapted to hypoxic conditions. This hypothesis was recently corroborated by studies of Tibetan highlanders, which showed that polymorphisms in candidate genes show signatures of natural selection as well as well-replicated association signals for variation in hemoglobin levels. We extended genomic analysis to two Ethiopian ethnic groups: Amhara and Oromo. For each ethnic group, we sampled low and high altitude residents, thus allowing genetic and phenotypic comparisons across altitudes and across ethnic groups. Genome-wide SNP genotype data were collected in these samples by using Illumina arrays. We find that variants associated with hemoglobin variation among Tibetans or other variants at the same loci do not influence the trait in Ethiopians. However, in the Amhara, SNP rs10803083 is associated with hemoglobin levels at genome-wide levels of significance. No significant genotype association was observed for oxygen saturation levels in either ethnic group. Approaches based on allele frequency divergence did not detect outliers in candidate hypoxia genes, but the most differentiated variants between high- and lowlanders have a clear role in pathogen defense. Interestingly, a significant excess of allele frequency divergence was consistently detected for genes involved in cell cycle control and DNA damage and repair, thus pointing to new pathways for high altitude adaptations. Finally, a comparison of CpG methylation levels between high- and lowlanders found several significant signals at individual genes in the Oromo.

  1. Development of Aptitude at Altitude

    Science.gov (United States)

    Hogan, Alexandra M.; Virues-Ortega, Javier; Botti, Ana Baya; Bucks, Romola; Holloway, John W.; Rose-Zerilli, Matthew J.; Palmer, Lyle J.; Webster, Rebecca J.; Baldeweg, Torsten; Kirkham, Fenella J.

    2010-01-01

    Millions of people currently live at altitudes in excess of 2500 metres, where oxygen supply is limited, but very little is known about the development of brain and behavioural function under such hypoxic conditions. We describe the physiological, cognitive and behavioural profile of a large cohort of infants (6-12 months), children (6-10 years)…

  2. High Altitude Cooking and Food Safety

    Science.gov (United States)

    ... Standard Forms FSIS United States Department of Agriculture Food Safety and Inspection Service About FSIS District Offices Careers ... 286) Actions ${title} Loading... High Altitude Cooking and Food Safety What is considered a high altitude? How is ...

  3. Residency Allocation Database

    Data.gov (United States)

    Department of Veterans Affairs — The Residency Allocation Database is used to determine allocation of funds for residency programs offered by Veterans Affairs Medical Centers (VAMCs). Information...

  4. Cold Stress at High Altitudes

    Directory of Open Access Journals (Sweden)

    N. C. Majumdar

    1983-04-01

    Full Text Available The problem of cold at high altitudes has been analysed from a purely physical standpoint. It has been shown that Siple's Wind-Chill Index is not reliable because (i it does not make use of the well established principles governing the physical processes of heat transfer by convection and radiation, and (ii it assumes that the mean radiant temperature of the surroundings is the same as the ambient dry bulb temperature. A Cold Stress Index has been proposed which is likely to be a more reliable guide for assessing the climatic hazards of high altitude environments. The Index can be quickly estimated with the help of two nomograms devised for the purpose.

  5. The influence of intermittent altitude exposure to 4100 m on exercise capacity and blood variables

    DEFF Research Database (Denmark)

    Lundby, C; Nielsen, T K; Dela, F

    2005-01-01

    This study was performed to investigate the effects of intermittent hypoxic exposure on blood and exercise parameters. Eight sea level residents were exposed to 2 h daily stimulus to 4100 m altitude in a hypobaric chamber for a total of 14 days. Exercise performance was evaluated at sea level bef...

  6. Space Operations Center orbit altitude selection strategy

    Science.gov (United States)

    Indrikis, J.; Myers, H. L.

    1982-01-01

    The strategy for the operational altitude selection has to respond to the Space Operation Center's (SOC) maintenance requirements and the logistics demands of the missions to be supported by the SOC. Three orbit strategies are developed: two are constant altitude, and one variable altitude. In order to minimize the effect of atmospheric uncertainty the dynamic altitude method is recommended. In this approach the SOC will operate at the optimum altitude for the prevailing atmospheric conditions and logistics model, provided that mission safety constraints are not violated. Over a typical solar activity cycle this method produces significant savings in the overall logistics cost.

  7. Altitude Stress During Participation of Medical Congress.

    Science.gov (United States)

    Kim, Soon Bae; Kim, Jong Sung; Kim, Sang Jun; Cho, Su Hee; Suh, Dae Chul

    2016-09-01

    Medical congresses often held in highlands. We reviewed several medical issues associated with altitude stress especially while physicians have participated medical congress held in high altitude. Altitude stress, also known as an acute mountain sickness (AMS), is caused by acute exposure to low oxygen level at high altitude which is defined as elevations at or above 1,200 m and AMS commonly occurs above 2,500 m. Altitude stress with various symptoms including insomnia can also be experienced in airplane. AMS and drunken state share many common features in symptoms, neurologic manifestations and even show multiple microbleeds in corpus callosum and white matter on MRI. Children are more susceptible to altitude stress than adults. Gradual ascent is the best method for the prevention of altitude stress. Adequate nutrition (mainly carbohydrates) and hydration are recommended. Consumption of alcohol can exacerbate the altitude-induced impairments in judgment and the visual senses and promote psychomotor dysfunction. For prevention or treatment of altitude stress, acetazolamide, phosphodiesterase inhibitors, dexamethasone and erythropoietin are helpful. Altitude stress can be experienced relatively often during participation of medical congress. It is necessary to remind the harmful effect of AMS because it can cause serious permanent organ damage even though the symptoms are negligible in most cases.

  8. Does high altitude increase risks of the elderly patients with coronary artery disease?

    Institute of Scientific and Technical Information of China (English)

    Tian-Yi Wu; Zhong-Yan Zhan; Qin-Li Wu; Suo-Lung Baomu; Yu-Ling Jie; Min Sun

    2009-01-01

    Objective To assess the effect of altitude hypoxia on the elderly patients with coronary artery disease (CAD). Methods Three subject groups were surveyed during their train trip on the highest railroad--the Qinghai-Tibet Railway: 22 elderly individuals with documented CAD, 20 healthy elderly controls, and 20 healthy young controls, all of whom from Beijing near the sea level (76 m). Survey questions addressed clinical features of their healthy conditions and aspects of their coronary disease. The baseline study was performed at Xining at an altitude of 2261 m, and then during acute exposure to altitudes of 2808 m, 4768m, 5072 m and 4257 m by train for 24 hours. Resting pulse rate, blood pressure, oxygen saturation, electrocardiograph (ECG), and cardiac work estimated by the heart rate-blood pressure double product were obtained five times in each subject at different altitudes. Results On arrival to altitudes between 4768 m and 5072 m, the older passengers, especially those with preexisting coronary disease, had higher HR, higher BP, and lower SaO2, as well as more frequent abnormalities on ECG, as compared to the younger healthy subjects. As compared with the healthy elderly controls, incomplete right bundle branch block, left ventricular hypertrophy, and ST segment depression were more frequently seen in the elderly coronary patients (P<0.01). Cardiac work in group 1 was increased by 13% 12 hours after arrival to altitudes between 2808 m and 5072 m. Oxygen saturation decreased significantly with the altitude increasing by train ascent but improved after inhalation of oxygen. Most of the older subjects tolerated their sojourn at high altitude well except one who developed angina repeatedly with a significant ST segment depression. Conclusions Coronary events and ECG signs of myocardial ischemia are rare in elderly individuals with CAD who travel from sea level to moderate altitudes of 1500m to 2800 m. Patients with CAD who are well compensated at sea level

  9. The genetic architecture of adaptations to high altitude in Ethiopia.

    Directory of Open Access Journals (Sweden)

    Gorka Alkorta-Aranburu

    Full Text Available Although hypoxia is a major stress on physiological processes, several human populations have survived for millennia at high altitudes, suggesting that they have adapted to hypoxic conditions. This hypothesis was recently corroborated by studies of Tibetan highlanders, which showed that polymorphisms in candidate genes show signatures of natural selection as well as well-replicated association signals for variation in hemoglobin levels. We extended genomic analysis to two Ethiopian ethnic groups: Amhara and Oromo. For each ethnic group, we sampled low and high altitude residents, thus allowing genetic and phenotypic comparisons across altitudes and across ethnic groups. Genome-wide SNP genotype data were collected in these samples by using Illumina arrays. We find that variants associated with hemoglobin variation among Tibetans or other variants at the same loci do not influence the trait in Ethiopians. However, in the Amhara, SNP rs10803083 is associated with hemoglobin levels at genome-wide levels of significance. No significant genotype association was observed for oxygen saturation levels in either ethnic group. Approaches based on allele frequency divergence did not detect outliers in candidate hypoxia genes, but the most differentiated variants between high- and lowlanders have a clear role in pathogen defense. Interestingly, a significant excess of allele frequency divergence was consistently detected for genes involved in cell cycle control and DNA damage and repair, thus pointing to new pathways for high altitude adaptations. Finally, a comparison of CpG methylation levels between high- and lowlanders found several significant signals at individual genes in the Oromo.

  10. Correlates of University Students' Soft and Energy Drink Consumption According to Gender and Residency

    National Research Council Canada - National Science Library

    Deliens, Tom; Clarys, Peter; De Bourdeaudhuij, Ilse; Deforche, Benedicte

    2015-01-01

    This study assessed personal and environmental correlates of Belgian university students' soft and energy drink consumption and investigated whether these associations were moderated by gender or residency...

  11. 1962 Satellite High Altitude Radiation Belt Database

    Science.gov (United States)

    2014-03-01

    TR-14-18 1962 Satellite High Altitude Radiation Belt Database Approved for public release; distribution is unlimited. March...the Status of the High Altitude Nuclear Explosion (HANE) Trapped Radiation Belt Database”, AFRL-VS-PS-TR- 2006-1079, Air Force Research Laboratory...Roth, B., “Blue Ribbon Panel and Support Work Assessing the Status of the High Altitude Nuclear Explosion (HANE) Trapped Radiation Belt Database

  12. Aspirated Compressors for High Altitude Engines Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Aurora Flight Sciences proposes to incorporate aspirated compressor technology into a high altitude, long endurance (HALE) concept engine. Aspiration has been proven...

  13. Resident Characteristics Report

    Data.gov (United States)

    Department of Housing and Urban Development — The Resident Characteristics Report summarizes general information about households who reside in Public Housing, or who receive Section 8 assistance. The report...

  14. Fellowship or Further Training for Family Medicine Residents?

    Science.gov (United States)

    Sairenji, Tomoko; Dai, Mingliang; Eden, Aimee R; Peterson, Lars E; Mainous, Arch G

    2017-09-01

    The breadth of family medicine (FM) generates debate about the length of residency training. One argument used by proponents for lengthening training is that residents feel unprepared for practice. The objectives of our study were to (1) identify the proportion of FM residency graduates intending to pursue fellowship training and those who would have done an additional year of core residency training had it been available, and (2) determine whether an association exists between these two variables. We used data collected by the American Board of Family Medicine (ABFM) as part of resident certification examination application in 2014 and 2015. Data included fellowship intention, and interest in pursuing another year of residency training if it were available. We used descriptive and bivariate statistics. The questionnaire was completed by 6,235 residents, of which 17.0% (n=1,063) intended to enroll in a fellowship. Overall 54.2% of residents were "not at all likely" to extend residency training, with 19.9% "extremely/moderately likely". Forty-six percent of those intending a fellowship were "not at all likely" to extend training and only 29% of those "extremely/moderately likely" to extend residency training intended to enroll in a fellowship. We found a disconnect between fellowship intention and desire for another year of residency training. Desire for fellowship may be more about obtaining specific skills and expertise or additional certifications, and less about being prepared for general practice in family medicine.

  15. The Ideal Resident Doctor: Á Resident's Perspective

    African Journals Online (AJOL)

    trainer relationship can only then be imagined. ... like these lend themselves to personal and cultural ... An ideal resident's clinical options .... of humanistic and professional values, the lack of .... graduate medical education should do more in mak-.

  16. Impact of pharmaceutical company representatives on internal medicine residency programs. A survey of residency program directors.

    Science.gov (United States)

    Lichstein, P R; Turner, R C; O'Brien, K

    1992-05-01

    To survey internal medicine residency program directors regarding interactions between their residents and pharmaceutical company (PC) representatives (PCRs) a questionnaire was sent to the directors of all Accreditation Council for Graduate Medical Education-approved internal medicine residency programs. The survey included 444 program directors, of whom 272 (61.16%) responded. The majority of program directors, 228 (83.8%), allowed PCRs to meet with residents during working hours and 241 (88.6%) permitted PC sponsorship of conferences. About half of the program directors were "moderately" or "very" concerned about the potential adverse effects of PC marketing on resident attitudes and prescribing practices. Seventy percent "agreed" or "strongly agreed" that the benefits of PC sponsorship outweigh the adverse effects and 41.5% believed that refusal to allow PCRs to meet with residents would jeopardize PC funding of other departmental activities. Most program directors reported that alternate funds for conferences were available if PC support was withdrawn. "Unethical" marketing activities were observed by 14.3% of program directors and 37.5% reported that residents had participated in PC-sponsored trips during the 3 years prior to the survey. At the time of this survey, only 35.3% of programs had developed formal policies regulating PCR activities and 25.7% provided residents with formal instruction on marketing issues. Knowledge of the current extent of PCR interactions with residents may be helpful to program directors in developing policies regulating PC-marketing activities.

  17. High-altitude adaptations in vertebrate hemoglobins

    DEFF Research Database (Denmark)

    Weber, Roy E.

    2007-01-01

    Vertebrates at high altitude are subjected to hypoxic conditions that challenge aerobic metabolism. O2 transport from the respiratory surfaces to tissues requires matching between the O2 loading and unloading tensions and theO2-affinity of blood, which is an integrated function of hemoglobin......, birds and ectothermic vertebrates at high altitude....

  18. High-altitude adaptations in vertebrate hemoglobins

    DEFF Research Database (Denmark)

    Weber, Roy E.

    2007-01-01

    Vertebrates at high altitude are subjected to hypoxic conditions that challenge aerobic metabolism. O2 transport from the respiratory surfaces to tissues requires matching between the O2 loading and unloading tensions and theO2-affinity of blood, which is an integrated function of hemoglobin......, birds and ectothermic vertebrates at high altitude....

  19. Visual system effects of exercise on Mauna Kea at 2,200 and 4,200 meters altitude.

    Science.gov (United States)

    Schmeisser, E T; Gagliano, D L; Santiago-Marini, J

    1997-03-01

    Field exercise studies were performed at two altitudes (2,200 and 4,200 m) in 2 successive years using different sets of young male volunteers. Visual function indices were measured both at sea level and during a strenuous exercise regime at altitude. Volunteers were grouped in the first study by initial rest period (2 days vs. no rest) and in the second by diet (supplemental carbohydrates vs. Meals Ready to Eat rations only). Overall results showed no effect according to grouping, a decrease in average visual acuity at the higher altitude overall, and a decrease in electroretinographic (ERG) photopic flicker responses at moderate altitude. It is concluded that heavy exercise at these altitudes may not have operationally significant effects on ground troops in night vision or target recognition, although the change in ERG parameters does indicate a shift in retinal cone physiology that may have subtler effects.

  20. Diving at altitude: from definition to practice.

    Science.gov (United States)

    Egi, S Murat; Pieri, Massimo; Marroni, Alessandro

    2014-01-01

    Diving above sea level has different motivations for recreational, military, commercial and scientific activities. Despite the apparently wide practice of inland diving, there are three major discrepancies about diving at altitude: threshold elevation that requires changes in sea level procedures; upper altitude limit of the applicability of these modifications; and independent validation of altitude adaptation methods of decompression algorithms. The first problem is solved by converting the normal fluctuation in barometric pressure to an altitude equivalent. Based on the barometric variations recorded from a meteorological center, it is possible to suggest 600 meters as a threshold for classifying a dive as an "altitude" dive. The second problem is solved by proposing the threshold altitude of aviation (2,400 meters) to classify "high" altitude dives. The DAN (Divers Alert Network) Europe diving database (DB) is analyzed to solve the third problem. The database consists of 65,050 dives collected from different dive computers. A total of 1,467 dives were found to be classified as altitude dives. However, by checking the elevation according to the logged geographical coordinates, 1,284 dives were disqualified because the altitude setting had been used as a conservative setting by the dive computer despite the fact that the dive was made at sea level. Furthermore, according to the description put forward in this manuscript, 72 dives were disqualified because the surface level elevation is lower than 600 meters. The number of field data (111 dives) is still very low to use for the validation of any particular method of altitude adaptation concerning decompression algorithms.

  1. Effect of Doximity Residency Rankings on Residency Applicants’ Program Choices

    Directory of Open Access Journals (Sweden)

    Aimee M. Rolston

    2015-11-01

    Full Text Available Introduction: Choosing a residency program is a stressful and important decision. Doximity released residency program rankings by specialty in September 2014. This study sought to investigate the impact of those rankings on residency application choices made by fourth year medical students. Methods: A 12-item survey was administered in October 2014 to fourth year medical students at three schools. Students indicated their specialty, awareness of and perceived accuracy of the rankings, and the rankings’ impact on the programs to which they chose to apply. Descriptive statistics were reported for all students and those applying to Emergency Medicine (EM. Results: A total of 461 (75.8% students responded, with 425 applying in one of the 20 Doximity ranked specialties. Of the 425, 247 (58% were aware of the rankings and 177 looked at them. On a 1-100 scale (100=very accurate, students reported a mean ranking accuracy rating of 56.7 (SD 20.3. Forty-five percent of students who looked at the rankings modified the number of programs to which they applied. The majority added programs. Of the 47 students applying to EM, 18 looked at the rankings and 33% changed their application list with most adding programs. Conclusion: The Doximity rankings had real effects on students applying to residencies as almost half of students who looked at the rankings modified their program list. Additionally, students found the rankings to be moderately accurate. Graduating students might benefit from emphasis on more objective characterization of programs to assess in light of their own interests and personal/career goals

  2. Integration of radar altimeter, precision navigation, and digital terrain data for low-altitude flight

    Science.gov (United States)

    Zelenka, Richard E.

    1992-01-01

    Avionic systems that depend on digitized terrain elevation data for guidance generation or navigational reference require accurate absolute and relative distance measurements to the terrain, especially as they approach lower altitudes. This is particularly exacting in low-altitude helicopter missions, where aggressive terrain hugging maneuvers create minimal horizontal and vertical clearances and demand precise terrain positioning. Sole reliance on airborne precision navigation and stored terrain elevation data for above-ground-level (AGL) positioning severely limits the operational altitude of such systems. A Kalman filter is presented which blends radar altimeter returns, precision navigation, and stored terrain elevation data for AGL positioning. The filter is evaluated using low-altitude helicopter flight test data acquired over moderately rugged terrain. The proposed Kalman filter is found to remove large disparities in predicted AGL altitude (i.e., from airborne navigation and terrain elevation data) in the presence of measurement anomalies and dropouts. Previous work suggested a minimum clearance altitude of 220 ft AGL for a near-terrain guidance system; integration of a radar altimeter allows for operation of that system below 50 ft, subject to obstacle-avoidance limitations.

  3. Effect of altitude on some blood factors and its stability after leaving the altitude.

    Science.gov (United States)

    Hematy, Yones; Setorki, Mahbubeh; Razavi, Akram; Doudi, Monir

    2014-09-01

    The underlying mechanisms of altitude training are still a matter of controversial discussion. The aim of this study was to compare the hemoglobin concentration, red blood cell count and volume between normal and high altitude situations and their persistence after returning back from higher altitudes. The study population included male students of Ardal Branch, Islamic Azad University. Twelve apparently healthy individual with high level of physical activity, mean age of 22.6 ± 1.50 years were selected through purposive and available sampling method. In this study, blood samples were collected at different time and altitudes in order to compare the changes of Red Blood Cell (RBC), Mean Cell Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC) and Mean Cell Volume (MCV). The first blood sampling was conducted at the altitude of 1830 m. The subsequent blood samplings were conducted 48 and 72 h after reaching the altitude of 4000 m and 24, 48 and 72 h after returning back to the altitude of 1830 m. The statistical method used in this study was repeated measurement ANOVA. Red Blood Cell (RBC) changes between onset of climbing to 1830 m and 24, 48 and 2 h after sojourn at 1830 m height (after returning from 4000 m altitude) was significant. Mean Cell Hemoglobin (MCH) showed no significant change in any of the altitudes. MCHC changes between onset of moving toward altitude 1830 meters and 24, 48 and 72 h after sojourn at 1830 m height (after returning from 4000 m altitude) was also significant in addition, MCHC showed a significant difference between 24 h staying at 1830 m altitude with 48 and 72 h staying at 4000 m altitude. Mean Cell Volume (MCV) showed no significant difference between 48 and 72 h staying at 4000 m altitude and also between 24, 48 and 72 h staying at 1830 m altitude; however, there was a significant difference between onset of moving toward 1830 m altitude with 24, 48 and 72 h staying at 1830 m altitude and also 48 and 72 h staying at

  4. The laryngeal mask airway at altitude.

    Science.gov (United States)

    Wilson, Grant D; Sittig, Steven E; Schears, Gregory J

    2008-02-01

    The Laryngeal Mask Airway (LMA) is an accepted adjunct for airway management in emergency patients. There are a number of case reports describing its use in transport medicine for infant to adult patients, including during flight. Although studies of the effect altitude has on air-filled tracheal tubes exists, we were unable to find documentation of the effect of altitude on laryngeal mask airways. Our objective was to assess the effect of altitude on the LMA in both fixed wing and rotary wing models. We performed an in vitro study of the effect of altitude on the LMA cuff. Infant and adult airway trainer mannequins with properly sized and inserted LMA-Classic laryngeal mask airways were monitored for cuff pressure changes while flown at altitudes commonly encountered during air medical transport. Both models demonstrated that LMA cuff pressures may exceed manufacturer recommended levels for safe use even at the relatively low altitudes experienced during rotor wing flight. Properly inserted and inflated laryngeal mask airways at ground level may result in overinflated LMA cuffs when flown to altitudes commonly used for rotor and fixed wing medical transport unless monitored and corrected.

  5. Serum immunoreactive erythropoietin in high altitude natives with and without excessive erythrocytosis.

    Science.gov (United States)

    León-Velarde, F; Monge, C C; Vidal, A; Carcagno, M; Criscuolo, M; Bozzini, C E

    1991-05-01

    We report the estimation of blood hemoglobin (Hb), arterial blood oxygen saturation (SaO2), and serum immunoreactive erythropoietin (siEPO) in a group of Peruvian workers residing in Cerro de Pasco at 4300 m showing "excessive erythrocytosis" (EE, Monge's disease, chronic mountain sickness). These estimates were compared with those of humans residing either in Cerro de Pasco and showing "normal erythrocytosis" (NE) or in Lima (sea level, SL) to determine whether Hb and SaO2 are related to siEPO in high altitude (HA) natives with NE or EE. The three parameters showed statistically significant differences between HA and SL groups--the values in SL being lower. Significant differences were also found between NE and EE groups in Hb and SaO2. There was no statistical difference in siEPo between the two groups. The results indicate, therefore, that HA residents who develop EE are not distinguishable from residents who develop NE on the basis of estimates of siEPO. As a result, siEPO and Hb do not show a dose-response relationship in HA residents, and variation in EPO does not explain the striking variation in Hb at high altitudes.

  6. [Burnout in nursing residents].

    Science.gov (United States)

    Franco, Gianfábio Pimentel; de Barros, Alba Lúcia Bottura Leite; Nogueira-Martins, Luiz Antônio; Zeitoun, Sandra Salloum

    2011-03-01

    Nursing residents may experience physical and emotional exhaustion from the daily life of attending the Program. The aim of this study was to determine the Burnout incidence among Nursing Residents. An investigative, descriptive, analytical, longitudinal-prospective study was conducted with 16 Residents over two years. The Maslach Burnout Inventory was used, translated and validated for Brazil, as well as a sociodemographic/occupational data tool. Of all residents, 17.2% showed high rates in Emotional Exhaustion and Depersonalization; 18.8% showed impaired commitment in Personal Accomplishment, 75% of which belonged to specialty areas, such as Emergency Nursing, Adult and Pediatric Intensive Care. Age and specialty area were positively correlated with Personal Accomplishment. One of the Residents was identified with changes in three subscales of the Maslach Burnout Inventory, thus characterized as a Burnout Syndrome patient. Nursing Residents have profiles of disease. Knowing these factors can minimize health risks of these workers.

  7. Residents in difficulty

    DEFF Research Database (Denmark)

    Christensen, Mette K.; O'Neill, Lotte Dyhrberg; Hansen, Dorthe H.;

    2016-01-01

    Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world such as the Scand......Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world...... of the topic. Methods We performed a mixed methods study. All regional residency program directors (N = 157) were invited to participate in an e-survey about residents in difficulty. Survey data were combined with database data on demographical characteristics of the background population (N = 2399...

  8. Pupillary light reaction during high altitude exposure.

    Directory of Open Access Journals (Sweden)

    Maximilian Schultheiss

    Full Text Available PURPOSE: This study aimed to quantify the pupillary light reaction during high altitude exposure using the state of the art Compact Integrated Pupillograph (CIP and to investigate a potential correlation of altered pupil reaction with severity of acute mountain sickness (AMS. This work is related to the Tübingen High Altitude Ophthalmology (THAO study. METHODS: Parameters of pupil dynamics (initial diameter, amplitude, relative amplitude, latency, constriction velocity were quantified in 14 healthy volunteers at baseline (341 m and high altitude (4559 m over several days using the CIP. Scores of AMS, peripheral oxygen saturation and heart rate were assessed for respective correlations with pupil dynamics. For statistical analysis JMP was used and data are shown in terms of intra-individual normalized values (value during exposure/value at baseline and the 95% confidence interval for each time point. RESULTS: During high altitude exposure the initial diameter size was significantly reduced (p<0.05. In contrast, the amplitude, the relative amplitude and the contraction velocity of the light reaction were significantly increased (p<0.05 on all days measured at high altitude. The latency did not show any significant differences at high altitude compared to baseline recordings. Changes in pupil parameters did not correlate with scores of AMS. CONCLUSIONS: Key parameters of the pupillary light reaction are significantly altered at high altitude. We hypothesize that high altitude hypoxia itself as well as known side effects of high altitude exposure such as fatigue or exhaustion after ascent may account for an altered pupillogram. Interestingly, none of these changes are related to AMS.

  9. Pupillary Light Reaction during High Altitude Exposure

    Science.gov (United States)

    Schatz, Andreas; Wilhelm, Barbara; Peters, Tobias; Fischer, M. Dominik; Zrenner, Eberhart; Bartz-Schmidt, Karl U.; Gekeler, Florian; Willmann, Gabriel

    2014-01-01

    Purpose This study aimed to quantify the pupillary light reaction during high altitude exposure using the state of the art Compact Integrated Pupillograph (CIP) and to investigate a potential correlation of altered pupil reaction with severity of acute mountain sickness (AMS). This work is related to the Tübingen High Altitude Ophthalmology (THAO) study. Methods Parameters of pupil dynamics (initial diameter, amplitude, relative amplitude, latency, constriction velocity) were quantified in 14 healthy volunteers at baseline (341 m) and high altitude (4559 m) over several days using the CIP. Scores of AMS, peripheral oxygen saturation and heart rate were assessed for respective correlations with pupil dynamics. For statistical analysis JMP was used and data are shown in terms of intra-individual normalized values (value during exposure/value at baseline) and the 95% confidence interval for each time point. Results During high altitude exposure the initial diameter size was significantly reduced (p<0.05). In contrast, the amplitude, the relative amplitude and the contraction velocity of the light reaction were significantly increased (p<0.05) on all days measured at high altitude. The latency did not show any significant differences at high altitude compared to baseline recordings. Changes in pupil parameters did not correlate with scores of AMS. Conclusions Key parameters of the pupillary light reaction are significantly altered at high altitude. We hypothesize that high altitude hypoxia itself as well as known side effects of high altitude exposure such as fatigue or exhaustion after ascent may account for an altered pupillogram. Interestingly, none of these changes are related to AMS. PMID:24503770

  10. Soldier at High Altitude: Problem & Preventive Measures

    Directory of Open Access Journals (Sweden)

    S.S Purkayastha

    2000-04-01

    Full Text Available Due to military and j trategic reasons, a large body of troops is being regularly dcployed in the snowbound areas through ut the Himalayan regions to guard Ihe Ironliers. Thc mountain environment at high 'allitude (HA consisls of several faclors alien lo plain dwellers, which evoke a series of physiological responses in human system. Some of the sea' level residents on induction to HA suffer from several unloward symploms of HA" ailmenls varying from mild-lo-severe degrees. Suddenexposure to HA is detrimental to physical and mental  performance of the low landers and  certain cases, may even lead to dreaded condition like high altitude pulmonary oedema (HAPO. These may make a man Jisturbed physically and mentally. So, there is a need lo prevent such hazards v(hich ispossible if the individual is aware of the problems and prevenlive measures ofHA ailments in advance, before going to HA for a safe and happy living there. Hence, a noble effort has been made to provide guidelines to create awareness about physical and physiological problems of life at HA and themethods of protection against its ill-effects for the soldiers, mountaineers and sojourners conducting scientific trials it HA. In th.:s revieJ, an attempt has been made to describe vital aspects of HA in a popular way, st~ing with its concept and various environmental factors which exert considerableettects on human body functions, heallh and performance on exposure to such environment, on the b¥is of a series of studies coitlucted at Ithe Defence Institute of Physiology & Allied Sciences, Delhi, oVer the years. The most important featurelof HA (3,000 m and above is hypoxia or deficiency ofoxygej1 in the body. Olher cnvironmental tactors are: scverc cold, high velocity wind, low rclalivc humidily, high solar radiatior, increased ultraviolet radialion and difficult terrain. These faclors are responsible for various HA cWtdc old syndromes, viz., acute mountain sickness, HAPO, dehydration,4

  11. High Altitude Clear Air Turbulence Project

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Air Force Flight Dynamics Laboratory conducted the High Altitude Clear Air Turbulence Project in the mid 1960s with the intention of better understanding air...

  12. Python Engine Installed in Altitude Wind Tunnel

    Science.gov (United States)

    1949-01-01

    An engine mechanic checks instrumentation prior to an investigation of engine operating characteristics and thrust control of a large turboprop engine with counter-rotating propellers under high-altitude flight conditions in the 20-foot-dianieter test section of the Altitude Wind Tunnel at the Lewis Flight Propulsion Laboratory of the National Advisory Committee for Aeronautics, Cleveland, Ohio, now known as the John H. Glenn Research Center at Lewis Field.

  13. Malaria morbidity and immunity among residents of villages with different Plasmodium falciparum transmission intensity in North-Eastern Tanzania

    DEFF Research Database (Denmark)

    Lusingu, John P A; Vestergaard, Lasse S; Mmbando, Bruno P;

    2004-01-01

    and febrile malaria episodes was conducted among individuals aged below 20 years, residing in three villages of different altitude in areas of high, moderate and low malaria transmission intensity in North-Eastern Tanzania. RESULTS: The burden of anaemia and malarial fever fell mainly on the youngest children...... and was highest in the village with high transmission intensity. Although a considerable percentage of individuals in all villages carried intestinal worms, logistic regression models indicated that Plasmodium falciparum was the only significant parasitic determinant of anaemia. Interestingly, children who...... carried low-density parasitaemia at the start of the study had a lower risk of contracting a febrile malaria episode but a higher risk of anaemia during the study period, than children who were slide negative at this point in time. CONCLUSION: Young children living in the high transmission village carried...

  14. Rain Forest Dance Residency.

    Science.gov (United States)

    Watson, Dawn

    1997-01-01

    Outlines the author's experience as a dancer and choreographer artist-in-residence with third graders at a public elementary school, providing a cultural arts experience to tie in with a theme study of the rain forest. Details the residency and the insights she gained working with students, teachers, and theme. (SR)

  15. The prevalence and severity of dental fluorosis in the high and low altitude parts of Central Plateau, Nigeria.

    Science.gov (United States)

    Akosu, T J; Zoakah, A I; Chirdan, O A

    2009-09-01

    To compare the prevalence and severity of dental fluorosis in the high and low altitude parts of the Central Senatorial District of Plateau State. The study was cross-sectional and descriptive. The community based study was carried out in Central Plateau Nigeria, in 2005. The study subjects were 12-15 year old life long residents selected using the multistage sampling technique. One Local Government Area each was randomly selected from the high and low altitude parts of the district and from each selected Local Government Area two health districts were randomly selected with probability proportional to size. From each of the selected health Districts two major settlements were selected again with probability proportional to size. 12-15 year old life long residents of the selected settlements were studied. Each respondent completed an interviewer administered questionnaire after which he/she was clinically examined to ascertain his/her fluorosis status. Samples of water were collected from water sources consumed by the respondents in each settlement. The main outcome measures were presence and severity of dental fluorosis as measured by the Thylstrup and Fejerskov index. (TF score). One thousand one hundred children were studied, 554 (50.4%) from the high altitude part of the district and 546 (49.6%) from the low altitude part. Fluorosis prevalence was 12.9% in the district, but significantly higher (22.2%) in the high altitude areas compared to the low altitude ones (3.5%). The severest form of fluorosis in the district was TF 6 for tooth 14 and TF 5 for tooth 11. The prevalence and severity of dental fluorosis is significantly higher in the high altitude parts of the District compared to the low altitude ones. Efforts are needed to further investigate and control the problem.

  16. High serum zinc and serum testosterone levels were associated with excessive erythrocytosis in men at high altitudes.

    Science.gov (United States)

    Gonzales, Gustavo F; Tapia, Vilma; Gasco, Manuel; Rubio, Julio; Gonzales-Castañeda, Cynthia

    2011-12-01

    Chronic mountain sickness (CMS), a lack of adaptation to altitude characterized by excessive erythrocytosis (EE), is a health problem associated with life at high altitude. The erythropoietic process is regulated by both erythropoietin and testosterone. Zinc (Zn) is known to be related with testosterone and hemoglobin levels; meanwhile, nitric oxide was also associated with adaptation to high altitude. The aim of this study was to determine the relationship of hemoglobin and CMS score with serum levels of zinc, total testosterone (TT), calculated free testosterone (cFT), bioavailable testosterone (BAT), hemoglobin, and nitric oxide in men at high altitude with or without EE. Men residing in Lima (150 m) and Cerro de Pasco (4,340 m), Peru, were divided into three groups: (1) low altitude, (2) high altitude without EE (hemoglobin < 21 g/dl), and (3) high altitude with EE (hemoglobin ≥ 21 g/dl). Adjusted multivariable regression models showed that serum testosterone (total or free) and Zn levels were independently correlated with increased hemoglobin levels. Similarly, hemoglobin was positively related with signs/symptoms of CMS; however, both increased the serum Zn and the nitric oxide levels correlated with reduced risk for signs/symptoms of CMS. In conclusion, higher serum testosterone levels and Zn levels were associated with EE, and low scores of signs/symptoms of CMS were associated with higher Zn and nitric oxide levels.

  17. Early history of high-altitude physiology.

    Science.gov (United States)

    West, John B

    2016-02-01

    High-altitude physiology can be said to have begun in 1644 when Torricelli described the first mercury barometer and wrote the immortal words "We live submerged at the bottom of an ocean of the element air." Interestingly, the notion of atmospheric pressure had eluded his teacher, the great Galileo. Blaise Pascal was responsible for describing the fall in pressure with increasing altitude, and Otto von Guericke gave a dramatic demonstration of the enormous force that could be developed by atmospheric pressure. Robert Boyle learned of Guericke's experiment and, with Robert Hooke, constructed the first air pump that allowed small animals to be exposed to a low pressure. Hooke also constructed a small low-pressure chamber and exposed himself to a simulated altitude of about 2400 meters. With the advent of ballooning, humans were rapidly exposed to very low pressures, sometimes with tragic results. For example, the French balloon, Zénith, rose to over 8000 m, and two of the three aeronauts succumbed to the hypoxia. Paul Bert was the first person to clearly state that the deleterious effects of high altitude were caused by the low partial pressure of oxygen (PO2), and later research was accelerated by high-altitude stations and expeditions to high altitude.

  18. Residents in difficulty

    DEFF Research Database (Denmark)

    Christensen, Mette Krogh; O'Neill, Lotte; Hansen, Dorthe Høgh;

    2016-01-01

    Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world such as the Scand......Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world...... such as the Scandinavian countries, where healthcare systems are slightly different. The aim of this study was to examine prevalence and characteristics of residents in difficulty in one out of three postgraduate medical training regions in Denmark, and to produce both a quantifiable overview and in-depth understanding...

  19. REACTOR MODERATOR STRUCTURE

    Science.gov (United States)

    Greenstreet, B.L.

    1963-12-31

    A system for maintaining the alignment of moderator block structures in reactors is presented. Integral restraining grids are placed between each layer of blocks in the moderator structure, at the top of the uppermost layer, and at the bottom of the lowermost layer. Slots are provided in the top and bottom surfaces of the moderator blocks so as to provide a keying action with the grids. The grids are maintained in alignment by vertical guiding members disposed about their peripheries. (AEC)

  20. Nitric oxide in adaptation to altitude.

    Science.gov (United States)

    Beall, Cynthia M; Laskowski, Daniel; Erzurum, Serpil C

    2012-04-01

    This review summarizes published information on the levels of nitric oxide gas (NO) in the lungs and NO-derived liquid-phase molecules in the acclimatization of visitors newly arrived at altitudes of 2500 m or more and adaptation of populations whose ancestors arrived thousands of years ago. Studies of acutely exposed visitors to high altitude focus on the first 24-48 h with just a few extending to days or weeks. Among healthy visitors, NO levels in the lung, plasma, and/or red blood cells fell within 2h, but then returned toward baseline or slightly higher by 48 h and increased above baseline by 5 days. Among visitors ill with high-altitude pulmonary edema at the time of the study or in the past, NO levels were lower than those of their healthy counterparts. As for highland populations, Tibetans had NO levels in the lung, plasma, and red blood cells that were at least double and in some cases orders of magnitude greater than other populations regardless of altitude. Red blood cell-associated nitrogen oxides were more than 200 times higher. Other highland populations had generally higher levels although not to the degree shown by Tibetans. Overall, responses of those acclimatized and those presumed to be adapted are in the same direction, although the Tibetans have much larger responses. Missing are long-term data on lowlanders at altitude showing how similar they become to the Tibetan phenotype. Also missing are data on Tibetans at low altitude to see the extent to which their phenotype is a response to the immediate environment or expressed constitutively. The mechanisms causing the visitors' and the Tibetans' high levels of NO and NO-derived molecules at altitude remain unknown. Limited data suggest processes including hypoxic upregulation of NO synthase gene expression, hemoglobin-NO reactions, and genetic variation. Gains in understanding will require integrating appropriate methods and measurement techniques with indicators of adaptive function under hypoxic

  1. Responses of the autonomic nervous system in altitude adapted and high altitude pulmonary oedema subjects

    Science.gov (United States)

    Mathew, Lazar; Purkayastha, S. S.; Jayashankar, A.; Radhakrishnan, U.; Sen Gupta, J.; Nayar, H. S.

    1985-06-01

    Studies were carried out to ascertain the role of sympatho-parasympathetic responses in the process of adaptation to altitude. The assessment of status of autonomic balance was carried out in a group of 20 young male subjects by recording their resting heart rate, blood pressure, oral temperature, mean skin temperature, extremity temperatures, pupillary diameter, cold pressor response, oxygen consumption, cardioacceleration during orthostasis and urinary excretion of catecholamines; in a thermoneutral laboratory. The same parameters were repeated on day 3 and at weekly intervals for a period of 3 weeks, after exposing them to 3,500 m; and also after return to sea level. At altitude, similar studies were carried out in a group of 10 acclimatized lowlanders, 10 high altitude natives and 6 patients who had recently recovered from high altitude pulmonary oedema. In another phase, similar studies were done in two groups of subjects, one representing 15 subjects who had stayed at altitude (3,500 4,000 m) without any ill effects and the other comprising of 10 subjects who had either suffered from high altitude pulmonary oedema (HAPO) or acute mountain sickness (AMS). The results revealed sympathetic overactivity on acute induction to altitude which showed gradual recovery on prolonged stay, the high altitude natives had preponderance to parasympathetic system. Sympathetic preponderance may not be an essential etiological factor for the causation of maladaptation syndromes.

  2. Altitude Registration of Limb-Scattered Radiation

    Science.gov (United States)

    Moy, Leslie; Bhartia, Pawan K.; Jaross, Glen; Loughman, Robert; Kramarova, Natalya; Chen, Zhong; Taha, Ghassan; Chen, Grace; Xu, Philippe

    2017-01-01

    One of the largest constraints to the retrieval of accurate ozone profiles from UV backscatter limb sounding sensors is altitude registration. Two methods, the Rayleigh scattering attitude sensing (RSAS) and absolute radiance residual method (ARRM), are able to determine altitude registration to the accuracy necessary for long-term ozone monitoring. The methods compare model calculations of radiances to measured radiances and are independent of onboard tracking devices. RSAS determines absolute altitude errors, but, because the method is susceptible to aerosol interference, it is limited to latitudes and time periods with minimal aerosol contamination. ARRM, a new technique introduced in this paper, can be applied across all seasons and altitudes. However, it is only appropriate for relative altitude error estimates. The application of RSAS to Limb Profiler (LP) measurements from the Ozone Mapping and Profiler Suite (OMPS) on board the Suomi NPP (SNPP) satellite indicates tangent height (TH) errors greater than 1 km with an absolute accuracy of +/-200 m. Results using ARRM indicate a approx. 300 to 400m intra-orbital TH change varying seasonally +/-100 m, likely due to either errors in the spacecraft pointing or in the geopotential height (GPH) data that we use in our analysis. ARRM shows a change of approx. 200m over 5 years with a relative accuracy (a long-term accuracy) of 100m outside the polar regions.

  3. Oxygen ion energization observed at high altitudes

    Directory of Open Access Journals (Sweden)

    M. Waara

    2010-04-01

    Full Text Available We present a case study of significant heating (up to 8 keV perpendicular to the geomagnetic field of outflowing oxygen ions at high altitude (12 RE above the polar cap. The shape of the distribution functions indicates that most of the heating occurs locally (within 0.2–0.4 RE in altitude. This is a clear example of local ion energization at much higher altitude than usually reported. In contrast to many events at lower altitudes, it is not likely that the locally observed wave fields can cause the observed ion energization. Also, it is not likely that the ions have drifted from some nearby energization region to the point of observation. This suggests that additional fundamentally different ion energization mechanisms are present at high altitudes. One possibility is that the magnetic moment of the ions is not conserved, resulting in slower outflow velocities and longer time for ion energization.

  4. Altitude Registration of Limb-Scattered Radiation

    Science.gov (United States)

    Moy, Leslie; Bhartia, Pawan K.; Jaross, Glen; Loughman, Robert; Kramarova, Natalya; Chen, Zhong; Taha, Ghassan; Chen, Grace; Xu, Philippe

    2017-01-01

    One of the largest constraints to the retrieval of accurate ozone profiles from UV backscatter limb sounding sensors is altitude registration. Two methods, the Rayleigh scattering attitude sensing (RSAS) and absolute radiance residual method (ARRM), are able to determine altitude registration to the accuracy necessary for long-term ozone monitoring. The methods compare model calculations of radiances to measured radiances and are independent of onboard tracking devices. RSAS determines absolute altitude errors, but, because the method is susceptible to aerosol interference, it is limited to latitudes and time periods with minimal aerosol contamination. ARRM, a new technique introduced in this paper, can be applied across all seasons and altitudes. However, it is only appropriate for relative altitude error estimates. The application of RSAS to Limb Profiler (LP) measurements from the Ozone Mapping and Profiler Suite (OMPS) on board the Suomi NPP (SNPP) satellite indicates tangent height (TH) errors greater than 1 km with an absolute accuracy of +/-200 m. Results using ARRM indicate a approx. 300 to 400m intra-orbital TH change varying seasonally +/-100 m, likely due to either errors in the spacecraft pointing or in the geopotential height (GPH) data that we use in our analysis. ARRM shows a change of approx. 200m over 5 years with a relative accuracy (a long-term accuracy) of 100m outside the polar regions.

  5. High altitude syndromes at intermediate altitudes: a pilot study in the Australian Alps.

    Science.gov (United States)

    Slaney, Graham; Cook, Angus; Weinstein, Philip

    2013-10-01

    Our hypothesis is that symptoms of high altitude syndromes are detectable even at intermediate altitudes, as commonly encountered under Australian conditions (flatus expulsion (HAFE). Symptoms of high altitude syndromes are of growing concern because of the global trend toward increasing numbers of tourists and workers exposed to both rapid ascent and sustained physical activity at high altitude. However, in Australia, high altitude medicine has almost no profile because of our relatively low altitudes by international standards. Three factors lead us to believe that altitude sickness in Australia deserves more serious consideration: Australia is subject to rapid growth in alpine recreational industries; altitude sickness is highly variable between individuals, and some people do experience symptoms already at 1500 m; and there is potential for an occupational health and safety issue amongst workers. To test this hypothesis we examined the relationship between any high altitude symptoms and a rapid ascent to an intermediate altitude (1800 m) by undertaking an intervention study in a cohort of eight medical clinic staff, conducted during July of the 2012 (Southern Hemisphere) ski season, using self-reporting questionnaires, at Mansfield (316 m above sea level) and at the Ski Resort of Mt Buller (1800 m), Victoria, Australia. The intervention consisted of ascent by car from Mansfield to Mt Buller (approx. 40 min drive). Participants completed a self-reporting questionnaire including demographic data and information on frequency of normal homeostatic processes (fluid intake and output, food intake and output, symptoms including thirst and headaches, and frequency of passing wind or urine). Data were recorded in hourly periods extending over 18 h before and 18 h after ascent. We found that the frequency of flatus production more than doubled following ascent, with a post-ascent frequency of approximately 14 expulsions per person over the 18 h recording period (Rate

  6. Pulmonary Embolism Masquerading as High Altitude Pulmonary Edema at High Altitude.

    Science.gov (United States)

    Pandey, Prativa; Lohani, Benu; Murphy, Holly

    2016-12-01

    Pandey, Prativa, Benu Lohani, and Holly Murphy. Pulmonary embolism masquerading as high altitude pulmonary edema at high altitude. High Alt Med Biol. 17:353-358, 2016.-Pulmonary embolism (PE) at high altitude is a rare entity that can masquerade as or occur in conjunction with high altitude pulmonary edema (HAPE) and can complicate the diagnosis and management. When HAPE cases do not improve rapidly with descent, other diagnoses, including PE, ought to be considered. From 2013 to 2015, we identified eight cases of PE among 303 patients with initial diagnosis of HAPE. Upon further evaluation, five had deep vein thrombosis (DVT). One woman had a contraceptive ring and seven patients had no known thrombotic risks. PE can coexist with or mimic HAPE and should be considered in patients presenting with shortness of breath from high altitude regardless of thrombotic risk.

  7. Reducing body fat with altitude hypoxia training in swimmers: role of blood perfusion to skeletal muscles.

    Science.gov (United States)

    Chia, Michael; Liao, Chin-An; Huang, Chih-Yang; Lee, Wen-Chih; Hou, Chien-Wen; Yu, Szu-Hsien; Harris, M Brennan; Hsu, Tung-Shiung; Lee, Shin-Da; Kuo, Chia-Hua

    2013-02-28

    Swimmers tend to have greater body fat than athletes from other sports. The purpose of the study was to examine changes in body composition after altitude hypoxia exposure and the role of blood distribution to the skeletal muscle in swimmers. With a constant training volume of 12.3 km/day, young male swimmers (N = 10, 14.8 ± 0.5 years) moved from sea-level to a higher altitude of 2,300 meters. Body composition was measured before and after translocation to altitude using dual-energy X-ray absorptiometry (DXA) along with 8 control male subjects who resided at sea level for the same period of time. To determine the effects of hypoxia on muscle blood perfusion, total hemoglobin concentration (THC) was traced by near-infrared spectroscopy (NIRS) in the triceps and quadriceps muscles under glucose-ingested and insulin-secreted conditions during hypoxia exposure (16% O2) after training. While no change in body composition was found in the control group, subjects who trained at altitude had unequivocally decreased fat mass (-1.7 ± 0.3 kg, -11.4%) with increased lean mass (+0.8 ± 0.2 kg, +1.5%). Arterial oxygen saturation significantly decreased with increased plasma lactate during hypoxia recovery mimicking 2,300 meters at altitude (~93% versus ~97%). Intriguingly, hypoxia resulted in elevated muscle THC, and sympathetic nervous activities occurred in parallel with greater-percent oxygen saturation in both muscle groups. In conclusion, the present study provides evidence that increased blood distribution to the skeletal muscle under postprandial condition may contribute to the reciprocally increased muscle mass and decreased body mass after a 3-week altitude exposure in swimmers.

  8. Burnout Syndrome During Residency.

    Science.gov (United States)

    Turgut, Namigar; Karacalar, Serap; Polat, Cengiz; Kıran, Özlem; Gültop, Fethi; Kalyon, Seray Türkmen; Sinoğlu, Betül; Zincirci, Mehmet; Kaya, Ender

    2016-10-01

    The aim of this study is identified the degree of Burnout Syndrome (BOS) and find out its correlation with years of recidency and sociodemograpfic chareacteristics, training, sleeping habits, such as smoking and alcohol consumption. After approval from the Hospital Ethics Committee and obtaining informed consent, First, second, third, fourth and fifth year of recidency staff (n=127) working in our hospital were involved in this study. The standardized Maslach Burnout Inventory (MBI) was used in this study. Fifty six male (44.1%) and seventy one female (55.9%) residents were enroled in this study (Coranbach Alfa(α)=0.873). 57% of the first year residents smokes cigaret and 54% of them use alcohol. 2% of them gets one day off after hospital night shift, 61% of them suffers from disturbed sleep. 60% of them had been stated that they willingly selected their profession. 61% of them prefers talking to friends and 32% of them prefers shopping to overcome stress. There were statistical difference acording to years of recidency in MBI, Emotional Burnout (EB) and desensitisation scale (DS) points. EB scale points of the second year of residency group was statisticaly higher than fourth year of residency group. DS points of second year of residency group was also statisticaly higher than the third and fourth year of residency group. There was no statistical difference between any groups in Personal Success. BOS is a frequent problem during residency in anaesthesia. Appropriate definition and awareness are the first important steps to prevent this syndrome. Further administrative approaches should be evaluated with regard to their effects.

  9. Analysis of Resident Case Logs in an Anesthesiology Residency Program

    DEFF Research Database (Denmark)

    Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias Vested;

    2016-01-01

    Our goal in this study was to examine Accreditation Council for Graduate Medical Education case logs for Stanford anesthesia residents graduating in 2013 (25 residents) and 2014 (26 residents). The resident with the fewest recorded patients in 2013 had 43% the number of patients compared with the...

  10. Variability in low altitude astronomical refraction as a function of altitude.

    Science.gov (United States)

    Sampson, Russell D; Lozowski, Edward P; Fathi-Nejad, Arsha

    2008-12-01

    Low altitude astronomical refraction (LAAR) of the setting Sun was measured over a sea horizon from a coastal location in Barbados, West Indies. The altitude of the upper limb of the Sun and the apparent horizon were determined using a digital video camera (Canon XL2) and a digital SLR camera (Canon EOS 5D). A total of 14 sunsets were measured between 2005 and 2007. From these measurements LAAR variability was estimated at 14 standard altitudes of the refracted Sun between 0 degrees .01 and 4 degrees .5. The relative variability decreases with increasing altitude from +/- 0.0195 of mean refraction at an altitude of 0 degrees .01 to +/- 0.0142 at 4 degrees .5. If extrapolated to an altitude of 15 degrees , a linear fit to the data produces a relative variability of +/- 0.0038 and an absolute variability of +/- 0(").45. Statistical analysis of the relative variability in LAAR appears to support the decreasing trend. However, error propagation analysis further suggests that the observed values of refraction may exceed the accuracy of the measurement system at altitudes higher than 2 degrees .

  11. Oxidative stress at high altitude: genotype–phenotype correlations

    Directory of Open Access Journals (Sweden)

    Pandey P

    2014-05-01

    Full Text Available Priyanka Pandey,1,2 MA Qadar Pasha1,2 1CSIR-Institute of Genomics and Integrative Biology, Delhi, India; 2Department of Biotechnology, University of Pune, Ganeshkhind, Pune, India Abstract: It has been well-documented that the hypobaric hypoxic environment at high altitude (HA causes stress to both the permanent residents of HA and the sojourners. This oxidative stress primarily disturbs the oxygen-sensing and vascular homeostasis pathways, thereby upsetting normal human physiology, especially in sojourners. These environmental challenges have caused dynamic evolutionary changes within natives of HA, allowing them to develop adaptive plasticity. This review focuses on the genomic and biochemical features of the molecules involved in the oxygen-sensing and vascular homeostasis pathways with respect to HA pulmonary edema (HAPE and adaptation. We review the role of genetic markers such as HIF-prolyl hydroxylase 2, endothelial PAS domain-containing protein 1, endothelial nitric oxide synthase, endothelin 1, cytochrome b-245 alpha polypeptide, and glutathione S-transferase pi 1, as well as three circulatory biomarkers (nitric oxide, endothelin 1, and 8-iso-prostaglandin F2α, by highlighting approaches such as candidate gene and genome-wide, adopted in deciphering the pathways. A disagreement between the two approaches has also been highlighted. In addition, we discuss that an overrepresentation of wild-type alleles in HA natives and mutant alleles of same polymorphisms in HAPE patients implies that the allelic variants at the same locus are involved in adaptation and HAPE, respectively. Moreover, healthy sojourners present a number of genomic features similar to HA natives, further strengthening the concept of genetic predisposition. A trend in correlation between protective and risk alleles and altered levels of circulatory markers clearly documents the phenomenon of genotype–phenotype correlations. We conclude that the genetic and biochemical

  12. Altitude Preexposure Recommendations for Inducing Acclimatization

    Science.gov (United States)

    2010-01-01

    acetazolamide ( Kronenberg and Cain, 1968). Acute exposure to high altitude increases heart rate and cardiac output to maintain systemic oxygen delivery...emphasizing the regulation of breathing. Physiologist. 11:37–57. Kronenberg R.S., and Cain S.M. (1968). Hastening respiratory acclimatization to

  13. High-altitude physiology: lessons from Tibet

    Science.gov (United States)

    Wagner, Peter D.; Simonson, Tatum S.; Wei, Guan; Wagner, Harrieth; Wuren, Tanna; Yan, Ma; Qin, Ga; Ge, Rili

    2013-05-01

    Polycythemia is a universal lowlander response to altitude; healthy Andean high-altitude natives also have elevated [Hb]. While this may enhance O2 transport to tissues, studies have shown that acute isovolumic changes in [Hb] do not affect exercise capacity. Many high-altitude Tibetans have evolved sea-level values of [Hb], providing a natural opportunity to study this issue. In 21 young healthy male Tibetans with [Hb] between 15 and 23 g/dl, we measured VO2MAX and O2 transport capacity at 4200m. VO2MAX was higher when [Hb] was lower (Pcardiac output and muscle O2 diffusional conductance, but neither ventilation nor the alveolar-arterial PO2 difference (AaPO2) varied with [Hb]. In contrast, Andean high altitude natives remain polycythemic with larger lungs and higher lung diffusing capacity, a smaller exercising AaPO2, and lower ventilation. The challenges now are (1) to understand the different adaptive pathways used by Andeans and Tibetans, and (2) to determine in Tibetans whether, during evolution, reduced [Hb] appeared first, causing compensatory cardiac and muscle adaptations, or if enhanced cardiac function and muscle O2 transport capacity appeared first, permitting secondary reduction in [Hb]. For (2), further research is necessary to determine the basis of enhanced cardiac function and muscle O2 transport, and identify molecular targets of evolution in heart and muscle. Putative mutations can then be timed and compared to appearance of those affecting [Hb].

  14. Measurement of Aircraft Speed and Altitude

    Science.gov (United States)

    1980-05-01

    Albert W. Hall, Thomas M. Moul, Virgil S. Ritchie, and Robert T. Taylor who, as members of a technical review covinittee, made many valuable...Terry J.; and Webb, Lainie D.: Calibrations and Comparisons of Pressuie-Type Airspeed-Altitude Systems of the X-15 Airplane From Subsonic to High

  15. Altitude, Orthocenter of a Triangle and Triangulation

    Directory of Open Access Journals (Sweden)

    Coghetto Roland

    2016-03-01

    Full Text Available We introduce the altitudes of a triangle (the cevians perpendicular to the opposite sides. Using the generalized Ceva’s Theorem, we prove the existence and uniqueness of the orthocenter of a triangle [7]. Finally, we formalize in Mizar [1] some formulas [2] to calculate distance using triangulation.

  16. Breathing and sleep at high altitude.

    Science.gov (United States)

    Ainslie, Philip N; Lucas, Samuel J E; Burgess, Keith R

    2013-09-15

    We provide an updated review on the current understanding of breathing and sleep at high altitude in humans. We conclude that: (1) progressive changes in pH initiated by the respiratory alkalosis do not underlie early (48 h), complex cellular and neurochemical re-organization occurs both in the peripheral chemoreceptors as well as within the central nervous system. The latter is likely influenced by central acid-base changes secondary to the extent of the initial respiratory responses to initial exposure to high altitude; (3) sleep at high altitude is disturbed by various factors, but principally by periodic breathing; (4) the extent of periodic breathing during sleep at altitude intensifies with duration and severity of exposure; (5) complex interactions between hypoxic-induced enhancement in peripheral and central chemoreflexes and cerebral blood flow--leading to higher loop gain and breathing instability--underpin this development of periodic breathing during sleep; (6) because periodic breathing may elevate rather than reduce mean SaO2 during sleep, this may represent an adaptive rather than maladaptive response; (7) although oral acetazolamide is an effective means to reduce periodic breathing by 50-80%, recent studies using positive airway pressure devices to increase dead space, hyponotics and theophylline are emerging but appear less practical and effective compared to acetazolamide. Finally, we suggest avenues for future research, and discuss implications for understanding sleep pathology.

  17. Teaching professionalism to residents.

    Science.gov (United States)

    Klein, Eileen J; Jackson, J Craig; Kratz, Lyn; Marcuse, Edgar K; McPhillips, Heather A; Shugerman, Richard P; Watkins, Sandra; Stapleton, F Bruder

    2003-01-01

    The need to teach professionalism during residency has been affirmed by the Accreditation Council for Graduate Medical Education, which will require documentation of education and evaluation of professionalism by 2007. Recently the American Academy of Pediatrics has proposed the following components of professionalism be taught and measured: honesty/integrity, reliability/responsibility, respect for others, compassion/empathy, self-improvement, self-awareness/knowledge of limits, communication/collaboration, and altruism/advocacy. The authors describe a curriculum for introducing the above principles of professionalism into a pediatrics residency that could serve as a model for other programs. The curriculum is taught at an annual five-day retreat for interns, with 11 mandatory sessions devoted to addressing key professionalism issues. The authors also explain how the retreat is evaluated and how the retreat's topics are revisited during the residency, and discuss general issues of teaching and evaluating professionalism.

  18. [Concept for a bioclimatic evaluation of an expedition and trekking area at moderate and high altitudes].

    Science.gov (United States)

    Lazar, Reinhold

    2005-04-01

    This paper presents a concept which is built up on climate data with a long period of observation (temperature, wind conditions, precipitation, irradiation, and the frequency of low pressure weather situations with unfavorable biotropy stages). It therefore allows an evaluation of the bioclimate of a high mountain area. With the help of this relatively simple method, the risk of problems like AMS can be better estimated. Latest comparisons between different agencies of expeditions show that often the time schedule for climbing to the summit is too short and allows too little time for acclimatization; furthermore the number of days allowed for recreation is too small. A comparison of selected alpine regions shows better conditions in, for example, the Mount Kenia/Kilimandjaro region and parts of the western Andes in Chile, whereas the Himalaya and the Karakorum group can be problematic.

  19. Changes in physical performance parameters during and after moderate altitude training in elite cross country skiers

    DEFF Research Database (Denmark)

    Jensen, Kurt; Höög, Martina; Willis, Sarah

    2013-01-01

    and then grade every minute. Oxygen uptake (VO2) was measured continuously during submaximal and maximal exercise. Blood lactate concentrations were measured during the 1 min rest between submax stages and 2 min after the max test. Power at each submax and max stage were calculated from roller ski friction...... and body weight against gravity [1]. Each stage power was further used for calculations of power at VO2max, (WVO2max), work efficiency at submaximal loads (GE) and for the estimation of O2 cost at maximal work load (used to calculate accumulated O2 deficit (MOD)) [2]. RESULTS: At NORM1, the skiers’ body...... mass was 71.9±10.7kg and VO2max 214±12ml/min/kg0.73. The GE varied between 17.9-19.5% during the 3-5 submaximal loads, with no difference between conditions (P>0.05). Also, blood lactate accumulation after submaximal exercise loads showed no difference between conditions (PVO2max...

  20. Cardiopulmonary exercise testing in healthy children and adolescents at moderately high altitude.

    Science.gov (United States)

    Ilarraza-Lomelí, Hermes; Castañeda-López, Javier; Myers, Jonathan; Miranda, Irma; Quiroga, Paula; Rius, María-Dolores; Lopez-de-la-Vega, César; Vallejo, Enrique; Calderón, Juan; Figueroa, Javier; Buendía, Alfonso

    2013-01-01

    Cardiopulmonary exercise testing is a tool that helps clinicians to establish diagnosis and calculate risk stratification in adults. However, the utility of this test among children with congenital heart disease has not been fully explored. The goal of this study was to describe reference values for cardiopulmonary performance of healthy children. This study included 103 apparently healthy children (aged from 4 to 18 years; 61 boys), who underwent cardiopulmonary test using a treadmill protocol. All tests took place at 2240m above sea level (Mexico City). Exercise time was 11±4min. There were no complications. Peak oxygen uptake correlated closely with height in both genders (girls r=0.84; boys r=0.84, p<0.001). A multivariable linear regression model showed that body surface area, exercise time, gender and heart rate reserve were significant predictors of peak oxygen uptake (R(2)=0.815, p<0.001). Peak oxygen uptake was strongly associated with age even among children younger than thirteen years (r=0.74, p<0.001). This study provides physiological values for the major cardiopulmonary variables obtained from exercise testing using a treadmill among healthy children. Cardiopulmonary exercise test can be safely and effectively performed in young children even as young as 4 years old. Variables including age, gender and height are strongly associated with exercise time, peak heart rate and peak oxygen uptake. Regression equations for predicting peak heart rate and peak oxygen uptake are presented as reference values that allow researchers to compare children with heart disease versus those who are healthy. Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  1. Is High Altitude Pulmonary Edema Relevant to Hawai‘i?

    Science.gov (United States)

    2014-01-01

    High altitude clinical syndromes have been described in the medical literature but may be under recognized in the state of Hawai‘i. As tourism increases, high altitude injuries may follow given the easy access to high altitude attractions. Visitors and clinicians should be aware of the dangers associated with the rapid ascent to high altitudes in the perceived comfort of a vehicle. This paper will review the basic pathophysiology, prevention, and treatment of the most serious of the high altitude clinical syndromes, high altitude pulmonary edema. PMID:25478294

  2. Estimation of high altitude Martian dust parameters

    Science.gov (United States)

    Pabari, Jayesh; Bhalodi, Pinali

    2016-07-01

    Dust devils are known to occur near the Martian surface mostly during the mid of Southern hemisphere summer and they play vital role in deciding background dust opacity in the atmosphere. The second source of high altitude Martian dust could be due to the secondary ejecta caused by impacts on Martian Moons, Phobos and Deimos. Also, the surfaces of the Moons are charged positively due to ultraviolet rays from the Sun and negatively due to space plasma currents. Such surface charging may cause fine grains to be levitated, which can easily escape the Moons. It is expected that the escaping dust form dust rings within the orbits of the Moons and therefore also around the Mars. One more possible source of high altitude Martian dust is interplanetary in nature. Due to continuous supply of the dust from various sources and also due to a kind of feedback mechanism existing between the ring or tori and the sources, the dust rings or tori can sustain over a period of time. Recently, very high altitude dust at about 1000 km has been found by MAVEN mission and it is expected that the dust may be concentrated at about 150 to 500 km. However, it is mystery how dust has reached to such high altitudes. Estimation of dust parameters before-hand is necessary to design an instrument for the detection of high altitude Martian dust from a future orbiter. In this work, we have studied the dust supply rate responsible primarily for the formation of dust ring or tori, the life time of dust particles around the Mars, the dust number density as well as the effect of solar radiation pressure and Martian oblateness on dust dynamics. The results presented in this paper may be useful to space scientists for understanding the scenario and designing an orbiter based instrument to measure the dust surrounding the Mars for solving the mystery. The further work is underway.

  3. Can aneroid sphygmomanometers be used at altitude?

    Science.gov (United States)

    Kametas, N A; McAuliffe, F; Krampl, E; Nicolaides, K H; Shennan, A H

    2006-07-01

    Mercury-independent devices are increasingly being used in clinical practice as mercury will soon be removed from clinical use as a result of environmental, health and safety concerns. The aim of this study was to evaluate the accuracy of a portable aneroid device in an adult population at high altitude by following the part of the protocol of the British Hypertension Society regarding comparison between device and observer. We examined 10 subjects in Cerro de Pasco, Peru, which is situated 4370 m above sea level. The aneroid device was initially calibrated at both high altitude and at sea level to ensure optimal function. Validation of the device was undertaken at high altitude by connecting it in parallel to two mercury sphygmomanometers. Eleven sequential same-arm measurements were taken from each subject by two trained observers, alternating between mercury sphygmomanometry and the aneroid device. Simultaneous mercury readings were also recorded for additional analysis. During calibration, all 60 comparisons between the aneroid and mercury sphygmomanometers were within 3 mm Hg both at sea level and at high altitude. At validation, the device achieved an A grade for both systolic and diastolic pressures and also fulfilled the requirements of the Association for the Advancement of Medical Instrumentation. The mean and standard deviation for systolic and diastolic pressures, respectively, were -1.32 (4.3) mm Hg and 3.7 (4.7) mm Hg in sequential analysis and -0.7 (2.6) mm Hg and -3.3 (2.7) mm Hg in simultaneous analysis. We conclude that the Riester-Exacta portable aneroid device can be recommended for use in an adult population at high altitude.

  4. High altitude pulmonary edema among "Amarnath Yatris"

    Directory of Open Access Journals (Sweden)

    Parvaiz A Koul

    2013-01-01

    Full Text Available Background: Annual pilgrimage (Yatra to the cave shrine of Shri Amarnath Ji′ is a holy ritual among the Hindu devotees of Lord Shiva. Located in the Himalayan Mountain Range (altitude 13,000 ft in south Kashmir, the shrine is visited by thousands of devotees and altitude sickness is reportedly common. Materials and Methods: More than 600,000 pilgrims visited the cave shrine in 2011 and 2012 with 239 recorded deaths. Thirty one patients with suspected altitude sickness were referred from medical centers en-route the cave to Sher-i-Kashmir Institute of Medical Sciences, a tertiary-care center in capital Srinagar (5,000 ft. The clinical features and the response to treatment were recorded. Results: Thirty-one patients (all lowlanders, 19 male; age 18-60 years, median 41 had presented with acute onset breathlessness of 1-4 days (median 1.9 d starting within 12-24 h of a rapid ascent; accompanied by cough (68%, headache (8%, dizziness and nausea (65%. Sixteen patients had associated encephalopathy. Clinical features on admission included tachypnea ( n = 31, tachycardia ( n = 23, bilateral chest rales ( n = 29, cyanosis ( n = 22 and grade 2-4 encephalopathy. Hypoxemia was demonstrable in 24 cases and bilateral infiltrates on radiologic imaging in 29. Ten patients had evidence of high-altitude cerebral edema. All patients were managed with oxygen, steroids, nifedipine, sildenafil and other supportive measures including invasive ventilation ( n = 3. Three patients died due to multiorgan dysfunction. Conclusions: Altitude sickness is common among Amaranath Yatris from the plains and appropriate educational strategies should be invoked for prevention and prompt treatment.

  5. Integrated bariatric surgery residency

    Directory of Open Access Journals (Sweden)

    Eltorai AE

    2014-11-01

    Full Text Available Adam EM Eltorai Warren Alpert Medical School of Brown University, RI, USA Abstract: Obesity is a major public health concern. Given its lasting efficacy for improving obesity and obesity-related diseases, bariatric surgery is an increasingly common treatment option. As the implementation of the Affordable Care Act progresses, the impending physician shortage will become more severe. Thus there will be an even greater need for doctors specialized in the management and treatment of obese patients. The development of integrated bariatric surgery residency programs could be considered and is discussed herein. Keywords: obesity, bariatric surgery, integrated residency, surgery education

  6. THE HIGH-ALTITUDE RESEARCH OF MABEL PUREFOY FITZGERALD, 1911-13.

    Science.gov (United States)

    Goodman, Martin

    2015-03-20

    Home schooled without a science education, Mabel Purefoy FitzGerald (1872-1973) attended physiology lectures at Oxford in 1897, even though the school was closed to women. She found work as a researcher, published early noted papers and earned the active respect and support of senior scientists of her day. Her laboratory work with the physiologist J. S. Haldane saw her invited to the join the Pikes Peak Expedition in 1911. While the male team members measured the physiological effects of long-term residency at 14101 feet, as the sole woman FitzGerald took measurements of haemoglobin and alveolar air from herself and from mining staff and families at altitudes from 6000 to 12500 feet, travelling to remote mining communities in the Colorado Rockies. A subsequent expedition collected data at lower altitudes. Recorded in two papers, the results presented pioneering evidence of the role of oxygen in breathing.

  7. Financial debt of orthopedic residents.

    Science.gov (United States)

    Hwang, John S; Beebe, Kathleen S; Benevenia, Joseph; Karanfilian, Briette; Berberian, Wayne S

    2012-04-01

    Many orthopedic residents accrue considerable debt by residency graduation. These debts for graduating medical students continue to increase due to the yearly increase of medical school tuition. The purpose of this study was to examine the causes of financial debt, as well the effects of debt on orthopedic residents.Orthopedic residents from postgraduate years 1 to 5 (N=27) completed an anonymous, optional financial survey. The survey asked questions regarding the characteristics of the residents' debt and their concern caused by their debt. All residents from our institute (N=27) voluntarily participated in the survey. The residents consisted of 4 (15%) women and 23 (85%) men, with 14 (56%) single residents and 12 (44%) married residents. No statistically significant difference existed in total debt >$100,000 between single and married residents or men and women. Forty-eight percent (n=13) of the residents had medical educational debt >$100,000, whereas 45% (n=12) had total debt >$200,000. Residents with total debt >$100,000 were concerned about their debt, whereas 1 of 4 residents with orthopedic residents financially and may cause stress and hinder their medical training. Appropriate measures should be taken to help residents properly manage their debt and to provide supplemental assistance with their financial struggles.

  8. Resident fatigue in otolaryngology residents: a Web based survey.

    Science.gov (United States)

    Nida, Andrew M; Googe, Benjamin J; Lewis, Andrea F; May, Warren L

    2016-01-01

    Resident fatigue has become a point of emphasis in medical education and its effects on otolaryngology residents and their patients require further study. The purpose of our study was to evaluate the prevalence and nature of fatigue in otolaryngology residents, evaluate various quality of life measures, and investigate associations of increased fatigue with resident safety. Anonymous survey. Internet based. United States allopathic otolaryngology residents. None. The survey topics included demographics, residency structure, sleep habits and perceived stress. Responses were correlated with a concurrent Epworth Sleep Scale questionnaire to evaluate effects of fatigue on resident training and quality of life. 190 residents responded to the survey with 178 completing the Epworth Sleep Scale questionnaire. Results revealed a mean Epworth Sleep Scale score of 9.9±5.1 with a median of 10.0 indicating a significant number of otolaryngology residents are excessively sleepy. Statistically significant correlations between Epworth Sleep Scale and sex, region, hours of sleep, and work hours were found. Residents taking in-house call had significantly fewer hours of sleep compared to home call (p=0.01). Residents on "head and neck" (typically consisting of a large proportion of head and neck oncologic surgery) rotations tended to have higher Epworth Sleep Scale and had significantly fewer hours of sleep (p=.003) and greater work hours (potolaryngology residents are excessively sleepy. Our data suggest that the effects of fatigue play a role in resident well-being and resident safety. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Living at Higher Altitude and Incidence of Overweight/Obesity: Prospective Analysis of the SUN Cohort

    Science.gov (United States)

    Martínez-González, Miguel Ángel; Pons Izquierdo, Juan José; González-Muniesa, Pedro; Martínez, J. Alfredo; Bes-Rastrollo, Maira

    2016-01-01

    Background Residence at high altitude has been associated with lower obesity rates probably due to hypoxia conditions. However, there is no evidence of this association in a free-living population. Objectives We assessed the association between the altitude where each participant of a Spanish cohort (the SUN Project) was living and the incidence of overweight/obesity. Methods The SUN Project is a dynamic, prospective, multipurpose cohort of Spanish university graduates with a retention rate of 89%. We included in the analysis 9 365 participants free of overweight/obesity at baseline. At the baseline questionnaire, participants reported their postal code and the time they had been living in their city/village. We imputed the altitude of each postal code according to the data of the Spanish National Cartographic Institute and categorized participants in tertiles. We used Cox regression models to adjust for potential confounding variables. Results During a median follow-up of 10 years, we identified 2 156 incident cases of overweight/obesity. After adjusting for sex, age, time of residence at current city, baseline body mass index, physical activity, sedentarism and years of education (≤ 3 years, ≥ 4 years, Master/PhD), those participants in the third tertile (>456 m) exhibited a statistically significant 14% reduction in the risk of developing overweight/obesity in comparison to those in the first tertile (<124 m) (adjusted HR = 0.86; 95% CI: 0.77, 0.96). Conclusions Living in cities of higher altitude was inversely associated with the risk of developing overweight/obesity in a cohort of Spanish university graduates. PMID:27812092

  10. A Fine Arts Residency.

    Science.gov (United States)

    Riggs, Patricia L.

    1982-01-01

    A four-week writer-in-residence program designed to stimulate the creativity of K-5 students was held in the Briar Glen Library Media Center, Wheaton, Illinois, with poet Joan Colby. This description of the program includes information on planning, funding, and future plans. (CHC)

  11. Selection of Anesthesiology Residents.

    Science.gov (United States)

    Baker, J. David, III; And Others

    1993-01-01

    Selection data for all Medical University of South Carolina anesthesiology residency applicants (about 200 per year) and the 8 selected per year were compared for 4 years. Results showed standardized test scores, grades, and class ranks of those selected were not higher than of others, but interview and recommendation scores were higher.…

  12. Summer lodge residency

    OpenAIRE

    Morrad, Annie

    2015-01-01

    The summer lodge residency was based in Nottingham from June 29th to July 10th Each of the artists was given a studio space and technical facilities. There were discussion points and meals, a seminar day, open presentations and reflection time.

  13. Pulmonary gas exchange at maximal exercise in Danish lowlanders during 8 wk of acclimatization to 4,100 m and in high-altitude Aymara natives

    DEFF Research Database (Denmark)

    Lundby, Carsten; Calbet, Jose A L; van Hall, Gerrit

    2004-01-01

    We aimed to test effects of altitude acclimatization on pulmonary gas exchange at maximal exercise. Six lowlanders were studied at sea level, in acute hypoxia (AH), and after 2 and 8 wk of acclimatization to 4,100 m (2W and 8W) and compared with Aymara high-altitude natives residing at this altit......We aimed to test effects of altitude acclimatization on pulmonary gas exchange at maximal exercise. Six lowlanders were studied at sea level, in acute hypoxia (AH), and after 2 and 8 wk of acclimatization to 4,100 m (2W and 8W) and compared with Aymara high-altitude natives residing...... at this altitude. As expected, alveolar Po2 was reduced during AH but increased gradually during acclimatization (61 +/- 0.7, 69 +/- 0.9, and 72 +/- 1.4 mmHg in AH, 2W, and 8W, respectively), reaching values significantly higher than in Aymaras (67 +/- 0.6 mmHg). Arterial Po2 (PaO2) also decreased during exercise...... in AH but increased significantly with acclimatization (51 +/- 1.1, 58 +/- 1.7, and 62 +/- 1.6 mmHg in AH, 2W, and 8W, respectively). PaO2 in lowlanders reached levels that were not different from those in high-altitude natives (66 +/- 1.2 mmHg). Arterial O2 saturation (SaO2) decreased during maximum...

  14. Interviewing the moderator

    DEFF Research Database (Denmark)

    Traulsen, Janine Morgall; Almarsdóttir, Anna Birna; Björnsdóttir, Ingunn

    2004-01-01

    of a one-on-one interview with the FG moderator by another member of the research team. The authors argue, with reference to a specific study, that interviewing the moderator adds a new and valuable dimension to group interviews used in research. They describe how this method came about and provide...... a concrete example of its use in a recently completed research project. They discuss several advantages of the interview, among them that it provides information about group interaction and participant behavior, and furnishes additional data on what is discussed when the tape recorder is turned off....

  15. Global Health Simulation During Residency

    Directory of Open Access Journals (Sweden)

    Jane R. Rosenman MD

    2016-08-01

    Full Text Available Resident participation in international health electives (IHEs has been shown to be beneficial, yet not all residents have the opportunity to participate. We sought to determine whether participating in simulated global health cases, via the standardized Simulation Use for Global Away Rotations (SUGAR curriculum, was useful for all pediatric residents, not merely those planning to go on an IHE. Pediatric residents in our program took part in 2 SUGAR cases and provided feedback via an online survey. Thirty-six of 40 residents participated (90%; 72% responded to the survey. Three of 10 residents not previously planning to work in resource-limited settings indicated participation in SUGAR made them more likely to do so. Nearly all residents (88% felt SUGAR should be part of the residency curriculum. All felt better prepared for working cross-culturally. While designed to prepare trainees for work in resource-limited settings, SUGAR may be beneficial for all residents.

  16. Pulmonary embolism in young natives of high altitude

    Directory of Open Access Journals (Sweden)

    Sanjay Singhal

    2016-01-01

    Full Text Available Thrombotic events are relatively common in high altitude areas and known to occur in young soldiers working at high altitude without usual risk factors associated with thrombosis at sea-level. However, till now, cases with thrombotic events were reported only in lowlanders staying at high altitude. These two cases of pulmonary embolism demonstrate that thrombotic events can occur in highlanders after a prolonged stay at the extreme altitude.

  17. Effectiveness of Preacclimatization Strategies for High-Altitude Exposure

    Science.gov (United States)

    2013-01-01

    hypobaric conditions. IAE 15, 15 d of intermittent altitude exposure; IAE 7, 7 d of intermittent altitude expo- sure; NH (Sleep), Ambient normobaric hypoxia ...than those using norm(!)baric hypoxia (breathing, ង.9% ox-ygen). Key Words: hypobaric hypoxia , normobaric hypoxia , staging, acute mountain sickness...large decrements in endurance exercise performance occur when unacclimatized individuals rapidly ascend to high altitudes. Six altitude and hypoxia

  18. Altitude Performance of Modified J71 Afterburner with Revised Engine Operating Conditions

    Science.gov (United States)

    Useller, James W.; Russey, Robert E.

    1955-01-01

    An investigation was conducted in an altitude test chamber at the NACA Lewis laboratory to determine the effect of a revision of the rated engine operating conditions and modifications to the afterburner fue1 system, flameholder, and shell cooling on the augmented performance of the J71-A-2 (x-29) turbo jet engine operating at altitude . The afterburner modifications were made by the manufacturer to improve the endurance at sea-level, high-pressure conditions and to reduce the afterburner shell temperatures. The engine operating conditions of rated rotational speed and turbine-outlet gas temperature were increased. Data were obtained at conditions simulating flight at a Mach number of 0.9 and at altitudes from 40,000 to 60,000 feet. The afterburner modifications caused a reduction in afterburner combustion efficiency. The increase in rated engine speed and turbine-outlet temperature coupled with the afterburner modifications resulted in the over-all thrust of the engine and afterburner being unchanged at a given afterburner equivalence ratio, while the specific fuel consumption was increased slightly. A moderate shift in the range of equivalence ratios over which the afterburner would operate was encountered, but the maximum operable altitude remained unaltered. The afterburner-shell temperatures were also slightly reduced because of the modifications to the afterburner.

  19. HAWC - The High Altitude Water Cherenkov Detector

    Science.gov (United States)

    Tepe, Andreas; HAWC Collaboration

    2012-07-01

    The high altitude water Cherenkov observatory (HAWC) is an instrument for the detection of high energy cosmic gamma-rays. Its predecessor Milagro has successfully proven that the water Cherenkov technology for gamma-ray astronomy is a useful technique. HAWC is currently under construction at Sierra Negra in Mexico at an altitude of 4100 m and will include several improvements compared to Milagro. Two complementary DAQ systems of the HAWC detector allow for the observation of a large fraction of the sky with a very high duty cycle and independent of environmental conditions. HAWC will observe the gamma-ray sky from about 100 GeV up to 100 TeV. Also the cosmic ray flux anisotropy on different angular length scales is object of HAWC science. Because of HAWC's large effective area and field of view, we describe its prospects to observe gamma-ray bursts (GRBs) as an example for transient sources.

  20. Dust observations at orbital altitudes surrounding Mars.

    Science.gov (United States)

    Andersson, L; Weber, T D; Malaspina, D; Crary, F; Ergun, R E; Delory, G T; Fowler, C M; Morooka, M W; McEnulty, T; Eriksson, A I; Andrews, D J; Horanyi, M; Collette, A; Yelle, R; Jakosky, B M

    2015-11-01

    Dust is common close to the martian surface, but no known process can lift appreciable concentrations of particles to altitudes above ~150 kilometers. We present observations of dust at altitudes ranging from 150 to above 1000 kilometers by the Langmuir Probe and Wave instrument on the Mars Atmosphere and Volatile Evolution spacecraft. Based on its distribution, we interpret this dust to be interplanetary in origin. A comparison with laboratory measurements indicates that the dust grain size ranges from 1 to 12 micrometers, assuming a typical grain velocity of ~18 kilometers per second. These direct observations of dust entering the martian atmosphere improve our understanding of the sources, sinks, and transport of interplanetary dust throughout the inner solar system and the associated impacts on Mars's atmosphere.

  1. Decreased plasma soluble erythropoietin receptor in high-altitude excessive erythrocytosis and Chronic Mountain Sickness.

    Science.gov (United States)

    Villafuerte, Francisco C; Macarlupú, José Luis; Anza-Ramírez, Cecilia; Corrales-Melgar, Daniela; Vizcardo-Galindo, Gustavo; Corante, Noemí; León-Velarde, Fabiola

    2014-12-01

    Excessive erythrocytosis (EE) is the hallmark of chronic mountain sickness (CMS), a prevalent syndrome in high-altitude Andean populations. Although hypoxemia represents its underlying stimulus, why some individuals develop EE despite having altitude-normal blood erythropoietin (Epo) concentration is still unclear. A soluble form of the Epo receptor (sEpoR) has been identified in human blood and competes directly for Epo with its membrane counterpart (mEpoR). Thus, reduced levels of circulating sEpoR could lead to higher Epo availability and ultimately to EE. We characterized the relationship between Epo and sEpoR, with hematocrit and hemoglobin concentration in healthy highlanders and CMS patients at 4,340 m in Cerro de Pasco, Peru. Our results show that EE patients show decreased plasma sEpoR levels and can be subdivided into two subgroups of normal and high plasma Epo concentration for the altitude of residence, with hemoglobin concentration rising exponentially with an increasing Epo-to-sEpoR ratio (Epo/sEpoR). Also, we showed that the latter varies as an inverse exponential function of arterial pulse O2 saturation. Our findings suggests that EE is strongly associated with higher Epo/sEpoR values, leading to elevated plasma Epo availability to bind mEpoR, and thereby a stronger stimulus for augmented erythropoiesis. Differences in the altitude normal and high Epo CMS patients with a progressively higher Epo/sEpoR supports the hypothesis of the existence of two genetically different subgroups suffering from EE and possibly different degrees of adaptation to chronic high-altitude hypoxia.

  2. The effect of altitude hypoxia on glucose homeostasis in men

    DEFF Research Database (Denmark)

    Larsen, J J; Hansen, J M; Olsen, Niels Vidiendal

    1997-01-01

    1. Exposure to altitude hypoxia elicits changes in glucose homeostasis with increases in glucose and insulin concentrations within the first few days at altitude. Both increased and unchanged hepatic glucose production (HGP) have previously been reported in response to acute altitude hypoxia...

  3. 14 CFR 135.93 - Autopilot: Minimum altitudes for use.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Autopilot: Minimum altitudes for use. 135... Operations § 135.93 Autopilot: Minimum altitudes for use. (a) Except as provided in paragraphs (b), (c), (d), and (e) of this section, no person may use an autopilot at an altitude above the terrain which is...

  4. Endotracheal Tube Cuff Management at Altitude

    Science.gov (United States)

    2014-02-05

    model study of endotracheal intubation including mechanical ventilation and four methods of cuff pressure management during ascent and descent...AFRL-SA-WP-SR-2014-0007 Endotracheal Tube Cuff Management at Altitude SSgt Tyler J. Britton, RRT1; Richard D. Branson, RRT2...REPORT TYPE Special Report 3. DATES COVERED (From – To) June 2012 – December 2013 4. TITLE AND SUBTITLE Endotracheal Tube Cuff Management

  5. Performance of portable ventilators at altitude

    Science.gov (United States)

    2015-04-20

    including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services , Directorate for Information Operations...D.R.J.). This study was presented as a poster at the Military Health System Research Symposium, August 12Y15, 2013, in Fort Lauderdale, Florida. Address...BirdVSO2 and theLTV- 1000 at ranges of altitudes from sea level to 9,800 ft using lung models of adult respiratory distress syndrome and severe asthma

  6. Neutral Barium Cloud Evolution at Different Altitudes

    Institute of Scientific and Technical Information of China (English)

    李磊; 徐荣栏

    2002-01-01

    Considering the joint effects of diffusion, collision, oxidation and photoionization, we study the evolution of the barium cloud at different altitudes in the space plasma active experiment. The results present the variation of the loss rate, number density distribution and brightness of the barium cloud over the range from 120 to 260km.This can be divided into oxidation, oxidation plus photoionization and photoionization regions.

  7. Leadership Training in Otolaryngology Residency.

    Science.gov (United States)

    Bent, John P; Fried, Marvin P; Smith, Richard V; Hsueh, Wayne; Choi, Karen

    2017-06-01

    Although residency training offers numerous leadership opportunities, most residents are not exposed to scripted leadership instruction. To explore one program's attitudes about leadership training, a group of otolaryngology faculty (n = 14) and residents (n = 17) was polled about their attitudes. In terms of self-perception, more faculty (10 of 14, 71.4%) than residents (9 of 17, 52.9%; P = .461) considered themselves good leaders. The majority of faculty and residents (27 of 31) thought that adults could be taught leadership ability. Given attitudes about leadership ability and the potential for improvement through instruction, consideration should be given to including such training in otolaryngology residency.

  8. The High Altitude Water Cherenkov Observatory

    Science.gov (United States)

    Mostafa, Miguel; HAWC Collaboration

    2016-03-01

    The High Altitude Water Cherenkov (HAWC) Observatory is a continuously operated, wide field of view experiment comprised of an array of 300 water Cherenkov detectors (WCDs) to study transient and steady emission of TeV gamma and cosmic rays. Each 200000 l WCD is instrumented with 4 PMTs providing charge and timing information. The array covers ~22000 m2 at an altitude of 4100 m a.s.l. inside the Pico de Orizaba national park in Mexico. The high altitude, large active area, and optical isolation of the PMTs allows us to reliably estimate the energy and determine the arrival direction of gamma and cosmic rays with significant sensitivity over energies from several hundred GeV to a hundred TeV. Continuously observing 2 / 3 of the sky every 24 h, HAWC plays a significant role as a survey instrument for multi-wavelength studies. The performance of HAWC makes possible the detection of both transient and steady emissions, the study of diffuse emission and the measurement of the spectra of gamma-ray sources at TeV energies. HAWC is also sensitive to the emission from GRBs above 100 GeV. I will highlight the results from the first year of operation of the full HAWC array, and describe the ongoing site work to expand the array by a factor of 4 to explore the high energy range.

  9. Resident-to-resident violence triggers in nursing homes.

    Science.gov (United States)

    Snellgrove, Susan; Beck, Cornelia; Green, Angela; McSweeney, Jean C

    2013-11-01

    Certified nurses' assistants (CNAs) employed by a rural nursing home in Northeast Arkansas described their perceptions of resident-to-resident violence in order to provide insight on factors, including unmet needs, that may trigger the phenomenon. Semistructured interviews were conducted with 11 CNAs. Data were analyzed using content analysis and constant comparison. Two categories of triggers emerged from the data-active and passive. Active triggers involved the actions of other residents that were intrusive in nature, such as wandering into a residents' personal space, taking a resident's belongings, and so forth. Passive triggers did not involve the actions of residents but related to the internal and external environment of the residents. Examples were factors such as boredom, competition for attention and communication difficulties. Results indicate that there are factors, including unmet needs within the nursing home environment that may be identified and altered to prevent violence between residents.

  10. Moderator Chemistry Program

    Energy Technology Data Exchange (ETDEWEB)

    Dewitt, L.V.; Gibbs, A.; Lambert, D.P.; Bohrer, S.R.; Fanning, R.L.; Houston, M.W.; Stinson, S.L.; Deible, R.W.; Abdel-Khalik, S.I.

    1990-11-01

    Over the past fifteen months, the Systems Chemistry Group of the Reactor Engineering Department has undertaken a comprehensive study of the Department`s moderator chemistry program at Savannah River Site (SRS). An internal review was developed to formalize and document this program. Objectives were as outlined in a mission statement and action plan. In addition to the mission statement and action plan, nine separate task reports have been issued during the course of this study. Each of these task reports is included in this document as a chapter. This document is an organized compilation of the individual reports issued by the Systems Chemistry Group in assessment of SRS moderator chemistry to determine if there were significant gaps in the program as ft existed in October, 1989. While these reviews found no significant gaps in that mode of operation, or any items that adversely affected safety, items were identified that could be improved. Many of the items have already been dear with or are in the process of completion under this Moderator Chemistry Program and other Reactor Restart programs. A complete list of the items of improvement found under this assessment is found in Chapter 9, along with a proposed time table for correcting remaining items that can be improved for the chemistry program of SRS reactors. An additional external review of the moderator chemistry processes, recommendations, and responses to/from the Reactor Corrosion Mitigation Committee is included as Appendix to this compilation.

  11. Moderator Chemistry Program

    Energy Technology Data Exchange (ETDEWEB)

    Dewitt, L.V.; Gibbs, A.; Lambert, D.P.; Bohrer, S.R.; Fanning, R.L.; Houston, M.W.; Stinson, S.L.; Deible, R.W.; Abdel-Khalik, S.I.

    1990-11-01

    Over the past fifteen months, the Systems Chemistry Group of the Reactor Engineering Department has undertaken a comprehensive study of the Department's moderator chemistry program at Savannah River Site (SRS). An internal review was developed to formalize and document this program. Objectives were as outlined in a mission statement and action plan. In addition to the mission statement and action plan, nine separate task reports have been issued during the course of this study. Each of these task reports is included in this document as a chapter. This document is an organized compilation of the individual reports issued by the Systems Chemistry Group in assessment of SRS moderator chemistry to determine if there were significant gaps in the program as ft existed in October, 1989. While these reviews found no significant gaps in that mode of operation, or any items that adversely affected safety, items were identified that could be improved. Many of the items have already been dear with or are in the process of completion under this Moderator Chemistry Program and other Reactor Restart programs. A complete list of the items of improvement found under this assessment is found in Chapter 9, along with a proposed time table for correcting remaining items that can be improved for the chemistry program of SRS reactors. An additional external review of the moderator chemistry processes, recommendations, and responses to/from the Reactor Corrosion Mitigation Committee is included as Appendix to this compilation.

  12. Den moderate revolution

    DEFF Research Database (Denmark)

    Larsen, Bøje

    "normale" industrivirksomheder, men den er absolut set begrænset. Årsagerne til denne kun "moderate revolution" af organisationsformerne diskuteres: Er det fordi klassisk organisation og social nærkontakt er nødvendig i den nye økonomi, eller er det manglende fantasi og tryghedsbehov? Begge muligheder...

  13. The Fundamentals of Resident Dismissal.

    Science.gov (United States)

    Schenarts, Paul J; Langenfeld, Sean

    2017-02-01

    Residents have the rights and responsibilities of both students and employees. Dismissal of a resident from a training program is traumatic and has lasting repercussions for the program director, the faculty, the dismissed resident, and the residency. A review of English language literature was performed using PUBMED and OVID databases, using the search terms, resident dismissal, resident termination, student dismissal, student and resident evaluation, legal aspects of education, and remediation. The references of each publication were also reviewed to identify additional appropriate citations. If the Just Cause threshold has been met, educators have the absolute discretion to evaluate academic and clinical performance. Legal opinion has stated that it is not necessary to wait until a patient is harmed to dismiss a resident. Evaluations should be standard and robust. Negative evaluations are not defamatory as the resident gave consent to be evaluated. Provided departmental and institutional polices have been followed, a resident can be dismissed without a formal hearing. Residencies are entitled to modify academic requirements and dismissal is not considered a breach of contract. Although there is anxiety regarding resident dismissal, the courts have uniformly supported faculty having this role. When indicated, failure to dismiss a resident also places the program director and the faculty at risk for educational malpractice.

  14. [Altitude, the ratio of PaO2 to fraction of inspired oxygen, and shunt: impact on the assessment of acute lung injury].

    Science.gov (United States)

    Pérez-Padilla, J R

    2004-10-01

    The ratio of PaO2 to the fraction of inspired oxygen (PaO2/FIO2) is commonly used to determine the severity of acute lung injury and acute respiratory distress syndrome (ARDS). The research presented here used computational models of the lung to analyze the effect of altitude on the PaO2/FIO2 ratio and pulmonary shunt. At a given shunt, the PaO2/FIO2 ratio is lower at higher altitudes. Therefore, when evaluating for ARDS based on a PaO2/FIO2 ratio of <200 mm Hg, patients residing at high altitudes will have less shunt and, presumably, less severe lung injury than patients at sea level. This should be taken into consideration when comparing patients from different altitudes. Shunt should more often be measured directly or be estimated assuming a constant arteriovenous oxygen content difference.

  15. High altitude pulmonary oedema (HAPE) in an Indian pilgrim.

    Science.gov (United States)

    Panthi, Sagar; Basnyat, Buddha

    2013-11-01

    Increasing number of Hindu pilgrims visit the Himalayas where some of them suffer from high altitude illness including the life threatening forms, high altitude pulmonary oedema (HAPE) and high altitude cerebral oedema. Compared to tourists and trekkers, pilgrims are usually ignorant about altitude illness. This is a case of a pilgrim who suffered from HAPE on his trip to Kailash-Mansarovar and is brought to a tertiary level hospital in Kathmandu. This report emphasises on how to treat a patient with HAPE, a disease which is increasingly being seen in the high altitude pilgrim population.

  16. Population Trends of Central European Montane Birds Provide Evidence for Adverse Impacts of Climate Change on High-Altitude Species.

    Directory of Open Access Journals (Sweden)

    Jiří Flousek

    Full Text Available Climate change is among the most important global threats to biodiversity and mountain areas are supposed to be under especially high pressure. Although recent modelling studies suggest considerable future range contractions of montane species accompanied with increased extinction risk, data allowing to test actual population consequences of the observed climate changes and identifying traits associated to their adverse impacts are very scarce. To fill this knowledge gap, we estimated long-term population trends of montane birds from 1984 to 2011 in a central European mountain range, the Giant Mountains (Krkonoše, where significant warming occurred over this period. We then related the population trends to several species' traits related to the climate change effects. We found that the species breeding in various habitats at higher altitudes had more negative trends than species breeding at lower altitudes. We also found that the species moved upwards as a response to warming climate, and these altitudinal range shifts were associated with more positive population trends at lower altitudes than at higher altitudes. Moreover, long-distance migrants declined more than residents or species migrating for shorter distances. Taken together, these results indicate that the climate change, besides other possible environmental changes, already influences populations of montane birds with particularly adverse impacts on high-altitude species such as water pipit (Anthus spinoletta. It is evident that the alpine species, predicted to undergo serious climatically induced range contractions due to warming climate in the future, already started moving along this trajectory.

  17. Population Trends of Central European Montane Birds Provide Evidence for Adverse Impacts of Climate Change on High-Altitude Species.

    Science.gov (United States)

    Flousek, Jiří; Telenský, Tomáš; Hanzelka, Jan; Reif, Jiří

    2015-01-01

    Climate change is among the most important global threats to biodiversity and mountain areas are supposed to be under especially high pressure. Although recent modelling studies suggest considerable future range contractions of montane species accompanied with increased extinction risk, data allowing to test actual population consequences of the observed climate changes and identifying traits associated to their adverse impacts are very scarce. To fill this knowledge gap, we estimated long-term population trends of montane birds from 1984 to 2011 in a central European mountain range, the Giant Mountains (Krkonoše), where significant warming occurred over this period. We then related the population trends to several species' traits related to the climate change effects. We found that the species breeding in various habitats at higher altitudes had more negative trends than species breeding at lower altitudes. We also found that the species moved upwards as a response to warming climate, and these altitudinal range shifts were associated with more positive population trends at lower altitudes than at higher altitudes. Moreover, long-distance migrants declined more than residents or species migrating for shorter distances. Taken together, these results indicate that the climate change, besides other possible environmental changes, already influences populations of montane birds with particularly adverse impacts on high-altitude species such as water pipit (Anthus spinoletta). It is evident that the alpine species, predicted to undergo serious climatically induced range contractions due to warming climate in the future, already started moving along this trajectory.

  18. Lawful Permanent Residents - Annual Report

    Data.gov (United States)

    Department of Homeland Security — A lawful permanent resident (LPR) or 'green card' recipient is defined by immigration law as a person who has been granted lawful permanent residence in the United...

  19. Prevalence of Chronic Mountain Sickness in high altitude districts of Himachal Pradesh

    Directory of Open Access Journals (Sweden)

    Inderjeet Singh Sahota

    2013-01-01

    Full Text Available Introduction: Chronic Mountain Sickness (CMS is a maladaptation condition that can affect people who reside permanently at high altitude (HA. It is characterized by polycythemia, hypoxemia and dyspnea and can be fatal. Over 140 million people live permanently at HA around the world. Unfortunately, research into CMS is lacking and accurate data on the prevalence of this condition do not exist for many regions around the world. In this study, we sought to examine prevalence rates of CMS in the Indian Himalayas, focusing on the Northern State of Himachal Pradesh. Materials and Methods: We surveyed 83 individuals (69 males in eight towns across the HA districts of Sirmaur, Kinnaur and Lahaul and Spiti in Himachal Pradesh, India. Altitudes ranged from 2350 to 4150 m. We used an adapted Qinghai CMS scoring system to diagnose CMS. Information related to subject demographics, medical history, socioeconomic status, and geography were collected to identify risk factors for CMS. Physiologic recordings of oxygen saturation (SpO 2 and pulse rate were made through pulse oximetry. Results: Overall CMS prevalence was 6.17% and mean altitude was 3281 m. At altitudes above 3000 m CMS prevalence rose to 13.73%. All cases of CMS were mild and there was a significant positive correlation between CMS scores and altitude (R = 0.784, P = 0.0213. Mean SpO 2 was 90.7 ± 0.4% and mean pulse rate was 80.3 ± 1.3 bpm. SpO 2 significantly correlated with altitude (R = −0.929, P < 0.001. In our study, age, gender, and tobacco use were not independent risk factors for CMS. Individuals with CMS lived at higher altitudes than their non-CMS counterparts (3736.00 ± 113.30 m vs. 3279.80 ± 69.50 m, respectively; P = 0.017. Conclusion: CMS prevalence in HA towns of the Indian Himalayas of Himachal Pradesh is 6.17% and 13.73% for towns above 3000 m. Further research is required to determine the prevalence of CMS in other regions of the world and to determine risk factors

  20. Cerebrovascular responses to hypoxia and hypocapnia in high-altitude dwellers.

    Science.gov (United States)

    Norcliffe, L J; Rivera-Ch, M; Claydon, V E; Moore, J P; Leon-Velarde, F; Appenzeller, O; Hainsworth, R

    2005-07-01

    Cerebral blood flow is known to increase in response to hypoxia and to decrease with hypocapnia. It is not known, however, whether these responses are altered in high-altitude dwellers who are not only chronically hypoxic and hypocapnic, but also polycythaemic. Here we examined cerebral blood flow responses to hypoxia and hypocapnia, separately and together, in Andean high-altitude dwellers, including some with chronic mountain sickness (CMS), which is characterized by excessive polycythaemia. Studies were carried out at high altitude (Cerro de Pasco (CP), Peru; barometric pressure (P(B)) 450 mmHg) and repeated, following relief of the hypoxia, on the day following arrival at sea level (Lima, Peru; P(B) 755 mmHg). We compared these results with those from eight sea-level residents studied at sea level. In nine high-altitude normal subjects (HA) and nine CMS patients, we recorded middle cerebral artery mean blood flow velocity (MCAVm) using transcranial Doppler ultrasonography, and expressed responses as changes from baseline. MCAVm responses to hypoxia were determined by changing end-tidal partial pressure of oxygen (P(ET,O2)) from 100 to 50 mmHg, with end-tidal partial pressure of carbon dioxide clamped. MCAVm responses to hypocapnia were studied by voluntary hyperventilation with (P(ET,O2)) clamped at 100 and 50 mmHg. There were no significant differences between the cerebrovascular responses of the two groups to any of the interventions at either location. In both groups, the MCAVm responses to hypoxia were significantly greater at Lima than at CP (HA, 12.1 +/- 1.3 and 6.1 +/- 1.0%; CMS, 12.5 +/- 0.8 and 5.6 +/- 1.2%; P < 0.01 both groups). The responses at Lima were similar to those in the sea-level subjects (13.6 +/- 2.3%). The responses to normoxic hypocapnia in the altitude subjects were also similar at both locations and greater than those in sea-level residents. During hypoxia, both high-altitude groups showed responses to hypocapnia that were

  1. Analysis of Resident Case Logs in an Anesthesiology Residency Program.

    Science.gov (United States)

    Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias Vested; Macario, Alex

    2016-04-15

    Our goal in this study was to examine Accreditation Council for Graduate Medical Education case logs for Stanford anesthesia residents graduating in 2013 (25 residents) and 2014 (26 residents). The resident with the fewest recorded patients in 2013 had 43% the number of patients compared with the resident with the most patients, and in 2014, this equaled 48%. There were residents who had 75% more than the class average number of cases for several of the 12 case types and 3 procedure types required by the Accreditation Council for Graduate Medical Education. Also, there were residents with fewer than half as many for some of the required cases or procedure types. Some of the variability may have been because of the hazards of self-reporting.

  2. Global Trends in Glacial Cirque Floor Altitudes and Their Relationships with Climate, Equilibrium Line Altitudes, and Mountain Range Heights

    Science.gov (United States)

    Mitchell, S. G.; Humphries, E.

    2013-12-01

    Glacial erosion at the base of cirque headwalls and the creation of threshold slopes above cirque floors may contribute to the 'glacial buzzsaw' effect in limiting the altitude of some mountain ranges. Since glacial extent and therefore glacial erosion rate depends on the equilibrium line altitude (ELA) of a region, the altitude of cirque formation should be a function of the ELA. Several regional studies have shown that cirque floors form at an altitude approximating average Quaternary ELAs in some mountain ranges, but a global correlation has not yet been demonstrated. We examined the correlation between cirque altitudes and global ELA trends by compiling existing and new cirque altitude and morphometry data from > 30 mountain ranges at a wide range of latitudes. Where available, we calculate or present the average cirque altitude, relief, and latitude. We compared these altitudes to both the global East Pacific ELA and local ELAs where available. For the locations analyzed, the majority of average cirque altitudes fall between the Eastern Pacific modern and LGM ELAs, and mountain range height is typically limited to cirque formation is dependent upon the ELA, and that cirques likely form as a result of average, rather than extreme, glacial conditions. Furthermore, the correlation between cirque altitude and ELA, along with the restricted window of relief, implies that cirque formation is a factor in limiting peak altitude in ranges that rise above the ELA.

  3. High altitude balloon experiments at IIA

    Science.gov (United States)

    Nayak, Akshata; Sreejith, A. G.; Safonova, Margarita; Murthy, Jayant

    Recent advances in balloon experiments as well as in electronics have made it possible to fly scientific payloads at costs accessible to university departments. We have begun a program of high altitude ballooning at the Indian Institute of Astrophysics, Bengaluru. The primary purpose of this activity is to test low-cost ultraviolet (UV) payloads for eventual space flight, but we will also try scientific exploration of the phenomena occurring in the upper atmosphere, including sprites and meteorite impacts. We present the results of the initial experiments carried out at the CREST campus of IIA, Hosakote, and describe our plans for the future.

  4. Regression of altitude-produced cardiac hypertrophy.

    Science.gov (United States)

    Sizemore, D. A.; Mcintyre, T. W.; Van Liere, E. J.; Wilson , M. F.

    1973-01-01

    The rate of regression of cardiac hypertrophy with time has been determined in adult male albino rats. The hypertrophy was induced by intermittent exposure to simulated high altitude. The percentage hypertrophy was much greater (46%) in the right ventricle than in the left (16%). The regression could be adequately fitted to a single exponential function with a half-time of 6.73 plus or minus 0.71 days (90% CI). There was no significant difference in the rates of regression for the two ventricles.

  5. Regression of altitude-produced cardiac hypertrophy.

    Science.gov (United States)

    Sizemore, D. A.; Mcintyre, T. W.; Van Liere, E. J.; Wilson , M. F.

    1973-01-01

    The rate of regression of cardiac hypertrophy with time has been determined in adult male albino rats. The hypertrophy was induced by intermittent exposure to simulated high altitude. The percentage hypertrophy was much greater (46%) in the right ventricle than in the left (16%). The regression could be adequately fitted to a single exponential function with a half-time of 6.73 plus or minus 0.71 days (90% CI). There was no significant difference in the rates of regression for the two ventricles.

  6. [Resident foreigners in Spain].

    Science.gov (United States)

    Solana, A M; Pascual De Sans, A

    1994-01-01

    The authors review trends in the size of the resident foreign population in Spain over time since the 1940s. A continuing growth over time, with temporal fluctuations, is noted, with a rapid rise in immigration in the 1980s, leading to new legislation designed to control immigration in 1985-1986 and 1991. The authors note that Europeans, particularly from countries of the European Union, make up a large percentage of the foreign population, but that the number of immigrants from developing countries has increased significantly in the last 10 years.

  7. Efficient Cryosolid Positron Moderators

    Science.gov (United States)

    2012-08-01

    Howell, and Mr. Roy Larsen for infrastructure and equipment support. Mrs. Karen Clayton for administrative support. Mr. Byron Allmon for critical...showing explicitly the long, bent slow positron transport tube scaled to fit onto a 4x4-foot optical table. The sharp 90° bend in this tube is intended...half-cycle RPA scan of an N2 moderator. The ≈ 0.15 cps CEM signal is clearly visible above the ≈ 0.03 cps background. The very sharp absorption lines

  8. THE HIGH ALTITUDE GAMMA RAY OBSERVATORY, HAWC

    Directory of Open Access Journals (Sweden)

    M. M. González

    2011-01-01

    Full Text Available El volcán Sierra Negra en Puebla, México fue seleccionado para albergar a HAWC (High Altitude Water Cherenkov, un observatorio de gran apertura (2Pi sr, único en el mundo, capaz de observar contínuamente el cielo a energías de 0.1 a 100 TeV. HAWC consiste en un arreglo a una altitud de 4100 m sobre el nivel del mar de 300 contenedores de 7.3 m de diámetro y 5 m de altura llenos de agua pura y sensores de luz que observan partículas sumamente energ´eticas provenientes de los eventos más violentos del universo y será 15 veces más sensible que su antecesor Milagro. Las aportaciones científicas de Milagro han demostrado las capacidades únicas de este tipo de observatorios. En este trabajo se presentará HAWC y se discutirá brevemente su caso científico y capacidades.

  9. A challenge to the highest balloon altitude

    Science.gov (United States)

    Saito, Y.; Akita, D.; Fuke, H.; Iijima, I.; Izutsu, N.; Kato, Y.; Kawada, J.; Matsuzaka, Y.; Mizuta, E.; Namiki, M.; Nonaka, N.; Ohta, S.; Sato, T.; Seo, M.; Takada, A.; Tamura, K.; Toriumi, M.; Yamagami, T.; Yamada, K.; Yoshida, T.; Matsushima, K.; Tanaka, S.

    2012-02-01

    Development of a balloon to fly at higher altitudes is one of the most attractive challenges for scientific balloon technologies. After reaching the highest balloon altitude of 53.0 km using the 3.4 μm film in 2002, a thinner balloon film with a thickness of 2.8 μm was developed. A 5000 m3 balloon made with this film was launched successfully in 2004. However, three 60,000 m3 balloons with the same film launched in 2005, 2006, and 2007, failed during ascent. The mechanical properties of the 2.8 μm film were investigated intensively to look for degradation of the ultimate strength and its elongation as compared to the other thicker balloon films. The requirement of the balloon film was also studied using an empirical and a physical model assuming an axis-symmetrical balloon shape and the static pressure. It was found that the film was strong enough. A stress due to the dynamic pressure by the wind shear is considered as the possible reason for the unsuccessful flights. A 80,000 m3 balloon with cap films covering 9 m from the balloon top will be launch in 2011 to test the appropriateness of this reinforcement.

  10. Development of the High Altitude Student Platform

    Science.gov (United States)

    Guzik, T. G.; Besse, S.; Calongne, A.; Dominique, A.; Ellison, S. B.; Gould, R.; Granger, D.; Olano, D.; Smith, D.; Stewart, M.; Wefel, J. P.

    2008-11-01

    The High Altitude Student Platform (HASP) was originally conceived to provide student groups with access to the near-space environment for flight durations and experiment capabilities intermediate between what is possible with small sounding balloons and low Earth orbit rocket launches. HASP is designed to carry up to twelve student payloads to an altitude of about 36 km with flight durations of 15 20 h using a small zero-pressure polyethylene film balloon. This provides a flight capability that can be used to flight-test compact satellites, prototypes and other small payloads designed and built by students. HASP includes a standard mechanical, power and communication interface for the student payload to simplify integration and allows the payloads to be fully exercised. Over the last two years a partnership between the NASA Balloon Program Office (BPO), Columbia Scientific Balloon Facility (CSBF), Louisiana State University (LSU), the Louisiana Board of Regents (BoR), and the Louisiana Space Consortium (LaSPACE) has led to the development, construction and, finally, the first flight of HASP with a complement of eight student payloads on September 4, 2006. Here we discuss the primary as-built HASP systems and features, the student payload interface, HASP performance during the first flight and plans for continuing HASP flights. The HASP project maintains a website at http://laspace.lsu.edu/hasp/ where flight application, interface documentation and status information can be obtained.

  11. Guidelines for resident teaching experiences.

    Science.gov (United States)

    Havrda, Dawn E; Engle, Janet P; Anderson, Keri C; Ray, Shaunta' M; Haines, Seena L; Kane-Gill, Sandra L; Ballard, Stephanie L; Crannage, Andrew J; Rochester, Charmaine D; Parman, Malinda G

    2013-07-01

    Postgraduate year one (PGY1) and postgraduate year two (PGY2) residencies serve to develop pharmacists into skillful clinicians who provide advanced patient-centered care in various general and specialized areas of pharmacy practice. Pharmacy residencies are a minimum requirement for many clinical pharmacy positions, as well as for positions in academia. The role of clinical pharmacists typically includes teaching, regardless of whether they pursue an academic appointment. Common teaching duties of pharmacist-clinicians include giving continuing education or other invited presentations, providing education to colleagues regarding clinical initiatives, precepting pharmacy students (early and advanced experiences) and residents, and educating other health care professionals. Although ASHP provides accreditation standards for PGY1 and PGY2 residencies, the standards pertaining to teaching or education training are vague. Through the years, teaching certificate programs that develop residents' teaching skills and better prepare residents for a diverse pharmacy job market have increased in popularity; moreover, teaching certificate programs serve as an attractive recruitment tool. However, the consistency of requirements for teaching certificate programs is lacking, and standardization is needed. The Task Force on Residencies developed two sets of guidelines to define teaching experiences within residencies. The first guideline defines the minimum standards for teaching experiences in any residency-training program. The second guideline is for programs offering a teaching certificate program to provide standardization, ensuring similar outcomes and quality on program completion. One of the main differences between the guidelines is the recommendation that residency programs offering a teaching certificate program be affiliated with an academic institution to provide the pedagogy and variety of teaching experiences for the resident. Residency program directors should

  12. Efectos de la hipoxia en montañeros expuestos a altitudes extremas

    Directory of Open Access Journals (Sweden)

    Javier Aceña Medina

    2017-03-01

    Full Text Available La práctica del montañismo goza en la actualidad de una gran popularidad entre nuestros deportistas. Los montañeros que se mueven en grandes altitudes se ven expuestos frecuentemente a climatologías muy adversas y vías de gran dificultad física y técnica, pero posiblemente el enemigo más temible al que se tienen que enfrentar tiene que ver con los indeseables efectos de la hipoxia. La presente investigación se centra en constatar posibles deterioros en las habilidades del pensamiento de un grupo de montañeros expuesto a altitudes extremas (por encima de los 5.500 metros, sin ayuda de oxígeno suplementario. Para ello hemos contado con la participación de montañeros de tres expediciones a los “ochomiles” Manaslu, Makalu y Gasherbrum II a los que se aplicaron pruebas de aptitudes mentales antes, durante y después de cada expedición. La singularidad de nuestro estudio reside en haber incorporado resultados de pruebas realizadas en altitudes extremas, en concreto a 5.800, 6.200 y 6.000 metros respectivamente. Los resultados ponen de manifiesto que de todas las áreas y funciones cognitivas evaluadas, parece ser que las más afectadas por los efectos de la hipoxia han sido las relacionadas con la capacidad de razonamiento abstracto, espacial y verbal. Los deterioros más evidentes se observaron en altitud, persistiendo estos a la semana de regresar. Tras seis meses dichos déficits se recuperaron por completo.

  13. Collision risks at sea: species composition and altitude distributions of birds in Danish offshore wind farms

    Energy Technology Data Exchange (ETDEWEB)

    Blew, J.; Hoffmann, M.; Nehls, G. [BioConsult SH (Germany)

    2007-07-01

    This study investigates the collision risks of birds in operating offshore wind farms, focussing on all bird species present in the direct vicinity of the wind farms, their altitude distribution and reactions. The project was conducted jointly by BioConsult SH and the University of Hamburg in the two Danish offshore wind farms Horns Rev (North Sea) and Nysted (Baltic Sea) in the framework of a Danish-German cooperation and financed by the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety (BMU). Data were collected between March 2005 and November 2006, using a ship anchored at the edge of the offshore wind farms. In this way, bird species of all sizes could be considered. Daytime observations yielded data on species composition, flight routes and potential reactions of the birds. Radar observations provided altitude distributions inside and outside the wind farm area and also reactions. The results shall help to further describe and assess the collision risk of different species groups. Since data analysis is still running, exemplary results will be presented here. 114 species have been recorded in Nysted and 99 in Horns Rev, approximately 65% of which have been observed inside the wind farm areas. Migrating birds seem to avoid flying into the wind farms, whereas individuals present in the areas for extended time periods utilize areas within the wind farms. While a barrier effect exists for species on migration, resident species probably have a higher collision risk. Raptors migrating during daylight frequently enter the wind farm area on their flight routes, correcting their flight paths in order to avoid collisions. Radar results show that during times of intensive migration, the proportion of birds flying at high altitudes and thus above windmill height is higher than in times of low migration intensity. Consequently, there is a lower proportion of migrating birds flying within the risk area. Data will be further analysed to

  14. What Is 'Moderate' Exercise Anyway?

    Science.gov (United States)

    ... gov/news/fullstory_166905.html What Is 'Moderate' Exercise Anyway? How to figure out the best intensity ... most adults to get 30 minutes of moderate exercise on most days to stay fit. But what ...

  15. Prevalence of Anemia among Older Adults Residing in the Coastal and Andes Mountains in Ecuador: Results of the SABE Survey

    OpenAIRE

    Orces, Carlos H.

    2017-01-01

    Objectives. To estimate the prevalence of anemia and its determinants among older adults in Ecuador. Methods. The present study was based on data from the National Survey of Health, Wellbeing, and Aging. Hemoglobin concentrations were adjusted by participants’ smoking status and altitude of residence, and anemia was defined according to the World Health Organization criteria (

  16. Altitude variations of ionospheric currents at auroral latitudes

    Energy Technology Data Exchange (ETDEWEB)

    Kamide, Y. (Nagoya Univ. (Japan)); Brekke, A. (Univ. of Tromso (Netherlands))

    1993-02-19

    On the basis of updated EISCAT experiments, the first full derivation of the ionospheric current density of the auroral electrojets at six different altitudes are presented. It is found that current vectors at different altitudes are quite different, although the eastward and westward currents prevail in the evening and morning sectors, respectively, once the currents are integrated over altitude. The eastward electrojet becomes almost northward whilst the westward electrojet becomes almost southward, at the highest altitude, 125 km, in this study. The physical implications of these characteristics are discussed.

  17. The effect of high altitude on nasal nitric oxide levels.

    Science.gov (United States)

    Altundag, Aytug; Salihoglu, Murat; Cayonu, Melih; Cingi, Cemal; Tekeli, Hakan; Hummel, Thomas

    2014-09-01

    The aim of the present study was to investigate whether nasal nitric oxide (nNO) levels change in relation to high altitude in a natural setting where the weather conditions were favorable. The present study included 41 healthy volunteers without a history of acute rhinosinusitis within 3 weeks and nasal polyposis. The study group consisted of 31 males (76 %) and 10 females (24 %) and the mean age of the study population was 38 ± 10 years. The volunteers encamped for 2 days in a mountain village at an altitude of 1,500 m above sea level (masl) and proceeded to highlands at an altitude of 2,200 masl throughout the day. The measurements of nNO were done randomly, either first at the mountain village or at sea level. Each participant had nNO values both at sea level and at high altitude at the end of the study. The nNO values of sea level and high altitude were compared to investigate the effect of high altitude on nNO levels. The mean of average nNO measurements at the high altitude was 74.2 ± 41 parts-per-billion (ppb) and the mean of the measurements at sea level was 93.4 ± 45 ppb. The change in nNO depending on the altitude level was statistically significant (p high altitude even if the weather conditions were favorable, such as temperature, humidity, and wind.

  18. Neurophysiological Problems in Snow Bound High Altitude Areas

    Directory of Open Access Journals (Sweden)

    W. Selvamurthy

    1984-10-01

    Full Text Available A series of studies have been conducted to evaluate the neurophysiological responses in young healthy soldiers during acclimatization at 3,500m altitude in Western Himalayas. The responses of autonomic nervous system, electroencephalogram hypothalamic thermoregulatory efficiency, orthostatic tolerance, sleep profile and effects of sleep deprivation have been studied in fresh inductees during three to five weeks of acclimatization at high altitude and compared with those of one year acclimatized lowlanders and high altitude natives. Physiological significance of these neurophysiological responses in the process of altitude adaptation is discussed in the light of current knowledge in the field.

  19. Effect of Fasting on Tolerance to Moderate Hypoxia,

    Science.gov (United States)

    Blood pressure response to moderate hypoxia was compared in a fasting and a control (non- fasting ) state in 10 seated subjects. End-tidal gas tensions...exposure to a simulated altitude of 17,000 ft. When exposed to the same stress after fasting for 18 hours, the MAP fell to 87% (P less than 0.01) of...its resting value. The mean end-tidal Po2 was significantly lower in the fasting state and the end-tidal Pco2 was unchanged. It is concluded that

  20. Incorporating resident research into the dermatology residency program

    Directory of Open Access Journals (Sweden)

    Wagner RF Jr

    2013-04-01

    Full Text Available Richard F Wagner Jr, Sharon S Raimer, Brent C Kelly Department of Dermatology, The University of Texas Medical Branch, Galveston, Texas, USA Abstract: Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by

  1. Perceptual Assessment of Velopharyngeal Dysfunction by Otolaryngology Residents.

    Science.gov (United States)

    Butts, Sydney C; Truong, Alan; Forde, Christina; Stefanov, Dimitre G; Marrinan, Eileen

    2016-12-01

    To assess the ability of otolaryngology residents to rate the hypernasal resonance of patients with velopharyngeal dysfunction. We hypothesize that experience (postgraduate year [PGY] level) and training will result in improved ratings of speech samples. Prospective cohort study. Otolaryngology training programs at 2 academic medical centers. Thirty otolaryngology residents (PGY 1-5) were enrolled in the study. All residents rated 30 speech samples at 2 separate times. Half the residents completed a training module between the rating exercises, with the other half serving as a control group. Percentage agreement with the expert rating of each speech sample and intrarater reliability were calculated for each resident. Analysis of covariance was used to model accuracy at session 2. The median percentage agreement at session 1 was 53.3% for all residents. At the second session, the median scores were 53.3% for the control group and 60% for the training group, but this difference was not statistically significant. Intrarater reliability was moderate for both groups. Residents were more accurate in their ratings of normal and severely hypernasal speech. There was no correlation between rating accuracy and PGY level. Score at session 1 positively correlated with score at session 2. Perceptual training of otolaryngology residents has the potential to improve their ratings of hypernasal speech. Length of time in residency may not be best predictor of perceptual skill. Training modalities incorporating practice with hypernasal speech samples could improve rater skills and should be studied more extensively. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  2. RaD-X: Complementary measurements of dose rates at aviation altitudes

    Science.gov (United States)

    Meier, Matthias M.; Matthiä, Daniel; Forkert, Tomas; Wirtz, Michael; Scheibinger, Markus; Hübel, Robert; Mertens, Christopher J.

    2016-09-01

    The RaD-X stratospheric balloon flight organized by the National Aeronautics and Space Administration was launched from Fort Sumner on 25 September 2015 and carried several instruments to measure the radiation field in the upper atmosphere at the average vertical cutoff rigidity Rc of 4.1 GV. The German Aerospace Center (Deutsches Zentrum für Luft- und Raumfahrt) in cooperation with Lufthansa German Airlines supported this campaign with an independent measuring flight at the altitudes of civil aviation on a round trip from Germany to Japan. The goal was to measure dose rates under similar space weather conditions over an area on the Northern Hemisphere opposite to the RaD-X flight. Dose rates were measured in the target areas, i.e., around vertical cutoff rigidity Rc of 4.1 GV, at two flight altitudes for about 1 h at each position with acceptable counting statistics. The analysis of the space weather situation during the flights shows that measuring data were acquired under stable and moderate space weather conditions with a virtually undisturbed magnetosphere. The measured rates of absorbed dose in silicon and ambient dose equivalent complement the data recorded during the balloon flight. The combined measurements provide a set of experimental data suitable for validating and improving numerical models for the calculation of radiation exposure at aviation altitudes.

  3. Aviation fuel property effects on altitude relight

    Science.gov (United States)

    Venkataramani, K.

    1987-01-01

    The major objective of this experimental program was to investigate the effects of fuel property variation on altitude relight characteristics. Four fuels with widely varying volatility properties (JP-4, Jet A, a blend of Jet A and 2040 Solvent, and Diesel 2) were tested in a five-swirl-cup-sector combustor at inlet temperatures and flows representative of windmilling conditions of turbofan engines. The effects of fuel physical properties on atomization were eliminated by using four sets of pressure-atomizing nozzles designed to give the same spray Sauter mean diameter (50 + or - 10 micron) for each fuel at the same design fuel flow. A second series of tests was run with a set of air-blast nozzles. With comparable atomization levels, fuel volatility assumes only a secondary role for first-swirl-cup lightoff and complete blowout. Full propagation first-cup blowout were independent of fuel volatility and depended only on the combustor operating conditions.

  4. Effects of altitude to blood parameters

    Directory of Open Access Journals (Sweden)

    Đelkapić Milosava

    2012-01-01

    Full Text Available Reducing of partial pressure of oxygen in the air leads to a reduced arterial oxygen saturation and increases secretion of erythropoietin, wich stimulates erythropoiesis. Study included 63 healthy children aged 7 years, devided into 3 groups. I group consists of 21 children from suburb of altitude of 370 m, II group of 22 children from the village on 822 m, III group of 21 children from the town on 411 m. Complete blood count was determined on a Hematology analyzer HmX ( Beckman Coulter. Statistical analysis of data showed that children from II group have a higher average values of erythrocytes than children from the I (p0.05. Results show that stay in the village is useful for stimulation of erythropoiesis.

  5. Sleep apneas and high altitude newcomers.

    Science.gov (United States)

    Goldenberg, F; Richalet, J P; Onnen, I; Antezana, A M

    1992-10-01

    Sleep and respiration data from two French medical high altitude expeditions (Annapurna 4,800 m and Mt Sajama 6,542 m) are presented. Difficulties in maintaining sleep and a SWS decrease were found with periodic breathing (PB) during both non-REM and REM sleep. Extent of PB varied considerably among subjects and was not correlated to the number of arousals but to the intercurrent wakefulness duration. There was a positive correlation between the time spent in PB and the individual hypoxic ventilatory drive. The relation between PB, nocturnal desaturation, and mountain sickness intensity are discussed. Acclimatization decreased the latency toward PB and improved sleep. Hypnotic benzodiazepine intake (loprazolam 1 mg) did not worsen either SWS depression or apneas and allowed normal sleep reappearance after acclimatization.

  6. Education Research: Neurology resident education

    Science.gov (United States)

    Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M.; Engstrom, John

    2016-01-01

    Objective: To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. Methods: An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Results: Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Discussion: Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. PMID:26976522

  7. [Physical performance of older adults living in rural areas at sea level and at high altitude in Peru].

    Science.gov (United States)

    Estela-Ayamamani, David; Espinoza-Figueroa, Jossué; Columbus-Morales, Mauricio; Runzer-Colmenares, Fernando; Parodi, José F; Mayta-Tristán, Percy

    2015-01-01

    Living at high altitudes requires the inhabitants to adapt biologically and socially to the environment. The objective of this study was to determine the difference in physical performance (PP) in rural populations at sea level and at high altitude. A cross-sectional study was conducted in rural communities in Ancash, Peru, located at 3.345 meters above sea level (m.a.s.l.) and also in communities located in coastal areas at 6m.a.s.l. PP was measured by the Short Physical Performance Battery (SPPB) and other associated factors. Adjusted prevalence ratios (aPR) were calculated. A total of 130 older adults were assessed in the high altitude communities and 129 on the coast. The median age was 71.4 years, and 55.6% were female. Low physical performance (SPPB ≤ 6) was 10.0% at high altitude and 19.4% on the coast (p<0.05). Factors associated with low physical performance were residing at the coast (aPR: 2.10, 95% CI 1.02 to 4.33), self-reported poor health (aPR: 2.48, 95% CI 1.21 -5.08), hypertension (aPR: 1.73, 95% CI 1.01 to 2.98), and age (aPR: 1.04, 95% CI 1.01 to 1.07), while being a farmer (aPR: 0.49, 95% CI 0.25 to 0.97), and being independent (aPR: 0.37, 95% CI 0,20-, 072) were found to be protective factors. It was also found that the inhabitants of the coast have a mean of 0.86 points lower total SPPB than the high altitude ones (p=0.004). There is an association between altitude of residence and PP in older adults. The prevalence of a low PP in older adults in rural areas at sea level is twice as high compared to those living in high altitude rural communities. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  8. Resident training in pathology: From resident's point of view

    Directory of Open Access Journals (Sweden)

    Kemal KÖSEMEHMETOĞLU

    2008-01-01

    Full Text Available In many recent studies in the literature have described and commented on “competency based resident training” in pathology. According to this model, competencies are subclassified in 6 main categories: Patient care, medical knowledge, practice based learning and improvement, interpersonal and communication skills, professionalism, and systems based practice. Assessment of competency forms the main component of this model.Under the framework of Ankara Society of Pathology, a working group, composed of 11 residents, 6 of which representing the Training and Research Hospitals of Ministry of Health and the rest representing the university hospitals in Ankara, was established in order to participate in the think-tank about resident training in pathology. A questionnaire, composed of 12 questions, was prepared. According to this questionnaire, the number of trainers in the university hospitals is much higher than in the commercial hospitals. While the total number of cases and cases per resident do not differ between the university and commercial hospitals, microscopes used for the educational purposes are significantly less in the commercial hospitals, that is due to less number of binocular microscopes. The amount of resident training program, which consists of intra and intersectional meetings, are similar in the university and commercial hospitals, however, theoretic lectures are given only in 3 departments. Residents working in the university hospitals have obviously heavier burden than in the commercial hospitals. Lastly, residents generally exclaimed that the time dedicated to the macroscopy training is less sufficient than time used for the microscopy training.The factors affecting the training of resident in pathology are divided into two main groups: 1 Factors directly affecting training (quality of trainer, time dedicated for education, feed back, eg. and 2 Conditions which waste residents' time. For instant, workload which does need

  9. AltitudeOmics: The Basic Biology of Human Acclimatization to High Altitude. Addendum

    Science.gov (United States)

    2014-09-01

    After obtaining written consent, physical exams and the Army Physical Fitness Test (push-ups, sit-ups, and a 3.2-km run) were performed to verify health...imposed by the MFVL. Membrane Excitability and Contractile Function M-waves. As a measure of membrane excitability we exam - ined pre- vs. postexercise...Rose MS, Forte VA, Jr., Young PM, and Cymerman A. Effect of caffeine on submaximal exercise performance at altitude. Aviat Space Environ Med 65: 539

  10. AltitudeOmics: The Basic Biology of Human Acclimatization to High Altitude

    Science.gov (United States)

    2013-09-01

    met the limit imposed by the MFVL. Membrane Excitability and Contractile Function M-waves. As a measure of membrane excitability we exam - ined pre...least 3 h postprandial, and avoided strenuous exercise in the 48 h preceding each trial. They also refrained from caffeine for 12 h before each test...traveled to altitudes > 1,000 m in the past 3 months. After obtaining written consent, physical exams and the Army Physical Fitness Test (push ups

  11. [Prevalence of burnout among obstetrics and gynecology residents].

    Science.gov (United States)

    Rua, C; Body, G; Marret, H; Ouldamer, L

    2015-01-01

    Prevalence assessment of burnout among obstetrics and gynecology residents and predisposing factors. Multicentric cross-sectional survey based on a questionnaire sent by email to the residents including demographics data and Maslach Burnout Inventory. Mean burnout scores were 19.67±10.19 for emotional exhaustion, 33.94±5.01 for personal accomplishment and 8.72±6.10 for depersonalization, corresponding to a moderate burnout for each category. High scores of burnout were seen on 19.45 % of residents for emotional exhaustion, 33.33 % for depersonalization and 11.11 % for personal accomplishment. 36.11 % of residents showed evidence of high burnout in emotional exhaustion or depersonalization, and 5.55 % in the three dimensions. The number of semesters is correlated with depersonalization (P=0.01). There is a strong personal accomplishment among obstetrics and gynecology residents; however, burnout and emotional exhaustion remains a reality during obstetrics and gynecology residency. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  12. Determinants of team-sport performance: implications for altitude training by team-sport athletes

    Science.gov (United States)

    Bishop, David J; Girard, Olivier

    2013-01-01

    Team sports are increasingly popular, with millions of participants worldwide. Athletes engaged in these sports are required to repeatedly produce skilful actions and maximal or near-maximal efforts (eg, accelerations, changes in pace and direction, sprints, jumps and kicks), interspersed with brief recovery intervals (consisting of rest or low-intensity to moderate-intensity activity), over an extended period of time (1–2 h). While performance in most team sports is dominated by technical and tactical proficiencies, successful team-sport athletes must also have highly-developed, specific, physical capacities. Much effort goes into designing training programmes to improve these physical capacities, with expected benefits for team-sport performance. Recently, some team sports have introduced altitude training in the belief that it can further enhance team-sport physical performance. Until now, however, there is little published evidence showing improved team-sport performance following altitude training, despite the often considerable expense involved. In the absence of such studies, this review will identify important determinants of team-sport physical performance that may be improved by altitude training, with potential benefits for team-sport performance. These determinants can be broadly described as factors that enhance either sprint performance or the ability to recover from maximal or near-maximal efforts. There is some evidence that some of these physical capacities may be enhanced by altitude training, but further research is required to verify that these adaptations occur, that they are greater than what could be achieved by appropriate sea-level training and that they translate to improved team-sport performance. PMID:24282200

  13. Determinants of team-sport performance: implications for altitude training by team-sport athletes.

    Science.gov (United States)

    Bishop, David J; Girard, Olivier

    2013-12-01

    Team sports are increasingly popular, with millions of participants worldwide. Athletes engaged in these sports are required to repeatedly produce skilful actions and maximal or near-maximal efforts (eg, accelerations, changes in pace and direction, sprints, jumps and kicks), interspersed with brief recovery intervals (consisting of rest or low-intensity to moderate-intensity activity), over an extended period of time (1-2 h). While performance in most team sports is dominated by technical and tactical proficiencies, successful team-sport athletes must also have highly-developed, specific, physical capacities. Much effort goes into designing training programmes to improve these physical capacities, with expected benefits for team-sport performance. Recently, some team sports have introduced altitude training in the belief that it can further enhance team-sport physical performance. Until now, however, there is little published evidence showing improved team-sport performance following altitude training, despite the often considerable expense involved. In the absence of such studies, this review will identify important determinants of team-sport physical performance that may be improved by altitude training, with potential benefits for team-sport performance. These determinants can be broadly described as factors that enhance either sprint performance or the ability to recover from maximal or near-maximal efforts. There is some evidence that some of these physical capacities may be enhanced by altitude training, but further research is required to verify that these adaptations occur, that they are greater than what could be achieved by appropriate sea-level training and that they translate to improved team-sport performance.

  14. Burnout among Dutch medical residents

    NARCIS (Netherlands)

    Prins, J.T.; Hoekstra-Weebers, J.E.; Van De Wiel, H.B.; Gazendam-Donofrio, S.M.; Sprangers, F.; Jaspers, F.C.; van der Heijden, F.M.

    2007-01-01

    We examined levels of burnout and relationships between burnout, gender, age, years in training, and medical specialty in 158 medical residents working at the University Medical Center Groningen, the Netherlands. Thirteen percent of the residents met the criteria for burnout, with the highest percen

  15. Burnout among Dutch medical residents

    NARCIS (Netherlands)

    Prins, J.T.; Hoekstra-Weebers, J.E.; Van De Wiel, H.B.; Gazendam-Donofrio, S.M.; Sprangers, F.; Jaspers, F.C.; van der Heijden, F.M.

    2007-01-01

    We examined levels of burnout and relationships between burnout, gender, age, years in training, and medical specialty in 158 medical residents working at the University Medical Center Groningen, the Netherlands. Thirteen percent of the residents met the criteria for burnout, with the highest percen

  16. Sexual Education for Psychiatric Residents

    Science.gov (United States)

    Levine, Stephen B.; Scott, David L.

    2010-01-01

    Objective: The authors seek to promote sexuality curriculum development in departments of psychiatry. Methods: The authors first focus on educational philosophy about what residents can be taught about sexual topics and then provide numerical and narrative resident evaluation data following a 6-month, half day per week rotation in a sexuality…

  17. Fellowship trends of pathology residents.

    Science.gov (United States)

    Lagwinski, Nikolaj; Hunt, Jennifer L

    2009-09-01

    Recent changes in pathology residency education have included a decrease in the program length (from 5 years to 4 years for combined anatomic and clinical pathology training) and a national mandate for programs to assess 6 general competencies of trainees. These have undoubtedly led to changes in program curricula and in residents' desires to seek fellowship training. This study was designed to gather information about what residents are seeking from fellowship training programs. This study used an online survey to assess attitudes of residents in training programs toward fellowship training. The survey instrument had 26 questions pertaining to fellowship choices, motivations for pursuing fellowships, expectations of the fellowships, and postresidency concerns. There were 213 respondents from a mix of program types and representing each postgraduate year. Most residents will seek at least 1 or 2 fellowships after residency training. The most popular first-choice fellowship was surgical pathology (26%), followed by cytopathology (16%), hematopathology (15%), gastrointestinal pathology (10%), dermatopathology (8%), and forensic pathology (5%). The most common reasons for pursuing fellowship training were to "increase marketability" (43%) or to "become an expert in a particular area" (33%). Most trainees got their information about fellowship training programs from Internet sources. Fellowship programs will benefit from an optimally designed Web site because residents seek information predominantly from the Internet. Residents seeking fellowships are particularly concerned with selecting programs that provide job connections, an increase in their marketability, and the opportunity to develop diagnostic expertise.

  18. Substance Abuse by Anesthesiology Residents.

    Science.gov (United States)

    Lutsky, Irving; And Others

    1991-01-01

    The analysis of 183 responses to a survey of former anesthesiology residents of the Medical College of Wisconsin found that 29 had been self-administered problematic substance abusers during their residencies, 23 had been alcohol dependent, and 6 had been drug dependent. More than 85 percent of respondents considered the drug policy information…

  19. The Artist-in-Residence

    Science.gov (United States)

    Hall, James W.

    1977-01-01

    Institutions are bringing the professional artist into their instructional and cultural environments through five approaches: concert performances, extended performances, master classes, part-time residencies, and full-time residencies. The effect of each program on the artist and the college or university is examined. (Author/LBH)

  20. Burnout among Dutch medical residents

    NARCIS (Netherlands)

    Prins, J.T.; Hoekstra-Weebers, J.E.; Van De Wiel, H.B.; Gazendam-Donofrio, S.M.; Sprangers, F.; Jaspers, F.C.; van der Heijden, F.M.

    2007-01-01

    We examined levels of burnout and relationships between burnout, gender, age, years in training, and medical specialty in 158 medical residents working at the University Medical Center Groningen, the Netherlands. Thirteen percent of the residents met the criteria for burnout, with the highest

  1. Accuracy of Handheld Blood Glucose Meters at High Altitude

    NARCIS (Netherlands)

    de Mol, Pieter; Krabbe, Hans G.; de Vries, Suzanna T.; Fokkert, Marion J.; Dikkeschei, Bert D.; Rienks, Rienk; Bilo, Karin M.; Bilo, Henk J. G.

    2010-01-01

    Background: Due to increasing numbers of people with diabetes taking part in extreme sports (e. g., high-altitude trekking), reliable handheld blood glucose meters (BGMs) are necessary. Accurate blood glucose measurement under extreme conditions is paramount for safe recreation at altitude. Prior st

  2. Quadrant to Measure the Sun's Altitude

    Science.gov (United States)

    Windsor, A Morgan, Jr.

    2013-01-01

    The changing altitude of the Sun (either over the course of a day or longer periods) is a phenomenon that students do not normally appreciate. However, the altitude of the Sun affects many topics in disciplines as diverse as astronomy, meteorology, navigation, or horology, such as the basis for seasons, determination of latitude and longitude, or…

  3. Cold induced peripheral vasodilation at high altitudes- a field study

    NARCIS (Netherlands)

    Daanen, H.A.M.; Ruiten, H.J.A. van

    2000-01-01

    A significant reduction in cold-induced vasodilation (CIVD) is observed at high altitudes. No agreement is found in the literature about acclimatization effects on CIVD. Two studies were performed to investigate the effect of altitude acclimatization on CIVD. In the first study 13 male subjects imme

  4. 14 CFR 93.307 - Minimum flight altitudes.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Minimum flight altitudes. 93.307 Section 93...) AIR TRAFFIC AND GENERAL OPERATING RULES SPECIAL AIR TRAFFIC RULES Special Flight Rules in the Vicinity of Grand Canyon National Park, AZ § 93.307 Minimum flight altitudes. Except in an emergency, or...

  5. Exercise and Training at Altitudes: Physiological Effects and Protocols

    Directory of Open Access Journals (Sweden)

    Olga Cecilia Vargas Pinilla

    2014-01-01

    Full Text Available An increase in altitude leads to a proportional fall in the barometric pressure, and a decrease in atmospheric oxygen pressure, producing hypobaric hypoxia that affects, in different degrees, all body organs, systems and functions. The chronically reduced partial pressure of oxygen causes that individuals adapt and adjust to physiological stress. These adaptations are modulated by many factors, including the degree of hypoxia related to altitude, time of exposure, exercise intensity and individual conditions. It has been established that exposure to high altitude is an environmental stressor that elicits a response that contributes to many adjustments and adaptations that influence exercise capacity and endurance performance. These adaptations include in crease in hemoglobin concentration, ventilation, capillary density and tissue myoglobin concentration. However, a negative effect in strength and power is related to a decrease in muscle fiber size and body mass due to the decrease in the training intensity. Many researches aim at establishing how training or living at high altitudes affects performance in athletes. Training methods, such as living in high altitudes training low, and training high-living in low altitudes have been used to research the changes in the physical condition in athletes and how the physiological adaptations to hypoxia can enhanceperformance at sea level. This review analyzes the literature related to altitude training focused on how physiological adaptations to hypoxic environments influence performance, and which protocols are most frequently used to train in high altitudes.

  6. Introductory address: lessons to be learned from high altitude.

    Science.gov (United States)

    Houston, C S

    1979-07-01

    A historical account of the important landmarks in man's experience with the high altitude environment is followed by comments on the important stages in the understanding of its physiological effects. The work of The Mount Logan High Altitude Physiology Study on acute mountain sickness is reviewed from its inception in 1967 until the present.

  7. Cold induced peripheral vasodilation at high altitudes- a field study

    NARCIS (Netherlands)

    Daanen, H.A.M.; Ruiten, H.J.A. van

    2000-01-01

    A significant reduction in cold-induced vasodilation (CIVD) is observed at high altitudes. No agreement is found in the literature about acclimatization effects on CIVD. Two studies were performed to investigate the effect of altitude acclimatization on CIVD. In the first study 13 male subjects imme

  8. Toward a Moderate Autoethnography

    Directory of Open Access Journals (Sweden)

    Sarah Stahlke Wall

    2016-10-01

    Full Text Available Autoethnography is an avant-garde method of qualitative inquiry that has captured the attention of an ever-increasing number of scholars from a variety of disciplines. Personal experience methods can offer a new and unique vantage point from which to make a contribution to social science yet, autoethnography has been criticized for being self-indulgent, narcissistic, introspective, and individualized. Methodological discussions about this method are polarized. As an autoethnographer and qualitative methodologist with an interest in personal experience methods, I have had the opportunity to review several autoethnographic manuscripts over the years. As my reviews accumulated, I began to see themes in my responses and it became apparent that I was advocating for an approach to autoethnography that lies in contrast to the frequently offered methodological polemics from philosophically divergent scholars. In this article, I draw from the reviews I have done to address topics such as applications and purposes for autoethnography, the degree of theory and analysis used within the method, data sources and dissemination of findings, and ethical issues. I then connect the concerns I see in the reviewed manuscripts to examples in the autoethnographic literature. Ultimately, I propose a moderate and balanced treatment of autoethnography that allows for innovation, imagination, and the representation of a range of voices in qualitative inquiry while also sustaining confidence in the quality, rigor, and usefulness of academic research.

  9. Understanding controls on cirque floor altitudes: Insights from Kamchatka

    Science.gov (United States)

    Barr, Iestyn D.; Spagnolo, Matteo

    2015-11-01

    Glacial cirques reflect former regions of glacier initiation, and are therefore used as indicators of past climate. One specific way in which palaeoclimatic information is obtained from cirques is by analysing their elevations, on the assumption that cirque floor altitudes are a proxy for climatically controlled equilibrium-line altitudes (ELAs) during former periods of small scale (cirque-type) glaciation. However, specific controls on cirque altitudes are rarely assessed, and the validity of using cirque floor altitudes as a source of palaeoclimatic information remains open to question. In order to address this, here we analyse the distribution of 3520 ice-free cirques on the Kamchatka Peninsula (eastern Russia), and assess various controls on their floor altitudes. In addition, we analyse controls on the mid-altitudes of 503 modern glaciers, currently identifiable on the peninsula, and make comparisons with the cirque altitude data. The main study findings are that cirque floor altitudes increase steeply inland from the Pacific, suggesting that moisture availability (i.e., proximity to the coastline) played a key role in regulating the altitudes at which former (cirque-forming) glaciers were able to initiate. Other factors, such as latitude, aspect, topography, geology, and neo-tectonics seem to have played a limited (but not insignificant) role in regulating cirque floor altitudes, though south-facing cirques are typically higher than their north-facing equivalents, potentially reflecting the impact of prevailing wind directions (from the SSE) and/or variations in solar radiation on the altitudes at which former glaciers were able to initiate. Trends in glacier and cirque altitudes across the peninsula are typically comparable (i.e., values typically rise from both the north and south, inland from the Pacific coastline, and where glaciers/cirques are south-facing), yet the relationship with latitude is stronger for modern glaciers, and the relationship with

  10. Early resident-to-resident physics education in diagnostic radiology.

    Science.gov (United States)

    Kansagra, Akash P

    2014-01-01

    The revised ABR board certification process has updated the method by which diagnostic radiology residents are evaluated for competency in clinical radiologic physics. In this work, the author reports the successful design and implementation of a resident-taught physics course consisting of 5 weekly, hour-long lectures intended for incoming first-year radiology residents in their first month of training. To the author's knowledge, this is the first description of a course designed to provide a very early framework for ongoing physics education throughout residency without increasing the didactic burden on faculty members. Twenty-six first-year residents spanning 2 academic years took the course and reported subjective improvement in their knowledge (90%) and interest (75%) in imaging physics and a high level of satisfaction with the use of senior residents as physics educators. Based on the success of this course and the minimal resources required for implementation, this work may serve as a blueprint for other radiology residency programs seeking to develop revised physics curricula.

  11. The impact of altitude on hospitalization and hospital mortality from pandemic 2009 influenza A (H1N1 virus pneumonia in Mexico El impacto de la altitud en las tasas de hospitalización y mortalidad por el virus de la influenza A (H1N1 pandémico en México

    Directory of Open Access Journals (Sweden)

    Rogelio Pérez-Padilla

    2013-02-01

    Full Text Available OBJECTIVE: To determine the effect of altitude of residence on influenza A (H1N1. MATERIALS AND METHODS: We analyzed 207 135 officially notified of influenza-like illness (ILI cases, 23 048 hospitalizations and 573 deaths during the first months of the novel pandemic influenza A H1N1 virus, to examine if residents of high altitude had more frequently these adverse outcomes. RESULTS: Adjusted rates for hospitalization and hospital mortality rates increased with altitude, probably due to hypoxemia.OBJETIVO: Determinar el efecto de la altitud del lugar de residencia sobre la epidemia de influenza A (H1N1. MATERIAL Y MÉTODOS: Se analizaron 207 135 casos notificados a la Secretaría de Salud, 23 048 hospitalizaciones y 573 muertes por enfermedad similar a la influenza (ILI, por sus siglas en inglés durante los primeros meses de la pandemia del nuevo virus de la influenza A H1N1 durante 2009, para examinar si los residentes de zonas más altas presentaron tasas más altas de hospitalización y muerte. RESULTADOS: Las tasas ajustadas de hospitalización y mortalidad hospitalaria se incrementaron con la altitud probablemente por la presencia de hipoxemia.

  12. Low altitude dose measurements from APEX, CRRES and DMSP.

    Science.gov (United States)

    Mullen, E G; Gussenhoven, M S; Bell, J T; Madden, D; Holeman, E; Delorey, D

    1998-01-01

    Dosimeter data taken on the APEX (1994-1996), CRRES (1990-1991) and DMSP (1984-1987) satellites have been used to study the low altitude (down to 350 km) radiation environment. Of special concern has been the inner edge of the inner radiation belt due to its steep gradient. We have constructed dose models of the inner edge of the belt from all three spacecraft and put them into a personal computer utility, called APEXRAD, that calculates dose for user-selected orbits. The variation of dose for low altitude, circular orbits is given as a function of altitude, inclination and particle type. Dose-depth curves show that shielding greater than approximately 1/4 in Al is largely ineffectual for low altitude orbits. The contribution of outer zone electrons to low altitude dose is shown to be important only for thin shields and to have significant variation with magnetic activity and solar cycle.

  13. Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training.

    Science.gov (United States)

    Shweiki, Ehyal; Martin, Niels D; Beekley, Alec C; Jenoff, Jay S; Koenig, George J; Kaulback, Kris R; Lindenbaum, Gary A; Patel, Pankaj H; Rosen, Matthew M; Weinstein, Michael S; Zubair, Muhammad H; Cohen, Murray J

    2015-01-01

    Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people's choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education.

  14. Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training

    Science.gov (United States)

    Shweiki, Ehyal; Martin, Niels D; Beekley, Alec C; Jenoff, Jay S; Koenig, George J; Kaulback, Kris R; Lindenbaum, Gary A; Patel, Pankaj H; Rosen, Matthew M; Weinstein, Michael S; Zubair, Muhammad H; Cohen, Murray J

    2015-01-01

    Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people’s choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education. PMID:25995656

  15. Development and implementation of a formalized geriatric surgery curriculum for general surgery residents.

    Science.gov (United States)

    Barbas, Andrew S; Haney, John C; Henry, Brandon V; Heflin, Mitchell T; Lagoo, Sandhya A

    2014-01-01

    Despite the growth of the elderly population, most surgical training programs lack formalized geriatric education. The authors' aim was to implement a formalized geriatric surgery curriculum at an academic medical center. Surgery residents were surveyed on attitudes toward the care of elderly patients and the importance of various geriatric topics to daily practice. A curriculum consisting of 16 didactic sessions was created with faculty experts moderating. After curriculum completion, residents were surveyed to assess curriculum impact. Residents expressed increased comfort in accessing community resources. A greater percentage of residents recognized the significance of delirium and acute renal failure in elderly patients. Implementing a geriatric surgery curriculum geared toward surgery residents is feasible and can increase resident comfort with multidisciplinary care and recognition of clinical conditions pertinent to elderly surgical patients. This initiative also provided valuable experience for geriatric surgery curriculum development.

  16. Solar electric energy supply at high altitude

    Energy Technology Data Exchange (ETDEWEB)

    Knaupp, W.; Mundschau, E. [Zentrum fur Sonnenenergie- und Wasserstoff-Forschung (ZSW), Ulm (Germany)

    2004-04-01

    Solar-hydrogen systems were analyzed regarding their usability as energy supply system for high altitude platforms. In a first step for an assessment of solar and photovoltaic resources near-ground spectral transmittances of atmosphere were extended with simplified height correction functions to achieve spectral irradiance descriptions versus atmospheric height up to 25 km. The influence of atmospheric height to different solar cell technologies regarding electrical performance was quantified at some examples for the aspect of spectral distribution with the help of the introduced spectral height factor. The main attention during analysis of the whole solar-hydrogen energy system was directed to characteristics of current or near term available technology. Specific power weight of photovoltaic system, electrolyzer, fuel cell and gas tanks and their dependence on operation mode and power range were assessed. A pre-design of a solar-hydrogen energy system was carried out for an airship (volume 580,000 m3) withstanding continuous wind speeds up to {approx} 130 km/h. The calculated coverage ratio of photovoltaic and load share of energy system mark the frame of usability. Depending on the airship size, shape and other external boundary conditions the total electrical energy demand could be covered by a solar-hydrogen energy system of current or near term technology for full year operation. However further investigations are necessary regarding e.g. further mass reductions. (author)

  17. The High-Altitude Water Cherenkov Observatory

    Science.gov (United States)

    Mostafá, Miguel A.

    2014-10-01

    The High-Altitude Water Cherenkov (HAWC) observatory is a large field of view, continuously operated, TeV γ-ray experiment under construction at 4,100 m a.s.l. in Mexico. The HAWC observatory will have an order of magnitude better sensitivity, angular resolution, and background rejection than its predecessor, the Milagro experiment. The improved performance will allow us to detect both the transient and steady emissions, to study the Galactic diffuse emission at TeV energies, and to measure or constrain the TeV spectra of GeV γ-ray sources. In addition, HAWC will be the only ground-based instrument capable of detecting prompt emission from γ-ray bursts above 50 GeV. The HAWC observatory will consist of an array of 300 water Cherenkov detectors (WCDs), each with four photomultiplier tubes. This array is currently under construction on the flanks of the Sierra Negra volcano near the city of Puebla, Mexico. The first 30 WCDs (forming an array approximately the size of Milagro) were deployed in Summer 2012, and 100 WCDs will be taking data by May, 2013. We present in this paper the motivation for constructing the HAWC observatory, the status of the deployment, and the first results from the constantly growing array.

  18. The high-altitude water Cherenkov Observatory

    Energy Technology Data Exchange (ETDEWEB)

    Mostafa, Miguel A., E-mail: miguel@psu.edu [Department of Physics, Colorado State University, Ft Collins, CO (United States)

    2014-07-01

    The High-Altitude Water Cherenkov (HAWC) observatory is a large field of view, continuously operated, TeV γ -ray experiment under construction at 4,100ma.s.l. in Mexico. The HAWC observatory will have an order of magnitude better sensitivity, angular resolution, and background rejection than its predecessor, the Milagro experiment. The improved performance will allow to detect both the transient and steady emissions, to study the Galactic diffuse emission at TeV energies, and to measure or constrain the TeV spectra of GeV γ -ray sources. In addition, HAWC will be the only ground-based instrument capable of detecting prompt emission from γ -ray bursts above 50 GeV. The HAWC observatory will consist of an array of 300 water Cherenkov detectors (WCDs), each with four photomultiplier tubes. This array is currently under construction on the flanks of the Sierra Negra volcano near the city of Puebla, Mexico. The first 30 WCDs (forming an array approximately the size of Milagro) were deployed in Summer 2012, and 100 WCDs will be taking data by May, 2013. We present in this paper the motivation for constructing the HAWC observatory, the status of the deployment, and the first results from the constantly growing array. (author)

  19. The High Altitude Water Cherenkov (HAWC) Observatory

    Science.gov (United States)

    Springer, Wayne

    2014-06-01

    The High Altitude Water Cherenkov (HAWC) observatory is a continuously operated, wide field of view detector based upon a water Cherenkov technology developed by the Milagro experiment. HAWC observes, at an elevation of 4100 m on Sierra Negra Mountain in Mexico, extensive air showers initiated by gamma and cosmic rays. The completed detector will consist of 300 closely spaced water tanks each instrumented with four photomultiplier tubes that provide timing and charge information used to reconstruct energy and arrival direction. HAWC has been optimized to observe transient and steady emission from point as well as diffuse sources of gamma rays in the energy range from several hundred GeV to several hundred TeV. Studies in solar physics as well as the properties of cosmic rays will also be performed. HAWC has been making observations at various stages of deployment since completion of 10% of the array in summer 2012. A discussion of the detector design, science capabilities, current construction/commissioning status, and first results will be presented...

  20. The High Altitude Water Cherenkov Observatory

    CERN Document Server

    ,

    2013-01-01

    The High Altitude Water Cherenkov (HAWC) observatory is a large field of view, continuously operated, TeV gamma-ray experiment under construction at 4,100 m a.s.l. in Mexico. The HAWC observatory will have an order of magnitude better sensitivity, angular resolution, and background rejection than its predecessor, the Milagro experiment. The improved performance will allow us to detect both transient and steady emissions, to study the Galactic diffuse emission at TeV energies, and to measure or constrain the TeV spectra of GeV gamma-ray sources. In addition, HAWC will be the only ground-based instrument capable of detecting prompt emission from gamma-ray bursts above 50 GeV. The HAWC observatory will consist of an array of 300 water Cherenkov detectors (WCDs), each with four photomultiplier tubes. This array is currently under construction on the flanks of the Sierra Negra volcano near the city of Puebla, Mexico. The first thirty WCDs (forming an array approximately the size of Milagro) were deployed in Summer...

  1. DLR HABLEG- High Altitude Balloon Launched Experimental Glider

    Science.gov (United States)

    Wlach, S.; Schwarzbauch, M.; Laiacker, M.

    2015-09-01

    The group Flying Robots at the DLR Institute of Robotics and Mechatronics in Oberpfaffenhofen conducts research on solar powered high altitude aircrafts. Due to the high altitude and the almost infinite mission duration, these platforms are also denoted as High Altitude Pseudo-Satellites (HAPS). This paper highlights some aspects of the design, building, integration and testing of a flying experimental platform for high altitudes. This unmanned aircraft, with a wingspan of 3 m and a mass of less than 10 kg, is meant to be launched as a glider from a high altitude balloon in 20 km altitude and shall investigate technologies for future large HAPS platforms. The aerodynamic requirements for high altitude flight included the development of a launch method allowing for a safe transition to horizontal flight from free-fall with low control authority. Due to the harsh environmental conditions in the stratosphere, the integration of electronic components in the airframe is a major effort. For regulatory reasons a reliable and situation dependent flight termination system had to be implemented. In May 2015 a flight campaign was conducted. The mission was a full success demonstrating that stratospheric research flights are feasible with rather small aircrafts.

  2. Aging, High Altitude, and Blood Pressure: A Complex Relationship.

    Science.gov (United States)

    Parati, Gianfranco; Ochoa, Juan Eugenio; Torlasco, Camilla; Salvi, Paolo; Lombardi, Carolina; Bilo, Grzegorz

    2015-06-01

    Parati, Gianfranco, Juan Eugenio Ochoa, Camilla Torlasco, Paolo Salvi, Carolina Lombardi, and Grzegorz Bilo. Aging, high altitude, and blood pressure: A complex relationship. High Alt Biol Med 16:97-109, 2015.--Both aging and high altitude exposure may induce important changes in BP regulation, leading to significant increases in BP levels. By inducing atherosclerotic changes, stiffening of large arteries, renal dysfunction, and arterial baroreflex impairment, advancing age may induce progressive increases in systolic BP levels, promoting development and progression of arterial hypertension. It is also known, although mainly from studies in young or middle-aged subjects, that exposure to high altitude may influence different mechanisms involved in BP regulation (i.e., neural central and reflex control of sympathetic activity), leading to important increases in BP levels. The evidence is less clear, however, on whether and to what extent advancing age may influence the BP response to acute or chronic high altitude exposure. This is a question not only of scientific interest but also of practical relevance given the consistent number of elderly individuals who are exposed for short time periods (either for leisure or work) or live permanently at high altitude, in whom arterial hypertension is frequently observed. This article will review the evidence available on the relationship between aging and blood pressure levels at high altitude, the pathophysiological mechanisms behind this complex association, as well as some questions of practical interest regarding antihypertensive treatment in elderly subjects, and the effects of antihypertensive drugs on blood pressure response during high altitude exposure.

  3. Travel to High Altitude Following Solid Organ Transplantation.

    Science.gov (United States)

    Luks, Andrew M

    2016-09-01

    Luks, Andrew M. Clinician's corner: travel to high altitude following solid organ transplantation. High Alt Med Biol. 17:147-156, 2016.-As they regain active lifestyles following successful organ transplantation, transplant recipients may travel to high altitude for a variety of activities, including skiing, climbing, and trekking. This review is intended to provide information for medical providers who may encounter transplant patients seeking advice before planned high altitude travel or care for medical issues that develop during the actual sojourn. There is currently limited information in the literature about outcomes during high-altitude travel following solid organ transplantation, but the available evidence suggests that the physiologic responses to hypobaric hypoxia are comparable to those seen in nontransplanted individuals and well-selected transplant recipients with no evidence of organ rejection can tolerate ascents as high as 6200 m. All transplant recipients planning high-altitude travel should undergo pretravel assessment and counseling with an emphasis on the recognition, prevention, and treatment of altitude illness, as well as the importance of preventing infection and limiting sun exposure. Transplant recipients can use the standard medications for altitude illness prophylaxis and treatment, but the choice and dose of medication should take into account the patient's preexisting medication regimen and current renal function. With careful attention to these and other details, the healthy transplant recipient can safely experience the rewards of traveling in the mountains.

  4. Mitochondrial DNA response to high altitude: a new perspective on high-altitude adaptation.

    Science.gov (United States)

    Luo, Yongjun; Yang, Xiaohong; Gao, Yuqi

    2013-08-01

    Mitochondria are the energy metabolism centers of the cell. More than 95% of cellular energy is produced by mitochondrial oxidative phosphorylation. Hypoxia affects a wide range of energy generation and consumption processes in animals. The most important mechanisms limiting ATP consumption increase the efficiency of ATP production and accommodate the reduced production of ATP by the body. All of these mechanisms relate to changes in mitochondrial function. Mitochondrial function can be affected by variations in mitochondrial DNA, including polymorphisms, content changes, and deletions. These variations play an important role in acclimatization or adaptation to hypoxia. In this paper, the association between mitochondrial genome sequences and high-altitude adaptation is reviewed.

  5. Gravity Disturbances at Altitude and at the Surface

    Science.gov (United States)

    Damiani, T.

    2013-12-01

    The U.S. National Geodetic Survey (NGS) is committed to redefining the nation's vertical datum by 2022. In support of the new vertical datum, NGS is collecting high-altitude airborne gravity data across the United States through the Gravity for the Redefinition of the American Vertical Datum (GRAV-D) project. GRAV-D (as of August 2013) has publicly released full-field gravity products from these high-altitude flights for >15% of the country. The full-field gravity (FFG) at altitude product is versatile because it allows the user to calculate any disturbance or anomaly that is appropriate for their application- based on any datum and height above the datum desired. However, conventional geophysical methods for calculating gravity disturbances assume very low altitudes above the ellipsoid. This presentation addresses the differences between several conventional and non-conventional methods for calculating gravity disturbances, from the perspective of altitudes as high as 40,000 ft. The methods for calculating a disturbance at altitude apply different corrections to the FFG for: 1. Normal gravity at the surface of the ellipsoid and the free-air reduction (1st order, 2nd order, and higher order approximations); 2. Normal gravity at the surface of the ellipsoid, upward continued to flight height; 3. Normal gravity at flight altitude above the ellipsoid from Heiskanen and Moritz (1967)'s closed equations; 4. Normal gravity at flight altitude above the ellipsoid from spherical and ellipsoidal harmonic coefficients of the ellipsoid. Initial results indicate that these methods produce gravity disturbances that are 10s of mGals different at altitude. This presentation will also investigate disturbances calculated at the surface of the ellipsoid, by downward continuing the results of the above methods. Gravity disturbances continued from airborne flight heights down to the surface are desired for comparison to terrestrial and marine gravity data.

  6. Oxidative stress and the high altitude environment

    Directory of Open Access Journals (Sweden)

    Jakub Krzeszowiak

    2013-03-01

    Full Text Available In the recent years there has been considerable interest in mountain sports, including mountaineering, owing to the general availability of climbing clothing and equipment as well trainings and professional literature. This raised a new question for the environmental and mountain medicine: Is mountaineering harmful to health? Potential hazards include the conditions existing in the alpine environment, i.e. lower atmospheric pressure leading to the development of hypobaric hypoxia, extreme physical effort, increased UV radiation, lack of access to fresh food, and mental stress. A reasonable measure of harmfulness of these factors is to determine the increase in the level of oxidative stress. Alpine environment can stimulate the antioxidant enzyme system but under specific circumstances it may exceed its capabilities with simultaneous consumption of low-molecular antioxidants resulting in increased generation of reactive oxygen species (ROS. This situation is referred to as oxidative stress. Rapid and uncontrolled proliferation of reactive oxygen species leads to a number of adverse changes, resulting in the above-average damage to the lipid structures of cell membranes (peroxidation, proteins (denaturation, and nucleic acids. Such situation within the human body cannot take place without resultant systemic consequences. This explains the malaise of people returning from high altitude and a marked decrease in their physical fitness. In addition, a theory is put forward that the increase in the level of oxidative stress is one of the factors responsible for the onset of acute mountain sickness (AMS. However, such statement requires further investigation because the currently available literature is inconclusive. This article presents the causes and effects of development of oxidative stress in the high mountains.

  7. Minimum Data Set Active Resident Information Report

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MDS Active Resident Report summarizes information for residents currently in nursing homes. The source of these counts is the residents MDS assessment record....

  8. Factors associated with successful self-directed learning using individualized learning plans during pediatric residency.

    Science.gov (United States)

    Li, Su-Ting T; Tancredi, Daniel J; Co, John Patrick T; West, Daniel C

    2010-01-01

    The aim of this study was to determine whether resident or program characteristics are associated with effective self-directed learning of residents. A cross-sectional survey of pediatric and medicine/pediatric residents and program directors from a nationally representative sample of residency programs was conducted. Self-directed learning efficacy was measured by resident-reported progress on learning goals from their most recent individualized learning plan (ILP). Multilevel linear regression models were used to analyze the relationship between learner and program characteristics and self-directed learning efficacy of residents. All program directors of participating programs (N = 46) completed the survey; the response rate from residents was 57% (992/1739). At the time of the survey, 78% of residents had previously written an ILP. Most residents achieved moderate self-directed learning efficacy. The most important factors associated with greater self-directed learning efficacy included using a system to track one's own progress in achieving learning goals, higher score on a propensity toward lifelong learning scale, and reporting greater confidence in self-directed learning abilities. Program characteristics, including program-level support for ILPs, had little or mixed association with resident self-directed learning efficacy. The most important factors associated with effective self-directed learning were resident characteristics. Our findings imply that residency programs should invest their limited resources in curricula that help residents develop measurable goals and systems for tracking progress toward goal attainment. Since propensity toward lifelong learning was an important factor, medical schools and residency training programs should enhance their efforts to develop this characteristic in learners. Copyright 2010 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  9. How Dutch medical specialists perceive the competencies and training needs of medical residents in healthcare management.

    Science.gov (United States)

    Berkenbosch, L; Bax, M; Scherpbier, A; Heyligers, I; Muijtjens, A M M; Busari, J O

    2013-04-01

    The Dutch postgraduate medical training has been revised to focus on seven competencies. The role as manager is one of these competencies. Recent studies show that this competency receives little attention during the residency training. In an earlier study, we discovered that residents perceived their competency as managers to be moderate. In this study, we investigated how medical specialists perceived the managerial competencies of medical residents and their need for management education. In September 2010, a 46-item questionnaire was designed which examined medical specialists' perceptions of the competency and needs of residents in the field of medical management. Two hundred ninety-eight specialists were invited via email to participate. Hundred twenty-nine specialists (43.3%) responded to our survey. They rated the residents' competencies in contract negotiating skills, knowledge of the healthcare system, and specialist department poorly. They felt that residents were competent in updating their medical knowledge. Ninety-four percent reported a need for training in management among residents. Preferred topics were time management and healthcare organization. The preferred training method was a workshop given during residency by an extramural expert. Dutch medical specialists perceive the management competencies of residents in some areas to be inadequate. They feel that training in medical management during residency is necessary.

  10. Residents' Positive and Negative Relationship Networks in a Nursing Home.

    Science.gov (United States)

    Casey, Anne-Nicole S; Low, Lee-Fay; Jeon, Yun-Hee; Brodaty, Henry

    2016-11-01

    Person-centered care involves consideration of long-term care residents' lived experience, including social relationships. The current cross-sectional study investigated co-resident social networks in three units of a 94-bed Australian nursing home, including an 18-bed dementia-specific unit (DSU). Six care staff were interviewed. Chart, self-reported social isolation, and staff-reported social engagement data were collected for 36 residents ages 63 to 94 who consented to full participation. Fifty-five additional residents were included in observations. Median positive-to-negative network size ratios within units were 1.5:1 (Unit 1), 0.7:1 (Unit 3), and 0:1 (DSU). Moderate positive correlations existed between: perceived social support and total positive relationships [ρ(25) = 0.44, p = 0.03]; social withdrawal and total negative relationships [ρ(36) = 0.51, p = 0.002]; and objective social isolation and total negative relationships [ρ(22) = -0.44, p = 0.042]. Number and quality of relationships were associated with resident social withdrawal, perceived support, and isolation. High prevalence of isolation and negative relationships demonstrate the need for interventions. [Journal of Gerontological Nursing, 42(11), 9-13.].

  11. Increasing enjoyable activities to treat depression in nursing home residents with dementia: A pilot study.

    Science.gov (United States)

    Travers, Catherine

    2017-02-01

    This pilot study aimed to assess the feasibility and acceptability of a behavioral activities intervention (BE-ACTIV) in Australian nursing homes. BE-ACTIV was developed by researchers at the University of Louisville, USA, to improve mood and quality of life (QOL) in nursing home residents with mild to moderate dementia. An eight-week trial was conducted and 10 residents with mild to moderate dementia received the BE-ACTIV intervention while eight residents received a Walking and Talking intervention. Measures of depression (GDS-12R) and QOL (QOL-AD-NH) were administered prior to and following the interventions. Qualitative feedback indicated residents benefited from BE-ACTIV, evident by improved mood, although no statistically significant treatment effect was found. Moreover, the intervention was found to be feasible and acceptable to Australian nursing home staff and our findings highlight the importance of individualizing activities for people with dementia, of which 1:1 staff attention was a key component.

  12. Spatial patterns of ecosystem carbon residence time in Chinese forests

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Capacity of carbon sequestration in forest ecosystem largely depends on the trend of net primary production (NPP) and the length of ecosystem carbon residence time. Retrieving spatial patterns of ecosystem carbon residence time is important and necessary for accurately predicting regional carbon cycles in the future. In this study, a data-model fusion method that combined a process-based regional carbon model (TECO-R) with various ground-based ecosystem observations (NPP, biomass, and soil organic carbon) and auxiliary data sets (NDVI, meteorological data, and maps of vegetation and soil texture) was applied to estimate spatial patterns of ecosystem carbon residence time in Chinese forests at steady state. In the data-model fusion, the genetic algorithm was used to estimate the optimal model parameters related with the ecosystem carbon residence time by minimizing total deviation between modeled and observed values. The results indicated that data-model fusion technology could effectively retrieve model parameters and simulate carbon cycling processes for Chinese forest ecosystems. The estimated carbon residence times were highly heterogenous over China, with most of regions having values between 24 and 70 years. The deciduous needleleaf forest and the evergreen needleleaf forest had the highest averaged carbon residence times (73.8 and 71.3 years, respectively), the mixed forest and the deciduous broadleaf forest had moderate values (38.1 and 37.3 years, respectively), and the evergreen broadleaf forest had the lowest value (31.7 years). The averaged carbon residence time of forest ecosystems in China was 57.8 years.

  13. Altitude and latitude dependence of the equatorial electrojet

    Science.gov (United States)

    Singh, A.; Cole, K. D.

    1988-07-01

    A self-consistent and high-resolution dynamo model is used to investigate the effects of day-to-day or seasonal variation of altitude and latitude profiles of the E-plasma density in the equatorial ionosphere on equatorial electrojet (EEJ) structure. Variations in the E-layer peak altitude and amplitude are shown to significantly affect EEJ structure. The results indicate that, for any shape, the EEJ peak appears at or below the E-layer peak altitude. Distinct double peaks occur in the EEJ structure if the E-layer peak is above 105 km or if the gradient is large. The effect of the latitudinal variation of the integrated conductivities of ionospheric field lines upon the amplitude and altitude of the EEJ peak is discussed.

  14. Altitude Compensating Nozzle Transonic Performance Flight Demonstration Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Altitude compensating nozzles continue to be of interest for use on future launch vehicle boosters and upper stages because of their higher mission average Isp and...

  15. Children's exercise capacity at high altitude in Tibet.

    Science.gov (United States)

    Bianba; Andersen, Lars Bo; Stigum, Hein; Ouzhuluobu; Bjertness, Espen

    2014-11-01

    Maximal oxygen uptake (exercise capacity) is a vital parameter in the evaluation of adaptation to high altitude, providing an index of the integrated function of the oxygen transport system. Previous studies of maximal oxygen uptake in population at high altitude have mainly focused on adults and adolescents, though data on children are uncommon. Maximal oxygen uptake can be measured directly, using an oxygen analyser, or indirectly through the development of equations for estimation from the maximal power output (W(max)). Such estimations and studies of the physiological aspects of children's capacity to work and live at different altitudes in Tibet ancestry were not reported previously, although differences similar to those seen in adults may be expected to occur. The present paper summarized the findings of studies on exercise capacity among children living at high altitude in Tibet.

  16. Recognising and mitigating the risk of altitude-related illness

    African Journals Online (AJOL)

    Typically, above 3 500 m, an increase in sleep- ing altitude of ... Everest. Fig. 1. Relative heights of well-known African and international peaks in comparison to Kilimanjaro, ... recent times, however, the importance of providing high-quality,.

  17. Altitude training considerations for the winter sport athlete

    National Research Council Canada - National Science Library

    Robert F. Chapman; Jonathon L. Stickford; Benjamin D. Levine

    2010-01-01

    .... The reduction in air resistance at altitude can dramatically affect sports involving high velocities and technical skill components, such as ski jumping, speed skating, figure skating and ice hockey...

  18. General introduction to altitude adaptation and mountain sickness

    DEFF Research Database (Denmark)

    Bartsch, P.; Saltin, B.

    2008-01-01

    ascent (average ascent rate 300 m/day above 2000 m a.s.l.), primarily in order to sleep and feel well, and minimize the risk of mountain sickness. A new classification of altitude levels based on the effects on performance and well-being is proposed and an overview given over the various modalities using...... at altitudes between 2500 and 3000 m a.s.l. Pulmonary edema is rarely seen below 3000 m a.s.l. and brain edema is not seen below 4000 m a.s.l. It is possible to travel to altitudes of 2500-3000 m a.s.l., wait for 2 days, and then gradually start to train. At higher altitudes, one should consider a staged...

  19. NHAP = National High-Altitude Aerial Photography: 1980 - 1989

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The National High Altitude Photography (NHAP) program, which was operated from 1980-1989, was coordinated by the U.S. Geological Survey as an interagency project to...

  20. Ben Macdhui High Altitude Trace Gas and Aerosol Transport Experiment

    CSIR Research Space (South Africa)

    Piketh, SJ

    1999-01-01

    Full Text Available The Ben Macdhui High Altitude Aerosol and Trace Gas Transport Experiment (BHATTEX) was started to characterize the nature and magnitude of atmospheric, aerosol and trace gas transport paths recirculation over and exiting from southern Africa...

  1. NHAP = National High-Altitude Aerial Photography: 1980 - 1989

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The National High Altitude Photography (NHAP) program, which was operated from 1980-1989, was coordinated by the U.S. Geological Survey as an interagency project to...

  2. The yak genome and adaptation to life at high altitude.

    Science.gov (United States)

    Qiu, Qiang; Zhang, Guojie; Ma, Tao; Qian, Wubin; Wang, Junyi; Ye, Zhiqiang; Cao, Changchang; Hu, Quanjun; Kim, Jaebum; Larkin, Denis M; Auvil, Loretta; Capitanu, Boris; Ma, Jian; Lewin, Harris A; Qian, Xiaoju; Lang, Yongshan; Zhou, Ran; Wang, Lizhong; Wang, Kun; Xia, Jinquan; Liao, Shengguang; Pan, Shengkai; Lu, Xu; Hou, Haolong; Wang, Yan; Zang, Xuetao; Yin, Ye; Ma, Hui; Zhang, Jian; Wang, Zhaofeng; Zhang, Yingmei; Zhang, Dawei; Yonezawa, Takahiro; Hasegawa, Masami; Zhong, Yang; Liu, Wenbin; Zhang, Yan; Huang, Zhiyong; Zhang, Shengxiang; Long, Ruijun; Yang, Huanming; Wang, Jian; Lenstra, Johannes A; Cooper, David N; Wu, Yi; Wang, Jun; Shi, Peng; Wang, Jian; Liu, Jianquan

    2012-07-01

    Domestic yaks (Bos grunniens) provide meat and other necessities for Tibetans living at high altitude on the Qinghai-Tibetan Plateau and in adjacent regions. Comparison between yak and the closely related low-altitude cattle (Bos taurus) is informative in studying animal adaptation to high altitude. Here, we present the draft genome sequence of a female domestic yak generated using Illumina-based technology at 65-fold coverage. Genomic comparisons between yak and cattle identify an expansion in yak of gene families related to sensory perception and energy metabolism, as well as an enrichment of protein domains involved in sensing the extracellular environment and hypoxic stress. Positively selected and rapidly evolving genes in the yak lineage are also found to be significantly enriched in functional categories and pathways related to hypoxia and nutrition metabolism. These findings may have important implications for understanding adaptation to high altitude in other animal species and for hypoxia-related diseases in humans.

  3. Travelling to new heights: practical high altitude medicine.

    Science.gov (United States)

    Plant, Tracie; Aref-Adib, Golnar

    2008-06-01

    Over 40 million people travel to high altitude for both work and pleasure each year, and all of them are at risk of the acute effects of hypoxia. This article reviews the prevention, diagnostic features and treatments of these illnesses.

  4. Investigation of Correction Method of the Spacecraft Low Altitude Ranging

    CERN Document Server

    Liu, Jing-Lei; Wu, Shi-Tong; Huang, Wei

    2015-01-01

    gamma ray altitude control system is an important equipment for deep space exploration and sample return mission, its main purpose is a low altitude measurement of the spacecraft based on Compton Effect at the moment when it lands on extraterrestrial celestial or sampling returns to the Earth land, and an ignition altitude correction of the spacecraft retrograde landing rocket at different landing speeds. This paper presents an ignition altitude correction method of the spacecraft at different landing speeds, based on the number of particles gamma ray reflected field gradient graded. Through the establishment of a theoretical model, its algorithm feasibility is proved by a mathematical derivation and verified by an experiment, and also the adaptability of the algorithm under different parameters is described. The method provides a certain value for landing control of the deep space exploration spacecraft landing the planet surface.

  5. Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training

    Directory of Open Access Journals (Sweden)

    Shweiki E

    2015-04-01

    Full Text Available Ehyal Shweiki,1 Niels D Martin,2 Alec C Beekley,1 Jay S Jenoff,1 George J Koenig,1 Kris R Kaulback,1 Gary A Lindenbaum,1 Pankaj H Patel,1 Matthew M Rosen,1 Michael S Weinstein,1 Muhammad H Zubair,2 Murray J Cohen1 1Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA; 2Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Abstract: Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people's choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education. Keywords: learning, education, achievement

  6. Measurement of the energy spectrum of cosmic-ray induced neutrons aboard an ER-2 high-altitude airplane

    CERN Document Server

    Goldhagen, P E; Kniss, T; Reginatto, M; Singleterry, R C; Van Steveninck, W; Wilson, J W

    2002-01-01

    Crews working on present-day jet aircraft are a large occupationally exposed group with a relatively high average effective dose from galactic cosmic radiation. Crews of future high-speed commercial aircraft flying at higher altitudes would be even more exposed. To help reduce the significant uncertainties in calculations of such exposures, the atmospheric ionizing radiation (AIR) project, an international collaboration of 15 laboratories, made simultaneous radiation measurements with 14 instruments on five flights of a NASA ER-2 high-altitude aircraft. The primary AIR instrument was a highly sensitive extended-energy multisphere neutron spectrometer with lead and steel shells placed within the moderators of two of its 14 detectors to enhance response at high energies. Detector responses were calculated for neutrons and charged hadrons at energies up to 100 GeV using MCNPX. Neutron spectra were unfolded from the measured count rates using the new MAXED code. We have measured the cosmic-ray neutron spectrum (t...

  7. Functions and Design Scheme of Tibet High Altitude Test Base

    Institute of Scientific and Technical Information of China (English)

    Yu Yongqing; Guo Jian; Yin Yu; Mao Yan; Li Guangfan; Fan Jianbin; Lu Jiayu; Su Zhiyi; Li Peng; Li Qingfeng; Liao Weiming; Zhou Jun

    2010-01-01

    @@ The functional orientation of the Tibet High Altitude Test Base, subordinated to the State Grid Corporation of China (SGCC), is to serve power transmission projects in high altitude areas, especially to provide technical support for southwestern hydropower delivery projects by UHVDC transmission and Qinghai-Tibet grid interconnection project. This paper presents the matters concerned during siting and planning, functions,design scheme, the main performances and parameters of the test facilities, as well as the tests and research tasks already carried out.

  8. Birth weight and altitude: a study in Peruvian communities.

    Science.gov (United States)

    Mortola, J P; Frappell, P B; Aguero, L; Armstrong, K

    2000-03-01

    We tested the hypothesis that at high altitude birth weight decreases once a critical barometric pressure (Pb) is reached. Birth weight data covering the 1-year period from November 1997 to October 1998 were collected in Peru from the data files of 15 community and mining centers between sea level and 4575 m altitude. These centers are scattered along the main road that joins Lima (on the Pacific shore) to Cerro de Pasco (4330 m) and surroundings. Above approximately 2000 m (ie, at Pb below approximately 590 mm Hg, inspired O(2) partial pressure of approximately 114 mm Hg) and up to approximately 4500 m altitude birth weight declined at an average of 65 g for every additional 500 m altitude (or 105 g for every additional 50 mm Hg drop in Pb). This pattern did not differ between sexes. Averages and modal distributions of the birth weight from 2 hospitals in Cerro de Pasco (4330 m) serving different social groups were similar. Body length at birth was similar at various altitudes, with the exception of the 2 highest locations above 4500 m, where it was slightly reduced. From these data, together with additional data collected in the North of Peru (Chacas, 3360 m) and with results from other ethnic groups previously published, we conclude that the drop in birth weight at altitude is (1) apparent once the critical Pb of approximately 590 mm Hg is reached, corresponding to an altitude of approximately 2000 m, (2) proportional to the increase in altitude between approximately 2000 m and 4500 m, and (3) independent from socioeconomic factors.

  9. Functions and Design Scheme of Tibet High Altitude Test Base

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The functional orientation of the Tibet High Altitude Test Base, subordinated to the State Grid Corporation of China (SGCC), is to serve power transmission projects in high altitude areas, especially to provide technical support for southwestern hydropower delivery projects by UHVDC transmission and Qinghai-Tibet grid interconnection project. This paper presents the matters concerned during siting and planning, functions, design scheme, the main performances and parameters of the test facilities, as well as...

  10. Effects of altitude on the climbing performance of Monarch butterflies

    Science.gov (United States)

    Kang, Chang-Kwon; Sridhar, Madhu; Landrum, David; Aono, Hikaru

    2016-11-01

    Millions of Monarchs annually travel up to 4,000km, the longest migration distance among insects. They fly and overwinter at high altitudes. However, the aerodynamic mechanism enabling the long-range flight of Monarch butterflies is unknown. To study the effects of altitude on the aerodynamic performance of Monarch butterflies, a unique combination of a motion tracking system and a variable pressure chamber that allows controlling the density is used. The condition inside the chamber is systematically varied to simulate high altitude conditions up to 3,000 m. An optical tracking technique is used to characterize the climbing trajectories of freely flying Monarch butterflies. Customized reflective markers are designed to minimize the effects of marker addition. Flapping amplitude and frequency as well as climbing trajectories are measured. Lift acting on the butterfly is also determined by considering the force balance. Results show that the average flight speed and the Reynolds number, in general, decreased with the altitude, whereas, interestingly, the lift coefficient increased with the altitude. More detailed measurements and analyses will be performed in the future to explain the lift enhancement by flying at higher altitudes. This work is partly supported by NSF Grant CBET-1335572 and in part by CK's startup fund provided by UAH.

  11. Doing statistical mediation and moderation

    CERN Document Server

    Jose, Paul E

    2013-01-01

    Written in a friendly, conversational style, this book offers a hands-on approach to statistical mediation and moderation for both beginning researchers and those familiar with modeling. Starting with a gentle review of regression-based analysis, Paul Jose covers basic mediation and moderation techniques before moving on to advanced topics in multilevel modeling, structural equation modeling, and hybrid combinations, such as moderated mediation. User-friendly features include numerous graphs and carefully worked-through examples; ""Helpful Suggestions"" about procedures and pitfalls; ""Knowled

  12. Measurement of the energy spectrum of cosmic-ray induced neutrons aboard an ER-2 high-altitude airplane.

    Science.gov (United States)

    Goldhagen, P; Reginatto, M; Kniss, T; Wilson, J W; Singleterry, R C; Jones, I W; Van Steveninck, W

    2002-01-01

    Crews working on present-day jet aircraft are a large occupationally exposed group with a relatively high average effective dose from galactic cosmic radiation. Crews of future high-speed commercial aircraft flying at higher altitudes would be even more exposed. To help reduce the significant uncertainties in calculations of such exposures, the atmospheric ionizing radiation (AIR) project, an international collaboration of 15 laboratories, made simultaneous radiation measurements with 14 instruments on five flights of a NASA ER-2 high-altitude aircraft. The primary AIR instrument was a highly sensitive extended-energy multisphere neutron spectrometer with lead and steel shells placed within the moderators of two of its 14 detectors to enhance response at high energies. Detector responses were calculated for neutrons and charged hadrons at energies up to 100 GeV using MCNPX. Neutron spectra were unfolded from the measured count rates using the new MAXED code. We have measured the cosmic-ray neutron spectrum (thermal to >10 GeV), total neutron fluence rate, and neutron effective dose and dose equivalent rates and their dependence on altitude and geomagnetic cutoff. The measured cosmic-ray neutron spectra have almost no thermal neutrons, a large "evaporation" peak near 1 MeV and a second broad peak near 100 MeV which contributes about 69% of the neutron effective dose. At high altitude, geomagnetic latitude has very little effect on the shape of the spectrum, but it is the dominant variable affecting neutron fluence rate, which was eight times higher at the northernmost measurement location than it was at the southernmost. The shape of the spectrum varied only slightly with altitude from 21 km down to 12 km (56-201 g cm-2 atmospheric depth), but was significantly different on the ground. In all cases, ambient dose equivalent was greater than effective dose for cosmic-ray neutrons.

  13. Kajian Teknologi High Altitude Platform (HAP [Study of High Altitude Platform (HAP Technology

    Directory of Open Access Journals (Sweden)

    Amry Daulat Gultom

    2016-07-01

    Full Text Available High Altitude Platform (HAP merupakan solusi alternatif untuk mengatasi keterbatasan infrastruktur terestrial maupun satelit. HAP merupakan pesawat ataupun balon udara yang ditempatkan pada ketinggian 20-50 km di atas permukaan bumi. Kelebihan yang utama dari HAP adalah kemudahan dalam penempatan, fleksibilitas, biaya operasionalnya rendah, delay  propagasi rendah, sudut elevasi lebar, cakupan yang luas. Penelitian ini dilakukan untuk mengetahui potensi HAP untuk komunikasi pita lebar dan perkembangannya di Indonesia. Analisis dilakukan secara deskriptif dengan mengolah data literatur yang didapat. Hasil penelitian menunjukkan bahwa di Indonesia terdapat potensi teknologi HAP untuk komunikasi pita lebar dengan lebar pita 2x300 MHz di band 27,9-28,2 GHz dan 31-31,3 GHz. Namun, belum ada peraturan yang mengatur alokasi frekuensi untuk HAP secara khusus di Indonesia.*****High Altitude Platform (HAP has been developed as an alternative solution in order to overcome limitation of terrestrial and satellite communication system. HAP is an aircraft or balloon situated on 20-50 km above the earth. Main advantages of HAP are flexibility in deployment, low propagation delay, wide elevation angle and broad coverage. The research is conducted to gather HAP potential for broadband communication and its development in Indonesia. Analysis is conducted by descriptive analysis from literature study gather. The research result shows that in Indonesia, there is potential of HAP technology for broadband communication with 2x300 MHz bandwidth within 27,9-28,2 GHz and 31-31,3 GHz. Yet, there are no specific regulations managing frequency allocation for HAP in Indonesia.

  14. Nutrition Education for Family Practice Residents.

    Science.gov (United States)

    Dappen, Alan; And Others

    1986-01-01

    The American Academy of Family Practice requires that nutrition be taught to residents throughout their three-year residencies, although it does not specify a block of nutrition instruction. The nutrition knowledge of residents in eight family practice residencies in California were examined. (MLW)

  15. Predictors of Success in an Anesthesiology Residency.

    Science.gov (United States)

    Warrick, Shirley S.; Crumrine, Robert S.

    1986-01-01

    Factors that contributed to successful residency performance by anesthesiology residents were examined in order to assist the program's selection committee in developing selection criteria. The best predictor of a resident's academic average in the anethesiology program was the number of years the resident had spent in other specialities.…

  16. Plagiarism in residency application essays.

    Science.gov (United States)

    Segal, Scott; Gelfand, Brian J; Hurwitz, Shelley; Berkowitz, Lori; Ashley, Stanley W; Nadel, Eric S; Katz, Joel T

    2010-07-20

    Anecdotal reports suggest that some residency application essays contain plagiarized content. To determine the prevalence of plagiarism in a large cohort of residency application essays. Retrospective cohort study. 4975 application essays submitted to residency programs at a single large academic medical center between 1 September 2005 and 22 March 2007. Specialized software was used to compare residency application essays with a database of Internet pages, published works, and previously submitted essays and the percentage of the submission matching another source was calculated. A match of more than 10% to an existing work was defined as evidence of plagiarism. Evidence of plagiarism was found in 5.2% (95% CI, 4.6% to 5.9%) of essays. The essays of non-U.S. citizens were more likely to demonstrate evidence of plagiarism. Other characteristics associated with the prevalence of plagiarism included medical school location outside the United States and Canada; previous residency or fellowship; lack of research experience, volunteer experience, or publications; a low United States Medical Licensing Examination Step 1 score; and non-membership in the Alpha Omega Alpha Honor Medical Society. The software database is probably incomplete, the 10%-match threshold for defining plagiarism has not been statistically validated, and the study was confined to applicants to 1 institution. Evidence of matching content in an essay cannot be used to infer the applicant's intent and is not sensitive to variations in the cultural context of copying in some societies. Evidence of plagiarism in residency application essays is more common in international applicants but was found in those by applicants to all specialty programs, from all medical school types, and even among applicants with significant academic honors. No external funding.

  17. Simulation Activity in Otolaryngology Residencies.

    Science.gov (United States)

    Deutsch, Ellen S; Wiet, Gregory J; Seidman, Michael; Hussey, Heather M; Malekzadeh, Sonya; Fried, Marvin P

    2015-08-01

    Simulation has become a valuable tool in medical education, and several specialties accept or require simulation as a resource for resident training or assessment as well as for board certification or maintenance of certification. This study investigates current simulation resources and activities in US otolaryngology residency programs and examines interest in advancing simulation training and assessment within the specialty. Web-based survey. US otolaryngology residency training programs. An electronic web-based survey was disseminated to all US otolaryngology program directors to determine their respective institutional and departmental simulation resources, existing simulation activities, and interest in further simulation initiatives. Descriptive results are reported. Responses were received from 43 of 104 (43%) residency programs. Simulation capabilities and resources are available in most respondents' institutions (78.6% report onsite resources; 73.8% report availability of models, manikins, and devices). Most respondents (61%) report limited simulation activity within otolaryngology. Areas of simulation are broad, addressing technical and nontechnical skills related to clinical training (94%). Simulation is infrequently used for research, credentialing, or systems improvement. The majority of respondents (83.8%) expressed interest in participating in multicenter trials of simulation initiatives. Most respondents from otolaryngology residency programs have incorporated some simulation into their curriculum. Interest among program directors to participate in future multicenter trials appears high. Future research efforts in this area should aim to determine optimal simulators and simulation activities for training and assessment as well as how to best incorporate simulation into otolaryngology residency training programs. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  18. Training residents in problem-solving treatment of depression: a pilot feasibility and impact study.

    Science.gov (United States)

    Hegel, Mark T; Dietrich, Allen J; Seville, Janette L; Jordan, Caren B

    2004-03-01

    Primary care patients with depression may prefer or require a non-pharmacological treatment such as counseling. We investigated the feasibility of teaching family medicine residents an evidence-based brief counseling intervention for depression (Problem-solving Treatment of Depression for Primary Care [PST-PC]). Eleven residents over 3 consecutive years were provided a brief training program in PST-PC. Residents were evaluated for skill acquisition, changes in self efficacy, intentions to improve their care for depression, and post-residency integration of PST-PC into their daily practice. Trainees met established criteria for competency to administer PST-PC. They improved to moderate-to-high levels of self efficacy for treating depression, including for their counseling skills, and in their intentions to improve their depression management. At up to 3 years post residency, 90% indicated they were using PST-PC, often in a modified form, and also for illnesses other than depression. They indicated they would recommend the training to new residents. The PST-PC training program evaluated in this study is feasible in residency training and appears to influence practice post residency. These findings warrant continued investigation of this training program with a larger sample of residents and evaluation of outcomes with depressed patients treated with PST-PC in real-world practice settings.

  19. A survey of primary care resident attitudes toward continuity clinic patient handover

    Directory of Open Access Journals (Sweden)

    Victor O. Kolade

    2014-11-01

    Full Text Available Background: Transfer of clinic patients from graduating residents to interns or junior residents occurs every year, affecting large numbers of patients. Breaches in care continuity may occur, with potential for risk to patient safety. Several guidelines have been developed for implementing standardized inpatient sign-outs, but no specific guidelines exist for outpatient handover. Methods: Residents in primary care programs – internal medicine, family medicine, and pediatrics – at a US academic medical center were invited to participate in an online survey. The invitation was extended approximately 2 years after electronic medical record (EMR rollout began at the institution. Results: Of 71 eligible residents, 22 (31% responded to the survey. Of these, 18 felt that handover of ambulatory patients was at least moderately important – but only one affirmed the existence of a system for handover. IM residents perceived that they had the highest proportion of high-risk patients (p=0.042; transition-of-care letters were more important to IM residents than other respondents (p=0.041. Conclusion: There is room for improvement in resident acknowledgement of handover processes in continuity clinics. In this study, IM residents attached greater importance to a specific handover tool than other primary care residents. Thus, the different primary care specialties may need to have different handover tools available to them within a shared EMR system.

  20. Enhancing Mutual Respect among Nursing Assistants, Residents, and Residents' Families.

    Science.gov (United States)

    Heiselman, Terry; Noelker, Linda S.

    1991-01-01

    Interviewed nursing assistants (n=40) and nursing facility residents (n=37) regarding ways they experienced respect, disrespect, attachment, and distancing in their relationships with each other. As a result of finding evidence of disrespect, an inservice session on gaining respect as a nursing assistant was presented. (ABL)

  1. The Role of Visual Occlusion in Altitude Maintenance during Simulated Flight

    Science.gov (United States)

    Gray, R.; Geri, G. A.; Akhtar, S. C.; Covas, C. M.

    2008-01-01

    The use of visual occlusion as a cue to altitude maintenance in low-altitude flight (LAF) was investigated. The extent to which the ground surface is occluded by 3-D objects varies with altitude and depends on the height, radius, and density of the objects. Participants attempted to maintain a constant altitude during simulated flight over an…

  2. Moderate dementia: relational social engagement (RSE) during family visits.

    Science.gov (United States)

    Walmsley, Bruce; McCormack, Lynne

    2017-05-17

    This qualitative study seeks evidence of retained social awareness in individuals with moderate dementia residing in care-homes, when engaged in interactive family visits. Speech/non-speech data collected from 10/15-minute video-recorded family interactions of five family groups (12 individuals; 2 sessions per family group) were coded using thematic analysis. Interactional patterns embedded in familiar bonds provided the context for the superordinate theme: relational social engagement (RSE). This overarched two subthemes: in-step and out-of-step; highlighting that RSE, can occur as a result of both positive and negative familial communication patterns. When familial communication was in-step, despite changed communication pathways, the resident's attempts at social engagement appeared open, relaxed, and responsive. A sense of trust, and familiarity appeared to facilitate reciprocal understanding and the striving of resident family members to retain family group membership. When familial communication was out-of-step, active attempts at reciprocity or open engagement from visiting family members were not observed. At such times, communication became discordant, and frustrated in their efforts to remain an integral part of the family group, the resident appeared disinterested or guarded often retorting with annoyance at visiting family members. The construct of RSE appears specific to prior meaningful relationships, where optimal social awareness and communication, positive and negative, can occur. Currently, dementia assessment and care does not include RSE during family interactions. Implications are discussed.

  3. Cleaner in Hall of Residence

    Science.gov (United States)

    Hotel and Catering Industry Training Board, Wembley (England).

    This syllabus is intended for the use of training personnel in drawing up training programs for cleaners in halls of residence. Its main objective is to produce fully trained cleaners, thereby maintaining and raising standards. The syllabus is divided into three sections: Introduction to Housekeeping Employees, and Tasks Performed by the Majority…

  4. Resilience Approach for Medical Residents

    NARCIS (Netherlands)

    Bezemer, R.A.; Bos, E.W.

    2014-01-01

    Medical residents are in a vulnerable position. While still in training, they are responsible for patient care. They have a dependent relation with their supervisor and low decision latitude. An intervention was developed to increase individual and system resilience, addressing burnout, patient safe

  5. Transcriptome and network changes in climbers at extreme altitudes.

    Directory of Open Access Journals (Sweden)

    Fang Chen

    Full Text Available Extreme altitude can induce a range of cellular and systemic responses. Although it is known that hypoxia underlies the major changes and that the physiological responses include hemodynamic changes and erythropoiesis, the molecular mechanisms and signaling pathways mediating such changes are largely unknown. To obtain a more complete picture of the transcriptional regulatory landscape and networks involved in extreme altitude response, we followed four climbers on an expedition up Mount Xixiabangma (8,012 m, and collected blood samples at four stages during the climb for mRNA and miRNA expression assays. By analyzing dynamic changes of gene networks in response to extreme altitudes, we uncovered a highly modular network with 7 modules of various functions that changed in response to extreme altitudes. The erythrocyte differentiation module is the most prominently up-regulated, reflecting increased erythrocyte differentiation from hematopoietic stem cells, probably at the expense of differentiation into other cell lineages. These changes are accompanied by coordinated down-regulation of general translation. Network topology and flow analyses also uncovered regulators known to modulate hypoxia responses and erythrocyte development, as well as unknown regulators, such as the OCT4 gene, an important regulator in stem cells and assumed to only function in stem cells. We predicted computationally and validated experimentally that increased OCT4 expression at extreme altitude can directly elevate the expression of hemoglobin genes. Our approach established a new framework for analyzing the transcriptional regulatory network from a very limited number of samples.

  6. Altitude dependence of plasma density in the auroral zone

    Directory of Open Access Journals (Sweden)

    P. Janhunen

    Full Text Available We study the altitude dependence of plasma depletions above the auroral region in the 5000–30 000 km altitude range using five years of Polar spacecraft potential data. We find that besides a general decrease of plasma density with altitude, there frequently exist additional density depletions at 2–4 RE radial distance, where RE is the Earth radius. The position of the depletions tends to move to higher altitude when the ionospheric footpoint is sunlit as compared to darkness. Apart from these cavities at 2–4 RE radial distance, separate cavities above 4 RE occur in the midnight sector for all Kp and also in the morning sector for high Kp. In the evening sector our data remain inconclusive in this respect. This holds for the ILAT range 68–74. These additional depletions may be substorm-related. Our study shows that auroral phenomena modify the plasma density in the auroral region in such a way that a nontrivial and interesting altitude variation results, which reflects the nature of the auroral acceleration processes.

    Key words. Magnetospheric physics (auroral phenomena; magnetosphere–ionosphere interactions

  7. Physiological Changes at Altitude in Nonasthmatic and Asthmatic Subjects

    Directory of Open Access Journals (Sweden)

    Dianna Louie

    2004-01-01

    Full Text Available Exercised-induced asthma is not due to exercise itself per se, but rather is due to cooling and/or drying of the airway because of the increased ventilation that accompanies exercise. Travel to high altitudes is accompanied by increased ventilation of cool, often dry, air, irrespective of the level of exertion, and by itself, this could represent an 'exercise' challenge for asthmatic subjects. Exercise-induced bronchoconstriction was measured at sea level and at various altitudes during a two-week trek through the Himalayas in a group of nonasthmatic and asthmatic subjects. The results of this study showed that in mild asthmatics, there was a significant reduction in peak expiratory flow at very high altitudes. Contrary to the authors' hypothesis, there was not a significant additional decrease in peak expiratory flow after exercise in the asthmatic subjects at high altitude. However, there was a significant fall in arterial oxygen saturation postexercise in the asthmatic subjects, a change that was not seen in the nonasthmatic subjects. These data suggest that asthmatic subjects develop bronchoconstriction when they go to very high altitudes, possibly via the same mechanism that causes exercise-induced asthma.

  8. Joseph Barcroft's studies of high-altitude physiology.

    Science.gov (United States)

    West, John B

    2013-10-15

    Joseph Barcroft (1872-1947) was an eminent British physiologist who made contributions to many areas. Some of his studies at high altitude and related topics are reviewed here. In a remarkable experiment he spent 6 days in a small sealed room while the oxygen concentration of the air gradually fell, simulating an ascent to an altitude of nearly 5,500 m. The study was prompted by earlier reports by J. S. Haldane that the lung secreted oxygen at high altitude. Barcroft tested this by having blood removed from an exposed radial artery during both rest and exercise. No evidence for oxygen secretion was found, and the combination of 6 days incarceration and the loss of an artery was heroic. To obtain more data, Barcroft organized an expedition to Cerro de Pasco, Peru, altitude 4,300 m, that included investigators from both Cambridge, UK and Harvard. Again oxygen secretion was ruled out. The protocol included neuropsychometric measurements, and Barcroft famously concluded that all dwellers at high altitude are persons of impaired physical and mental powers, an assertion that has been hotly debated. Another colorful experiment in a low-pressure chamber involved reducing the pressure below that at the summit of Mt. Everest but giving the subjects 100% oxygen to breathe while exercising as a climber would on Everest. The conclusion was that it would be possible to reach the summit while breathing 100% oxygen. Barcroft was exceptional for his self-experimentation under hazardous conditions.

  9. Mobile platform of altitude measurement based on a smartphone

    Science.gov (United States)

    Roszkowski, Paweł; Kowalczyk, Marcin

    2016-09-01

    The article presents a low cost, fully - functional meter of altitude and pressure changes in a form of mobile application controlled by Android OS (operating system). The measurements are possible due to pressure sensor inserted in majority of latest modern mobile phones, which are known as smartphones. Using their computing capabilities and other equipment components like GPS receiver in connection with data from the sensor enabled authors to create a sophisticated handheld measuring platform with many unique features. One of them is a drawing altitude maps mode in which user can create maps of altitude changes just by moving around examined area. Another one is a convenient mode for altitude measurement. It is also extended with analysis tools which provide a possibility to compare measured values by displaying the data in a form of plots. The platform consists of external backup server, where the user can secure all gathered data. Moreover, the results of measurement's accuracy examination process which was executed after building the solution were shown. At the end, the realized meter of altitude was compared to other popular altimeters, which are available on the market currently.

  10. Changes of autonomic nervous system function in healthy young men during initial phase at acute high-altitude exposure

    Institute of Scientific and Technical Information of China (English)

    Qin Jun; Huang Lan; Tian Kaixin; Yu Shiyong; Yu Yang; Long Min

    2008-01-01

    Objective: To investigate the changes of autonomic nervous system (ANS) function during the initial phase at acute high-altitude exposure. Methods: Ninety-nine healthy sea-level male residents were studied in Chengdu plain and then Tibet plateau. Heart rate variability (HRV), cold pressor test (CPT), resting heart rate (HR) and blood pressure (BP) were measured at baseline (560 m altitude) and in 2 to 4 d after arriving at Tibet plateau (3 675 m altitude) to assess the ANS function. Results: Compared with baseline, on day 2 in Tibet the standard deviation of normal to normal intervals (SDNN), high-frequency (HF) power, total power (TP), root mean square of delta RR (rMSSD), percentage of delta RR>50 ms (PNN50), normalized high-frequency (Hfnu) and fractal dimension (FD) decreased significantly (SDNN, HF,TP P<0.01, rMSSD, PNNs0, Hfnu, FD P<0.05), while the normalized low-frequency (Lfnu) and LF/HF increased significantly (P<0.01). During day 3-4 in Tibet, SDNN, rMSSD, HF, TP and Hfnu tended to rebound while Lfnu and LF/HF decreased towards baseline day by day. In addition, in Tibet the increase in systolic pressure (SP) and diastolic pressure (DP) during CPT decreased significantly (P<0.01, 0.05), but resting HR increased compared with baseline (P<0.01). Conclusion: ANS modulation is generally blunted, and the relatively predominant sympathetic control is enhanced originally, then it reverts to the sea level states gradually during the initial days of acute high-altitude exposure.

  11. Acute emesis: moderately emetogenic chemotherapy

    DEFF Research Database (Denmark)

    Herrstedt, Jørn; Rapoport, Bernardo; Warr, David

    2011-01-01

    This paper is a review of the recommendations for the prophylaxis of acute emesis induced by moderately emetogenic chemotherapy as concluded at the third Perugia Consensus Conference, which took place in June 2009. The review will focus on new studies appearing since the Second consensus conference...... receiving multiple cycles of moderately emetogenic chemotherapy will be reviewed. Consensus statements are given, including optimal dose and schedule of serotonin(3) receptor antagonists, dexamethasone, and neurokinin(1) receptor antagonists. The most significant recommendations (and changes since the 2004...... version of the guidelines) are as follows: the best prophylaxis in patients receiving moderately emetogenic chemotherapy (not including a combination of an anthracycline plus cyclophosphamide) is the combination of palonosetron and dexamethasone on the day of chemotherapy, followed by dexamethasone...

  12. Modelling circumplanetary ejecta clouds at low altitudes: a probabilistic approach

    CERN Document Server

    Christou, Apostolos A

    2014-01-01

    A model is presented of a ballistic, collisionless, steady state population of ejecta launched at randomly distributed times and velocities and moving under constant gravity above the surface of an airless planetary body. Within a probabilistic framework, closed form solutions are derived for the probability density functions of the altitude distribution of particles, the distribution of their speeds in a rest frame both at the surface and at altitude and with respect to a moving platform such as an orbiting spacecraft. These expressions are validated against numerically-generated synthetic populations of ejecta under lunar surface gravity. The model is applied to the cases where the ejection speed distribution is (a) uniform (b) a power law. For the latter law, it is found that the effective scale height of the ejecta envelope directly depends on the exponent of the power law and increases with altitude. The same holds for the speed distribution of particles near the surface. Ejection model parameters can, t...

  13. Microcomputer-controlled high-altitude data aquisition system

    Science.gov (United States)

    1985-05-01

    A new microcomputer controlled high altitude data acquisition system was developed. The system provides a new technique for data acquisition from China's astronomical, meteorological and other high altitude experiments and opens up new territory in microcomputer applications. This microcomputer controlled high altitude data acquisition system is made up of a Z80 single board computer, 10 K memory expansion board, and keyboard and display board which can collect 16 analog signals simultaneously, and through analog/digital conversion can convert external analog signals into digital signals then encode them in a certain form through program modulation and store them on audio cassette. The data is immediately retrieved from the tape and sent to the surface microcomputer system for data processing and analysis.

  14. Pharmacy residents' attitudes toward pharmaceutical industry promotion.

    Science.gov (United States)

    Ashker, Sumer; Burkiewicz, Jill S

    2007-08-15

    The attitudes of pharmacy residents toward pharmaceutical industry promotion and the perceived effects of such promotion on the knowledge and professional practice of the residents were studied. A questionnaire study of current postgraduate year 1 and postgraduate year 2 pharmacy residents was conducted. Questions were adapted from instruments used in studies of medical student or physician attitudes regarding the pharmaceutical industry. The questionnaire requested demographic information about the resident, information regarding the resident's exposure to specific types of pharmaceutical company-related activities, and the resident's perception of whether the residency program or department had policies or guidelines regarding interactions with the pharmaceutical industry. Questions investigated the attitudes toward pharmaceutical industry promotion and the perceived influence of pharmaceutical industry promotion on the professional knowledge and behavior of the residents. Responses were received from 496 pharmacy residents. Nearly all (89%) residents agreed that pharmaceutical company-sponsored educational events enhance knowledge. Almost half (43%) of the respondents reported that information from educational events influences therapeutic recommendations. One quarter (26%) of the pharmacy residents indicated prior training regarding pharmacist-industry interactions, and most (60%) residents indicated that their institution's residencies or departments have policies regarding interactions with the pharmaceutical industry. Most surveyed pharmacy residents believed that educational events sponsored by pharmaceutical companies enhance knowledge. Respondents whose institutions had policies or who had received training about such events were less likely than other respondents to perceive an influence of the events on their knowledge and behavior.

  15. High incidence of abnormal glucose metabolism in acute coronary syndrome patients at a moderate altitude: A sub-Himalayan study

    Directory of Open Access Journals (Sweden)

    Jitender Mokta

    2017-01-01

    Full Text Available Background: Abnormal glucose metabolic status at admission is an important marker of future cardiovascular events and long-term mortality after acute coronary syndrome (ACS, whether or not they are known diabetics. Objective: The aims were to study the prevalence of abnormal glucose metabolism in ACS patients and to compare the different methods of diagnosing diabetes in ACS patients. Methods: We did a prospective study. About 250 consecutive nondiabetic patients (200 men and 50 women with ACS admitted to a tertiary care institute of Himachal Pradesh in 1 year were enrolled. Admission plasma glucose, next morning fasting plasma glucose (FPG, A1C, and a standardized 75-g oral glucose tolerance test (OGTT 72 h after admission were done. Glucose metabolism was categorized as normal glucose metabolism, impaired glucose metabolism (impaired fasting glucose or impaired glucose tolerance [IGT], and diabetes. Diabetes was arbitrarily classified further as undiagnosed (HBA1c ≥6.5% or possibly stress diabetes (HBA1c <6.5%. A repeat OGTT after 3 months in objects with IGT and stress hyperglycemia at a time of admission was done. Results: The mean age was 54 ± 12.46 years. The mean plasma glucose at admission was 124 ± 53.96 mg/dL, and the mean FPG was 102 ± 27.07 mg/dL. The mean 2-h postglucose load concentration was 159.5 ± 56.58 mg/dL. At baseline, 95 (38% had normal glucose metabolism, 95 (38% had impaired glucose metabolism (IGT and or IGT and 60 (24% had diabetes; 48 (19.2% were undiagnosed diabetes and 12 (4.8% had stress hyperglycemia. At follow up 58.66% and 55.55% of patients with impaired glucose tolerance and stress hyperglycemia continued to have impaired glucose tolerance respectively. About 75 gm OGTT has highest sensitivity and specificity to diagnose diabetes, whereas A1C most specific to rule out stress hyperglycemia. Conclusions: In this small hilly state of India, abnormal glucose metabolism (previously undiagnosed diabetes and IGT is common in patients admitted with ACS. Abnormal glucometabolic status can be detected early in the postadmission period. Our results further suggest that 75-g OGTT remained the gold standard test to detect diabetes and could be used before discharge to diagnose diabetes.

  16. High incidence of abnormal glucose metabolism in acute coronary syndrome patients at a moderate altitude: A sub-Himalayan study

    Science.gov (United States)

    Mokta, Jitender; Kumar, Subash; Ganju, Neeraj; Mokta, Kiran; Panda, Prashant Kumar; Gupta, Swatantra

    2017-01-01

    Background: Abnormal glucose metabolic status at admission is an important marker of future cardiovascular events and long-term mortality after acute coronary syndrome (ACS), whether or not they are known diabetics. Objective: The aims were to study the prevalence of abnormal glucose metabolism in ACS patients and to compare the different methods of diagnosing diabetes in ACS patients. Methods: We did a prospective study. About 250 consecutive nondiabetic patients (200 men and 50 women) with ACS admitted to a tertiary care institute of Himachal Pradesh in 1 year were enrolled. Admission plasma glucose, next morning fasting plasma glucose (FPG), A1C, and a standardized 75-g oral glucose tolerance test (OGTT) 72 h after admission were done. Glucose metabolism was categorized as normal glucose metabolism, impaired glucose metabolism (impaired fasting glucose or impaired glucose tolerance [IGT]), and diabetes. Diabetes was arbitrarily classified further as undiagnosed (HBA1c ≥6.5%) or possibly stress diabetes (HBA1c <6.5%). A repeat OGTT after 3 months in objects with IGT and stress hyperglycemia at a time of admission was done. Results: The mean age was 54 ± 12.46 years. The mean plasma glucose at admission was 124 ± 53.96 mg/dL, and the mean FPG was 102 ± 27.07 mg/dL. The mean 2-h postglucose load concentration was 159.5 ± 56.58 mg/dL. At baseline, 95 (38%) had normal glucose metabolism, 95 (38%) had impaired glucose metabolism (IGT and or IGT) and 60 (24%) had diabetes; 48 (19.2%) were undiagnosed diabetes and 12 (4.8%) had stress hyperglycemia. At follow up 58.66% and 55.55% of patients with impaired glucose tolerance and stress hyperglycemia continued to have impaired glucose tolerance respectively. About 75 gm OGTT has highest sensitivity and specificity to diagnose diabetes, whereas A1C most specific to rule out stress hyperglycemia. Conclusions: In this small hilly state of India, abnormal glucose metabolism (previously undiagnosed diabetes and IGT) is common in patients admitted with ACS. Abnormal glucometabolic status can be detected early in the postadmission period. Our results further suggest that 75-g OGTT remained the gold standard test to detect diabetes and could be used before discharge to diagnose diabetes. PMID:28217514

  17. Substrate utilization in sea level residents during exercise in acute hypoxia and after 4 weeks of acclimatization to 4100 m

    DEFF Research Database (Denmark)

    Lundby, C; Van Hall, Gerrit

    2002-01-01

    To investigate the effect of acclimatization to hypoxia on substrate utilization, eight sea level residents were studied during exercise at the same relative (rel) and absolute (abs) work rate as at sea level (SL), under acute (AH), and after 4 weeks exposure to 4100 m altitude (CH). Carbohydrate...... utilization is unaffected by AH and CH, when the work rate is matched to the same relative intensity as at SL....

  18. Prevalence of Anemia among Older Adults Residing in the Coastal and Andes Mountains in Ecuador: Results of the SABE Survey

    Science.gov (United States)

    2017-01-01

    Objectives. To estimate the prevalence of anemia and its determinants among older adults in Ecuador. Methods. The present study was based on data from the National Survey of Health, Wellbeing, and Aging. Hemoglobin concentrations were adjusted by participants' smoking status and altitude of residence, and anemia was defined according to the World Health Organization criteria (Ecuador. Moreover, further research is needed to examine the association between anemia and adverse health-related outcomes among older Ecuadorians. PMID:28321252

  19. Hyperuricemia, hypertension, and proteinuria associated with high-altitude polycythemia.

    Science.gov (United States)

    Jefferson, J Ashley; Escudero, Elizabeth; Hurtado, Maria-Elena; Kelly, Jackeline Pando; Swenson, Erik R; Wener, Mark H; Burnier, Michel; Maillard, Marc; Schreiner, George F; Schoene, Robert B; Hurtado, Abdias; Johnson, Richard J

    2002-06-01

    Chronic exposure to high altitude is associated with the development of erythrocytosis, proteinuria, and, in some cases, hyperuricemia. We examined the relationship between high-altitude polycythemia and proteinuria and hyperuricemia in Cerro de Pasco, Peru (altitude, 4,300 m). We studied 25 adult men with hematocrits less than 65% and 27 subjects with excessive erythrocytosis (EE; hematocrit > 65%) living in Cerro de Pasco, Peru and compared them with 28 control subjects living in Lima, Peru (at sea level) and after 48 hours of exposure to high altitude. Serum urate levels were significantly elevated in patients with EE at altitude, and gout occurred in 4 of 27 of these subjects. Urate level strongly correlated with hematocrit (r = 0.71; P < 0.0001). Urate production (24-hour urine urate excretion and urine urate-creatinine ratio) was increased in this group compared with those at sea level. Fractional urate excretion was not increased, and fractional lithium excretion was reduced, in keeping with increased proximal reabsorption of filtrate. Significantly higher blood pressures and decreased renin levels in the EE group were in keeping with increased proximal sodium reabsorption. Serum urate levels correlated with mean blood pressure (r = 0.50; P < 0.0001). Significant proteinuria was more prevalent in the EE group despite normal renal function. Hyperuricemia is common in subjects living at high altitude and associated with EE, hypertension, and proteinuria. The increase in uric acid levels appears to be caused by increased urate generation secondary to systemic hypoxia, although a relative impairment in renal excretion also may contribute.

  20. Wilderness medicine at high altitude: recent developments in the field

    Directory of Open Access Journals (Sweden)

    Shah NM

    2015-09-01

    Full Text Available Neeraj M Shah,1 Sidra Hussain,2 Mark Cooke,3 John P O’Hara,3 Adrian Mellor3,4 1Division of Asthma, Allergy and Lung Biology, King’s College London, UK; 2School of Medicine, University College London, London, UK; 3Research Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK; 4Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, Birmingham, UK Abstract: Travel to high altitude is increasingly popular. With this comes an increased incidence of high-altitude illness and therefore an increased need to improve our strategies to prevent and accurately diagnose these. In this review, we provide a summary of recent advances of relevance to practitioners who may be advising travelers to altitude. Although the Lake Louise Score is now widely used as a diagnostic tool for acute mountain sickness (AMS, increasing evidence questions the validity of doing so, and of considering AMS as a single condition. Biomarkers, such as brain natriuretic peptide, are likely correlating with pulmonary artery systolic pressure, thus potential markers of the development of altitude illness. Established drug treatments include acetazolamide, nifedipine, and dexamethasone. Drugs with a potential to reduce the risk of developing AMS include nitrate supplements, propagators of nitric oxide, and supplemental iron. The role of exercise in the development of altitude illness remains hotly debated, and it appears that the intensity of exercise is more important than the exercise itself. Finally, despite copious studies demonstrating the value of preacclimatization in reducing the risk of altitude illness and improving performance, an optimal protocol to preacclimatize an individual remains elusive. Keywords: hypoxia, acute mountain sickness, acclimatization, biomarkers, preacclimatization

  1. A patient safety curriculum for medical residents based on the perspectives of residents and supervisors.

    NARCIS (Netherlands)

    Jansma, J.D.; Wagner, C.; Bijnen, A.B.

    2011-01-01

    Objectives: To develop a patient safety course for medical residents based on the views of medical residents and their supervisors. Methods: In 2007, questionnaires were distributed to investigate residents' and supervisors' perspectives on the current patient safety performance and educational

  2. [Sperm count and seminal biochemistry of high altitude inhabitants and patients with chronic altitude sickness].

    Science.gov (United States)

    García-Hjarles, M A

    1989-04-01

    Semen analysis has been studied in 9 healthy adult males from sea level (150 m), age 19-32 years old and 15 healthy males from high altitude (NA), 9 from Cerro de Pasco (4,300 m) and 6 from Morococha (4,540 m), ages 19-45 years old. Five patients with chronic mountain sickness (MMC), whose ages ranged from 23 to 52 years old were also studied. The volume and motility were similar in NA and MMC, however both were below than in sea level subjects, but still in the normal range; the number of spermatozoa per 1 ml was lower at sea level than in NA and MMC, although the total number was higher at sea level due to the higher semen volume. Fructose at sea level was 356 +/- 53 mg/100 ml (mean +/- S.E.) which is similar to NA 237 +/- 45 whereas a MMC was significantly lower, 142 +/- 60. Citric acid was lower at sea level than in NA and MMC. Na, K and Cl, were similar among the three groups. The lower concentration of fructose in MMC parallels the decreased testicular function already found in these groups. However it is worthy to point out that the fertility is preserved in all the groups. The normal reproductive function in MMC is against the concept that this process occurs as a consequence of environmental disadaptation.

  3. Measuring the competence of residents as teachers.

    Science.gov (United States)

    Zabar, Sondra; Hanley, Kathleen; Stevens, David L; Kalet, Adina; Schwartz, Mark D; Pearlman, Ellen; Brenner, Judy; Kachur, Elizabeth K; Lipkin, Mack

    2004-05-01

    Medical residents, frontline clinical educators, must be competent teachers. Typically, resident teaching competence is not assessed through any other means than gleaning learner's comments. We developed, evaluated, and integrated into our annual objective structured clinical examination a resident teaching skills assessment using "standardized" students. Faculty observers rated residents using a customized 19-item rating instrument developed to assess teaching competencies that were identified and defined as part of our project. This was feasible, acceptable, and valuable to all 65 residents, 8 students, and 16 faculty who participated. Teaching scenarios have potential as reliable, valid, and practical measures of resident teaching skills.

  4. Grappling the High Altitude for Safe Edible Bamboo Shoots with Rich Nutritional Attributes and Escaping Cyanogenic Toxicity

    Directory of Open Access Journals (Sweden)

    Sayanika Devi Waikhom

    2013-01-01

    Full Text Available Consumption of bamboo species with high level of total cyanogenic content (TCC in Asia by many ethnic groups is significantly associated with food poisoning and occasionally Konzo (a neurological disorder. Adequate characterization of edible bamboo species with low level of TCC and high nutritious attributes is required for consumer’s safety as well as for the conservation of the gene pool. Here, we employed morphological descriptors, atomic absorption spectrophotometer, RAPD, and trnL-F intergenic spacer to characterize 15 indigenous edible bamboo species of north-east India. The study indicates that morphologically and genetically evolved edible bamboo species having large and robust bamboo-shoot texture and growing at low altitude contain high level of TCC, low antioxidant properties, and low levels of beneficial macronutrients and micronutrients. Importantly, Dendrocalamus species are shown to be rich in TCC irrespective of the growing altitude while Bambusa species are found to have moderate level of TCC. The findings clearly demonstrated that Chimonobambusa callosa growing at high altitude represents safe edible bamboo species with nutritious attributes.

  5. Influence of Atmospheric Solar Radiation Absorption on Photodestruction of Ions at D-Region Altitudes of the Ionosphere

    Science.gov (United States)

    Pavlov, A. V.

    2016-07-01

    The influence of atmospheric solar radiation absorption on the photodetachment, dissociative photodetachment, and photodissociation rate coefficients (photodestruction rate coefficients) of O-, Cl-, O2 -, O3 -, OH-, NO2 -, NO3 -, O4 -, OH-(H2O), CO3 -, CO4 -, ONOO-, HCO3 -, CO3 -(H2O), NO3 -(H2O), O2 +(H2O), O4 +, N4 +, NO+(H2O), NO+(H2O)2, H+(H2O) n for n = 2-4, NO+(N2), and NO+(CO2) at D-region altitudes of the ionosphere is studied. A numerical one-dimensional time-dependent neutral atmospheric composition model has been developed to estimate this influence. The model simulations are carried out for the geomagnetically quiet time period of 15 October 1998 at moderate solar activity over the Boulder ozonesonde. If the solar zenith angle is not more than 90° then the strongest influence of atmospheric solar radiation absorption on photodestruction of ions is found for photodissociation of CO4 - ions when CO3 - ions are formed. It follows from the calculations that decreases in the photodestruction rate coefficients of ions under consideration caused by this influence are less than 2 % at 70 km altitude and above this altitude if the solar zenith angle does not exceed 90°.

  6. Evaluation of ethics education in obstetrics and gynecology residency programs.

    Science.gov (United States)

    Byrne, John; Straub, Heather; DiGiovanni, Laura; Chor, Julie

    2015-03-01

    The objective of the study was to assess the current status of ethics education in obstetrics-gynecology residency programs. A cross-sectional, web-based survey was designed in conjunction with a professional survey laboratory at the University of Chicago. The survey was piloted with a convenience sample of clinical medical ethics fellows to assess question content and clarity. The survey was deployed by e-mail to all obstetrics-gynecology residency program directors. Descriptive statistics were used to analyze participant responses. The University of Chicago's Institutional Review Board deemed this study exempt from institutional review board formal review. Of 242 eligible obstetrics-gynecology residency program directors, 118 (49%) completed the survey. Most respondents were from university-based programs (n = 78, 66%) that were not religiously affiliated (n = 98, 83%) and trained 4-6 residents per postgraduate year (n = 64, 70%). Although 50% of program directors (n = 60) reported having ethics as part of their core curriculum, most programs teach ethics in an unstructured manner. Fifty-seven percent of respondents (n = 66) stated their program dedicated 5 or fewer hours per year to ethics. The majority of program directors (n = 80, 73%) responded they would like more to a lot more ethics education and believed that ethics education should be required (n = 93, 85%) for residents to complete their training. Respondents identified that crowding in the curriculum was a significant barrier to increased ethics training (n = 50, 45%) and two-thirds (n = 74, 67%) reported a lack of faculty expertise as a moderate barrier to providing ethics education in the residency curriculum. This study found that a lack of structured curricula, inadequate faculty expertise, and limited time were important barriers for ethics education in obstetrics-gynecology programs across the nation. Despite these existing challenges, program directors have a strong interest in increasing ethics

  7. Moderate Secularism and Multicultural Equality

    DEFF Research Database (Denmark)

    Lægaard, Sune

    2008-01-01

    provides a response to a prominent argument against multicultural accommodation of religious minorities, what is really at stake in discussions of multiculturalism and secularism are political principles. Modood's case for accommodation of Muslims along the lines of moderate secularism presupposes...... a normative conception of equality, but his characterisation of multicultural equality is inadequate in several respects...

  8. Work-Related Quality of Life among Medical Residents at a University Hospital in Northeastern Thailand.

    Science.gov (United States)

    Somsila, Nattamon; Chaiear, Naesinee; Boonjaraspinyo, Sirintip; Tiamkao, Somsak

    2015-12-01

    1) To assess work-related quality of life (WRQOL) among medical residents at a university hospital in northeast Thailand. 2) To determine the strength of the association between personal and working condition components and WRQOL among medical residents. A descriptive study was used to describe the WRQOL among medical residents. The study population comprised of all 375 residents affiliated with the university hospital. The Thai version of a self-administered work-related quality of life scale-2 was used for data collection. Testing the reliability revealed a Cronbach's alpha of 0.908. Questionnaires were completed by 259 of 375 (68.3%). The study found that the mean rating by residents for overall WRQOL was 113.8 out of 170 (SD 14.8). Most rated WRQOL as moderate (76.6%). The seven sub-factors were rated as moderate to high for employee engagement and control at work, moderate for home/work interface, general well-being and working conditions, high-moderate for job career satisfaction, and low-moderate for stress at work. Relationships between the personal and working condition components and WRQOL were analyzed using binary logistic regression. Residents in minor specialties had a higher WRQOL than those in major specialties (OR 2.522, 95% CI: 1.37, 4.63). Residents who had less than eight duty shifts/week had a higher WRQOL than those with more than eight duty shifts/week (OR 2.263, 95% CI: 1.16, 4.41). Similarly, residents working with less than 80 hours/week had a higher WRQOL than those working more than 80 hours/week (OR 2.344, 95% CI: 1.17, 4.72). A subgroup analyzes of those working in minor specialties showed the trend that working less than eight shifts/month and working less than 80 hours/week had the potential association with good quality of work-life (QWL). This phenomenon is presented in the subgroup analyses of those working in major specialties. Therefore, working hours and number of shifts might have played important role in contributing good QWL

  9. Teaching professionalism in orthopaedic residency.

    Science.gov (United States)

    Cornwall, R

    2001-04-01

    Two residents, wearing white coats with their names and "Department of Orthopaedics" conspicuously embroidered on them, boarded a hospital elevator crowded with physicians, employees, and visitors. In a clearly audible voice, one resident began a story: "You should have seen the patient I saw in my clinic the other day. She was beautiful. I should send her to see Dr. W. He would love to see her!" This comment drew the undivided attention of everyone in the elevator and cast a ghastly silence over the rest of the ride. In recent years, interest has expanded regarding professionalism and its importance in medicine and surgery. Orthopaedic surgery is no exception, as the topic has recently reached prominence in our literature and policies. It is unlikely that professionalism is a universal and innate characteristic of college students entering medical school, yet it becomes a necessary value in medical practice. Somewhere in the ongoing process of medical education, the issue must be addressed.

  10. Beyond requirements: residency management through the Internet.

    Science.gov (United States)

    Civetta, J M; Morejón, O V; Kirton, O C; Reilly, P J; Serebriakov, I I; Dobkin, E D; D'Angelica, M; Antonetti, M

    2001-04-01

    An Internet application could collect information to satisfy documentation required by the Residency Review Committee. Beyond replacing a difficult and inefficient paper system, it would collect, process, and distribute information to administration, faculty, and residents. Descriptive study. An integrated residency of 18 services at a university teaching hospital with 4 affiliated institutions. Residency administrators, faculty, and residents. The application included a procedure recorder, resident evaluation of faculty and rotations, goals and objectives (stratified by service and resident level), and matching faculty evaluation of residents with these goals as competencies. Policies, schedules, research opportunities, clinical site information, and curriculum support were created. Degree of compliance with Residency Review Committee standards, number of deficiencies corrected, and quantity and quality of information available to administration, faculty, and residents. The Internet system increased resident compliance for faculty and rotation evaluations from 20% and 34%, respectively, to 100%, which was maintained for 22 months. These evaluations can be displayed individually, in summary grids, and as postgraduate year-specific averages. Faculty evaluations of residents can be reviewed throughout the system. The defined category report for procedures, which had deficiencies in the preceding 6 years, had none for the last 2 years. The Internet application provides Accreditation Council for Graduate Medical Education-validated operative logs to regulatory agencies. A Web-based system can satisfy requirements and provide processed data that are of better quality and more complete than our paper system. We are now able to use scarce time and personnel to nurture developing surgical residents instead of shuffling paper.

  11. Iron Supplementation and Altitude: Decision Making Using a Regression Tree

    Directory of Open Access Journals (Sweden)

    Laura A. Garvican-Lewis, Andrew D. Govus, Peter Peeling, Chris R. Abbiss, Christopher J. Gore

    2016-03-01

    Full Text Available Altitude exposure increases the body’s need for iron (Gassmann and Muckenthaler, 2015, primarily to support accelerated erythropoiesis, yet clear supplementation guidelines do not exist. Athletes are typically recommended to ingest a daily oral iron supplement to facilitate altitude adaptations, and to help maintain iron balance. However, there is some debate as to whether athletes with otherwise healthy iron stores should be supplemented, due in part to concerns of iron overload. Excess iron in vital organs is associated with an increased risk of a number of conditions including cancer, liver disease and heart failure. Therefore clear guidelines are warranted and athletes should be discouraged from ‘self-prescribing” supplementation without medical advice. In the absence of prospective-controlled studies, decision tree analysis can be used to describe a data set, with the resultant regression tree serving as guide for clinical decision making. Here, we present a regression tree in the context of iron supplementation during altitude exposure, to examine the association between pre-altitude ferritin (Ferritin-Pre and the haemoglobin mass (Hbmass response, based on daily iron supplement dose. De-identified ferritin and Hbmass data from 178 athletes engaged in altitude training were extracted from the Australian Institute of Sport (AIS database. Altitude exposure was predominantly achieved via normobaric Live high: Train low (n = 147 at a simulated altitude of 3000 m for 2 to 4 weeks. The remaining athletes engaged in natural altitude training at venues ranging from 1350 to 2800 m for 3-4 weeks. Thus, the “hypoxic dose” ranged from ~890 km.h to ~1400 km.h. Ethical approval was granted by the AIS Human Ethics Committee, and athletes provided written informed consent. An in depth description and traditional analysis of the complete data set is presented elsewhere (Govus et al., 2015. Iron supplementation was prescribed by a sports physician

  12. [Medical ethics in residency training].

    Science.gov (United States)

    Civaner, Murat; Sarikaya, Ozlem; Balcioğlu, Harun

    2009-04-01

    Medical ethics education in residency training is one of the hot topics of continuous medical education debates. Its importance and necessity is constantly stressed in declarations and statements on national and international level. Parallel to the major structural changes in the organization and the finance model of health care system, patient-physician relationship, identity of physicianship, social perception and status of profession are changing. Besides, scientific developments and technological advancements create possibilities that never exists before, and bring new ethical dilemmas along with. To be able to transplant human organs has created two major problems for instance; procurement of organs in sufficient numbers, and allocating them to the patients in need by using some prioritizing criteria. All those new and challenging questions force the health care workers to find authentic and justifiable solutions while keeping the basic professional values. In that sense, proper medical ethics education in undergraduate and postgraduate term that would make physician-to-be's and student-physicians acquire the core professional values and skill to notice, analyze and develop justifiable solutions to ethical problems is paramount. This article aims to express the importance of medical ethics education in residency training, and to propose major topics and educational methods to be implemented into. To this aim, first, undergraduate medical education, physician's working conditions, the exam of selection for residency training, and educational environment were revised, and then, some topics and educational methods, which are oriented to educate physicians regarding the professional values that they should have, were proposed.

  13. An Exploratory Analysis of Work Engagement, Satisfaction, and Depression in Psychiatry Residents.

    Science.gov (United States)

    Agarwal, Gaurava; Karpouzian, Tatiana

    2016-02-01

    This exploratory study aims to measure work engagement levels in psychiatry residents at three psychiatry residency programs using the Utrecht Work Engagement Scale (UWES). In addition, the study investigates the relationship between total engagement and its subscales, resident satisfaction, and a depression screen. Recruitment of 53/79 residents from three psychiatry residency programs in Illinois was completed. The residents were administered a questionnaire consisting of the UWES, the Primary Care Evaluation of Mental Disorders (Prime-MD) depression screen, and a residency satisfaction scale. Statistical analysis using independent samples t test and a one-way analysis of variance was used to assess differences on engagement total score and subscales and satisfaction scale. A logistic regression was used with the engagement subscales and the satisfaction scale as predictors of belonging to the depressed or non-depressed group. Psychiatry residents scored in the high range for total engagement and all its subscales except for vigor which was in the moderate range. Residents who screened positive for depression reported lower total engagement than those who were negative on the depression screen. Vigor was the only significant predictor (p = .004) of being in the depressed group after logistic regression. Total engagement and the subscale of dedication significantly predicted overall residency satisfaction (β = .473, p = .016). Higher total UWES-15 and its subscales of vigor and dedication are correlated with a lower rate of screening positive for depression and higher residency satisfaction. This exploratory study lends support for further study of this psychological construct in medical training programs, but replication is needed.

  14. Risk prediction score for severe high altitude illness: a cohort study.

    Directory of Open Access Journals (Sweden)

    Florence Canouï-Poitrine

    Full Text Available Risk prediction of acute mountain sickness, high altitude (HA pulmonary or cerebral edema is currently based on clinical assessment. Our objective was to develop a risk prediction score of Severe High Altitude Illness (SHAI combining clinical and physiological factors. Study population was 1017 sea-level subjects who performed a hypoxia exercise test before a stay at HA. The outcome was the occurrence of SHAI during HA exposure. Two scores were built, according to the presence (PRE, n = 537 or absence (ABS, n = 480 of previous experience at HA, using multivariate logistic regression. Calibration was evaluated by Hosmer-Lemeshow chisquare test and discrimination by Area Under ROC Curve (AUC and Net Reclassification Index (NRI.The score was a linear combination of history of SHAI, ventilatory and cardiac response to hypoxia at exercise, speed of ascent, desaturation during hypoxic exercise, history of migraine, geographical location, female sex, age under 46 and regular physical activity. In the PRE/ABS groups, the score ranged from 0 to 12/10, a cut-off of 5/5.5 gave a sensitivity of 87%/87% and a specificity of 82%/73%. Adding physiological variables via the hypoxic exercise test improved the discrimination ability of the models: AUC increased by 7% to 0.91 (95%CI: 0.87-0.93 and 17% to 0.89 (95%CI: 0.85-0.91, NRI was 30% and 54% in the PRE and ABS groups respectively. A score computed with ten clinical, environmental and physiological factors accurately predicted the risk of SHAI in a large cohort of sea-level residents visiting HA regions.

  15. Impacto de la altura en el embarazo y en el producto de la gestación Impact of high altitude on pregnancy and newborn parameters

    Directory of Open Access Journals (Sweden)

    Gustavo F. Gonzales

    2012-06-01

    Full Text Available Esta revisión describe los procesos asociados con mantener un embarazo en mujeres nacidas al nivel del mar que cursan su embarazo en la altura; en aquellas que viajan intermitentemente, o las que nacen y residen en la altura. La literatura examinada demuestra que la frecuencia de malformaciones congénitas es elevada en la altura; que las tasas de mortalidad fetal tardía, nacidos pequeños para su edad gestacional, y preeclampsia se encuentran incrementadas en la altura, asociadas a valores altos de hemoglobina materna (>14,5 g/dL. En conclusión, el embarazo en una mujer expuesta de forma aguda, intermitente o permanente a las grandes alturas, genera mayores riesgos en comparación con un embarazo desarrollado a nivel del mar.This review describes adverse outcomes in pregnancy after brief, intermittent, or permanent residence at high altitudes. Review of literature shows that congenital malformations rates are higher at high altitudes. Additionally, rates of stillbirths, small size for gestational age, and preeclampsia are increased in populations living at high altitudes and are associated with high maternal hemoglobin levels (>14.5 g/dl. In conclusion, a pregnant woman exposed briefly, intermittently, or permanently to high altitudes results in increased risk of adverse outcomes when compared to pregnancies observed at sea level.

  16. Intolerance of ambiguity among family practice residents.

    Science.gov (United States)

    DeForge, B R; Sobal, J

    1991-08-01

    The art of clinical medicine involves learning to deal with varying levels of ambiguity and uncertainty. Tolerance of ambiguity was examined by giving Budner's Intolerance of Ambiguity Scale to a sample of 37 family practice residents from a university hospital residency and 22 from a community hospital residency. Residents in both the community and university programs had similar scores. No differences existed between men and women. Compared to studies of medical students, first-year family practice residents were slightly more intolerant of ambiguity. However, intolerance of ambiguity was lower among third-year residents, suggesting that as training advances, residents may become more tolerant of ambiguity. The residency training process may lead to a reduction in intolerance of ambiguity, which produces physicians who can deal with the ambiguity and uncertainty of clinical practice.

  17. Framing resident acceptance of sustainable renovation

    NARCIS (Netherlands)

    Boess, S.U.

    2015-01-01

    This paper presents the initial theoretical framework adopted for a study into resident acceptance of sustainable renovation. Seven expert interviews and two retrospective case studies revealed that the relationship between social housing residents and the renovation process requires careful attenti

  18. [Burnout in Tunisian medical residents: About 149 cases].

    Science.gov (United States)

    Ben Zid, A; Homri, W; Ben Romdhane, I; Bram, N; Labbane, R

    2017-09-01

    Burnout is a professional psychological chronic stress-induced syndrome defined by three dimensions: emotional exhaustion, depersonalization, and low personal accomplishment. This syndrome concerns all professions but especially healthcare staff. Numerous studies have attempted to document the impact of work activities on the doctor's mental health. According to the literature, junior doctors are more vulnerable to develop this syndrome. Are to determine the prevalence of severe burnout among residents of different specialties: anesthesiology, general surgery, emergency medicine, psychiatry, basic sciences. The secondary end points are to analyze risk factors, causes and consequences associated with burnout. A cross-sectional study conducted among medical residents working in hospitals located in the governorates of Tunis. Three instruments were used: an anonymous self-administered questionnaire, Maslach Burnout Inventory (MBI) to assess burnout, and Abstract Beck Depression Inventory to evaluate the intensity of depression. Severe burnout was defined as a severely high level of both emotional exhaustion and depersonalization associated with a severely low level of personal accomplishment. A total of 149 participants (response rate=76.8%) participated in the survey. Among participants, 17.14% (n=26) had a severe burnout. The emergency medicine residents had the highest rate of emotional exhaustion and depersonalization and severe depression. Overall, resident respondents, 31% (n=46), had moderate to severe depression. Among stress factors, those significantly correlated to burnout were: lack of hobbies (Pburnout were: Antecedents of specialty change (P=0.017) and desire for a specialty change (Pburnout was not found. Medical residents in all specialties are at risk of burnout. Nevertheless, this study revealed that some specialties are more exhausting, which is consistent with the results reported in the literature. Moreover, it is shown that several stress factors

  19. Variation of environmental neutron flux with altitude and depth of both water and soil

    Institute of Scientific and Technical Information of China (English)

    K. KOMURA; N.K. AHMED; A.H. EL-KAMEL; A.M.M. YOUSEF

    2004-01-01

    Applying the extreme low-level γ-ray spectroscopic analysis the environmental neutron flux is measured using different moderator construction and environment through the reaction 197Au (n, γ) 198Au. The contribution of thermal and resonance neutrons is separated using the cadmium difference technique, while fast neutrons are measured by the paraffin moderator. The results of altitude dependence of the neutron flux are discussed. The thermal neutron flux near the surface of sea water is less than its value at 100 cm over ground near sea water, while the value over the surfaces of fresh water is higher than that near the surface of sea water. Also the thermal neutron flux at 5 cm soil depth increases, then decreases to its original value at 10 cm depth and still constant until 25 cm, then decreases rapidly to reach 27% of its original value at 60 cm depth. The soil compositions, corresponding neutron temperatures and effective absorption cross sections of earth are the most effective factors on the equilibrium region of thermal neutrons in the ground.

  20. PHYSICAL ADAPTATION OF CHILDREN TO LIFE AT HIGH-ALTITUDE

    NARCIS (Netherlands)

    DEMEER, K; HEYMANS, HSA; ZIJLSTRA, WG

    1995-01-01

    Children permanently exposed to hypoxia at altitudes of > 3000 m above sea level show a phenotypical form of adaptation. Under these environmental conditions, oxygen uptake in the lungs is enhanced by increases in ventilation, lung compliance, and pulmonary diffusion. Lung and thorax volumes in chil

  1. Climate Change Impacts on High-Altitude Ecosystems

    Directory of Open Access Journals (Sweden)

    Harald Pauli

    2016-02-01

    Full Text Available Reviewed: Climate Change Impacts on High-Altitude Ecosystems By Münir Öztürk, Khalid Rehman Hakeem, I. Faridah-Hanum and Efe. Recep, Cham, Switzerland: Springer International Publishing, 2015. xvii + 696 pp. US$ 239.00. ISBN 978-3-319-12858-0.

  2. Pathophysiology of acute mountain sickness and high altitude pulmonary oedema

    DEFF Research Database (Denmark)

    Sutton, J R; Lassen, N

    1979-01-01

    We review the evidence that acute mountain sickness (AMS) and high altitude pulmonary oedema (HAPO) occur together more often than is realized. We hypothesize that AMS and HAPO have a common pathophysiological basis: both are due to increased pressure and flow in the microcirculation, causing...

  3. Chicxulub High-Altitude Ballistic Ejecta from Central Belize

    Science.gov (United States)

    Pope, K. O.; Ocampo, A. C.

    2000-01-01

    Chicxulub ejecta are found in central Belize, 475 km southeast of the impact crater center. These deposits are ballistic ejecta launched along high-altitude trajectories above the atmosphere and deposited as a discontinuous sheet on the terminal Cretaceous land surface.

  4. Diurnal variations of serum erythropoietin at sea level and altitude

    DEFF Research Database (Denmark)

    Klausen, T; Poulsen, T D; Fogh-Andersen, N

    1996-01-01

    This study tested the hypothesis that the diurnal variations of serum-erythropoietin concentration (serum-EPO) observed in normoxia also exist in hypoxia. The study also attempted to investigate the regulation of EPO production during sustained hypoxia. Nine subjects were investigated at sea level...... and during 4 days at an altitude of 4350 m. Median sea level serum-EPO concentration was 6 (range 6-13) U.l-1. Serum-EPO concentration increased after 18 and 42 h at altitude, [58 (range 39-240) and 54 (range 36-340) U.l-1, respectively], and then decreased after 64 and 88 h at altitude [34 (range 18...... in 2, 3 diphosphoglycerate. After 64 h at altitude, six of the nine subjects had down-regulated their serum-EPO concentrations so that median values were three times above those at sea level. These six subjects had significant diurnal variations of serum-EPO concentration at sea level; the nadir...

  5. Flight Control of the High Altitude Wind Power System

    NARCIS (Netherlands)

    Podgaets, A.R.; Ockels, W.J.

    2007-01-01

    Closed loop Laddermill flight control problem is considered in this paper. Laddermill is a high altitude kites system for energy production. The kites have been simulated as rigid bodies and the cable as a thin elastic line. Euler angles and cable speed are controls. Flight control is written as a f

  6. Acetazolamide improves cerebral oxygenation during exercise at high altitude

    NARCIS (Netherlands)

    Vuyk, J.; Bos, J. van den; Terhell, K.; Bos, R. de; Vletter, A.; Valk, P.; Beuzekom, M. van; Kleef, J. van; Dahan, A.

    2006-01-01

    Acute mountain sickness is thought to be triggered by cerebral hypoxemia and be prevented by acetazolamide (Actz). The effect of Actz on cerebral oxygenation at altitude remains unknown. In 16 members of the 2005 Dutch Cho Oyu (8201 m, Tibet) expedition, the influence of Actz and exercise (750 mg PO

  7. HCN ice in Titan's high-altitude southern polar cloud

    CERN Document Server

    de Kok, Remco J; Maltagliati, Luca; Irwin, Patrick G J; Vinatier, Sandrine

    2014-01-01

    Titan's middle atmosphere is currently experiencing a rapid change of season after northern spring arrived in 2009. A large cloud was observed for the first time above Titan's southern pole in May 2012, at an altitude of 300 km. This altitude previously showed a temperature maximum and condensation was not expected for any of Titan's atmospheric gases. Here we show that this cloud is composed of micron-sized hydrogen cyanide (HCN) ice particles. The presence of HCN particles at this altitude, together with new temperature determinations from mid-infrared observations, indicate a very dramatic cooling of Titan's atmosphere inside the winter polar vortex in early 2012. Such a cooling is completely contrary to previously measured high-altitude warming in the polar vortex, and temperatures are a hundred degrees colder than predicted by circulation models. Besides elucidating the nature of Titan's mysterious polar cloud, these results thus show that post-equinox cooling at the winter pole is much more efficient th...

  8. Transcriptome and network changes in climbers at extreme altitudes

    DEFF Research Database (Denmark)

    Chen, Fang; Zhang, Wei; Liang, Yu;

    2012-01-01

    Extreme altitude can induce a range of cellular and systemic responses. Although it is known that hypoxia underlies the major changes and that the physiological responses include hemodynamic changes and erythropoiesis, the molecular mechanisms and signaling pathways mediating such changes are lar...

  9. Reduced autonomic activity during stepwise exposure to high altitude

    NARCIS (Netherlands)

    Sevre, K; Bendz, B; Hanko, E; Nakstad, AR; Hauge, A; Kasin, JI; Lefrandt, JD; Smit, AJ; Eide, [No Value; Rostrup, M

    2001-01-01

    Several studies have shown increased sympathetic activity during acute exposure to hypobaric hypoxia. In a recent field study we found reduced plasma catecholamines during the first days after a stepwise ascent to high altitude. In the present study 14 subjects were exposed to a simulated ascent in

  10. Abnormal blood flow in the sublingual microcirculation at high altitude

    NARCIS (Netherlands)

    Martin, D.S.; Ince, C.; Goedhart, P.; Levett, D.Z.H.; Grocott, M.P.W.

    2009-01-01

    We report the first direct observations of deranged microcirculatory blood flow at high altitude, using sidestream dark-field imaging. Images of the sublingual microcirculation were obtained from a group of 12 volunteers during a climbing expedition to Cho Oyu (8,201 m) in the Himalayas.

  11. Altitude effects on combustion in residential furnaces with fan assist

    Energy Technology Data Exchange (ETDEWEB)

    Arnold, S.; Fleck, B.A.; Ackerman, M.Y.; Dale, J.D.; Wilson, D.J. [Alberta Univ., Edmonton, AB (Canada). Dept. of Mechanical Engineering

    2002-07-01

    Five residential furnaces were tested to determine if altitude has an effect on the performance of modern furnaces equipped with fan assisted flue venting systems. The tests were conducted at 3 altitudes, 50 m, 685 m and 2050 m above sea level at sites in Vancouver, Edmonton, and Fortress Mountain, Alberta. Current furnace derating practices require that furnaces at high altitude have small fuel openings or decreased fuel supply manifold pressures. However, it is possible that modern furnaces with fan driven combustion venting do not have to be derated to the same extent. Propane and natural gas were the fuel sources for the tests. It was confirmed that since most residential systems are designed to operate at 100 per cent excess air, the current derating standard practice is overly conservative. The effects of altitude on carbon monoxide and carbon dioxide levels were also examined, along with burner and igniter operating characteristics, heat exchanger operating temperatures, and blocked-vent shutoff combustion performance. 1 tab., 3 figs.

  12. [Soil microbial functional diversity of different altitude Pinus koraiensis forests].

    Science.gov (United States)

    Han, Dong-xue; Wang, Ning; Wang, Nan-nan; Sun, Xue; Feng, Fu-juan

    2015-12-01

    In order to comprehensively understand the soil microbial carbon utilization characteristics of Pinus koraiensis forests, we took the topsoil (0-5 cm and 5-10 cm) along the 700-1100 m altitude in Changbai Mountains and analyzed the vertical distributed characteristics and variation of microbial functional diversity along the elevation gradient by Biolog microplate method. The results showed that there were significant differences in functional diversity of microbial communities at different elevations. AWCD increased with the extension of incubation time and AWCD at the same soil depth gradually decreased along with increasing altitude; Shannon, Simpson and McIntosh diversity index also showed the same trend with AWCD and three different diversity indices were significantly different along the elevation gradient; Species diversity and functional diversity showed the same variation. The utilization intensities of six categories carbon sources had differences while amino acids were constantly the most dominant carbon source. Principal component analysis (PCA) identified that soil microbial carbon utilization at different altitudes had obvious spatial differentiation, as reflected in the use of carbohydrates, amino acids and carboxylic acids. In addition, the cluster of the microbial diversity indexes and AWCD values of different altitudes showed that the composition of vegetation had a significant impact on soil microbial composition and functional activity.

  13. Altitude Chamber Testing of the Passenger Oxygen System (POS)

    Science.gov (United States)

    2009-08-01

    unlikely, rare manifestations of DCS could result in death or disability. Normally, DCS symptoms clear when the altitude chamber is returned to...Case File No. 09-411, 26 August 2009; approval given by 311th Public Affairs Office, Brooks City-Base, Texas procedures could affect an unborn

  14. Acute occlusive mesenteric ischemia in high altitude of ...

    African Journals Online (AJOL)

    in our region. Keywords: Acute mesenteric ischemia, high altitude, Saudi Arabia. Résumé .... Saudi Arabia for many diseases such as stroke,[13] deep venous .... intestinal vascular failure: a collective review of 43 cases in Taiwan. Br J Clin ...

  15. Investigating the auroral electrojets with low altitude polar orbiting satellites

    DEFF Research Database (Denmark)

    Moretto, T.; Olsen, Nils; Ritter, P.

    2002-01-01

    Three geomagnetic satellite missions currently provide high precision magnetic field measurements from low altitude polar orbiting spacecraft. We demonstrate how these data can be used to determine the intensity and location of the horizontal currents that flow in the ionosphere, predominantly...

  16. Are macroinvertebrates in high altitude streams affected by oxygen deficiency?

    DEFF Research Database (Denmark)

    Jacobsen, Dean; Rostgaard, S.; Vásconez, J. J.

    2003-01-01

    conditions. However, this fails to take into account that oxygen solubility declines with decreasing atmospheric pressure, which may be of importance at high altitudes. 2. Based on samples of macroinvertebrate benthos and in situ measurements of respiratory oxygen demand of macroinvertebrates in small...

  17. Wood anatomical variation in relation to latitude anf altitude

    NARCIS (Netherlands)

    Graaff, van der N.A.; Baas, P.

    1974-01-01

    The wood anatomical variation within 17 eurytherm hardwood genera in relation to altitude and latitude has been studied using wood samples from 52 species. With increasing latitude a miniaturization of secondary xylem elements (shorter vessel members, narrower vessels, shorter and sometimes narrower

  18. 77 FR 71735 - Minimum Altitudes for Use of Autopilots

    Science.gov (United States)

    2012-12-04

    ... Autopilots AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed rulemaking (NPRM). SUMMARY: The FAA proposes to amend and harmonize minimum altitudes for use of autopilots for transport category airplanes. The proposed rule would enable the operational use of advanced autopilot and...

  19. Insect Vision: A Few Tricks to Regulate Flight Altitude

    OpenAIRE

    Floreano D.; Zufferey J.-C.

    2010-01-01

    A recent study sheds new light on the visual cues used by Drosophila to regulate flight altitude. The striking similarity with previously identified steering mechanisms provides a coherent basis for novel models of vision-based flight control in insects and robots.

  20. Insect vision: a few tricks to regulate flight altitude.

    Science.gov (United States)

    Floreano, Dario; Zufferey, Jean-Christophe

    2010-10-12

    A recent study sheds new light on the visual cues used by Drosophila to regulate flight altitude. The striking similarity with previously identified steering mechanisms provides a coherent basis for novel models of vision-based flight control in insects and robots.

  1. Selection of Technical Routes for Resid Processing

    Institute of Scientific and Technical Information of China (English)

    Hu Weiqing

    2006-01-01

    With the increasing trend of heavy crudes supply with deteriorated quality and demand for clean fuels, deep processing of residuum, in particular the processing of low-grade resid, has become the main source for enhancing economic benefits of oil refiners. This article has discussed the technology for processing of different resids and the advantages and disadvantages of the combination processes for resid processing, while pinpointing the directions for development and application of technologies for resid processing in China.

  2. Temporal variations of flux and altitude of sulfur dioxide emissions during volcanic eruptions: implications for long-range dispersal of volcanic clouds

    Directory of Open Access Journals (Sweden)

    M. Boichu

    2015-07-01

    Full Text Available Sulfur-rich degassing, which is mostly composed of sulfur dioxide (SO2, plays a major role in the overall impact of volcanism on the atmosphere and climate. The accurate assessment of this impact is currently hampered by the poor knowledge of volcanic SO2 emissions. Here, using an inversion procedure, we show how assimilating snapshots of the volcanic SO2 load derived from the Infrared Atmospheric Sounding Interferometer (IASI allows for reconstructing both the flux and altitude of the SO2 emissions with an hourly resolution. For this purpose, the regional chemistry-transport model CHIMERE is used to describe the dispersion of SO2 when released in the atmosphere. As proof of concept, we study the 10 April 2011 eruption of the Etna volcano (Italy, which represents one of the few volcanoes instrumented on the ground for the continuous monitoring of SO2 degassing. We find that the SO2 flux time-series retrieved from satellite imagery using the inverse scheme is in agreement with ground observations during ash-poor phases of the eruption. However, large discrepancies are observed during the ash-rich paroxysmal phase as a result of enhanced plume opacity affecting ground-based ultraviolet (UV spectroscopic retrievals. As a consequence, the SO2 emission rate derived from the ground is underestimated by almost one order of magnitude. Altitudes of the SO2 emissions predicted by the inverse scheme are validated against an RGB image of the Moderate Resolution Imaging Spectroradiometer (MODIS capturing the near-source atmospheric pathways followed by Etna plumes, in combination with forward trajectories from the Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT model. At a large distance from the source, modelled SO2 altitudes are compared with independent information on the volcanic cloud height. We find that the altitude predicted by the inverse scheme is in agreement with snapshots of the SO2 height retrieved from recent algorithms

  3. The Chief Resident Role in Emergency Medicine Residency Programs

    Directory of Open Access Journals (Sweden)

    Hafner, John W. Jr., MD, MPH

    2010-05-01

    Full Text Available Study Objectives: Although other specialties have examined the role of the chief resident (CR, the role and training of the emergency medicine (EM CR has largely been undefined.Methods: A survey was mailed to all EM CRs and their respective program directors (PD in 124 EM residency programs. The survey consisted of questions defining demographics, duties of the typical CR, and opinions regarding the level of support and training received. Multiple choice, Likert scale (1 strong agreement, 5 strong disagreement and short-answer responses were used. We analyzed associations between CR and PD responses using Chi-square, Student’s T and Mann-Whitney U tests.Results: Seventy-six percent of CRs and 65% of PDs responded and were similar except for age (31 vs. 42 years; p<0.001. CR respondents were most often male, in year 3 of training and held the position for 12 months. CRs and PDs agreed that the assigned level of responsibility is appropriate (2.63 vs. 2.73, p=0.15; but CRs underestimate their influence in the residency program (1.94 vs. 2.34, p=0.002 and the emergency department (2.61 vs. 3.03, p=0.002. The majority of CRs (70% and PDs (77% report participating in an extramural training program, and those CRs who participated in training felt more prepared for their job duties (2.26 vs. 2.73; p=0.03.Conclusion: EM CRs feel they have appropriate job responsibility but believe they are less influential in program and department administration than PD respondents. Extramural training programs for incoming CRs are widely used and felt to be helpful. [West J Emerg Med. 2010; 11(2:120-125.

  4. Dark Adaptation at High Altitude: An Unexpected Pupillary Response to Chronic Hypoxia in Andean Highlanders.

    Science.gov (United States)

    Healy, Katherine; Labrique, Alain B; Miranda, J Jaime; Gilman, Robert H; Danz, David; Davila-Roman, Victor G; Huicho, Luis; León-Velarde, Fabiola; Checkley, William

    2016-09-01

    Healy, Katherine, Alain B. Labrique, J. Jaime Miranda, Robert H. Gilman, David Danz, Victor G. Davila-Roman, Luis Huicho, Fabiola León-Velarde, and William Checkley. Dark adaptation at high altitude: an unexpected pupillary response to chronic hypoxia in Andean highlanders. High Alt Med Biol. 17:208-213, 2016.-Chronic mountain sickness is a maladaptive response to high altitude (>2500 m above sea level) and is characterized by excessive erythrocytosis and hypoxemia resulting from long-term hypobaric hypoxia. There is no known early predictor of chronic mountain sickness and the diagnosis is based on the presence of excessive erythrocytosis and clinical features. Impaired dark adaptation, or an inability to visually adjust from high- to low-light settings, occurs in response to mild hypoxia and may serve as an early predictor of hypoxemia and chronic mountain sickness. We aimed to evaluate the association between pupillary response assessed by dark adaptometry and daytime hypoxemia in resident Andean highlanders aged ≥35 years living in Puno, Peru. Oxyhemoglobin saturation (SpO2) was recorded using a handheld pulse oximeter. Dark adaptation was quantitatively assessed as the magnitude of pupillary contraction to light stimuli of varying intensities (-2.9 to 0.1 log-cd/m(2)) using a portable dark adaptometer. Individual- and stimulus-specific multilevel analyses were conducted using mixed-effect models to elicit the relationship between SpO2 and pupillary responsiveness. Among 93 participants, mean age was 54.9 ± 11.0 years, 48% were male, 44% were night blind, and mean SpO2 was 89.3% ± 3.4%. The magnitude of pupillary contraction was greater with lower SpO2 (p dark-adapted conditions was exaggerated with hypoxemia and may serve as an early predictor of chronic mountain sickness. This unexpected association is potentially explained as an excessive and unregulated sympathetic response to hypoxemia at altitude.

  5. Sexual Health Education: A Psychiatric Resident's Perspective

    Science.gov (United States)

    Waineo, Eva; Arfken, Cynthia L.; Morreale, Mary K.

    2010-01-01

    Objective: This report discusses psychiatric residents' perceptions of sexual health education and their opinions regarding curricular improvements. Methods: An anonymous, web-based survey was sent to residents in one general psychiatry program (N = 33). The response rate was 69.7%. Results: Residents reported inadequate experience in multiple…

  6. Suicidal Thoughts Among Medical Residents with Burnout

    NARCIS (Netherlands)

    van der Heijden, Frank; Dillingh, Gea; Bakker, Arnold; Prins, Jelle

    2008-01-01

    Objectives: Recent research showed that medical residents have a high risk for developing burnout. The present study investigates the prevalence of burnout and its relationship with suicidal thoughts among medical residents. Methods: All Dutch medical residents (n = 5126) received a self-report ques

  7. Evaluating Medical Residents' Literature-Appraisal Skills.

    Science.gov (United States)

    Stern, David T.; And Others

    1995-01-01

    A study of 28 medical residents' skills in evaluating research compared student evaluations of a journal article with 1 developed by means of a Delphi technique utilizing 5 experts. Residents' scores were not significantly associated with residency year or self-assessed critical appraisal skill. The method is proposed as an objective means of…

  8. 38 CFR 51.110 - Resident assessment.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Resident assessment. 51...) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.110 Resident assessment. The... condition a comprehensive, accurate, standardized, reproducible assessment of each resident's functional...

  9. 38 CFR 51.70 - Resident rights.

    Science.gov (United States)

    2010-07-01

    ... United States. (2) The resident has the right to be free of interference, coercion, discrimination, and... resident has the right to— (1) Voice grievances without discrimination or reprisal. Residents may voice... has documented the need or desire for work in the plan of care; (ii) The plan specifies the nature...

  10. 24 CFR 964.340 - Resident compensation.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Resident compensation. 964.340 Section 964.340 Housing and Urban Development Regulations Relating to Housing and Urban Development...) Program § 964.340 Resident compensation. Residents employed to provide services or renovation...

  11. 19 CFR 141.38 - Resident corporations.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Resident corporations. 141.38 Section 141.38... TREASURY (CONTINUED) ENTRY OF MERCHANDISE Powers of Attorney § 141.38 Resident corporations. A power of attorney shall not be required if the person signing Customs documents on behalf of a resident...

  12. Suicidal Thoughts Among Medical Residents with Burnout

    NARCIS (Netherlands)

    van der Heijden, Frank; Dillingh, Gea; Bakker, Arnold; Prins, Jelle

    2008-01-01

    Objectives: Recent research showed that medical residents have a high risk for developing burnout. The present study investigates the prevalence of burnout and its relationship with suicidal thoughts among medical residents. Methods: All Dutch medical residents (n = 5126) received a self-report

  13. Sexual Health Education: A Psychiatric Resident's Perspective

    Science.gov (United States)

    Waineo, Eva; Arfken, Cynthia L.; Morreale, Mary K.

    2010-01-01

    Objective: This report discusses psychiatric residents' perceptions of sexual health education and their opinions regarding curricular improvements. Methods: An anonymous, web-based survey was sent to residents in one general psychiatry program (N = 33). The response rate was 69.7%. Results: Residents reported inadequate experience in multiple…

  14. Causal Moderation Analysis Using Propensity Score Methods

    Science.gov (United States)

    Dong, Nianbo

    2012-01-01

    This paper is based on previous studies in applying propensity score methods to study multiple treatment variables to examine the causal moderator effect. The propensity score methods will be demonstrated in a case study to examine the causal moderator effect, where the moderators are categorical and continuous variables. Moderation analysis is an…

  15. Elevation of circulating miR-210-3p in high-altitude hypoxic environment

    Directory of Open Access Journals (Sweden)

    Yan eYan

    2016-03-01

    Full Text Available Background: The induction of miR-210-3p, a master hypoxamir, is a consistent feature of the hypoxic response in both normal and malignant cells. However, whether miR-210-3p acts as a circulating factor in response to a hypoxic environment remains unknown. The current study aimed to examine the effect of a high-altitude hypoxic environment on circulating miR-210-3p.Methods: We examined and compared the levels of miR-210-3p using TaqMan-based qRT-PCR in both peripheral blood cells and plasma from 84 ethnic Chinese Tibetans residing at 3560 m, 46 newly arrived migrant Han Chinese (Tibet Han and 82 Han Chinese residing at 8.9 m (Nanjing Han. Furthermore, we analyzed the correlations of miR-210-3p with hematological indices. Results: The relative concentrations of miR-210-3p to internal reference U6 in blood cells were significantly higher in the Tibet Han group (1.01±0.11, P<0.001 and in the Tibetan group (1.17±0.09, P<0.001 than in the Nanjing Han group (0.51±0.04. The absolute concentrations of plasma miR-210-3p were also markedly elevated in the Tibet Han group (503.54±42.95 fmol/L, P=0.004 and in the Tibetan group (557.78±39.84 fmol/L, P<0.001 compared to the Nanjing Han group (358.39±16.16 fmol/L. However, in both blood cells and plasma, miR-210-3p levels were not significantly different between the Tibet Han group and the Tibetan group (P=0.280, P=0.620, respectively. Plasma miR-210-3p concentrations were positively correlated with miR-210-3p levels in blood cells (r=0.192, P=0.005. Furthermore, miR-210-3p levels in both blood cells and plasma showed strong positive correlations with red blood cell counts and hemoglobin and hematocrit values. Conclusion: These data demonstrated, for the first time, that miR-210-3p might act as a circulating factor in response to hypoxic environments and could be associated with human adaptation to life at high altitudes.

  16. China's Economy Registered Moderate Slowdown

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    @@ The Chinese economy registered a moderate slowdown over the course of 2011, the World Bank said in its East Asia and Pacific Economic Update.During the first nine months of 2011, growth slowed from 10.6 percent in 2010 to 9.4 percent.The bank estimates that China's economic growth is expected at 9.1 percent in 2011, 8.4 percent in 2012 and roughly similar rates thereafter.

  17. Moderate Psoriasis: A Proposed Definition.

    Science.gov (United States)

    Llamas-Velasco, M; de la Cueva, P; Notario, J; Martínez-Pilar, L; Martorell, A; Moreno-Ramírez, D

    2017-08-16

    The Psoriasis Area Severity Index (PASI) is the most widely used scale for assessing the severity of psoriasis and for therapeutic decision making. On the basis of the PASI score, patients have been stratified into 2 groups: mild disease and moderate-to-severe disease. To draft a proposal for the definition and characterization of moderate psoriasis based on PASI and Dermatology Life Quality Index (DLQI) scores. A group of 6 dermatologists with experience in the treatment of psoriasis undertook a critical review of the literature and a discussion of cases to draft a proposal. In order of priority, PASI, DLQI, and body surface area (BSA) are the parameters to be used in daily practice to classify psoriasis as mild, moderate, or severe. Severity should be assessed on the basis of a combined evaluation and interpretation of the PASI and DLQI. And 3, PASI and DLQI should carry equal weight in the determination of disease severity. On this basis, psoriasis severity was defined using the following criteria: mild, PASI15, independently of the DLQI score. A more precise classification of psoriasis according to disease severity will improve the risk-benefit assessment essential to therapeutic decision making in these patients. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Moderate and extreme maternal obesity.

    LENUS (Irish Health Repository)

    Abdelmaboud, M O

    2012-05-01

    The aim of this study was to investigate the prevalence of moderate and extreme obesity among an Irish obstetric population over a 10-year period, and to evaluate the obstetric features of such pregnancies. Of 31,869 women delivered during the years 2000-2009, there were 306 women in the study group, including 173 in the moderate or Class 2 obese category (BMI 35-39.9) and 133 in the extreme or Class 3 obese category (BMI > or = 40).The prevalence of obese women with BMI > or = 35 was 9.6 per 1000 (0.96%), with an upward trend observed from 2.1 per 1000 in the year 2000, to 11.8 per 1000 in the year 2009 (P = 0.001). There was an increase in emergency caesarean section (EMCS) risk for primigravida versus multigravid women, within both obese categories (P < 0.001). However, there was no significant difference in EMCS rates observed between Class 2 and Class 3 obese women, when matched for parity. The prevalence of moderate and extreme obesity reported in this population is high, and appears to be increasing. The increased rates of abdominal delivery, and the levels of associated morbidity observed, have serious implications for such women embarking on pregnancy.

  19. Residential exposures to PM2.5 and CO in Cusco, a high-altitude city in the Peruvian Andes: a pilot study.

    Science.gov (United States)

    Pearce, John L; Aguilar-Villalobos, Manuel; Rathbun, Stephen L; Naeher, Luke P

    2009-01-01

    High-altitude populations using biofuels for household energy may be at health risk due to a combination of altitudinal stress and indoor exposures to biomass smoke. In this article, the authors measure indoor and outdoor breathing level concentrations of PM(2.5) and CO during periods of meal preparation in a convenience sample of homes above 3000 m in Cusco, Peru. From July 10 to 21, 2005, 237 measurements were taken during a pilot study at 41 residences. Results show the highest levels of PM(2.5) and CO occurred during the early morning in the kitchen when dung and wood were used. Additionally, findings suggest that residential biomass fuel combustion in Cusco results in elevated indoor PM(2.5) and CO exposure levels that are of potential human health concern, an issue that may be exacerbated by the physiological impact of living in a high-altitude environment.

  20. Burnout, empathy and their relationships: a qualitative study with residents in General Medicine.

    Science.gov (United States)

    Picard, Jeanne; Catu-Pinault, Annie; Boujut, Emilie; Botella, Marion; Jaury, Philippe; Zenasni, Franck

    2016-01-01

    Some studies have shown that burnout may have a negative impact on clinical empathy during internship. However, clinical empathy may also be a protective factor, preventing residents from experiencing burnout. Although several quantitative studies have been conducted to examine these relationships between burnout and empathy, no qualitative studies have been carried out. To examine how residents in general practice evaluate the link between burnout and empathy, 24 of them participated in a semi-structured interview. A thematic analysis was carried out to examine residents' discourses and answers to closed questions. The results indicated that residents thought that empathy and burnout were clearly related in different ways. They identified five types of relationship: regulation strategy, empathy as protection, psychological balance/imbalance, fatigue and moderating factors.

  1. Plastic Surgery Residents' Understanding and Attitudes Toward Biostatistics: A National Survey.

    Science.gov (United States)

    Susarla, Srinivas M; Lifchez, Scott D; Losee, Joseph; Hultman, Charles Scott; Redett, Richard J

    2016-08-01

    An understanding of biostatistics is a critical skill for the practicing plastic surgeon. The purpose of the present study was to assess plastic surgery residents' attitudes and understanding of biostatistics. This was a cross-sectional study of plastic surgery residents. A survey assessing resident attitudes regarding biostatistics, confidence with biostatistical concepts, and objective knowledge of biostatistics was distributed electronically to trainees in plastic surgery programs in the United States. Bivariate and regression analyses were used to identify significant associations and adjust for confounders/effect modifiers. One hundred twenty-three residents responded to the survey (12.3% response rate). Respondents expressed positive attitudes regarding biostatistics in plastic surgery practice, but only moderate levels of confidence with various biostatistical concepts. Both attitudes and confidence were positively associated with the number of plastic surgery journals read monthly and formal coursework in biostatistics (P biostatistics in the practice of plastic surgery but have only a fair understanding of core statistical concepts.

  2. Why Are High Altitude Natives So Strong at High Altitude? Nature vs. Nurture: Genetic Factors vs. Growth and Development.

    Science.gov (United States)

    Brutsaert, Tom

    Among high-altitude natives there is evidence of a general hypoxia tolerance leading to enhanced performance and/or increased capacity in several important domains. These domains likely include an enhanced physical work capacity, an enhanced reproductive capacity, and an ability to resist several common pathologies of chronic high-altitude exposure. The "strength" of the high-altitude native in this regard may have both a developmental and a genetic basis, although there is better evidence for the former (developmental effects) than for the latter. For example, early-life hypoxia exposure clearly results in lung growth and remodeling leading to an increased O2 diffusing capacity in adulthood. Genetic research has yet to reveal a population genetic basis for enhanced capacity in high-altitude natives, but several traits are clearly under genetic control in Andean and Tibetan populations e.g., resting and exercise arterial O2 saturation (SaO2). This chapter reviews the effects of nature and nurture on traits that are relevant to the process of gas exchange, including pulmonary volumes and diffusion capacity, the maximal oxygen consumption (VO2max), the SaO2, and the alveolar-arterial oxygen partial pressure difference (A-aDO2) during exercise.

  3. 'Ome' on the range: update on high-altitude acclimatization/adaptation and disease.

    Science.gov (United States)

    Luo, Yongjun; Wang, Yuxiao; Lu, Hongxiang; Gao, Yuqi

    2014-11-01

    The main physiological challenge in high-altitude plateau environments is hypoxia. When people living in a plain environment migrate to the plateau, they face the threat of hypoxia. Most people can acclimatize to high altitudes; the acclimatization process mainly consists of short-term hyperventilation and long-term compensation by increased oxygen uptake, transport, and use due to increased red blood cell mass, myoglobin, and mitochondria. If individuals cannot acclimatize to high altitude, they may suffer from a high-altitude disease, such as acute mountain disease (AMS), high-altitude pulmonary edema (HAPE), high-altitude cerebral edema (HACE) or chronic mountain sickness (CMS). Because some individuals are more susceptible to high altitude diseases than others, the incidence of these high-altitude diseases is variable and cannot be predicted. Studying "omes" using genomics, proteomics, metabolomics, transcriptomics, lipidomics, immunomics, glycomics and RNomics can help us understand the factors that mediate susceptibility to high altitude illnesses. Moreover, analysis of the "omes" using a systems biology approach may provide a greater understanding of high-altitude illness pathogenesis and improve the efficiency of the diagnosis and treatment of high-altitude illnesses in the future. Below, we summarize the current literature regarding the role of "omes" in high-altitude acclimatization/adaptation and disease and discuss key research gaps to better understand the contribution of "omes" to high-altitude illness susceptibility.

  4. Compositae Plants Differed in Leaf Cuticular Waxes between High and Low Altitudes.

    Science.gov (United States)

    Guo, Na; Gao, Jianhua; He, Yuji; Guo, Yanjun

    2016-06-01

    We sampled eight Compositae species at high altitude (3482 m) and seven species at low altitude (220 m), analyzed the chemical compositions and contents of leaf cuticular wax, and calculated the values of average chain length (ACL), carbon preference index (CPI), dispersion (d), dispersion/weighted mean chain length (d/N), and C31 /(C31  + C29 ) (Norm31). The amounts of total wax and compositions were significantly higher at high altitude than at low altitude, except for primary alcohol, secondary alcohol, and ketone. The main n-alkanes in most samples were C31 , C29 , and C33 . Low altitude had more C31 and C33 , whereas more C29 occurred at high altitude. The ACL, CPI, d, d/N, and Norma 31 were higher at low altitude than at high altitude. The fatty acid and primary alcohol at low altitude contained more C26 homologous than at high altitude. More short-chain primary alcohols were observed at high altitude. At low altitude, the primary alcohol gave on average the largest amount, while it was n-alkane at high altitude. These results indicated that the variations of leaf cuticular waxes benefited Compositae plants to adapt to various environmental stresses and enlarge their distribution.

  5. Research by residents: obstacles and opportunities.

    Science.gov (United States)

    Torous, John; Padmanabhan, Jaya

    2015-02-01

    As the psychiatric field continues to evolve in a world with nascent mobile technology (Hilty et al., 2014), novel neuroscience and genetic research, and new payment and care models (Fried et al., 2014) it is likely that the psychiatry residents learn today will not match what they will be practicing tomorrow. Residents have the opportunity to help shape that future through conducting research today. While the prospect of research can initially seem daunting to the busy resident, here we examine, from psychiatry residents' perspective, the common pitfalls and rewards of research during residency.

  6. Misrepresentation by ophthalmology residency applicants.

    Science.gov (United States)

    Wiggins, Michael N

    2010-07-01

    To determine the percentage of publication misrepresentation among applicants to an ophthalmology residency, to compare that percentage with published percentages from other specialties, and to compare the number of US-trained applicants vs non-US-trained applicants found to misrepresent published articles. Published articles in peer-reviewed journals listed on residency applications to the Jones Eye Institute from October 10, 2000, to December 1, 2004, were searched, excluding applications that were unavailable or were from current residents and faculty. The type of misrepresentation of published articles and the country of medical school training were recorded. Compared were US-trained applicants vs non-US-trained applicants to determine which group was more likely to list published articles and which group was more likely to have a misrepresented published article. Eight hundred twenty-one of 852 applications (96.4%) were reviewed. Five hundred fifty applicants (67.0%) were from US medical schools, and 271 applicants (33.0%) were from non-US medical schools. Two hundred one applicants (24.5%) listed peer-reviewed published articles. Misrepresentation of published articles was found in 15 applicants (5 US trained and 10 non-US trained). The mean percentage of applicants with misrepresentation per applicant pool was 1.9%, while the mean percentage per applicants listing published articles was 8.1%. The most common misrepresentation found was self-promotion on the author list (50.0%), followed by omission of other authors (25.0%), nonexistent articles (12.5%), and nonauthorship (12.5%). Foreign medical graduates were more likely to list published articles (P = .008) and to have a misrepresented published article (P = .01). Ophthalmology has one of the lowest reported percentages of applicant publication misrepresentation in the literature. Foreign medical graduates were more likely to list published articles and to misrepresent published articles. Self-promotion on

  7. Predictors of success in an anesthesiology residency.

    Science.gov (United States)

    Warrick, S S; Crumrine, R S

    1986-07-01

    The selection of residents in medical specialty programs is a difficult task facing all selection committees. The present authors examined factors that contribute to successful residency performance by 26 anesthesiology residents in order to assist the program's selection committee in developing selection criteria. The best predictor of a resident's academic average in the anesthesiology program was the number of years the resident had spent in other specialties. Comparison of the residents' scores on the Anesthesiology In-Training Examination (ITE) and their scores on Part I of the examinations of the National Board of Medical Examiners (NBME) showed a statistically significant negative correlation. The higher that residents scored on the NBME Part I examination, the lower they scored on the ITE. No significant correlations were found between the residents' ITE scores and undergraduate grade-point average or nonacademic variables such as the residents' age or parents' level of education. The residents' composite grade-point average (GPA) for the residency and their interview scores had a strong positive relationship significant at the 0.06 level.

  8. Emotional problems of residents in psychiatry.

    Science.gov (United States)

    Russell, A T; Pasnau, R O; Taintor, Z C

    1975-03-01

    The authors used a questionnaire technique to determine the magnitude of the problem of emotional illness and poor performance during psychiatric residency, the procedures that are used to screen for or help disturbed residents, and characteristics that differentiate residents who are at risk. The data indicated that residents who have problems that lead to termination are rarely free of emotional disturbance. The general belief that women, foreign medical graduates, and minority group members are at higher risk for problems during residency was not supported; however, younger residents and transfers from other programs appeared to be at risk. A disturbing finding was the high rate of suicide reported. The authors stress the need for further work with the "marginal" resident and for research on screening and supportive procedures.

  9. Thoraco-abdominal coordination and performance during uphill running at altitude

    Science.gov (United States)

    Bernardi, Eva; Pratali, Lorenza; Mandolesi, Gaia; Spiridonova, Maria; Roi, Giulio Sergio; Cogo, Annalisa

    2017-01-01

    Introduction Running races on mountain trails at moderate-high altitude with large elevation changes throughout has become increasingly popular. During exercise at altitude, ventilatory demands increase due to the combined effects of exercise and hypoxia. Aim To investigate the relationships between thoraco-abdominal coordination, ventilatory pattern, oxygen saturation (SpO2), and endurance performance in runners during high-intensity uphill exercise. Methods Fifteen participants (13 males, mean age 42±9 yrs) ran a “Vertical Kilometer,” i.e., an uphill run involving a climb of approximately 1000 m with a slope greater than 30%. The athletes were equipped with a portable respiratory inductive plethysmography system, a finger pulse oximeter and a global positioning unit (GPS). The ventilatory pattern (ventilation (VE), tidal volume (VT), respiratory rate (RR), and VE/VT ratio), thoraco-abdominal coordination, which is represented by the phase angle (PhA), and SpO2 were evaluated at rest and during the run. Before and after the run, we assessed respiratory function, respiratory muscle strength and the occurrence of interstitial pulmonary edema by thoracic ultrasound. Results Two subjects were excluded from the respiratory inductive plethysmography analysis due to motion artifacts. A quadratic relationship between the slope and the PhA was observed (r = 0.995, p = 0.036). When the slope increased above 30%, the PhA increased, indicating a reduction in thoraco-abdominal coordination. The reduced thoraco-abdominal coordination was significantly related to reduced breathing efficiency (i.e., an increased VE/VT ratio; r = 0.961, p = 0.038) and SpO2 (r = -0.697, pabdominal coordination and consequent reduction in SpO2 were associated with interstitial pulmonary edema. Conclusion Reductions in thoraco-abdominal coordination are associated with a less efficient ventilatory pattern and lower SpO2 during uphill running. This fact could have a negative effect on performance

  10. Antioxidant and oxidative stress responses of sojourners at high altitude in different climatic temperatures

    Science.gov (United States)

    Sinha, Sanchari; Singh, Som Nath; Saha, Mantu; Kain, T. C.; Tyagi, A. K.; Ray, Uday Sankar

    2010-01-01

    High altitude (HA) is a multi-stressor environment comprising hypobaric hypoxia and cold. Climatic temperature varies with seasonal variation at HA. The present study was undertaken to investigate the effect of ambient temperature on antioxidant profile among sojourners at HA. The study was conducted on sojourners exposed to an altitude of 4,560 m in two different seasons and categorized into two groups (SOJ 1, n = 63, ambient temp. at HA: -6º to +10ºC; SOJ 2, n = 81, ambient temp. at HA: 3º-22ºC). Blood was collected at sea level (SL) and after 4 weeks of HA exposure. Antioxidant enzymes showed significant upregulation in SOJ 2 at HA. In SOJ 1, superoxide dismutase and glutathione peroxidase showed significant upregulation but catalase and glutathione reductase showed significant decrease at HA. Non-enzymatic antioxidants showed significant reduction in SOJ 1 whereas a sustained antioxidant profile was observed in SOJ 2 at HA. Oxidative stress markers showed higher levels in SOJ 1 than SOJ 2 at HA. Differences observed between SOJ 1 and SOJ 2 at HA may be the consequence of different environmental temperatures. Cold stress was higher in SOJ 1 as evidenced from the significantly lower oral temperature in SOJ 1 as compared to SOJ 2. Cold- and hypoxia-induced increase in energy expenditure was significantly high in SOJ 1 than SOJ 2. To conclude, chronic exposure to hypoxia in moderate climatic temperature has a potential preconditioning effect on antioxidant system, but exposure to both cold and hypoxia causes greater oxidative stress due to altered metabolic rate.

  11. Antioxidant and oxidative stress responses of sojourners at high altitude in different climatic temperatures.

    Science.gov (United States)

    Sinha, Sanchari; Singh, Som Nath; Saha, Mantu; Kain, T C; Tyagi, A K

    2010-01-01

    High altitude (HA) is a multi-stressor environment comprising hypobaric hypoxia and cold. Climatic temperature varies with seasonal variation at HA. The present study was undertaken to investigate the effect of ambient temperature on antioxidant profile among sojourners at HA. The study was conducted on sojourners exposed to an altitude of 4,560 m in two different seasons and categorized into two groups (SOJ 1, n=63, ambient temp. at HA: -6 degree to +10degreeC; SOJ 2, n=81, ambient temp. at HA: 3degree-22degreeC). Blood was collected at sea level (SL) and after 4 weeks of HA exposure. Antioxidant enzymes showed significant upregulation in SOJ 2 at HA. In SOJ 1, superoxide dismutase and glutathione peroxidase showed significant upregulation but catalase and glutathione reductase showed significant decrease at HA. Non-enzymatic antioxidants showed significant reduction in SOJ 1 whereas a sustained antioxidant profile was observed in SOJ 2 at HA. Oxidative stress markers showed higher levels in SOJ 1 than SOJ 2 at HA. Differences observed between SOJ 1 and SOJ 2 at HA may be the consequence of different environmental temperatures. Cold stress was higher in SOJ 1 as evidenced from the significantly lower oral temperature in SOJ 1 as compared to SOJ 2. Cold- and hypoxia-induced increase in energy expenditure was significantly high in SOJ 1 than SOJ 2. To conclude, chronic exposure to hypoxia in moderate climatic temperature has a potential preconditioning effect on antioxidant system, but exposure to both cold and hypoxia causes greater oxidative stress due to altered metabolic rate.

  12. Burnout, depression, and career satisfaction: cross-sectional study of obstetrics and gynecology residents.

    Science.gov (United States)

    Becker, Julie L; Milad, Magdy P; Klock, Susan C

    2006-11-01

    This study was undertaken to measure career satisfaction among obstetrics and gynecology residents and assess its relationship to burnout, depression, and malpractice concerns. A 63-item, anonymous, self-administered survey was distributed to residents at 23 randomly selected obstetric and gynecologic residency programs in the United States. The outcome measures included the Maslach Burnout Inventory-Human Services Survey, the Center for Epidemiological Studies-Depression Scale, and perceptions of malpractice and career satisfaction. Eighty-three percent of the residents were either "very or somewhat satisfied" with their career choice. The majority (89.8%) showed evidence of moderate burnout and 34.2% were considered depressed. Ninety-six percent were concerned about malpractice with 35% pursuing fellowship solely because of malpractice concerns. Residents dissatisfied with their career choice were twice as likely to be depressed (30% vs 55%, P = .03). Both emotional exhaustion (P career satisfaction. Resident career satisfaction was inversely correlated with burnout and depression, which were more prevalent than expected. Overall, residents were satisfied with their career choice, but also negatively influenced by malpractice concerns.

  13. Surface altitude of hydrogeologic layers of the Atlantic Coastal Plain of North and South Carolina

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — PP1773_unit_alt_grid is a polygon shapefile of surface altitudes for 16 hydrogeologic units as described in report Professional Paper 1773. Surface altitudes were...

  14. Mitogenomic analyses propose positive selection in mitochondrial genes for high-altitude adaptation in galliform birds.

    Science.gov (United States)

    Zhou, Taicheng; Shen, Xuejuan; Irwin, David M; Shen, Yongyi; Zhang, Yaping

    2014-09-01

    Galliform birds inhabit very diverse habitats, including plateaus that are above 3000 m in altitude. At high altitude, lower temperature and hypoxia are two important factors influencing survival. Mitochondria, as the ultimate oxygen transductor, play an important role in aerobic respiration through oxidative phosphorylation (OXPHOS). We analyzed the mitochondrial genomes of six high-altitude phasianidae birds and sixteen low-altitude relatives in an attempt to determine the role of mitochondrial genes in high-altitude adaptation. We reconstructed the phylogenetic relationships of these phasianidae birds and relatives and found at least four lineages that independently occupied this high-altitude habitat. Selective analyses revealed significant evidence for positive selection in the genes ND2, ND4, and ATP6 in three of the high-altitude lineages. This result strongly suggests that adaptive evolution of mitochondrial genes played a critical role during the independent acclimatization to high altitude by galliform birds.

  15. Sub-Scale Re-entry Capsule Drop via High Altitude Balloons Project

    Data.gov (United States)

    National Aeronautics and Space Administration — High-altitude balloon flights are an inexpensive method used to lift payloads to high altitudes. Federal Aviation Administration (FAA) regulations permit payloads...

  16. Science 101: Why Does It Take Longer to Boil Potatoes at High Altitudes?

    Science.gov (United States)

    Robertson, Bill

    2017-01-01

    Why Does It Take Longer to Boil Potatoes at High Altitudes? This column provides background science information for elementary teachers. This month's issue looks at why water boils at different temperatures at different altitudes.

  17. Upper atomosphere and Thermal control of the Super Low Altitude Test Satellite

    OpenAIRE

    2013-01-01

    The Super Low Altitude Test Satellite (SLATS) is an engineering test satellite currently under development in JAXA in an attempt to open a new frontier of space utilization on extremely low earth orbits. The altitude of SLATS orbit is around200km altitude. In this altitude, rarefied aerodynamics and high-density atomic oxygen effect on the thermal design of SLATS. The thermal control of SLATS was introduced in this paper. And, the equilibrium temperature on the bumper of SLATS was estimated w...

  18. Effect of Altitude Error on Position Precision of Double-Star Position System

    Institute of Scientific and Technical Information of China (English)

    LIN Xueyuan; LI Tingjun; QIU Libo; LIN Yu

    2006-01-01

    The effects of two kinds of methods for obtaining altitudes on the position precision are analyzed, and the error expressions are deduced. Many simulation results show that in the two cases, the effects of the same altitude errors on the positioning precision are identical, and the rules that the two altitude errors affect positioning precision can be expressed as that altitude error has little effect on the east-west position error, but has large effect on the south-north position error.

  19. Wissenschafts-Kriterien: Eine Moderation

    OpenAIRE

    Breuer, Franz; Reichertz, Jo

    2001-01-01

    Zur Moderation und Orientierung von Beiträgen zur FQS-Debatte über "Qualitätsstandards" qualitativer Sozialforschung wird an die Breite und Vielfalt von in Diskursen über Wissenschaft diskutierten Gütemaßstäben erinnert, und es werden einige Impressionen hinsichtlich ihres historischen Wandels in der jüngeren Vergangenheit präsentiert. Damit verbunden ist die Aufforderung an Debatten-Teilnehmer, sich des systematischen und historischen Stellenwerts postulierter Kriterien und Kriterien-Mixe ge...

  20. Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training

    OpenAIRE

    Shweiki E; Martin ND; Beekley AC; Jenoff JS; Koenig GJ; Kaulback KR; Lindenbaum GA; Patel PH; Rosen MM; Weinstein MS; Zubair MH; Cohen MJ

    2015-01-01

    Ehyal Shweiki,1 Niels D Martin,2 Alec C Beekley,1 Jay S Jenoff,1 George J Koenig,1 Kris R Kaulback,1 Gary A Lindenbaum,1 Pankaj H Patel,1 Matthew M Rosen,1 Michael S Weinstein,1 Muhammad H Zubair,2 Murray J Cohen1 1Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA; 2Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Abstract: Medical resident education in the United States has been a matter of national ...

  1. Impact of a moderate volcanic eruption on chemistry in the lower stratosphere: balloon-borne observations and model calculations

    Science.gov (United States)

    Berthet, Gwenaël; Jégou, Fabrice; Catoire, Valéry; Krysztofiak, Gisèle; Renard, Jean-Baptiste; Bourassa, Adam E.; Degenstein, Doug A.; Brogniez, Colette; Dorf, Marcel; Kreycy, Sebastian; Pfeilsticker, Klaus; Werner, Bodo; Lefèvre, Franck; Roberts, Tjarda J.; Lurton, Thibaut; Vignelles, Damien; Bègue, Nelson; Bourgeois, Quentin; Daugeron, Daniel; Chartier, Michel; Robert, Claude; Gaubicher, Bertrand; Guimbaud, Christophe

    2017-02-01

    The major volcanic eruption of Mount Pinatubo in 1991 has been shown to have significant effects on stratospheric chemistry and ozone depletion even at midlatitudes. Since then, only moderate but recurrent volcanic eruptions have modulated the stratospheric aerosol loading and are assumed to be one cause for the reported increase in the global aerosol content over the past 15 years. This particularly enhanced aerosol context raises questions about the effects on stratospheric chemistry which depend on the latitude, altitude and season of injection. In this study, we focus on the midlatitude Sarychev volcano eruption in June 2009, which injected 0.9 Tg of sulfur dioxide (about 20 times less than Pinatubo) into a lower stratosphere mainly governed by high-stratospheric temperatures. Together with in situ measurements of aerosol amounts, we analyse high-resolution in situ and/or remote-sensing observations of NO2, HNO3 and BrO from balloon-borne infrared and UV-visible spectrometers launched in Sweden in August-September 2009. It is shown that differences between observations and three-dimensional (3-D) chemistry-transport model (CTM) outputs are not due to transport calculation issues but rather reflect the chemical impact of the volcanic plume below 19 km altitude. Good measurement-model agreement is obtained when the CTM is driven by volcanic aerosol loadings derived from in situ or space-borne data. As a result of enhanced N2O5 hydrolysis in the Sarychev volcanic aerosol conditions, the model calculates reductions of ˜ 45 % and increases of ˜ 11 % in NO2 and HNO3 amounts respectively over the August-September 2009 period. The decrease in NOx abundances is limited due to the expected saturation effect for high aerosol loadings. The links between the various chemical catalytic cycles involving chlorine, bromine, nitrogen and HOx compounds in the lower stratosphere are discussed. The increased BrO amounts (˜ 22 %) compare rather well with the balloon

  2. Initial Feasibility Assessment of a High Altitude Long Endurance Airship

    Science.gov (United States)

    Colozza, Anthony; Dolce, James (Technical Monitor)

    2003-01-01

    A high altitude solar powered airship provides the ability to carry large payloads to high altitudes and remain on station for extended periods of time. This study examines the feasibility of this concept. Factors such as time of year, latitude, wind speeds and payload are considered in establishing the capabilities of a given size airship. East and West coast operation were evaluated. The key aspect to success of this type of airship is the design and operation of the propulsion and power system. A preliminary propulsion/power system design was produced based on a regenerative fuel cell energy storage system and solar photovoltaic array for energy production. A modular system design was chosen with four independent power/propulsion units utilized by the airship. Results on payload capacity and flight envelope (latitude and time of year) were produced for a range of airship sizes.

  3. [Umbilical artery blood gases of term neonates at altitude].

    Science.gov (United States)

    Villamonte, Wilfredo; Escalante, Darío; Yabar, Janet; Jerí, María; Peralta, Paola; Ochoa, Robert

    2014-01-01

    In order to determine the normal values of arterial blood gases in the umbilical artery of term infants at 3400 m altitude, a cross-sectional study was conducted. It was performed in the umbilical artery blood of 300 term infants, with an adequate gestational age and whose birth took place between January 2010 and December 2011 at the Essalud National Hospital Adolfo Guevara Velazco (Cusco, Peru). It was found that the average pH of healthy term infants was 7.33 ± 0.07; the values for percentiles 5 and 95 were 7.18 and 7.40 respectively. Tables with the 5th and 95th percentiles for pH, pO2, pCO2, SO2, p50, base excess and HCO3 of the umbilical artery of term infants at 3400 m altitude are provided.

  4. First year results of the High Altitude Water Cherenkov observatory

    CERN Document Server

    Carramiñana, Alberto

    2016-01-01

    The High Altitude Water Cherenkov (HAWC) gamma-ray observatory is a wide field of view (1.8 Sr) and high duty cycle (>95% up-time) detector of unique capabilities for the study of TeV gamma-ray sources. Installed at an altitude of 4100m in the Northern slope of Volc\\'an Sierra Negra, Puebla, by a collaboration of about thirty institutions of Mexico and the United States, HAWC has been in full operations since March 2015, surveying 2/3 of the sky every sidereal day, monitoring active galaxies and mapping sources in the Galactic Plane to a detection level of 1 Crab per day. This contribution summarizes the main results of the first year of observations of the HAWC gamma-ray observatory.

  5. High altitude aerodynamic platform concept evaluation and prototype engine testing

    Science.gov (United States)

    Akkerman, J. W.

    1984-01-01

    A design concept has been developed for maintaining a 150-pound payload at 60,000 feet altitude for about 50 hours. A 600-pound liftoff weight aerodynamic vehicle is used which operates at sufficient speeds to withstand prevailing winds. It is powered by a turbocharged four-stoke cycle gasoline fueled engine. Endurance time of 100 hours or more appears to be feasible with hydrogen fuel and a lighter payload. A prototype engine has been tested to 40,000 feet simulated altitude. Mismatch of the engine and the turbocharger system flow and problems with fuel/air mixture ratio control characteristics prohibited operation beyond 40,000 feet. But there seems to be no reason why the concept cannot be developed to function as analytically predicted.

  6. Physical condition among middle altitude trekkers in an aging society.

    Science.gov (United States)

    Saito, Shigeru; Tobe, Ken; Harada, Naomi; Aso, Chizu; Nishihara, Fumio; Shimada, Hitoshi

    2002-07-01

    The number of alpine accidents has markedly increased among elderly trekkers in an aging society, Japan. We evaluated the physical condition of 176 trekkers by interview and physical examination on a popular middle altitude mountain. Heart rate, noninvasive blood pressure and arterial oxygen saturation (SpO2) were measured using a portable life monitor. It was revealed that more than 70% of the trekkers were over 50. Seventy-five percent of trekkers over 70 had some pre-existing medical problems. Systolic and diastolic blood pressure before the start of trekking, increased with age. However, such age-dependent differences were not apparent at the summit hut. SpO2 values decreased slightly but significantly with age. In conclusion, many elderly people enjoy nonchallenging middle altitude trekking in an aging society. Alpine accidents caused by health problems tend to arise more frequently in this population. Alpine rescue teams should be well-prepared for the alpine accidents of elderly trekkers.

  7. Cosmic microwave background science at commercial airline altitudes

    Science.gov (United States)

    Feeney, Stephen M.; Gudmundsson, Jon E.; Peiris, Hiranya V.; Verde, Licia; Errard, Josquin

    2017-07-01

    Obtaining high-sensitivity measurements of degree-scale cosmic microwave background (CMB) polarization is the most direct path to detecting primordial gravitational waves. Robustly recovering any primordial signal from the dominant foreground emission will require high-fidelity observations at multiple frequencies, with excellent control of systematics. We explore the potential for a new platform for CMB observations, the Airlander 10 hybrid air vehicle, to perform this task. We show that the Airlander 10 platform, operating at commercial airline altitudes, is well suited to mapping frequencies above 220 GHz, which are critical for cleaning CMB maps of dust emission. Optimizing the distribution of detectors across frequencies, we forecast the ability of Airlander 10 to clean foregrounds of varying complexity as a function of altitude, demonstrating its complementarity with both existing (Planck) and ongoing (C-BASS) foreground observations. This novel platform could play a key role in defining our ultimate view of the polarized microwave sky.

  8. Cosmic Microwave Background Science at Commercial Airline Altitudes

    CERN Document Server

    Feeney, Stephen M; Peiris, Hiranya V; Verde, Licia; Errard, Josquin

    2016-01-01

    Obtaining high-sensitivity measurements of degree-scale cosmic microwave background (CMB) polarization is the most direct path to detecting primordial gravitational waves. Robustly recovering any primordial signal from the dominant foreground emission will require high-fidelity observations at multiple frequencies, with excellent control of systematics. We explore the potential for a new platform for CMB observations, the Airlander 10 hybrid air vehicle, to perform this task. We show that the Airlander 10 platform, operating at commercial airline altitudes, is well-suited to mapping frequencies above 220 GHz, which are critical for cleaning CMB maps of dust emission. Optimizing the distribution of detectors across frequencies, we forecast the ability of Airlander 10 to clean foregrounds of varying complexity as a function of altitude, demonstrating its complementarity with both existing (Planck) and ongoing (C-BASS) foreground observations. This novel platform could play a key role in defining our ultimate vi...

  9. First year results of the High Altitude Water Cherenkov observatory

    Science.gov (United States)

    Carramiñana, Alberto

    2016-10-01

    The High Altitude Water Cherenkov (HAWC) γ-ray observatory is a wide field of view (1.8 Sr) and high duty cycle (> 95% up-time) detector of unique capabilities for the study of TeV gamma-ray sources. Installed at an altitude of 4100m in the Northern slope of Volcan Sierra Negra, Puebla, by a collaboration of about thirty institutions of Mexico and the United States, HAWC has been in full operations since March 2015, surveying 2/3 of the sky every sidereal day, monitoring active galaxies and mapping sources in the Galactic Plane to a detection level of 1 Crab per day. This contribution summarizes the main results of the first year of observations of the HAWC γ-ray observatory.

  10. Increased insulin requirements during exercise at very high altitude in type 1 diabetes

    NARCIS (Netherlands)

    de Mol, Pieter; de Vries, Suzanna T.; de Koning, Eelco J. P.; Gans, Rijk O. B.; Tack, Cees J.; Bilo, Henk J. G.

    2011-01-01

    OBJECTIVE-Safe, very high altitude trekking in subjects with type 1 diabetes requires understanding of glucose regulation at high altitude. We investigated insulin requirements, energy expenditure, and glucose levels at very high altitude in relation to acute mountain sickness (AMS) symptoms in indi

  11. Increased insulin requirements during exercise at very high altitude in type 1 diabetes

    NARCIS (Netherlands)

    Mol, P. De; Vries, S.T. de; Koning, E.J. de; Gans, R.O.; Tack, C.J.J.; Bilo, H.J.

    2011-01-01

    OBJECTIVE: Safe, very high altitude trekking in subjects with type 1 diabetes requires understanding of glucose regulation at high altitude. We investigated insulin requirements, energy expenditure, and glucose levels at very high altitude in relation to acute mountain sickness (AMS) symptoms in ind

  12. Elevated Suicide Rates at High Altitude: Sociodemographic and Health Issues May Be to Blame

    Science.gov (United States)

    Betz, Marian E.; Valley, Morgan A.; Lowenstein, Steven R.; Hedegaard, Holly; Thomas, Deborah; Stallones, Lorann; Honigman, Benjamin

    2011-01-01

    Suicide rates are higher at high altitudes; some hypothesize that hypoxia is the cause. We examined 8,871 suicides recorded in 2006 in 15 states by the National Violent Death Reporting System, with the victim's home county altitude determined from the National Elevation Dataset through FIPS code matching. We grouped cases by altitude (low less…

  13. Increased insulin requirements during exercise at very high altitude in type 1 diabetes

    NARCIS (Netherlands)

    Mol, P. De; Vries, S.T. de; Koning, E.J. de; Gans, R.O.; Tack, C.J.J.; Bilo, H.J.

    2011-01-01

    OBJECTIVE: Safe, very high altitude trekking in subjects with type 1 diabetes requires understanding of glucose regulation at high altitude. We investigated insulin requirements, energy expenditure, and glucose levels at very high altitude in relation to acute mountain sickness (AMS) symptoms in

  14. Increased insulin requirements during exercise at very high altitude in type 1 diabetes

    NARCIS (Netherlands)

    de Mol, Pieter; de Vries, Suzanna T.; de Koning, Eelco J. P.; Gans, Rijk O. B.; Tack, Cees J.; Bilo, Henk J. G.

    OBJECTIVE-Safe, very high altitude trekking in subjects with type 1 diabetes requires understanding of glucose regulation at high altitude. We investigated insulin requirements, energy expenditure, and glucose levels at very high altitude in relation to acute mountain sickness (AMS) symptoms in

  15. 14 CFR 125.329 - Minimum altitudes for use of autopilot.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Minimum altitudes for use of autopilot. 125... § 125.329 Minimum altitudes for use of autopilot. (a) Except as provided in paragraphs (b), (c), (d), and (e) of this section, no person may use an autopilot at an altitude above the terrain which is...

  16. Nike Black Brant V high altitude dynamic instability characteristics

    Science.gov (United States)

    Montag, W. H.; Walker, L. L., Jr.

    1979-01-01

    Flight experience on the Nike Black Brant V has demonstrated the existence of plume induced flow separation over the fins and aft body of the Black Brant V motor. Modelling of the forces associated with this phenomenon as well as analysis of the resultant vehicle coning motion and its effect on the velocity vector heading are presented. A summary of Nike Black Brant V flight experience with high altitude dynamic instability is included.

  17. Lifespan of a Ceratitis fruit fly increases with higher altitude

    OpenAIRE

    2010-01-01

    Variation in lifespan may be linked to geographic factors. While latitudinal variation in lifespan has been studied for a number of species, altitude variation has received much less attention, particularly in insects. We measured the lifespan of different populations of the Natal fruit fly Ceratitis rosa along an altitudinal cline. For the different populations we first measured the residual longevity of wild flies by captive cohort approach and compared F1 generation from the same populatio...

  18. Lens autofluorescence is not increased at high altitude

    DEFF Research Database (Denmark)

    Kessel, Line; Kofoed, Peter Kristian; Zubieta-Calleja, Gustavo

    2010-01-01

    PURPOSE: To study the relation between ambient environmental ultraviolet radiation exposure and lens fluorescence. METHODS: Non-invasive lens fluorometry measurements were compared in healthy Bolivian and Danish subjects. Background ultraviolet radiation was 4.5 times higher in Bolivia than...... in Denmark. RESULTS: No significant differences in lens fluorescence or transmittance were found between Bolivian and Danish volunteers. CONCLUSION: Age-corrected lens fluorescence and transmittance were comparable for healthy participants living at high altitude near the equator and healthy volunteers...

  19. Nike Black Brant V high altitude dynamic instability characteristics

    Science.gov (United States)

    Montag, W. H.; Walker, L. L., Jr.

    1979-01-01

    Flight experience on the Nike Black Brant V has demonstrated the existence of plume induced flow separation over the fins and aft body of the Black Brant V motor. Modelling of the forces associated with this phenomenon as well as analysis of the resultant vehicle coning motion and its effect on the velocity vector heading are presented. A summary of Nike Black Brant V flight experience with high altitude dynamic instability is included.

  20. Determination of Altitude Sickness Risk (DASR) User’s Guide

    Science.gov (United States)

    2013-11-01

    Information Sciences Directorate Battlefield Environment Division (ATTN: RDRL- CIE -D) White Sands Missile Range, NM 88002-5501 8. PERFORMING ORGANIZATION...displayed accordingly as color -keyed indicators under the “RISK IMPACT” column on the right side of the view. The color coding key is displayed at the...impacts and the altitude illness risk. Again, color coding is the same as for the environmental factors. Note, that in this example, there is a

  1. Blood-Brain Barrier Changes in High Altitude.

    Science.gov (United States)

    Lafuente, José V; Bermudez, Garazi; Camargo-Arce, Lorena; Bulnes, Susana

    2016-01-01

    Cerebral syndromes related to high-altitude exposure are becoming more frequent as the number of trips to high altitudes has increased in the last decade. The commonest symptom is headache, followed by acute mountain sickness (AMS) and high-altitude cerebral edema (HACE), which can be fatal. The pathophysiology of these syndromes is not fully understood. The classical "tight-fit hypothesis" posits that there are some anatomical variations that would obstruct the sinovenous outflow and worsen vasogenic edema and intracranial hypertension reactive to hypoxia. This could explain microhemorrhages seen in autopsies. However, recent magnetic resonance imaging studies have demonstrated some components of cytotoxic edema in HACE absent in AMS, suggesting a dysfunction in water balance at the cellular level. Currently, the "red-ox theory" supports trigemino-vascular system activation by free radicals formed after hypoxia and the consequent oxidative stress cascades. Apart from trigemino-vascular system activation, free radicals can also provoke membrane destabilisation mediated by lipid peroxidation, inflammation, and local hypoxia inducible factor-1α and vascular endothelial growth factor activation, resulting in gross blood-brain barrier (BBB) dysfunction. Besides alterations in endothelial cells such as increased pinocytotic vesicles and disassembly of interendothelial tight junction proteins, capillary permeability may also increase with subsequent swelling of astrocyte end-feet. In conclusion, although the pathophysiology of AMS and HACE is not completely understood, recent evidence proposes a multifactorial entity, with brain swelling and compromise of the BBB considered to play an important role. A fuller comprehension of these processes is crucial to reduce and prevent BBB alterations during high-altitude exposure.

  2. Performance of the Volumetric Diffusive Respirator at Altitude

    Science.gov (United States)

    2014-08-18

    altitude include changes in the movement of gas through fixed orifices altering accuracy in ventilator settings as well as the measurement of flow and...control system relies on the movement of gas through known restrictions and changes in pressure on opposing sides of a diaphragm. Airway pressure... orifice restrictor is placed in line to dampen the pressures in an attempt to display the estimated tracheal pressure. This requires the clinician to

  3. The University of Alberta High Altitude Balloon Program

    Science.gov (United States)

    Johnson, W.; Buttenschoen, A.; Farr, Q.; Hodgson, C.; Mann, I. R.; Mazzino, L.; Rae, J.; University of Alberta High Altitude Balloon Team

    2011-12-01

    The University of Alberta High Altitude Balloon (UA-HAB) program is a one and half year program sponsored by the Canadian Space Agency (CSA) that offers hands on experience for undergraduate and graduate students in the design, build, test and flight of an experimental payload on a high altitude balloon platform. Utilising low cost weather balloon platforms, and through utilisation of the CSA David Florida Laboratory for thermal-vacuum tests , in advance of the final flight of the payload on a NASA high altitude balloon platform. Collectively the program provided unique opportunities for students to experience mission phases which parallel those of a space satellite mission. The program has facilitated several weather balloon missions, which additionally provide educational opportunities for university students and staff, as well as outreach opportunities among junior and senior high school students. Weather balloon missions provide a cheap and quick alternative to suborbital missions; they can be used to test components for more expensive missions, as well as to host student based projects from different disciplines such as Earth and Atmospheric Sciences (EAS), Physics, and Engineering. In addition to extensive skills development, the program aims to promote recruitment of graduate and undergraduate students into careers in space science and engineering. Results from the UA-HAB program and the flight of the UA-HAB shielded Gieger counter payload for cosmic ray and space radiation studies will be presented. Lessons learned from developing and maintaining a weather balloon program will also be discussed. This project is undertaken in partnership with the High Altitude Student Platform, organized by Louisiana State University and the Louisiana Space Consortium (LaSpace), and sponsored by NASA, with the financial support of the Canadian Space Agency.

  4. Neurocritical care education during neurology residency

    Science.gov (United States)

    Drogan, O.; Manno, E.; Geocadin, R.G.; Ziai, W.

    2012-01-01

    Objective: Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. Methods: A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. Results: A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Conclusions: Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents. PMID:22573636

  5. Dementia in a tribal landlocked elderly population at high altitude: What explains the lower prevalence?

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Raina

    2016-01-01

    Full Text Available Introduction: Studies across the populations have suggested that dementia is differentially distributed with a lower prevalence in developing regions than the developed ones. A comparison in the prevalence of dementia across populations may provide an insight into its risk factors. Earlier, we reported on the prevalence of dementia in elderly population in migrant, urban, rural, and tribal populations. The present study was conducted with a view to estimating the prevalence of dementia in Tribal Landlocked Elderly Population at high altitude and therefore to draw some conclusions on the differential distribution of dementia across populations. Methods: A cross-sectional comprehensive two-phase survey of all residents aged 60 years and older was conducted. Phase 1 involved screening of all individuals aged 60 and above with the help of a cognitive screen specifically developed for the tribal population. Phase 2 involved clinical examination of individuals who were suspected of dementia as per the developed cognitive screening test. Results: The results revealed that six individuals out of a total of 481 studied above 60 years of age in the studied population scored between 17 and 23, thus qualifying as suffering from mild cognitive impairment. Importantly, none of the individuals above 60 years of age scored <17. Discussion: The current study is in conformity with our previous study conducted on urban, rural, and migrant areas of the state of Himachal Pradesh again emphasizing on dementia being rare in tribal populations and thereby pointing to the presence of some protective factors among tribal people.

  6. The sleep of elite athletes at sea level and high altitude: a comparison of sea-level natives and high-altitude natives (ISA3600)

    Science.gov (United States)

    Roach, Gregory D; Schmidt, Walter F; Aughey, Robert J; Bourdon, Pitre C; Soria, Rudy; Claros, Jesus C Jimenez; Garvican-Lewis, Laura A; Buchheit, Martin; Simpson, Ben M; Hammond, Kristal; Kley, Marlen; Wachsmuth, Nadine; Gore, Christopher J; Sargent, Charli

    2013-01-01

    Background Altitude exposure causes acute sleep disruption in non-athletes, but little is known about its effects in elite athletes. The aim of this study was to examine the effects of altitude on two groups of elite athletes, that is, sea-level natives and high-altitude natives. Methods Sea-level natives were members of the Australian under-17 soccer team (n=14). High-altitude natives were members of a Bolivian under-20 club team (n=12). Teams participated in an 18-day (19 nights) training camp in Bolivia, with 6 nights at near sea level in Santa Cruz (430 m) and 13 nights at high altitude in La Paz (3600 m). Sleep was assessed on every day/night using activity monitors. Results The Australians’ sleep was shorter, and of poorer quality, on the first night at altitude compared with sea level. Sleep quality returned to normal by the end of the first week at altitude, but sleep quantity had still not stabilised at its normal level after 2 weeks. The quantity and quality of sleep obtained by the Bolivians was similar, or greater, on all nights at altitude compared with sea level. The Australians tended to obtain more sleep than the Bolivians at sea level and altitude, but the quality of the Bolivians’ sleep tended to be better than that of the Australians at altitude. Conclusions Exposure to high altitude causes acute and chronic disruption to the sleep of elite athletes who are sea-level natives, but it does not affect the sleep of elite athletes who are high-altitude natives. PMID:24282197

  7. Distribution of ionospheric O+ion in synchronous altitude region

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Based on satellite observation data, using dynamics equation, the ionospheric O+ion's distribution in the synchronous altitude region for different geomagnetic activity index Kp is studied by theoretical modeling and numerical analyzing, and semi-empirical models for the O+ion's density and flux versus longitude in the synchronous altitude region for different Kp are given. The main results show that in the synchronous altitude region:(i) The O+ ion's density andflux in dayside are larger than those in nightside.(ii) With longitude changing, the higher the geomagnetic activity index Kp is, the higher the O+ion's density and flux, and their variation amplitude will be. The O+ion's density and flux when Kp ≥ 6 will be about ten times as great as that when Kp = 0.(iii) When Kp = 0 or Kp ≥ 6, the O+ion's density reaches maximum at longitudes 120°and240°respectively, and minimum in the magnetotail. When Kp = 3-5, the O+ion'sdensity gets to maximum at longitude 0°, and minimum in the magnetotail. However, the O+ ion's flux reaches maximum at longitude 120°and 240°respectively, and minimum in the magnetotail for any Kp value.

  8. Contemporary sediment production and transfer in high-altitude glaciers

    Science.gov (United States)

    Owen, Lewis A.; Derbyshire, Edward; Scott, Christine H.

    2003-01-01

    The nature of fine-grained sediment production and transfer in high-altitude debris-covered glaciers was studied by examining the Rakhiot and Chungphar glaciers in the Nanga Parbat Himalaya, Northern Pakistan. Transport pathways, from the source areas to the glacier snout, were mapped and samples collected for particle size analysis and scanning electron microscopy. Positive down-glacier trends in sediment fining and increased weathering showed that debris transport in the supraglacial zone of these Himalayan glaciers is an important contributor to contemporary glacial sediment production, resulting in intense comminution that yields large volumes of fine sediment. These findings cast doubt on the traditional view that the basal traction zone of glaciers is the only major source of fine sediment production in glaciated environments, although that view may hold true for classic alpine glaciers that are at lower altitudes and, as a consequence, generally have less supraglacial debris cover. To test this hypothesis, the Glacier de Cheilon, in the Swiss Alps was also studied. This glacier did not exhibit such striking down-glacier trends in the particle size characteristics measured. It is thus suggested that a thick debris-cover may be an important source of fine-grained sediments on glaciers that occur in high-altitude environments.

  9. Altitude Correction for Breakdown Voltages of Long Air-Gaps

    Institute of Scientific and Technical Information of China (English)

    Wang Xuan; Li Yunge; Cao Xiaolong; Su Zhiyi; Liu Ying

    2006-01-01

    The breakdown voltage of long air-gaps in high-voltage transmission systems depends on not only the waveform of the applied voltage, but also the atmospheric conditions. Based on the results of the research project on the minimum air clearance for 800-Kv HVDC substations at high altitudes, and also on the monthly and yearly statistics of the atmospheric data of last ten years and the altitude correction of the atmospheric data of last ten years, the altitude correction of the air-gaps for the 800-Kv DC system under plan, 500-Kv AC system to be built, and 1000-Kv AC system under plan in the Inner Mongolia Plateau and the Yungui Plateau in China were studied with parameter G method. Correction factors for switching and lightning impulses were calculated and then compared with those achieved according to IEC 71. It is shown that IEC 71 is appropriate for damp regions, and correction factors differ between plateau regions in China because of different atmospheric conditions.

  10. Altitude characteristics of plasma turbulence excited with the Tromso superheater

    Energy Technology Data Exchange (ETDEWEB)

    Djuth, F.T.; Elder, J.H. (Geospace Research Inc., El Segundo, CA (United States)); Stubbe, P.; Kohl, H. (Max-Planck-Institut fuer Aeronomie, Katlenburg-Lindau (Germany)); Sulzer, M.P. (Arecibo Observatory (Puerto Rico)); Rietveld, M.T. (EISCAT Scientific Association, Ramfjordbotn (Norway))

    1994-01-01

    Langmuir/ion turbulence excited with the upgraded high-power (1.2-GW effective radiated power) HF heating facility at Tromso, Norway, has been recently studied with the European Incoherent Scatter VHF and UHF incoherent scatter radars. In this report the authors focus on the altitudinal development of the turbulence observed at the highest HF power levels available. Quite remarkably, the observed plasma turbulence plunges downward in altitude over timescales of tens of seconds following HF beam turn-on; the bottom altitude is generally reached after [approximately]30 s. This phenomenon has a well-defined HF power threshold. It is most likely caused by changes in the electron density profile brought about by HF heating of the electron gas. If this is the case, then the heat source must be nonlinearly dependent on HF power. Overall, the characteristics of the Tromso turbulence are quite distinctive when compared to similar high-resolution measurements made at Arecibo Observatory, Puerto Rico. After HF transmissions have been made for tens of seconds at Tromso, billowing altitude structures are often seen, in sharp contrast to layers of turbulence observed at Arecibo. 17 refs., 3 figs.

  11. Decompression to altitude: assumptions, experimental evidence, and future directions.

    Science.gov (United States)

    Foster, Philip P; Butler, Bruce D

    2009-02-01

    Although differences exist, hypobaric and hyperbaric exposures share common physiological, biochemical, and clinical features, and their comparison may provide further insight into the mechanisms of decompression stress. Although altitude decompression illness (DCI) has been experienced by high-altitude Air Force pilots and is common in ground-based experiments simulating decompression profiles of extravehicular activities (EVAs) or astronauts' space walks, no case has been reported during actual EVAs in the non-weight-bearing microgravity environment of orbital space missions. We are uncertain whether gravity influences decompression outcomes via nitrogen tissue washout or via alterations related to skeletal muscle activity. However, robust experimental evidence demonstrated the role of skeletal muscle exercise, activities, and/or movement in bubble formation and DCI occurrence. Dualism of effects of exercise, positive or negative, on bubble formation and DCI is a striking feature in hypobaric exposure. Therefore, the discussion and the structure of this review are centered on those highlighted unresolved topics about the relationship between muscle activity, decompression, and microgravity. This article also provides, in the context of altitude decompression, an overview of the role of denitrogenation, metabolic gases, gas micronuclei, stabilization of bubbles, biochemical pathways activated by bubbles, nitric oxide, oxygen, anthropometric or physiological variables, Doppler-detectable bubbles, and potential arterialization of bubbles. These findings and uncertainties will produce further physiological challenges to solve in order to line up for the programmed human return to the Moon, the preparation for human exploration of Mars, and the EVAs implementation in a non-zero gravity environment.

  12. Naturally enhanced ion-acoustic lines at high altitudes

    Directory of Open Access Journals (Sweden)

    Y. Ogawa

    2006-12-01

    Full Text Available Naturally enhanced ion-acoustic lines (NEIALs between 1200 and 1900 km altitude are investigated. The NEIALs were found in the background gates of data from the European Incoherent Scatter (EISCAT Svalbard radar (ESR at 78° N looking field-aligned. Only strongly enhanced lines are detected at such high altitudes. The estimated enhancement above incoherent scattering integrated over the antenna beam and preintegration time of 10 s reaches about 10 000. Both lines are always enhanced above 1000 km altitude, and the downshifted line, corresponding to upward propagating ion-acoustic waves, is always stronger than the upshifted line, for downgoing waves. The ratio of the downshifted and upshifted peaks is often remarkably constant along a profile. Using the line positions as indicators of the ion-acoustic speeds and the bulk drift velocity, we find that the bulk drift does not exceed the ion-acoustic (sound speed, but extrapolation of the profiles suggests that the sound barrier is reached around 2000 km in one event. The highest ion-acoustic speed is seen near 600 km, above the density peak, indicating that electrons are heated not only by ionizing precipitation but significantly also by upgoing waves. Upflow continues to speed up above the estimated temperature maximum. A certain qualitative similarity to the solar corona seems to be the case.

  13. Breathing in thin air: acclimatization to altitude in ducks.

    Science.gov (United States)

    Powell, Frank L; Shams, Hashim; Hempleman, Steven C; Mitchell, Gordon S

    2004-12-15

    We measured ventilation (VI) and arterial blood gases in Pekin ducks during acclimatization to 3800 m altitude for 1-90 days. Four experimental series were conducted over 4 years using both natural altitude and a hypobaric chamber. PaCO2 decreased to 3.5 Torr, relative to the value measured during acute hypoxia after 1 day and remained at this level for up to 90 days. However, PaO2 did not increase. Arterial pH showed an unexpected metabolic alkalosis during the first hours at altitude but after 3 days, a metabolic acidosis partially compensated the respiratory alkalosis and pHa was constant thereafter. When normoxia was restored after hypoxia, PaCO2 was 5.5 Torr less than the original normoxic control value, but PaO2 was not increased. VI showed variable changes during acclimatization but if metabolic rate was constant in our study, as reported by others, then effective parabronchial V(VP) increased during acclimatization. Increased VP tends to restore PaO2 toward normoxic levels and decreases adverse effects of gas exchange limitation, which apparently increased during acclimatization in ducks.

  14. Diurnal variations of serum erythropoietin at sea level and altitude

    DEFF Research Database (Denmark)

    Klausen, T; Poulsen, T D; Fogh-Andersen, N;

    1996-01-01

    This study tested the hypothesis that the diurnal variations of serum-erythropoietin concentration (serum-EPO) observed in normoxia also exist in hypoxia. The study also attempted to investigate the regulation of EPO production during sustained hypoxia. Nine subjects were investigated at sea level...... and during 4 days at an altitude of 4350 m. Median sea level serum-EPO concentration was 6 (range 6-13) U.l-1. Serum-EPO concentration increased after 18 and 42 h at altitude, [58 (range 39-240) and 54 (range 36-340) U.l-1, respectively], and then decreased after 64 and 88 h at altitude [34 (range 18......-290) and 31 (range 17-104) U.l-1, respectively]. These changes of serum-EPO concentration were correlated to the changes in arterial blood oxygen saturation (r = -0.60, P = 0.0009), pH (r = 0.67, P = 0.003), and in-vivo venous blood oxygen half saturation tension (r = -0.68, P = 0.004) but not to the changes...

  15. Role of thyroid hormones in thermoregulatory reactions during altitude adaptation

    Energy Technology Data Exchange (ETDEWEB)

    Bazhenov, Yu.I.; Sydykov, B.K.

    1981-02-01

    The influence of thyroid hormones on thermogenesis at various stages of altitude adaptation is investigated. Oxygen demand, muscle electrical activity and body temperatures were monitored in white rats at ambient temperatures of 22-24 C and 4-6 C during adaptation to an altitude of 3200 m in control animals and in rats injected daily with triiodothyronine or an antithyroidal preparation of thiamazole. Adaptation to altitude hypoxia is found to decrease the metabolic reactions of the control rats to cold. Injections of thiamazole are observed to lead to a decrease in transport processes and heat production, thus adding to the effects of hypoxia and decreasing the thermal stability of the organism. Triiodothyronine, on the other hand, is observed to increase transport levels and body temperatures and reverse the effects of hypoxia. It is thus proposed that a decrease in the functional capability of the thyroid may be partly responsible for the decrease in the effects of cold on muscular contractions observed during adaptation to hypoxia.

  16. Geriatrics Curricula for Internal and Family Medicine Residents: Assessing Study Quality and Learning Outcomes.

    Science.gov (United States)

    Cheng, Huai Yong; Davis, Molly

    2017-02-01

    Prior reviews of geriatrics curricula for internal medicine (IM) and family medicine (FM) residents have not evaluated study quality or assessed learning objectives or specific IM or FM competencies. This review of geriatrics curricula for IM and FM residents seeks to answer 3 questions: (1) What types of learning outcomes were measured? (2) How were learning outcomes measured? and (3) What was the quality of the studies? We evaluated geriatrics curricula that reported learning objectives or competencies, teaching methods, and learning outcomes, and those that used a comparative design. We searched PubMed and 4 other data sets from 2003-2015, and assessed learning outcomes, outcome measures, and the quality of studies using the Medical Education Research Study Quality Instrument (MERSQI) and Best Evidence Medical Education (BEME) methods. Fourteen studies met inclusion criteria. Most curricula were intended for IM residents in the inpatient setting; only 1 was solely dedicated to FM residents. Median duration was 1 month, and minimum geriatrics competencies covered were 4. Learning outcomes ranged from Kirkpatrick levels 1 to 3. Studies that reported effect size showed a considerable impact on attitudes and knowledge, mainly via pretests and posttests. The mean MERSQI score was 10.5 (range, 8.5-13) on a scale of 5 (lowest quality) to 18 (highest quality). Few geriatrics curricula for IM and FM residents that included learning outcome assessments were published recently. Overall, changes in attitudes and knowledge were sizeable, but reporting was limited to low to moderate Kirkpatrick levels. Study quality was moderate.

  17. Playing Moderately Hard to Get

    Directory of Open Access Journals (Sweden)

    Stephen Reysen

    2013-12-01

    Full Text Available In two studies, we examined the effect of different degrees of attraction reciprocation on ratings of attraction toward a potential romantic partner. Undergraduate college student participants imagined a potential romantic partner who reciprocated a low (reciprocating attraction one day a week, moderate (reciprocating attraction three days a week, high (reciprocating attraction five days a week, or unspecified degree of attraction (no mention of reciprocation. Participants then rated their degree of attraction toward the potential partner. The results of Study 1 provided only partial support for Brehm’s emotion intensity theory. However, after revising the high reciprocation condition vignette in Study 2, supporting Brehm’s emotion intensity theory, results show that a potential partners’ display of reciprocation of attraction acted as a deterrent to participants’ intensity of experienced attraction to the potential partner. The results support the notion that playing moderately hard to get elicits more intense feelings of attraction from potential suitors than playing too easy or too hard to get. Discussion of previous research examining playing hard to get is also re-examined through an emotion intensity theory theoretical lens.

  18. Emergency Medicine Residency Boot Camp Curriculum: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Ataya, Ramsey

    2015-03-01

    Full Text Available Introduction: Establishing a boot camp curriculum is pertinent for emergency medicine (EM residents in order to develop proficiency in a large scope of procedures and leadership skills.  In this article, we describe our program’s EM boot camp curriculum as well as measure the confidence levels of resident physicians through a pre- and post-boot camp survey. Methods: We designed a one-month boot camp curriculum with the intention of improving the confidence, procedural performance, leadership, communication and resource management of EM interns. Our curriculum consisted of 12 hours of initial training and culminated in a two-day boot camp. The initial day consisted of clinical skill training and the second day included code drill scenarios followed by interprofessional debriefing.   Results: Twelve EM interns entered residency with an overall confidence score of 3.2 (1-5 scale across all surveyed skills. Interns reported the highest pre-survey confidence scores in suturing (4.3 and genitourinary exams (3.9. The lowest pre-survey confidence score was in thoracostomy (2.4. Following the capstone experience, overall confidence scores increased to 4.0. Confidence increased the most in defibrillation and thoracostomy. Additionally, all interns reported post-survey confidence scores of at least 3.0 in all skills, representing an internal anchor of “moderately confident/need guidance at times to perform procedure.” Conclusion: At the completion of the boot camp curriculum, EM interns had improvement in self-reported confidence across all surveyed skills and procedures. The described EM boot camp curriculum was effective, feasible and provided a foundation to our trainees during their first month of residency. [West J Emerg Med. 2015;16(2:356–361.

  19. Mercury and methylmercury concentrations in high altitude lakes and fish (Arctic charr) from the French Alps related to watershed characteristics.

    Science.gov (United States)

    Marusczak, Nicolas; Larose, Catherine; Dommergue, Aurélien; Paquet, Serge; Beaulne, Jean-Sébastien; Maury-Brachet, Régine; Lucotte, Marc; Nedjai, Rachid; Ferrari, Christophe P

    2011-04-15

    Total mercury (THg) and methylmercury (MeHg) concentrations were measured in the muscle of Arctic charr (Salvelinus alpinus) and in the water column of 4 lakes that are located in the French Alps. Watershed characteristics were determined (6 coverage classes) for each lake in order to evaluate the influence of watershed composition on mercury and methylmercury concentrations in fish muscle and in the water column. THg and MeHg concentrations in surface water were relatively low and similar among lakes and watershed characteristics play a major role in determining water column Hg and MeHg levels. THg muscle concentrations for fish with either a standardized length of 220mm, a standardized age of 5 years or for individualuals did not exceed the 0.5mg kg(-1) fish consumption advisory limit established for Hg by the World Health Organization (WHO, 1990). These relatively low THg concentrations can be explained by watershed characteristics, which lead to short Hg residence time in the water column, and also by the short trophic chain that is characteristic of mountain lakes. Growth rate did not seem to influence THg concentrations in fish muscles of these lakes and we observed no relationship between fish Hg concentrations and altitude. This study shows that in the French Alps, high altitude lakes have relatively low THg and MeHg concentrations in both the water column and in Arctic charr populations. Therefore, Hg does not appear to present a danger for local populations and the fishermen of these lakes.

  20. Respiratory changes and structure of sleep in young high-altitude dwellers in the Andes of Peru.

    Science.gov (United States)

    Coote, J H; Tsang, G; Baker, A; Stone, B

    1993-01-01

    Sleep organisation in eight young [mean (SD); 20.9 (2.6) years] Peruvian high-altitude residents was studied in a laboratory in Cerro de Pasco at 4300 m. Electroencephalograms, electromyograms, electro-oculograms, electrocardiograms, respiratory movements and arterial oxygen saturation were recorded on an 8-channel Medilog recorder and analysed later in England. Haematocrits ranged from 48% to 64% [57.9 (5.6)%]. The amount of slow wave rapid eye movement (REM) sleep was similar to that reported in young lowlanders sleeping at sea level but very different to the disturbed sleep in visitors sleeping at high altitude. All the Peruvians showed episodes of periodic breathing and respiratory apnoeas [29 (15) night-1] resulting in marked arterial oxygen desaturation [81 (4.5)%; changes of 6 (2.5)%]. These events occurred either during stage 2 or REM sleep and were more frequent in those with lower haematocrits. The amount of wakefulness during the night was 2-3 times greater than would be expected in an age-matched lowland population at sea level. The awakenings were strongly associated with apnoeas (P < 0.02) but were negatively correlated with haematocrit, although this was only significant for seven of the subjects (P < 0.05).

  1. Case-Logging Practices in Otolaryngology Residency Training: National Survey of Residents and Program Directors.

    Science.gov (United States)

    Dermody, Sarah M; Gao, William; McGinn, Johnathan D; Malekzadeh, Sonya

    2017-06-01

    Objective (1) Evaluate the consistency and manner in which otolaryngology residents log surgical cases. (2) Assess the extent of instruction and guidance provided by program directors on case-logging practices. Study Design Cross-sectional national survey. Setting Accreditation Council for Graduate Medical Education otolaryngology residency programs in the United States. Subjects and Methods US otolaryngology residents, postgraduate year 2 through graduating chiefs as of July 2016, were recruited to respond to an anonymous questionnaire designed to characterize surgical case-logging practices. Program directors of US otolaryngology residency programs were recruited to respond to an anonymous questionnaire to elucidate how residents are instructed to log cases. Results A total of 272 residents and 53 program directors completed the survey, yielding response rates of 40.6% and 49.5%, respectively. Perceived accuracy of case logs is low among residents and program directors. Nearly 40% of residents purposely choose not to log certain cases, and 65.1% of residents underreport cases performed. More than 80% of program directors advise residents to log procedures performed outside the operating room, yet only 16% of residents consistently log such cases. Conclusion Variability in surgical case-logging behaviors and differences in provided instruction highlight the need for methods to improve consistency of logging practices. It is imperative to standardize practices across otolaryngology residency programs for case logs to serve as an accurate measure of surgical competency. This study provides a foundation for reform efforts within residency programs and for the Resident Case Log System.

  2. Interobserver agreement between radiologists and radiology residents and emergency physicians in the detection of PE using CTPA.

    Science.gov (United States)

    Hochhegger, Bruno; Alves, Giordano R T; Chaves, Marcus; Moreira, Ana Luiza; Kist, Renato; Watte, Guilherme; Moreira, José S; Irion, Klaus L; Marchiori, Edson

    2014-01-01

    To assess interobserver agreement between thoracic radiologists, radiology residents, and emergency physicians in diagnosing pulmonary embolism (PE). Emergency physicians, radiology residents, and thoracic radiologists evaluated 123 computed tomography pulmonary angiography images. Interobserver agreement was analysed using kappa statistics. Very good agreements were observed between thoracic radiologists and radiology residents (0.81 and 0.82). Fair and moderate agreements (0.39 and 0.42) were demonstrated between emergency physicians and thoracic radiologists. Important differences in interobserver agreement were found, with emergency physicians tending to overdiagnose PE. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Obstetrics and gynaecology chief resident attitudes toward teaching junior residents under normal working conditions.

    Science.gov (United States)

    Gil, Karen M; Savitski, Jennifer L; Bazan, Sara; Patterson, Laurene R; Kirven, Melissa

    2009-09-01

    This study aimed to identify factors that chief residents believe impact the teaching of junior residents under normal working conditions and the areas in which they believe education on the role of resident as teacher would be beneficial. Obstetrics and gynaecology (O&G) chief residents were asked to rate the importance of teaching various skills, how often conflict situations arose, and to identify training that would be helpful through a national web-based survey. An e-mail was sent to coordinators of the Residency Review Committee (RRC) O&G residency programmes with a request that they forward the link to their chief residents three times from January through March 2006. Responses were received from 204 postgraduate Year 4 (PGY4) residents (18% of all PGY4 residents) from 133 programmes (54% of all residency programmes) and 33 states. Teaching junior residents how to prioritise patient care and obtain critical information in an emergent situation was considered very to extremely important by 97%. Conflict situations with junior residents were reported to occur between one and five times by 41-58%; an additional 26-28% reported that these situations occurred six or more times. Residents felt it would be helpful to extremely helpful to have training in resolving conflicts that involved patient care (48-59%), as well as in resolving conflict among junior residents, communicating effectively with them and becoming an effective leader (65-78%). The skills that chief residents considered most important to teach junior residents involved direct patient care. Chief residents would like training in how to resolve conflict with, and among, junior residents, and in how to become an effective leader.

  4. Feasibility of an innovative third-year chief resident system: an internal medicine residency leadership study

    Directory of Open Access Journals (Sweden)

    Victor O. Kolade

    2014-07-01

    Full Text Available Introduction: The role of the internal medicine chief resident includes various administrative, academic, social, and educational responsibilities, fulfillment of which prepares residents for further leadership tasks. However, the chief resident position has historically only been held by a few residents. As fourth-year chief residents are becoming less common, we considered a new model for rotating third-year residents as the chief resident. Methods: Online surveys were given to all 29 internal medicine residents in a single university-based program after implementation of a leadership curriculum and specific job description for the third-year chief resident. Chief residents evaluated themselves on various aspects of leadership. Participation was voluntary. Descriptive statistics were generated using SPSS version 21. Results: Thirteen junior (first- or second-year resident responses reported that the chief residents elicited input from others (mean rating 6.8, were committed to the team (6.8, resolved conflict (6.7, ensured efficiency, organization and productivity of the team (6.7, participated actively (7.0, and managed resources (6.6. Responses from senior residents averaged 1 point higher for each item; this pattern repeated itself in teaching evaluations. Chief resident self-evaluators were more comfortable running a morning report (8.4 than with being chief resident (5.8. Conclusion: The feasibility of preparing internal medicine residents for leadership roles through a rotating PGY-3 (postgraduate year chief residency curriculum was explored at a small internal medicine residency, and we suggest extending the study to include other programs.

  5. The surgical residency baby boom: changing patterns of childbearing during residency over a 30-year span.

    Science.gov (United States)

    Smith, Caitlin; Galante, Joseph M; Pierce, Jonathan L; Scherer, Lynette A

    2013-12-01

    Birthrates during surgical residency appear to be rising. One assumption is that this is due to changes in the structure of surgical residencies. The purpose of our study was to explore whether an increase in birthrates has occurred and the reasons for this. We conducted an anonymous survey of current residents and alumni from 1976 to 2009 at a single university-based surgery training program. Alumni (46 of 116) and current residents (38 of 51) were surveyed, and our response rate was approximately 50% (84 of 167). Respondents were grouped into cohorts based on their residency start year. The early cohort consisted of residents starting residency between 1976 and 1999, and the late cohort consisted of residents starting residency between 2000 and 2009. The percentage of male residents with children during residency training was similar for the early and late cohorts (34% [10 of 29] versus 41% [9 of 22]). For female residents, there was a substantial increase in childbearing for the late cohort (7% [1 of 15] versus 35% [6 of 18]). Fifty-two percent (44 of 84) of the respondents who had children during residency reported that work hours and schedule had a negative effect on their decision to have children. Most respondents reported that availability or cost of child care, impact on residency, support from the program, increased length of training, or availability of family leave did not factor as concerns. Childbearing during residency has increased in female residents in our study. Surgical residency programs may need to accommodate this change if they want to continue to recruit and retain talented residents.

  6. Schistosomiasis transmission at high altitude crater lakes in Western Uganda

    Directory of Open Access Journals (Sweden)

    Philbert Clouds

    2008-08-01

    Full Text Available Abstract Background Contrary to previous reports which indicated no transmission of schistosomiasis at altitude >1,400 m above sea level in Uganda, in this study it has been established that schistosomiasis transmission can take place at an altitude range of 1487–1682 m above sea level in western Uganda. Methods An epidemiological survey of intestinal schistosomiasis was carried out in school children staying around 13 high altitude crater lakes in Western Uganda. Stool samples were collected and then processed with the Kato-Katz technique using 42 mg templates. Thereafter schistosome eggs were counted under a microscope and eggs per gram (epg of stool calculated. A semi-structured questionnaire was used to obtain demographic data and information on risk factors. Results 36.7% of the pupils studied used crater lakes as the main source of domestic water and the crater lakes studied were at altitude ranging from 1487–1682 m above sea level. 84.6% of the crater lakes studied were infective with over 50% of the users infected. The overall prevalence of Schistosoma mansoni infection was 27.8% (103/370 with stool egg load ranging from 24–6048 per gram of stool. 84.3%( 312 had light infections (400 egg/gm of stool. Prevalence was highest in the age group 12–14 years (49.5% and geometric mean intensity was highest in the age group 9–11 years (238 epg. The prevalence and geometric mean intensity of infection among girls was lower (26%; 290 epg compared to that of boys (29.6%; 463 epg (t = 4.383, p Conclusion and recommendations The altitudinal threshold for S. mansoni transmission in Uganda has changed and use of crater water at an altitude higher than 1,400 m above sea level poses a risk of acquiring S. mansoni infection in western Uganda. However, further research is required to establish whether the observed altitudinal threshold change is as a result of climate change or other factors. It is also necessary to establish the impact this could

  7. Edema pulmonar de gran altura HIGH ALTITUDE PULMONARY EDEMA

    Directory of Open Access Journals (Sweden)

    FELIPE UNDURRAGA M

    2003-04-01

    Full Text Available Las enfermedades de altura son de causa cerebral y pulmonar. Las primeras se refieren fundamentalmente al mal agudo de montaña y al edema cerebral de altura y las segundas al edema pulmonar agudo de montaña. Actuales evidencias señalan que el edema cerebral sería un fenómeno universal de los que ascienden a altura y que tres de cada cuatro individuos sanos que se expongan a altura desarrollarán un edema pulmonar agudo de montaña subclínico. La hipoxia de altura es la responsable de estos cuadros y los sujetos susceptibles serían aquellos que genéticamente tienen una respuesta ventilatoria reducida a la hipoxia y una exagerada respuesta vasopresora pulmonar al ejercicio.Se presenta un caso de edema pulmonar agudo de montaña en un deportista previamente sano que participó en una expedición al cerro El Plomo (5.280 msnm en la Cordillera de los Andes central. Posteriormente, se comenta la fisiopatología y tratamiento de esta condiciónHigh altitude diseases are originated from brain and lung. The first are Acute Mountain Sickness and Brain edema and the second is High Altitude Pulmonary Edema (HAPE. Current evidence shows that brain edema is an universal event of the people who are exposed to high altitude. By other hand 3 out of 4 healthy subjects exposed to high altitude will present a subclinical HAPE. Hypoxia of altitude is the responsable for this condition. The susceptible subjects would be those who genetically have a low ventilatory response to hypoxia and an exaggerated increase of vascular pulmonary pressure during exercise. A clinical case of acute pulmonary edema in a young sportman who participated in an expedition to Cerro El Plomo (5.280 m in Chilean Central Andes Mountains is presented. Pathophysiology and treatment of these conditions are discussed

  8. Ataxia, acute mountain sickness, and high altitude cerebral edema

    Institute of Scientific and Technical Information of China (English)

    Wu Tianyi; Ma Siqing; Bian Huiping; Zhang Minming

    2013-01-01

    Previous investigations suggest that ataxia is common and often one of the most reliable warning signs of high altitude cerebral edema(HACE).The aim of this study was to investigate the diagnostic role of ataxia in acute mountain sickness (AMS) and HACE among mountain rescuers on the quake areas,and in approaching the relation between AMS and HACE.After the earthquake on April 14,2010,approximately 24080 lowland rescuers were rapidly transported from sea level or lowlands to the mountainous rescue sites at 3750 ~ 4568 m,and extremely hardly worked for an emergency treatment after arrival.Assessments of acute altitude illness on the quake areas were using the Lake Louise Scoring System.73 % of the rescuers were found to be developed AMS.The incidence of high altitude pulmonary edema(HAPE) and HACE was 0.73 % and 0.26 %,respectively,on the second to third day at altitude.Ataxia sign was measured by simple tests of coordination including a modified Romberg test.The clinical features of 62 patients with HACE were analyzed.It was found that the most frequent,serious neurological symptoms and signs were altered mental status(50/62,80.6 %)and truncal ataxia (47/62,75.8 %).Mental status change was rated slightly higher than ataxia,but ataxia occurred earlier than mental status change and other symptoms.The earliest sign of ataxia was a vague unsteadiness of gait,which may be present alone in association with or without AMS.Advanced ataxia was correlated with the AMS scores,but mild ataxia did not correlate with AMS scores at altitudes of 3750~4568 m.Of them,14 patients were further examined by computerized tomographic scanning of the brain and cerebral magnetic resonance imagines were examined in another 15 cases.These imaging studies indicated that the presence of the cerebral edema was in 97 % of cases who were clinically diagnosed as HACE (28/29).Ataxia seems to be a reliable sign of advanced AMS or HACE,so does altered mental status.

  9. Women residents, women physicians and medicine's future.

    Science.gov (United States)

    Serrano, Karen

    2007-08-01

    The number of women in medicine has increased dramatically in the last few decades, and women now represent half of all incoming medical students. Yet residency training still resembles the historical model when there were few women in medicine. This article reviews the issues facing women in residency today. Data suggest that the experience of female residents is more negative than that of males. Unique challenges facing female residents include the existence of gender bias and sexual harassment, a scarcity of female mentors in leadership positions, and work/family conflicts. Further research is needed to understand the experience of female residents and to identify barriers that hinder their optimal professional and personal development. Structural and cultural changes to residency programs are needed to better accommodate the needs of female trainees.

  10. HUD Low and Moderate Income Areas

    Data.gov (United States)

    Department of Housing and Urban Development — This dataset and map service provides information on the U.S. Housing and Urban Development's (HUD) low to moderate income areas. The term Low to Moderate Income,...

  11. Regulation of human skeletal muscle perfusion and its heterogeneity during exercise in moderate hypoxia

    DEFF Research Database (Denmark)

    Heinonen, Ilkka H; Kemppainen, Jukka; Kaskinoro, Kimmo

    2010-01-01

    Although many effects of both acute and chronic hypoxia on the circulation are well characterized, the distribution and regulation of blood flow (BF) heterogeneity in skeletal muscle during systemic hypoxia is not well understood in humans. We measured muscle BF within the thigh muscles of nine...... healthy young men using positron emission tomography during one-leg dynamic knee extension exercise in normoxia and moderate physiological systemic hypoxia (14% O(2) corresponding to approximately 3,400 m of altitude) without and with local adenosine receptor inhibition with femoral artery infusion...

  12. [Hemo- and neurodynamics of the human brain during exposure to moderate hypoxic hypoxia].

    Science.gov (United States)

    Alekseev, D A; Zubarev, A F; Krupina, T N; Iarullin, Kh Kh; Kuznets, E I

    1984-01-01

    Synchronous electro- and rheoencephalography were used to study tolerance to moderate hypoxic hypoxia for 30 min at an altitude of 5000 m without additional oxygen supply. As test subject, men with autonomic-vascular dystonia (29-39 years old), 15 men over 40 (41-56 years old), and 16 essentially healthy controls (23-36 years old) were used. The aged volunteers (41-56 years old) did not differ from the controls with respect to their tolerance to hypoxic hypoxia. The men with early symptoms of hypertonic-type dystonia also showed high tolerance to hypoxic hypoxia. The subjects with hypotonic-type dystonia displayed lower tolerance.

  13. Low to moderate temperature nanolaminate heater

    Science.gov (United States)

    Eckels, J Del [Livermore, CA; Nunes, Peter J [Danville, CA; Simpson, Randall L [Livermore, CA; Hau-Riege, Stefan [Fremont, CA; Walton, Chris [Oakland, CA; Carter, J Chance [Livermore, CA; Reynolds, John G [San Ramon, CA

    2011-01-11

    A low to moderate temperature heat source comprising a high temperature energy source modified to output low to moderate temperatures wherein the high temperature energy source modified to output low to moderate temperatures is positioned between two thin pieces to form a close contact sheath. In one embodiment the high temperature energy source modified to output low to moderate temperatures is a nanolaminate multilayer foil of reactive materials that produces a heating level of less than 200.degree. C.

  14. Initial performance of a modified milestones global evaluation tool for semiannual evaluation of residents by faculty.

    Science.gov (United States)

    Borman, Karen R; Augustine, Rebecca; Leibrandt, Thomas; Pezzi, Christopher M; Kukora, John S

    2013-01-01

    To determine whether faculty could successfully evaluate residents using a competency-based modified Milestones global evaluation tool. A program's leadership team modified a draft Surgery Milestones Working Group summative global assessment instrument into a modified Milestones tool (MMT) for local use during faculty meetings devoted to semiannual resident review. Residents were scored on 15 items spanning all competencies using an 8-point graphic response scale; unstructured comments also were solicited. Arithmetic means were computed at the resident and postgraduate year cohort levels for items and competency item sets. Score ranges (highest minus lowest score) were calculated; variability was termed "low" (range 2.0). A subset of "low" was designated "small" (1.0-1.9). Trends were sought among item, competency, and total Milestones scores. MMT correlations with examination scores and multisource (360°) assessments were explored. The success of implementing MMT was judged using published criteria for educational assessment methods. Fully accredited, independently sponsored residency. Program leaders and 22 faculty members (71% voluntary, mean 12y of experience). Twenty-six residents were assessed, yielding 7 to 13 evaluations for MMT per categorical resident and 3 to 6 per preliminary trainee. Scores spanned the entire response scale. All MMT evaluations included narrative comments. Individual resident score variability was low (96% within competencies and 92% across competencies). Subset analysis showed that small variations were common (35% within competencies and 54% across competencies). Postgraduate year cohort variability was higher (61% moderate or high within competencies and 50% across competencies). Cohort scores at the item, competency, and total score levels exhibited rising trajectories, suggesting MMT construct validity. MMT scores did not demonstrate concurrent validity, correlating poorly with other metrics. The MMT met multiple criteria for

  15. Effects on Pharmacokinetics of Propranolol and Other Factors in Rats After Acute Exposure to High Altitude at 4,010 m.

    Science.gov (United States)

    Wenbin, Li; Rong, Wang; Hua, Xie; Juanhong, Zhang; Xiaoyu, Wu; Zhengping, Jia

    2015-05-01

    A series of pathological, physiological, and biochemical changes, even anatomical histological changes happen while humans arrive at the high plateau region from plain area. There is a certain relationship between the body's compensatory or decompensated adjustments to the environment and the changes of absorption, distribution, metabolism, and excretion of drugs. The objective of the study is to observe the effects of acute exposure to high altitude at 4,010 m on pharmacokinetics of propranolol in rats, and to provide basis and new ideas to adjust drug dosage and administration, so as to promote rational drug use in high altitude. 28 healthy male wistar rats were randomly divided into four groups, group A and B which were in plain area; group C and D which were acutely exposed to high altitude by aviation; group A and C were used for pharmacokinetics determination of propranolol, while group B and D had no drug administration for physiological and pathological changes research at high altitude. The pharmacokinetics of propranolol significantly changed; area under curve, C max (the peak concentration), mean residence time, and t 1/2 (the biological half-life) increased significantly by 481.72, 398.94, 44.87, and 58.77 %, respectively; clearance and V (apparent volume of distribution) decreased by 81.50 and 70.56 %, respectively, after acute exposure to high altitude at 4,010 m; Analytic results show that pH, buffer base, base excess, ctCO2 (content of total carbon dioxide), sO2 (oxygen saturation of arterial blood), pO2 (oxygen tension of arterial blood), and cNa(+) severely decreased by 2.43, 630.00, 311.00, 11.48, 91.38, 76.22, and 2.82 %, respectively, while pCO2 (carbon dioxide tension of arterial blood) and cCl(-) significantly increased by 47.40 and 6.76 %. Lactate dehydrogenase and total protein significantly decreased by 58.44 and 26.82 %, while total bilirubin and alkaline phosphatase severely increased by 338 and 24.94 % after acute exposure to high

  16. Radiology residents' experience with intussusception reduction.

    Science.gov (United States)

    Bateni, Cyrus; Stein-Wexler, Rebecca; Wootton-Gorges, Sandra L; Li, Chin-Shang

    2011-06-01

    Residents should be exposed to adequate procedural volume to act independently upon completion of training. Informal inquiry led us to question whether residents encounter enough intussusception reductions to become comfortable with the procedure. We sought to determine radiology residents' exposure to intussusception reductions, and whether their experiences vary by region or institution. U.S. radiology residency program directors were asked to encourage their residents to complete a 12-question online survey describing characteristics of their pediatric radiology department, experiences with intussusception reduction, and confidence in their own ability to perform the procedure. Six hundred sixty-four residents responded during the study period. Of those, 308 (46.4%) had not experienced an intussusception reduction, and 228 (34%) had experienced only one or two. Twenty-two percent of fourth-year residents had never experienced an intussusception reduction, and 21% had experienced only one. Among second- through fourth-year residents, only 99 (18.3%) felt confident that they could competently reduce an intussusception (P Radiology residents have limited opportunity to learn intussusception reduction and therefore lack confidence. Most think they would benefit from additional training with a computer-simulation model.

  17. Ethics seminars: teaching professionalism to "problem" residents

    National Research Council Canada - National Science Library

    Marco, Catherine A

    2002-01-01

    ..., are essential skills that should be taught during residency. A variety of approaches can be used, which include didactic teaching, bedside teaching, leadership, evaluation, and individualized mentorship...

  18. A positron moderator using porous metal

    Institute of Scientific and Technical Information of China (English)

    WANG Bao-Yi; YU Run-Sheng; ZHAO Fa-Ru; MA Chuang-Xin; ZHANG Tian-Bao; WEI Long

    2004-01-01

    Two types of porous metal moderators (i.e. porous nickel layer and multi-wire tungsten layer) are proposed and tested on a slow positron beam line. A moderation efficiency of about 2×10-4 has been achieved, which is higher than that for W vane geometry moderator by a factor of 4.

  19. MODERATOR ELEMENTS FOR UNIFORM POWER NUCLEAR REACTOR

    Science.gov (United States)

    Balent, R.

    1963-03-12

    This patent describes a method of obtaining a flatter flux and more uniform power generation across the core of a nuclear reactor. The method comprises using moderator elements having differing moderating strength. The elements have an increasing amount of the better moderating material as a function of radial and/or axial distance from the reactor core center. (AEC)

  20. Awareness of Infectious Diseases in Obstetrics and Gynecology Among Residents and Residency Directors

    Directory of Open Access Journals (Sweden)

    Richard H. Beigi

    2006-01-01

    Full Text Available Awareness of the subspecialty of infectious diseases in obstetrics and gynecology is low among United States residents and residency directors. Objective. Given the burden of infectious diseases on women's health, we sought to assess current awareness, interest, and perceived value of the subspecialty of infectious diseases in obstetrics and gynecology among current United States obstetrics and gynecology residents and residency directors. Methods. Two separate surveys addressing awareness, perceived value and interest in the subspecialty were sent to (1 a random 20% sample of obstetrics and gynecology residents and (2 all obstetrics and gynecology residency directors. Results. Seventy percent of the residency directors were familiar with the subspecialty and 67.0% placed value on infectious disease specialists in an academic department. Thirty percent of the residents reported awareness of the subspecialty. Thirty-six percent of residency directors reported that medical infectious disease specialists deliver formal education to the obstetrics and gynecology residents. Conclusion. United States obstetrics and gynecology residents and residency directors have a low awareness of the subspecialty. An open niche exists for formal education of residents in infectious diseases in obstetrics and gynecology by department specialists. These findings can be incorporated into ongoing recruitment efforts for the subspecialty of infectious diseases in obstetrics and gynecology.

  1. Phase offsets between core and conal components of radio pulsars and their emission altitudes

    CERN Document Server

    Kapoor, R C

    2002-01-01

    We present a new method for investigating emission altitudes of radio pulsar core and conal components by attributing them different altitudes and by providing a framework to understand the resulting longitude offsets between them which are frequently observed. By investigating the contributions to these offsets due to aberration and the magnetic field line sweepback, we show that they are always dominated by aberration for all emission altitudes and inclination angles. This directly allows the conclusion that the core emission does not necessarily come from the surface. Our results and the observational trends imply that for a large number of pulsars the emission altitudes of core and conal components are close when compared to the light cylinder radius but not necessarily relative to the stellar radius. The core/cone altitude differences that we find are typically larger than the individual altitudes ascribed to them so far. Widely different core/cone altitudes for some pulsars are also supported by data an...

  2. Global health training in pediatric residency programs.

    Science.gov (United States)

    Nelson, Brett D; Lee, Anne Cc; Newby, P K; Chamberlin, M Robert; Huang, Chi-Cheng

    2008-07-01

    Our goal was to describe current resident interest, participation, curricula, resources, and obstacles related to global health training within pediatric residency programs. We conducted a cross-sectional survey of the 201 accredited pediatric residency programs in the United States, Puerto Rico, and the Caribbean from October 2006 to January 2007. Survey topics included resident interest and participation in electives, training opportunities, program support, and educational curricular content related to global health. Of the 201 surveyed pediatric residency programs, 106 (53%) responded. Fifteen percent of responding programs reported that a majority of their residents were interested in global health. Fifty-two percent offered a global health elective within the previous year, and 47% had formally incorporated global health into their training curricula. Six percent of the programs reported a formalized track or certificate in global health. The median number of residents per program participating in global health electives within the previous year was 0 during postgraduate year 1, 1 during postgraduate year 2, and 2 during postgraduate year 3. The median number of all residents per program participating in a global health elective in the previous year was 3 (7.4% of program size). Among programs that offered a global health elective, support to participating residents included prerequisite clinical training (36%), cultural orientation (36%), language training (15%), faculty mentorship (82%), and post-elective debriefing (77%). Fourteen percent of the programs provided full funding for resident electives. Characteristics of pediatric residency programs that were significantly associated with higher resident participation in a global health elective were larger program size, university affiliation, greater reported resident interest, and faculty involvement in global health. More than half of the pediatric residency programs surveyed offered a global health

  3. Moderators of youth exercise intention and behavior.

    Science.gov (United States)

    Ellis, Rebecca; Kosma, Maria; Symons Downs, Danielle

    2013-06-01

    This study tested moderators of the theory of planned behavior (TPB) based on geographical region, gender, race, and income among adolescents in an exercise context using multigroup path analyses. Participants were eighth- and ninth-grade students from Louisiana (LA; N = 448, M age = 14.37 years) and Pennsylvania (PA; N = 681, M age = 14.28 years). They completed measures of intention, attitude, subjective norm, perceived behavioral control, and exercise behavior. Based on two path analyses, geographical region was a significant moderator (p < .001); therefore, the moderating effects of gender, race, and income were analyzed separately for each state. Gender was a significant moderator for LA (p < .001) but not for PA (p = .90). Race and income did not moderate the TPB relationships within each state. Findings support the moderating effect of geographical region on the TPB construct relationships and indicate that gender moderates the TPB construct relationships in LA youth.

  4. Radiology residents as teachers: Current status of teaching skills training in United States residency programs.

    Science.gov (United States)

    Donovan, Andrea

    2010-07-01

    Radiology residents often teach medical students and other residents. Workshops developed with the goal of improving resident teaching skills are becoming increasingly common in various fields of medicine. The purpose of this study was to determine the prevalence and structure of resident-teacher training opportunities within radiology programs in the United States. Program directors with membership in the Association of Program Directors in Radiology (APDR) were surveyed to determine views on a panel of topics related to resident-teacher training programs. A total of 114 (56%) of 205 APDR members completed an online survey. Approximately one-third (32%) stated that their program provided instruction to residents on teaching skills. The majority of these programs (72%) were established within the last 5 years. Residents provided teaching to medical students (94%) and radiology residents (90%). The vast majority of program directors agreed that it is important for residents to teach (98%) and that these teaching experiences helped residents become better radiologists (85%). Ninety-four percent of program directors felt that the teaching skills of their residents could be improved, and 85% felt that residents would benefit from instruction on teaching methods. Only one-third of program directors felt their program adequately recognized teaching provided by residents. Program directors identified residents as being active contributors to teaching in most programs. Although teaching was viewed as an important skill to develop, few programs had instituted a resident-teacher curriculum. Program directors felt that residents would benefit from structured training to enhance teaching skills. Future studies are needed to determine how best to provide teaching skills training for radiology trainees. 2010 AUR. Published by Elsevier Inc. All rights reserved.

  5. Radiology resident teaching skills improvement: impact of a resident teacher training program.

    Science.gov (United States)

    Donovan, Andrea

    2011-04-01

    Teaching is considered an essential competency for residents to achieve during their training. Instruction in teaching skills may assist radiology residents in becoming more effective teachers and increase their overall satisfaction with teaching. The purposes of this study were to survey radiology residents' teaching experiences during residency and to assess perceived benefits following participation in a teaching skills development course. Study participants were radiology residents with membership in the American Alliance of Academic Chief Residents in Radiology or the Siemens AUR Radiology Resident Academic Development Program who participated in a 1.5-hour workshop on teaching skills development at the 2010 Association of University Radiologists meeting. Participants completed a self-administered, precourse questionnaire that addressed their current teaching strategies, as well as the prevalence and structure of teaching skills training opportunities at their institutions. A second postcourse questionnaire enabled residents to evaluate the seminar and assessed new knowledge and skill acquisition. Seventy-eight residents completed the precourse and postcourse questionnaires. The vast majority of respondents indicated that they taught medical students (72 of 78 [92.3%]). Approximately 20% of residency programs (17 of 78) provided residents with formal didactic programs on teaching skills. Fewer than half (46.8%) of the resident respondents indicated that they received feedback on their teaching from attending physicians (36 of 77), and only 18% (13 of 78) routinely gave feedback to their own learners. All of the course participants agreed or strongly agreed that this workshop was helpful to them as teachers. Few residency programs had instituted resident teacher training curricula. A resident teacher training workshop was perceived as beneficial by the residents, and they reported improvement in their teaching skills. Copyright © 2011 AUR. Published by

  6. Community Structure of Skipper Butterflies (Lepidoptera, Hesperiidae) along Elevational Gradients in Brazilian Atlantic Forest Reflects Vegetation Type Rather than Altitude

    Science.gov (United States)

    Carneiro, Eduardo; Mielke, Olaf Hermann Hendrik; Casagrande, Mirna Martins; Fiedler, Konrad

    2014-01-01

    Species turnover across elevational gradients has matured into an important paradigm of community ecology. Here, we tested whether ecological and phylogenetic structure of skipper butterfly assemblages is more strongly structured according to altitude or vegetation type along three elevation gradients of moderate extent in Serra do Mar, Southern Brazil. Skippers were surveyed along three different mountain transects, and data on altitude and vegetation type of every collection site were recorded. NMDS ordination plots were used to assess community turnover and the influence of phylogenetic distance between species on apparent community patterns. Ordinations based on ecological similarity (Bray-Curtis index) were compared to those based on phylogenetic distance measures (MPD and MNTD) derived from a supertree. In the absence of a well-resolved phylogeny, various branch length transformation methods were applied together with four different null models, aiming to assess if results were confounded by low-resolution trees. Species composition as well as phylogenetic community structure of skipper butterflies were more prominently related to vegetation type instead of altitude per se. Phylogenetic distances reflected spatial community patterns less clearly than species composition, but revealed a more distinct fauna of monocot feeders associated with grassland habitats, implying that historical factors have played a fundamental role in shaping species composition across elevation gradients. Phylogenetic structure of community turned out to be a relevant additional tool which was even superior to identify faunal contrasts between forest and grassland habitats related to deep evolutionary splits. Since endemic skippers tend to occur in grassland habitats in the Serra do Mar, inclusion of phylogenetic diversity may also be important for conservation decisions. PMID:25272004

  7. Diagnosis and prediction of the occurrence of acute mountain sickness measuring oxygen saturation--independent of absolute altitude?

    Science.gov (United States)

    Leichtfried, Veronika; Basic, Daniel; Burtscher, Martin; Gothe, Raffaella Matteucci; Siebert, Uwe; Schobersberger, Wolfgang

    2016-03-01

    Commercialization of trekking tourism enables untrained persons to participate in trekking tours. Because hypoxia is one of the main purported triggers for acute mountain sickness (AMS), pulse oximetry, which measures arterial oxygen saturation (SPO2), is discussed to be a possible and useful tool for the diagnosis of AMS. The purpose of this study was to evaluate possible associations between SPO2 values and the occurrence of AMS. In 204 trekkers, SPO2 values (pulse oximetry) were measured and the Lake Louise Self-assessment Score (LLS) was administered over the first 7 days of their trekking tours. During treks at altitudes of 2500-5500 m in Nepal, India, Africa, and South America, 100 participants suffered from mild AMS, 3 participants suffered from severe AMS, and 9 participants reported both mild and severe AMS. The lowest mean SPO2 was 85.5 (95 % confidence interval (CI), 83.9-86.1 %) on day 5. SPO2 and LLS exhibited a weak to moderate negative correlation for all days of the study (ρ ranging from -0.142 to -0.370). Calculation of time-shifted associations of 24 and 48 h resulted in the disappearance of most associations. Susceptibility to headaches (odds ratio (OR) 2.9-7.2) and a history of AMS (OR 2.2-3.1) were determined to be potential risk factors for the development of AMS. Since there is no strong altitude-independent association between AMS and SPO2 during the first week of high-altitude adaptation, the implementation of pulse oximetry during trekking in order to detect and predict AMS remains questionable.

  8. Genomic divergence during speciation driven by adaptation to altitude.

    Science.gov (United States)

    Chapman, Mark A; Hiscock, Simon J; Filatov, Dmitry A

    2013-12-01

    Even though Darwin's "On the Origin of Species" implied selection being the main driver of species formation, the role of natural selection in speciation remains poorly understood. In particular, it remains unclear how selection at a few genes can lead to genomewide divergence and the formation of distinct species. We used a particularly attractive clear-cut case of recent plant ecological speciation to investigate the demography and genomic bases of species formation driven by adaptation to contrasting conditions. High-altitude Senecio aethnensis and low-altitude S. chrysanthemifolius live at the extremes of a mountain slope on Mt. Etna, Sicily, and form a hybrid zone at intermediate altitudes but remain morphologically distinct. Genetic differentiation of these species was analyzed at the DNA polymorphism and gene expression levels by high-throughput sequencing of transcriptomes from multiple individuals. Out of ≈ 18,000 genes analyzed, only a small number (90) displayed differential expression between the two species. These genes showed significantly elevated species differentiation (FST and Dxy), consistent with diversifying selection acting on these genes. Genomewide genetic differentiation of the species is surprisingly low (FST = 0.19), while ≈ 200 genes showed significantly higher (false discovery rate 0.6) interspecific differentiation and evidence for local adaptation. Diversifying selection at only a handful of loci may be enough for the formation and maintenance of taxonomically well-defined species, despite ongoing gene flow. This provides an explanation of why many closely related species (in plants, in particular) remain phenotypically and ecologically distinct despite ongoing hybridization, a question that has long puzzled naturalists and geneticists alike.

  9. Ergogenic properties of metformin in simulated high altitude.

    Science.gov (United States)

    Scalzo, Rebecca L; Paris, Hunter L; Binns, Scott E; Davis, Janelle L; Beals, Joseph W; Melby, Christopher L; Luckasen, Gary J; Hickey, Matthew S; Miller, Benjamin F; Hamilton, Karyn L; Bell, Christopher

    2017-07-01

    Metformin augments glucose/glycogen regulation and may acutely promote fatigue resistance during high-intensity exercise. In hypobaric environments, such as high altitude, the important contribution of carbohydrates to physiological function is accentuated as glucose/glycogen dependence is increased. Because hypoxia/hypobaria decreases insulin sensitivity, replenishing skeletal muscle glycogen in high altitude becomes challenging and subsequent physical performance may be compromised. We hypothesized that in conditions where glycogen repletion was critical to physical outcomes, metformin would attenuate hypoxia-mediated decrements in exercise performance. On three separate randomly ordered occasions, 13 healthy men performed glycogen-depleting exercise and ingested a low-carbohydrate dinner (1200 kcals, metformin (500 mg BID) was consumed 3 days prior to each hypoxia visit. Subjects completed a 12.5 km cycle ergometer time trial 3.5 hours following breakfast. Hypoxia decreased resting and exercise oxyhemoglobin saturation (Pmetformin affected the glucose response to breakfast (P=.977), however, compared with placebo, metformin lowered insulin concentration in hypoxia 45 minutes after breakfast (64.1±6.6 μU/mL vs 48.5±7.8 μU/mL; mean±SE; Pmetformin (+81%; P=.006), but not in hypoxia with placebo (+27%; P=.167). Hypoxia decreased time trial performance compared with normoxia (Pmetformin (+1.6±0.3 minutes). These results indicate that metformin promotes glycogen synthesis but not endurance exercise performance in healthy men exposed to simulated high altitude. © 2017 John Wiley & Sons Australia, Ltd.

  10. Capabilities of unmanned aircraft vehicles for low altitude weed detection

    Science.gov (United States)

    Pflanz, Michael; Nordmeyer, Henning

    2014-05-01

    Sustainable crop production and food security require a consumer and environmental safe plant protection. It is recently known, that precise weed monitoring approaches could help apply pesticides corresponding to field variability. In this regard the site-specific weed management may contribute to an application of herbicides with higher ecologically aware and economical savings. First attempts of precision agriculture date back to the 1980's. Since that time, remote sensing from satellites or manned aircrafts have been investigated and used in agricultural practice, but are currently inadequate for the separation of weeds in an early growth stage from cultivated plants. In contrast, low-cost image capturing at low altitude from unmanned aircraft vehicles (UAV) provides higher spatial resolution and almost real-time processing. Particularly, rotary-wing aircrafts are suitable for precise path or stationary flight. This minimises motion blur and provides better image overlapping for stitching and mapping procedures. Through improved image analyses and the recent increase in the availability of microcontrollers and powerful batteries for UAVs, it can be expected that the spatial mapping of weeds will be enhanced in the future. A six rotors microcopter was equipped with a modified RGB camera taking images from agricultural fields. The hexacopter operates within predefined pathways at adjusted altitudes (from 5 to 10 m) by using GPS navigation. Different scenarios of optical weed detection have been carried out regarding to variable altitude, image resolution, weed and crop growth stages. Our experiences showed high capabilities for site-specific weed control. Image analyses with regard to recognition of weed patches can be used to adapt herbicide application to varying weed occurrence across a field.

  11. A patient safety curriculum for medical residents based on the perspectives of residents and supervisors.

    NARCIS (Netherlands)

    Jansma, J.D.; Wagner, C.; Bijnen, A.B.

    2011-01-01

    Objectives: To develop a patient safety course for medical residents based on the views of medical residents and their supervisors. Methods: In 2007, questionnaires were distributed to investigate residents' and supervisors' perspectives on the current patient safety performance and educational need

  12. Suicide Intervention Skills among Japanese Medical Residents

    Science.gov (United States)

    Fujisawa, Daisuke; Suzuki, Yuriko; Kato, Takahiro A.; Hashimoto, Naoki; Sato, Ryoko; Aoyama-Uehara, Kumi; Fukasawa, Maiko; Tomita, Masayuki; Watanabe, Koichiro; Kashima, Haruo; Otsuka, Kotaro

    2013-01-01

    Objectives: Patient suicide is a tragic occurrence, and it can be a demoralizing experience for medical residents. Few studies, however, have assessed suicide management skills among these front-line healthcare professionals. This study evaluated the self-assessed competence and confidence of medical residents with regard to the management of…

  13. Contrasting Attitudes of Dormitory and Apartment Residents.

    Science.gov (United States)

    Chase, Clinton I.; Wolosin, Myrna A.

    This study was designed to discover the attitudes that distinguish apartment-dwelling students from dormitory residents at Indiana University. The study appears to support the following conclusions. Apartment dwellers see independence as a major factor in their choice of residence. They also believe that apartments are more convenient than…

  14. Adult neurology training during child neurology residency.

    Science.gov (United States)

    Schor, Nina F

    2012-08-21

    As it is currently configured, completion of child neurology residency requires performance of 12 months of training in adult neurology. Exploration of whether or not this duration of training in adult neurology is appropriate for what child neurology is today must take into account the initial reasons for this requirement and the goals of adult neurology training during child neurology residency.

  15. Displacing Media: LCD LAB Artistic Residency

    Directory of Open Access Journals (Sweden)

    Filipe Pais

    2012-12-01

    Full Text Available This review refers to an artistic residency which took place at LCD LAB -  CAAA at Guimarães, in March, exploring a strategy for media art called Media Displacement. The text introduces the strategy very briefly and describes the residency's organization, structure, processses and the results produced.

  16. Current Practices in Resident Assistant Training

    Science.gov (United States)

    Koch, Virginia Albaneso

    2016-01-01

    Developing resident assistant (RA) training is a challenge for most housing and residence life staff. Grounded in the author's doctoral research on the curricular design of RA training programs, this study summarizes current practices in three types of RA training programs--preservice training, in-service training, and academic courses--and…

  17. Co-Dependency and Resident Assistants.

    Science.gov (United States)

    Hetherington, Cheryl; Kerr, Barbara

    1988-01-01

    Proposes that an important psychological variable, codependence, may help to account for the phenomenon of burnout among resident assistants and other high-achieving, socially able college students. Explores characteristics of codependency. Suggests ways that institutional policy can help to decrease resident assistant burnout and related…

  18. Co-Dependency and Resident Assistants.

    Science.gov (United States)

    Hetherington, Cheryl; Kerr, Barbara

    1988-01-01

    Proposes that an important psychological variable, codependence, may help to account for the phenomenon of burnout among resident assistants and other high-achieving, socially able college students. Explores characteristics of codependency. Suggests ways that institutional policy can help to decrease resident assistant burnout and related…

  19. Putting "Rural" into Psychiatry Residency Training Programs

    Science.gov (United States)

    Nelson, William A.; Pomerantz, Andrew; Schwartz, Jonathan

    2007-01-01

    Objective: Evidence indicates disparities in the number of psychiatrists practicing in rural America compared to urban areas suggesting the need for a greater emphasis on rural psychiatry in residency training programs. The authors offer suggestions for integrating a rural focus in psychiatry residency training to foster greater competency and…

  20. Residents as Educators: A Modern Model.

    Science.gov (United States)

    Kensinger, Clark D; McMaster, William G; Vella, Michael A; Sexton, Kevin W; Snyder, Rebecca A; Terhune, Kyla P

    2015-01-01

    Education during surgical residency has changed significantly. As part of the shifting landscape, the importance of an organized and structured curriculum has increased. However, establishing this is often difficult secondary to clinical demands and pressure both on faculty and residents. We present a peer-assisted learning model for academic institutions without professional non-clinical educations. The "resident as educator" (RAE) model empowers residents to be the organizers of the education curriculum. RAE is built on a culture of commitment to education, skill development and team building, allowing the upper level residents to develop and execute the curriculum. Several modules designed to address junior level residents and medical students' educational needs have been implemented, including (1) intern boot camp, (2) summer school, (3) technical skill sessions, (4) trauma orientation, (5) weekly teaching conferences, and (4) a fourth year medical student surgical preparation course. Promoting residents as educators leads to an overall benefit for the program by being cost-effective and time-efficient, while simultaneously promoting professional development of residents and a culture of education. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.