[Arterial hypertension due to altitude].

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Domej, Wolfgang; Trapp, Michael; Miggitsch, Eva Maria; Krakher, Tiziana; Riedlbauer, Rita; Roher, Peter; Schwaberger, Günther

2008-01-01

The behavior of blood pressure under hypoxic conditions depends on individual factors, altitude and duration of stay at altitude. While most humans are normotensive at higher altitudes, a few will react with moderate hypertension or hypotension. Excessive elevation of arterial blood pressure is not even to be expected below 4,000 m. Rather, several weeks' stay at higher altitude will decrease systolic and diastolic blood pressure at rest as well as during physical exertion. A high-altitude treatment for rehabilitation purposes at moderate altitude may be recommended for patients with cardio-circulatory disorders. Improvements can last several months even after returning to accustomed altitudes. Furthermore, endurance-trained hypertensive patients with pharmacologically controlled arterial blood pressure might be able to participate in mountain treks without additional health risk.

EFFECT OF HIGH ALTITUDE ON ERECTILE FUNCTION IN OTHERWISE HEALTHY INDIVIDUALS

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Usama Bin Zubair

2016-06-01

Full Text Available Objective: To determine the effect of high altitude on Erectile function in otherwise healthy individuals and associated socio demographic factors. Study Design: Cross sectional descriptive study. Place and Duration of Study: January 2014 to March 2014 at Goma, Siachin. Material and Methods: One hundred & twenty two married male subjects living at an altitude of more than 15000 feet for more than 3 month and less than one year were included in the study. Erectile dysfunction (ED was assessed using International Index of Erectile Function-5 (IIEF-5. Age, education, smoking, monthly income, any drug intake, altitude, duration of stay and weather conditions were correlated independently with ED. Results: Out of 122, 26 (21.3% had no ED, 18 had mild, 28 (14.8% had mild to moderate, 36(29.5% had moderate and 14 (11.5% had severe ED. Advancing age, low monthly income, smoking, high altitude, cold weather and longer duration of stay had significant association with ED (p-value<0.05 while education and use of any drug were not found significantly associated in our study. Conclusion: This study showed a high prevalence of erectile dysfunction among otherwise healthy individuals when exposed to high altitude. Special attention should be paid on individuals with more age, less income and those working or residing at higher altitudes in peak winter season. Smoking and stay for longer durations should also be discouraged.

Advance Directives among Nursing Home Residents with Mild, Moderate, and Advanced Dementia.

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Tjia, Jennifer; Dharmawardene, Marisa; Givens, Jane L

2018-01-01

To describe prevalence and content of AD documentation among NH residents by dementia stage. The prevalence of advance directives (ADs) among nursing home (NH) residents with mild, moderate, and advanced dementia remains unclear. Population-based, cross-sectional study of all licensed NHs in five U.S. states. Subjects included all long-stay (>90 day) NH residents with dementia, aged ≥65 years, and a Cognitive Performance Scale (CPS) score ≥1 from the 2007 to 2008 Minimum Data Set 2.0 (n = 180,621). Dementia severity was classified as follows: mild (CPS 1-2), moderate (CPS 3-4), and advanced (CPS 5-6). ADs were defined as the presence of a living will, do-not-resuscitate order, do-not-hospitalize order, medication restriction, or feeding restriction). Overall, 59% of residents had any AD and 17% had a living will. Prevalence of any AD increased by dementia severity: mild (51.2%), moderate (58.2%), and advanced (61.5%) (p will was associated with higher education (≥high school graduate vs. some high school or less) and being married. While dementia severity was associated with greater likelihood of having documented any AD, almost 4 in 10 residents with dementia lacked any AD. Effective outreach may focus efforts on subgroups with lower odds of any AD or living wills, including non-white, less educated, and unmarried NH residents. A greater understanding of how such factors impact care planning will help to address barriers to patient-centered care for this population.

Measuring change in activities of daily living in nursing home residents with moderate to severe cognitive impairment

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Fries Brant E

2006-04-01

Full Text Available Abstract Background The objective of this study was to assess the responsiveness of the Minimum Data Set Activities of Daily Living (MDS-ADL Scale to change over time by examining the change in physical function in adults with moderate to severe dementia with no comorbid illness who had been resident in a nursing home for over 90 days. Methods Longitudinal data were collected on nursing home residents with moderate (n = 7001 or severe (n = 4616 dementia in one US state from the US national Minimum Data Set (MDS. Severity of dementia was determined by the MDS Cognitive Performance Scale (CPS. Physical function was assessed by summing the seven items (bed mobility, transfer, locomotion, dressing, eating, toilet use, personal hygiene on the MDS activities of daily living (ADL Long Form scale. Mean change over time of MDS-ADL scores were estimated at three and six months for residents with moderate (CPS score of 3 and severe (CPS score of 4 or 5 dementia. Results Physical function in residents with moderate cognitive impairment deteriorated over six months by an average of 1.78 points on the MDS-ADL Long Form scale, while those with severe cognitive impairment declined by an average of 1.70 points. Approximately one quarter of residents in both groups showed some improvement in physical function over the six month period. Residents with moderate cognitive impairment experienced the greatest deterioration in early-loss and mid-loss ADL items (personal hygiene, dressing, toilet use and residents with severe cognitive impairment showed the greatest deterioration in activities related to eating, a late loss ADL. Conclusion The MDS-ADL Long Form scale detected clinically meaningful change in physical function in a large cohort of long-stay nursing home residents with moderate to severe dementia, supporting its use as a research tool in future studies.

Measuring change in activities of daily living in nursing home residents with moderate to severe cognitive impairment

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Carpenter, G Iain; Hastie, Charlotte L; Morris, John N; Fries, Brant E; Ankri, Joel

2006-01-01

Background The objective of this study was to assess the responsiveness of the Minimum Data Set Activities of Daily Living (MDS-ADL) Scale to change over time by examining the change in physical function in adults with moderate to severe dementia with no comorbid illness who had been resident in a nursing home for over 90 days. Methods Longitudinal data were collected on nursing home residents with moderate (n = 7001) or severe (n = 4616) dementia in one US state from the US national Minimum Data Set (MDS). Severity of dementia was determined by the MDS Cognitive Performance Scale (CPS). Physical function was assessed by summing the seven items (bed mobility, transfer, locomotion, dressing, eating, toilet use, personal hygiene) on the MDS activities of daily living (ADL) Long Form scale. Mean change over time of MDS-ADL scores were estimated at three and six months for residents with moderate (CPS score of 3) and severe (CPS score of 4 or 5) dementia. Results Physical function in residents with moderate cognitive impairment deteriorated over six months by an average of 1.78 points on the MDS-ADL Long Form scale, while those with severe cognitive impairment declined by an average of 1.70 points. Approximately one quarter of residents in both groups showed some improvement in physical function over the six month period. Residents with moderate cognitive impairment experienced the greatest deterioration in early-loss and mid-loss ADL items (personal hygiene, dressing, toilet use) and residents with severe cognitive impairment showed the greatest deterioration in activities related to eating, a late loss ADL. Conclusion The MDS-ADL Long Form scale detected clinically meaningful change in physical function in a large cohort of long-stay nursing home residents with moderate to severe dementia, supporting its use as a research tool in future studies. PMID:16584565

Maternal and perinatal outcomes in second hemoglobin measurement in nonanemic women at first booking: effect of altitude of residence in peru.

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Gonzales, Gustavo F; Tapia, Vilma; Fort, Alfredo L

2012-01-01

Objective. To determine changes in hemoglobin concentration at second measurements after a normal hemoglobin concentration was detected at first booking during pregnancy at low and at high altitudes. Methods. This is a secondary analysis of a large database obtained from the Perinatal Information System in Peru which includes 379,816 pregnant women and their babies from 43 maternity units in Peru. Results. Most women remained with normal hemoglobin values at second measurement (75.1%). However, 21.4% of women became anemic at the second measurement. In all, 2.8% resulted with moderate/severe anemia and 3.5% with erythrocytosis (Hb>14.5 g/dL). In all cases Hb was higher as altitude increased. Risk for moderate/severe anemia increased associated with higher gestational age at second measurement of hemoglobin, BMI anemia was observed with normal high Hb level at first booking living at moderate and high altitude, and high BMI. Conclusion. Prevalence of anemia increases as pregnancy progress, and that a normal value at first booking may not be considered sufficient as Hb values should be observed throughout pregnancy. BMI was a risk for anemia in a second measurement.

Endurance training at altitude.

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Saunders, Philo U; Pyne, David B; Gore, Christopher J

2009-01-01

Since the 1968 Olympic Games when the effects of altitude on endurance performance became evident, moderate altitude training ( approximately 2000 to 3000 m) has become popular to improve competition performance both at altitude and sea level. When endurance athletes are exposed acutely to moderate altitude, a number of physiological responses occur that can comprise performance at altitude; these include increased ventilation, increased heart rate, decreased stroke volume, reduced plasma volume, and lower maximal aerobic power ((.)Vo(2max)) by approximately 15% to 20%. Over a period of several weeks, one primary acclimatization response is an increase in the volume of red blood cells and consequently of (.)Vo(2max). Altitudes > approximately 2000 m for >3 weeks and adequate iron stores are required to elicit these responses. However, the primacy of more red blood cells for superior sea-level performance is not clear-cut since the best endurance athletes in the world, from Ethiopia (approximately 2000 to 3000 m), have only marginally elevated hemoglobin concentrations. The substantial reduction in (.)Vo(2max) of athletes at moderate altitude implies that their training should include adequate short-duration (approximately 1 to 2 min), high-intensity efforts with long recoveries to avoid a reduction in race-specific fitness. At the elite level, athlete performance is not dependent solely on (.)Vo(2max), and the "smallest worthwhile change" in performance for improving race results is as little as 0.5%. Consequently, contemporary statistical approaches that utilize the concept of the smallest worthwhile change are likely to be more appropriate than conventional statistical methods when attempting to understand the potential benefits and mechanisms of altitude training.

Echocardiographic assessment of right ventricular functions in healthy subjects who migrated from the sea level to a moderate altitude.

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Arısoy, Arif; Topçu, Selim; Demirelli, Selami; Altunkaş, Fatih; Karayakalı, Metin; Çelik, Ataç; Tanboğa, İbrahim Halil; Aksakal, Enbiya; Sevimli, Serdar; Gürlertop, Hanefi Yekta

2015-11-25

The aim of this study was to evaluate right ventricle (RV) functions using echocardiography in healthy subjects who migrated from the sea level to moderate altitude (1890 m). The prospective observational in this study population consisted of 33 healthy subjects (23 men; mean age 20.4±3.2 years) who migrated from the sea level to a moderate altitude (Erzurum city centre, 1890 m above sea level) for long-term stay. Subjects underwent echocardiographic evaluation within the first 48 h of exposure to the moderate altitude and at the sixth month of arrival. Conventional echocardiographic parameters such as RV sizes and areas, systolic, and diastolic functional indices [fractional area change (FAC), tricuspid flow velocities, myocardial performance index (MPI), and tricuspid annular plane systolic excursion (TAPSE)] were obtained. Systolic (S) and diastolic (E', A') velocities were acquired from the apical fourchamber view using tissue Doppler imaging. Kolmogorov-Smirnov test, student's t-test, Wilcoxon test, and chi-square test were used in this study. There were no significant changes in RV size, FAC, MPI, TAPSE, inferior inspiratory vena cava collapse, tricuspid E velocity, and tricuspid annulus E' velocity. Compared with the baseline, there was a significant increase in mean pulmonary artery pressure (p=0.001); RV end systolic area (p=0.014); right atrial end diastolic area (p=0.021); tricuspid A velocity (p=0.013); tricuspid annulus S and A' velocity (p=0.031 and p=0.006, respectively); and RV free wall S, E', and A' velocity (p=0.007, pa significant decrease in tricuspid E/A ratio (1.61±0.3 vs. 1.45±0.2, p=0.038) and tricuspid annulus E'/A' ratio (1.52±0.5 vs. 1.23±0.4, p=0.002) at the sixth month. Our study revealed that right ventricular diastolic function was altered while the systolic function was preserved in healthy subjects who migrated from the sea level to a moderate altitude.

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

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2013-01-01

reduced AMS after rapid ascent to high altitude. Key Words: acute mountain sickness, hypobaric hypoxia, acclimatization, fluid balance, ventilatory...response to hypoxia Introduction Altitude acclimatization refers to a series of phys-iologic responses to prolonged exposure to hypobaric hypoxia in low...Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts. 2Center for Aerospace and Hyperbaric Medicine

Measuring the aerial application of oil dispersant from very large aircraft at moderate altitude

International Nuclear Information System (INIS)

Fay, R.R.; Giammona, C.P.; Binkley, K.; Engelhardt, F.R.

1993-01-01

As part of a study of various aspects of oil dispersant application technology, a comparison study was conducted employing the Airborne Dispersant Delivery System (ADDS) pack and the Modular Aerial Spray System (MASS) in C-130 Hercules aircraft at altitudes of 50-150 ft above ground and at speeds up to 200 knots. Dyed Corexit 9527 was applied at a target dose rate of 5 gal/acre over a collection grid composed of metal trays, Kromekote cards, oil-sensitive cards, a continuous trough, and a WRK string collector. Analysis of the collected dispersant was done by colorimetry, fluorometry, and image analysis. Correlations through the different methodologies demonstrated that high speed, moderate altitude application of oil dispersant could be successful in delivering dispersant to the surface at effective concentration and drop size. Environmental studies of the test area showed no residual dispersant in the soil following cessation of spraying. 1 ref

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

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Belén Feriche

Full Text Available 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 (P<0.05. We also observed a stimulating effect of natural hypoxia on P(mean and P(peak in the middle-high part of the curve (≥ 60 kg; P<0.01 and a 7.8% mean increase in barbell displacement velocity (P<0.001. No changes in any of the variables examined were observed in G2. According to these data, we can state that acute exposure to natural moderate altitude as opposed to simulated normobaric hypoxia leads to gains in 1 RM, movement velocity and power during the execution of a force-velocity curve in bench press.

[Physiological aspects of altitude training and the use of altitude simulators].

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Ranković, Goran; Radovanović, Dragan

2005-01-01

Altitude training in various forms is widely practiced by athletes and coaches in an attempt to improve sea level endurance. Training at high altitude may improve performance at sea level through altitude acclimatisation, which improves oxygen transport and/or utilisation, or through hypoxia, which intensifies the training stimulus. This basic physiological aspect allows three training modalities: live high and train high (classic high-altitude training), live low and train high (training through hypoxia), and live high and train low (the new trend). In an effort to reduce the financial and logistical challenges of travelling to high-altitude training sites, scientists and manufactures have developed artificial high-altitude environments, which simulate the hypoxic conditions of moderate altitude (2000-3000 meters). Endurance athletes from many sports have recently started using nitrogen environments, or hypoxic rooms and tents as part of their altitude training programmes. The results of controlled studies on these modalities of high-altitude training, their practical approach, and ethics are summarised.

Physiological aspects of altitude training and the use of altitude simulators

Directory of Open Access Journals (Sweden)

Ranković Goran

2005-01-01

Full Text Available Altitude training in various forms is widely practiced by athletes and coaches in an attempt to improve sea level endurance. Training at high altitude may improve performance at sea level through altitude acclimatization, which improves oxygen transport and/or utilization, or through hypoxia, which intensifies the training stimulus. This basic physiological aspect allows three training modalities: live high and train high (classic high-altitude training, live low and train high (training through hypoxia, and live high and train low (the new trend. In an effort to reduce the financial and logistical challenges of traveling to high-altitude training sites, scientists and manufactures have developed artificial high-altitude environments, which simulate the hypoxic conditions of moderate altitude (2000-3000 meters. Endurance athletes from many sports have recently started using nitrogen environments, or hypoxic rooms and tents as part of their altitude training programmes. The results of controlled studies on these modalities of high-altitude training, their practical approach, and ethics are summarized.

Effects of Dietary Nitrate Supplementation on Physiological Responses, Cognitive Function, and Exercise Performance at Moderate and Very-High Simulated Altitude

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Oliver M. Shannon

2017-06-01

Full Text Available Purpose: Nitric oxide (NO bioavailability is reduced during acute altitude exposure, contributing toward the decline in physiological and cognitive function in this environment. This study evaluated the effects of nitrate (NO3− supplementation on NO bioavailability, physiological and cognitive function, and exercise performance at moderate and very-high simulated altitude.Methods:Ten males (mean (SD: V˙O2max: 60.9 (10.1 ml·kg−1·min−1 rested and performed exercise twice at moderate (~14.0% O2; ~3,000 m and twice at very-high (~11.7% O2; ~4,300 m simulated altitude. Participants ingested either 140 ml concentrated NO3−-rich (BRJ; ~12.5 mmol NO3− or NO3−-deplete (PLA; 0.01 mmol NO3− beetroot juice 2 h before each trial. Participants rested for 45 min in normobaric hypoxia prior to completing an exercise task. Exercise comprised a 45 min walk at 30% V˙O2max and a 3 km time-trial (TT, both conducted on a treadmill at a 10% gradient whilst carrying a 10 kg backpack to simulate altitude hiking. Plasma nitrite concentration ([NO2−], peripheral oxygen saturation (SpO2, pulmonary oxygen uptake (V˙O2, muscle and cerebral oxygenation, and cognitive function were measured throughout.Results: Pre-exercise plasma [NO2−] was significantly elevated in BRJ compared with PLA (p = 0.001. Pulmonary V˙O2 was reduced (p = 0.020, and SpO2 was elevated (p = 0.005 during steady-state exercise in BRJ compared with PLA, with similar effects at both altitudes. BRJ supplementation enhanced 3 km TT performance relative to PLA by 3.8% [1,653.9 (261.3 vs. 1718.7 (213.0 s] and 4.2% [1,809.8 (262.0 vs. 1,889.1 (203.9 s] at 3,000 and 4,300 m, respectively (p = 0.019. Oxygenation of the gastrocnemius was elevated during the TT consequent to BRJ (p = 0.011. The number of false alarms during the Rapid Visual Information Processing Task tended to be lower with BRJ compared with PLA prior to altitude exposure (p = 0.056. Performance in all other cognitive tasks

Effects of ascent to high altitude on human antimycobacterial immunity.

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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

The Impact of Altitude on Sleep-Disordered Breathing in Children Dwelling at High Altitude: A Crossover Study.

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Hughes, Benjamin H; Brinton, John T; Ingram, David G; Halbower, Ann C

2017-09-01

Sleep-disordered breathing (SDB) is prevalent among children and is associated with adverse health outcomes. Worldwide, approximately 250 million individuals reside at altitudes higher than 2000 meters above sea level (masl). The effect of chronic high-altitude exposure on children with SDB is unknown. This study aims to determine the impact of altitude on sleep study outcomes in children with SDB dwelling at high altitude. A single-center crossover study was performed to compare results of high-altitude home polysomnography (H-PSG) with lower altitude laboratory polysomnography (L-PSG) in school-age children dwelling at high altitude with symptoms consistent with SDB. The primary outcome was apnea-hypopnea index (AHI), with secondary outcomes including obstructive AHI; central AHI; and measures of oxygenation, sleep quality, and pulse rate. Twelve participants were enrolled, with 10 included in the final analysis. Median altitude was 1644 masl on L-PSG and 2531 masl on H-PSG. Median AHI was 2.40 on L-PSG and 10.95 on H-PSG. Both obstructive and central respiratory events accounted for the difference in AHI. Oxygenation and sleep fragmentation were worse and pulse rate higher on H-PSG compared to L-PSG. These findings reveal a clinically substantial impact of altitude on respiratory, sleep, and cardiovascular outcomes in children with SDB who dwell at high altitude. Within this population, L-PSG underestimates obstructive sleep apnea and central sleep apnea compared to H-PSG. Given the shortage of high-altitude pediatric sleep laboratories, these results suggest a role for home sleep apnea testing for children residing at high altitude. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

High altitude headache and acute mountain sickness at moderate elevations in a military population during battalion-level training exercises.

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Norris, Jacob N; Viirre, Erik; Aralis, Hilary; Sracic, Michael K; Thomas, Darren; Gertsch, Jeffery H

2012-08-01

Few studies have evaluated high altitude headache (HAH) and acute mountain sickness (AMS) in military populations training at moderate (1,500-2,500 m) to high altitudes (>2,500 m). In the current study, researchers interviewed active duty personnel training at Marine Corps Mountain Warfare Training Center. Participants were asked about HAH and AMS symptoms, potential risk factors, and medications used. In a sample of 192 U.S. Navy and Marine Corps personnel, 14.6% reported AMS (Lake Louise Criteria > or = 3) and 28.6% reported HAH. Dehydration and recent arrival at altitude (defined as data collected on days 2-3) were significantly associated with AMS; decreased sleep allowance was significantly associated with HAH. Although ibuprofen/Motrin users were more likely to screen positive for AMS, among AMS-positive participants, ibuprofen/Motrin users had decreased likelihood of reporting robust AMS relative to non-ibuprofen/Motrin users (p altitude. Further, ibuprofen/Motrin may be a reasonable treatment for the symptoms of AMS and HAH, although further study is warranted.

Oxidative stress in elite athletes training at moderate altitude and at sea level.

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León-López, Josefa; Calderón-Soto, Carmen; Pérez-Sánchez, Matías; Feriche, Belén; Iglesias, Xavier; Chaverri, Diego; Rodréguez, Ferran A

2018-03-24

Using a controlled parallel group longitudinal trial design, we investigated the effects of different training interventions on the prooxidant/antioxidant status of elite athletes: living and training at moderate altitude for 3 (Hi-Hi3) and 4 weeks (Hi-Hi), and for 4 weeks too, living high and training high and low (Hi-HiLo) and living and training at sea level (Lo-Lo). From 61 swimmers, 54 completed the study. Nitrites, carbonyls, and lipid peroxidation (LPO) levels were assessed in plasma. Enzymatic antioxidants glutathione peroxidase (GPx) and glutathione reductase (GRd), and non-enzymatic antioxidants total glutathione (GST), reduced glutathione (GSH) and oxidized glutathione (GSSG) were analysed in the erythrocyte fraction. At the end of the intervention, nitrites levels were similar in all altitude groups but higher than in the Lo-Lo controls (P = .02). Hi-HiLo had greater GPx activity than Hi-Hi and Hi-Hi3 during most of the intervention (P ≤ .001). GRd activity was higher in Lo-Lo than in Hi-Hi at the end of the training camp (P ≤ .001). All groups showed increased levels of LPO, except Lo-Lo, and carbonyls at the end of the study (P ≤ .001). Training at altitude for 3 or 4 weeks drives oxidative stress leading to cellular damage mainly by worsening the antioxidant capacities. The GSSG/GSH ratio appears to be related to perceived exertion and fatigue. The stronger antioxidant defence showed by the Hi-HiLo group suggests an inverse relationship between redox alterations and performance. Further studies are required to investigate the role of oxidative stress in acclimatization, performance, and health.

Brain Food at High Altitude.

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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.

Secular trends of physical growth and abdominal adiposity of school children and adolescents living at a moderate altitude in Peru.

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Cossio-Bolaños, Marco; de Arruda, Miguel; Andruske, Cynthia Lee; Luarte-Rocha, Cristian; Gómez-Campos, Rossana

2017-02-01

Identify changes in physical growth and abdominal adiposity at an interval of 14 years in children and adolescents living at a moderate altitude in Peru. The data comes from two cross-sectional studies carried out in the city of Arequipa, Peru, located at a moderate altitude of 2,320 meters. In 2001, 473 males and 482 females were assessed, and in 2015, 432 males and 403 females between 6.0 and 12.9 years old were evaluated. Data were collected in public state schools and measured using the anthropometric variables for weight, height, and waist circumference. Body mass index (BMI) was calculated according to age and sex. Positive trends for weight were identified for both males and females at all ages (p  .05) occurred in height for females between the ages of 6 and 8 years. However, commencing at age 9 until 12 years, females showed positive and significant increases (p Peru. These changes may be associated with the rapid economic development in the country. © 2016 Wiley Periodicals, Inc.

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

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...

Altitude training improves glycemic control.

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Chen, Shu-Man; Lin, Hsueh-Yi; Kuo, Chia-Hua

2013-08-31

Under altitude hypoxia condition, energy reliance on anaerobic glycolysis increases to compensate the shortfall caused by reduced fatty acid oxidation. Short-term moderate altitude exposure plus endurance physical activity has been found to improve glucose tolerance (not fasting glucose) in humans, which is associated with the improvement in the whole-body insulin sensitivity. However, most of people cannot accommodate high altitude exposure above 4500 M due to acute mountain sickness and insulin resistance. There is a wide variation among individuals in response to the altitude challenge. In particular, the improvement in glucose tolerance and insulin sensitivity by prolonged altitude hiking activity was not apparent in those individuals with low baseline dehydroepiandrosterone sulfate (DHEA-S) concentration. In rats, exercise training recovery under prolonged hypoxia exposure (14-15% oxygen, 8 h per day for 6 weeks) can also improve insulin sensitivity, secondary to an effective suppression of adiposity. After prolonged hypoxia training, obese abnormality in upregulated baseline levels of AMP-activated protein kinase (AMPK) and AS160 phosphorylation in skeletal muscle can be reversed. In humans, moderate hypoxia increases postprandial blood distribution towards skeletal muscle during a training recovery. This physiological response plays a role in the redistribution of fuel storage among important energy storage sites and may explain its potent effect on the favorable change in body composition. Altitude training can exert strong impact on our metabolic system, and has the potential to be designed as a non-pharmacological or recreational intervention regimen for correcting metabolic syndromes.

Glucose Homeostasis During Short-term and Prolonged Exposure to High Altitudes

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Ader, Marilyn; Bergman, Richard N.

2015-01-01

Most of the literature related to high altitude medicine is devoted to the short-term effects of high-altitude exposure on human physiology. However, long-term effects of living at high altitudes may be more important in relation to human disease because more than 400 million people worldwide reside above 1500 m. Interestingly, individuals living at higher altitudes have a lower fasting glycemia and better glucose tolerance compared with those who live near sea level. There is also emerging evidence of the lower prevalence of both obesity and diabetes at higher altitudes. The mechanisms underlying improved glucose control at higher altitudes remain unclear. In this review, we present the most current evidence about glucose homeostasis in residents living above 1500 m and discuss possible mechanisms that could explain the lower fasting glycemia and lower prevalence of obesity and diabetes in this population. Understanding the mechanisms that regulate and maintain the lower fasting glycemia in individuals who live at higher altitudes could lead to new therapeutics for impaired glucose homeostasis. PMID:25675133

Determinants and the Moderating Effect of Perceived Policy Effectiveness on Residents' Separation Intention for Rural Household Solid Waste.

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Liao, Chuanhui; Zhao, Dingtao; Zhang, Shuang; Chen, Lanfang

2018-04-11

Currently, villages "besieged with garbage" have become a serious problem in rural areas of China. Separation of rural residential solid waste (RRSW) is one of the main strategies for waste reduction. Although previous studies have analyzed the social and psychological motivations of residents' separation intention for municipal solid waste (MSW), little attention has been paid to the situation in rural areas. This paper investigates key factors influencing rural residents' separation intention, as well as analyzing the moderating effects of perceived policy effectiveness on the relationship between the determinants and the intention, using survey data of 538 rural residents in the province of Sichuan in China. The results show that all the proposed key factors influence the separation intention significantly. Furthermore, the policies were divided into two types and the moderating effects were tested for each type. The results show that the perceived effectiveness of both the inducement policy and the capacity building policy moderated the relationship between attitude and separation intention positively, while the perceived effectiveness of the inducement policy moderated the relationship between subjective norms and intention negatively. The findings provide insightful information for policymakers to design effective RRSW separation policies.

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.

Sequencing of 50 human exomes reveals adaptation to high altitude

DEFF Research Database (Denmark)

Yi, Xin; Liang, Yu; Huerta-Sanchez, Emilia

2010-01-01

Residents of the Tibetan Plateau show heritable adaptations to extreme altitude. We sequenced 50 exomes of ethnic Tibetans, encompassing coding sequences of 92% of human genes, with an average coverage of 18x per individual. Genes showing population-specific allele frequency changes, which repres...... in genetic adaptation to high altitude.......Residents of the Tibetan Plateau show heritable adaptations to extreme altitude. We sequenced 50 exomes of ethnic Tibetans, encompassing coding sequences of 92% of human genes, with an average coverage of 18x per individual. Genes showing population-specific allele frequency changes, which...... represent strong candidates for altitude adaptation, were identified. The strongest signal of natural selection came from endothelial Per-Arnt-Sim (PAS) domain protein 1 (EPAS1), a transcription factor involved in response to hypoxia. One single-nucleotide polymorphism (SNP) at EPAS1 shows a 78% frequency...

High-altitude pulmonary hypertension

Directory of Open Access Journals (Sweden)

X-Q. Xu

2009-03-01

Full Text Available High-altitude pulmonary hypertension (HAPH is a specific disease affecting populations that live at high elevations. The prevalence of HAPH among those residing at high altitudes needs to be further defined. Whereas reduction in nitric oxide production may be one mechanism for the development of HAPH, the roles of endothelin-1 and prostaglandin I2 pathways in the pathogenesis of HAPH deserve further study. Although some studies have suggested that genetic factors contribute to the pathogenesis of HAPH, data published to date are insufficient for the identification of a significant number of gene polymorphims in HAPH. The clinical presentation of HAPH is nonspecific. Exertional dyspnoea is the most common symptom and signs related to right heart failure are common in late stages of HAPH. Echocardiography is the most useful screening tool and right heart catheterisation is the gold standard for the diagnosis of HAPH. The ideal management for HAPH is migration to lower altitudes. Phosphodiesterase 5 is an attractive drug target for the treatment of HAPH. In addition, acetazolamide is a promising therapeutic agent for high-altitude pulmonary hypertension. To date, no evidence has confirmed whether endothelin-receptor antagonists have efficacy in the treatment of high-altitude pulmonary hypertension.

[Improve, but measure in moderation; quality management in specialty residency training].

Science.gov (United States)

Ter Braak, E W M T

2017-01-01

Intuitively, we believe we gain knowledge through taking measurements, and our appetite for quality measurement in general has grown spectacularly. However, this approach has to be qualified. Many aspects of quality are difficult to measure, yet are very important, and choosing what to measure may be heavily influenced by the availability bias of instruments. Moreover, a lot can be known without actually measuring. Quantitative results tend to offer false reassurance simply by their abundance, and results presented by means of Likert scales may obscure the crucial critique of a minority of respondents. Narrative comments in surveys are often much more meaningful as they can foster an open dialogue between residents and their clinical teachers, preferably led by a neutral chairperson. Contrary to what is often claimed, it is even possible to engage in improvement without prior measurement. I propose measuring only in moderation and instead devoting time and money to patient care and educating residents, and on the design and execution of improvement plans.

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

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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.

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.

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

Exercise capacity and selected physiological factors by ancestry and residential altitude

DEFF Research Database (Denmark)

Bianba; Berntsen, Sveinung; Andersen, Lars Bo

2014-01-01

AIM: Several physiological compensatory mechanisms have enabled Tibetans to live and work at high altitude, including increased ventilation and pulmonary diffusion capacity, both of which serve to increase oxygen transport in the blood. The aim of the present study was to compare exercise capacity...... Tibetans vs. Han Chinese may reflect a better adaptation to life at high altitude. Tibetans at the lower residential altitude of 3700 m demonstrated a better exercise capacity than residents at a higher altitude of 4300 m when measured at their respective residential altitudes. Such altitude- or ancestry...... (maximal power output) and selected physiological factors (arterial oxygen saturation and heart rate at rest and during maximal exercise, resting hemoglobin concentration, and forced vital capacity) in groups of native Tibetan children living at different residential altitudes (3700 vs. 4300 m above sea...

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.

Hypoxic Hypoxia at Moderate Altitudes: State of the Science

Science.gov (United States)

2011-05-01

nature of cognitive appraisal during exercise in environmentally stressful conditions. Psychology of Sport and Exercise. 2: 47-67. Alpern, M...Shukitt-Hale, B. 1993. Effects of altitude on mood, behaviour and cognitive functioning: A review. Sports Medicine. 16(2): 97-125. Balldin, U...exposure to hypoxia in healthy males [Abstract]. Aviation, Space, and Environmental Medicine. 78(3): 399. Chiles , W. D., Iampietro, P. F. and

[Correlation between EGLN1 gene, protein express in lung tissue of rats and pulmonary artery pressure at different altitude].

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Li, S H; Li, S; Sun, L; Bai, Z Z; Yang, Q Y; Ga, Q; Jin, G E

2016-08-23

To investigate the correlation between pulmonary artery pressure (PAP) and the expression level of Egl nine homologue 1 (EGLN1) gene or its protein in lung tissue of rats at different altitudes. Totally 121 male Wistar rats were randomly divided into low altitude group (n=11), moderate altitude group and high altitude group, the rats in moderate altitude and high altitude group were further divided into 1(st) day, 3(rd) days, 7(th) days, 15(th) day and 30(th) day group according to the exposure time to hypoxic environment, each group 11 rats. The low altitude group, the PAP of rats were determined by physiological signal acquisition system, and tissue samples were collected in liquid nitrogen container for storage at an altitude of 498 m area. Moderate altitude group rats were placed in altitude of 2 260 meters of natural environment, 5 high altitude groups rats were placed in the hypobaric hypoxic chamber, simulating altitude of 4 500 meters. The PAP of rats in moderate altitude group and high altitude group were also determined by physiological signal acquisition system, and tissue samples were collected when rats were exposed to hypoxia at 1(st), 3(rd), 7(th), 15(th) and 30(th) day; Western blot was used to determine expression levels of EGLN1 protein, and person correlation analysis was used to analyze whether the protein was related to the formation of pulmonary arterial hypertension (PH) under hypoxia. Real-time quantitive PCR method determined expression levels of EGLN1 mRNA in lung tissues, and the relative expression method was used to analyze PCR data, and finally assess whether the EGLN1 gene was the initial cause of the formation of PH during hypoxia. The mean PAP of rats was (20.0±3.2) mmHg (1 mmHg=0.133 kPa) in low altitude group; in moderate altitude group, mean PAP began to increase slightly when rats were exposed to hypoxia on the 15(th) day and reached at (22.7±4.1) mmHg on hypoxic 30(th) day, but compared with the low altitude group, there was

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...

High-Altitude-Induced alterations in Gut-Immune Axis: A review.

Science.gov (United States)

Khanna, Kunjan; Mishra, K P; Ganju, Lilly; Kumar, Bhuvnesh; Singh, Shashi Bala

2018-03-04

High-altitude sojourn above 8000 ft is increasing day by day either for pilgrimage, mountaineering, holidaying or for strategic reasons. In India, soldiers are deployed to these high mountains for their duty or pilgrims visit to the holy places, which are located at very high altitude. A large population also resides permanently in high altitude regions. Every year thousands of pilgrims visit Holy cave of Shri Amarnath ji, which is above 15 000 ft. The poor acclimatization to high altitude may cause alteration in immunity. The low oxygen partial pressure may cause alterations in gut microbiota, which may cause changes in gut immunity. Effect of high altitude on gut-associated mucosal system is new area of research. Many studies have been carried out to understand the physiology and immunology behind the high-altitude-induced gut problems. Few interventions have also been discovered to circumvent the problems caused due to high-altitude conditions. In this review, we have discussed the effects of high-altitude-induced changes in gut immunity particularly peyer's patches, NK cells and inflammatory cytokines, secretary immunoglobulins and gut microbiota. The published articles from PubMed and Google scholar from year 1975 to 2017 on high-altitude hypoxia and gut immunity are cited in this review.

Effects of altitude and exercise on pulmonary capillary integrity: evidence for subclinical high-altitude pulmonary edema.

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Eldridge, Marlowe W; Braun, Ruedi K; Yoneda, Ken Y; Walby, William F

2006-03-01

Strenuous exercise may be a significant contributing factor for development of high-altitude pulmonary edema, particularly at low or moderate altitudes. Thus we investigated the effects of heavy cycle ergometer exercise (90% maximal effort) under hypoxic conditions in which the combined effects of a marked increase in pulmonary blood flow and nonuniform hypoxic pulmonary vasoconstriction could add significantly to augment the mechanical stress on the pulmonary microcirculation. We postulated that intense exercise at altitude would result in an augmented permeability edema. We recruited eight endurance athletes and examined their bronchoalveolar lavage fluid (BALF) for red blood cells (RBCs), protein, inflammatory cells, and soluble mediators at 2 and 26 h after intense exercise under normoxic and hypoxic conditions. After heavy exercise, under all conditions, the athletes developed a permeability edema with high BALF RBC and protein concentrations in the absence of inflammation. We found that exercise at altitude (3,810 m) caused significantly greater leakage of RBCs [9.2 (SD 3.1)x10(4) cells/ml] into the alveolar space than that seen with normoxic exercise [5.4 (SD 1.2)x10(4) cells/ml]. At altitude, the 26-h postexercise BALF revealed significantly higher RBC and protein concentrations, suggesting an ongoing capillary leak. Interestingly, the BALF profiles following exercise at altitude are similar to that of early high-altitude pulmonary edema. These findings suggest that pulmonary capillary disruption occurs with intense exercise in healthy humans and that hypoxia augments the mechanical stresses on the pulmonary microcirculation.

Stress and alcohol use in rural Chinese residents: A moderated mediation model examining the roles of resilience and negative emotions.

Science.gov (United States)

Wang, Yan; Chen, Xinguang

2015-10-01

Little research has been done on alcohol use and dependence among rural residents in China, a sub-population that might be under increased stress due to the rapid modernization and urbanization processes. We aimed to assess rural residents' levels of stress, negative emotions, resilience, alcohol use/dependence and the complex relationships among them. Survey data from a large random sample (n=1145, mean age=35.9, SD=7.7, 50.7% male) of rural residents in Wuhan, China were collected using Audio Computer-Assisted Self-Interview. The sample had high prevalence of frequently perceived stress (47%) and high prevalence of ever (54.4%), past 30-day (40.4%), and binge drinking (13.8%). Approximately 11% met the criterion for intermediate to severe alcohol dependence. Mediation analysis indicated that the association between perceived stress (predictor) and alcohol dependence (outcome) was fully mediated by anxiety (indirect effect=.203, pstress and two negative emotions (mediators) was significantly modified by resilience (moderator); an integrative moderated mediation analysis indicated that the indirect effect from stress to alcohol dependence through negative emotions was also moderated by resilience. Negative emotions play a key role in bridging stress and alcohol dependence, while resilience significantly buffers the impact of stress on depression, reducing the risk of alcohol dependence. Resilience training may be an effective component for alcohol intervention in rural China. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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.

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.

Hemoglobin mass after 21 days of conventional altitude training at 1816 m.

Science.gov (United States)

Pottgiesser, Torben; Ahlgrim, Christoph; Ruthardt, Sebastian; Dickhuth, Hans-Hermann; Schumacher, Yorck Olaf

2009-11-01

The underlying mechanisms of altitude training are still a matter of controversial discussion but erythropoietic adaptations with an increase of total haemoglobin mass (tHb) have been shown in several studies, partly depending on an adequate hypoxic dose. The aim of this retrospective study was to investigate if a 3 weeks sojourn at moderate altitude (1816 m) with conventional training sessions (live and train at moderate altitude), especially under real and uncontrolled conditions, results in an increased tHb. tHb was measured in seven male cyclists competing at elite level (German national cycling team, U23 category) prior to the ascent to altitude and immediately after descent to sea-level. The athletes completed a 21 days altitude training camp living at 1816 m and training at 1800-2400 m during the competitive season. No significant difference was found in tHb after the altitude sojourn (prior 927+/-109g vs. 951+/-113g post, 95% CI -13-61g). Additionally, the analysis of red cell volume, plasma volume and blood volume or haemoglobin concentration [Hb] as well as haematocrit (Hct) did not reveal any significant changes. The data supports the theory that an adequate hypoxic dose is required for adaptations of the erythropoietic system with an increase of tHb and a threshold of approximately 2100-2500 m has to be exceeded.

Altitude variation of cosmic-ray neutrons

International Nuclear Information System (INIS)

Nakamura, T.; Uwamino, Y.; Ohkubo, T.; Hara, A.

1987-01-01

The altitude variation of the cosmic-ray neutron energy spectrum and the dose equivalent rate was measured at an average geomagnetic latitude of 24 degrees N by using the high-efficiency multi-sphere neutron spectrometer and neutron dose-equivalent counter developed by the authors. The data were obtained from a 2-h flight over Japan on 27 February 1985. The neutron energy spectra measured at sea level and at altitudes of 4880 m and at 11,280 m were compared with the calculated spectra of O'Brien and with other experimental spectra, and they are in moderately good agreement with them. The dose equivalent rate increases according to a quadratic curve up to about 6000 m and then increases linearly between 6000 m and 11,280 m. The dependence of dose equivalent rates at sea level and at an altitude of 12,500 m on geomagnetic latitude also is given by referring to other experimental results

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.

Prevalence of high altitude pulmonary hypertension among the natives of Spiti Valley--a high altitude region in Himachal Pradesh, India.

Science.gov (United States)

Negi, Prakash Chand; Marwaha, Rajeev; Asotra, Sanjeev; Kandoria, Arvind; Ganju, Neeraj; Sharma, Rajesh; Kumar, Ravi V; Bhardwaj, Rajeev

2014-12-01

The study aimed to determine the prevalence of high altitude pulmonary hypertension (HAPH) and its predisposing factors among natives of Spiti Valley. A cross-sectional survey study was done on the permanent natives of Spiti Valley residing at an altitude of 3000 m to 4200 m. Demographic characteristics, health behavior, anthropometrics, and blood pressure were recorded. Investigations included recording of 12 lead electrocardiogram (ECG), SaO2 with pulse oximeter, spirometry and echocardiography study, and measurement of Hb levels using the cynmethhemoglobin method. HAPH was diagnosed using criteria; tricuspid regurgitation (TR) gradient of ≥46 mmHg. ECG evidence of RV overload on 12 lead ECG was documented based on presence of 2 out of 3 criteria; R>S in V1, right axis deviation or RV strain, T wave inversion in V1 and V2. Data of 1087 subjects were analyzed who were free of cardiorespiratory diseases to determine the prevalence of HAPH and its predisposing factors. HAPH was recorded in 3.23% (95% C.I. of 0.9-8.1%) and ECG evidence of right ventricular (RV) overload was 1.5% in the study population. Prevalence of HAPH was not different in men and women 2.63% vs. 3.54% p<0.2. Age (Z statistics of 3.4 p<0.0006), hypoxemia (Z statistics of 2.9 p<0.002), and erythrocythemia (Z statistics of 4.7 p<0.003) were independently associated with HAPH. Altitude of residence was not found to be significantly associated with HAPH, although there was a trend of increasing prevalence with increasing altitude. It can be concluded that HAPH is prevalent in 3.23% of natives of Spiti Valley. Increasing age, erythrocythemia and hypoxemia are independent predisposing factors.

Dietary Recommendations for Cyclists during Altitude Training

Science.gov (United States)

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

2016-01-01

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. PMID:27322318

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.

Unchanged cerebral blood flow and oxidative metabolism after acclimatization to high altitude

DEFF Research Database (Denmark)

Møller, Kirsten; Paulson, Olaf B; Hornbein, Thomas F.

2002-01-01

The authors investigated the effect of acclimatization to high altitude on cerebral blood flow and oxidative metabolism at rest and during exercise. Nine healthy, native sea-level residents were studied 3 weeks after arrival at Chacaltaya, Bolivia (5,260 m) and after reacclimatization to sea level....... At high altitude at rest, arterial carbon dioxide tension, oxygen saturation, and oxygen tension were significantly reduced, and arterial oxygen content was increased because of an increase in hemoglobin concentration. Global cerebral blood flow was similar in the four conditions. Cerebral oxygen delivery...... and cerebral metabolic rates of oxygen and glucose also remained unchanged, whereas cerebral metabolic rates of lactate increased slightly but nonsignificantly at high altitude during exercise compared with high altitude at rest. Reaction time was unchanged. The data indicate that cerebral blood flow...

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.

Ventilation and hypoxic ventilatory responsiveness in Chinese-Tibetan residents at 3,658 m.

Science.gov (United States)

Curran, L S; Zhuang, J; Sun, S F; Moore, L G

1997-12-01

When breathing ambient air at rest at 3,658 m altitude, Tibetan lifelong residents of 3,658 m ventilate as much as newcomers acclimatized to high altitude; they also ventilate more and have greater hypoxic ventilatory responses (HVRs) than do Han ("Chinese") long-term residents at 3,658 m. This suggests that Tibetan ancestry is advantageous in protecting resting ventilation levels during years of hypoxic exposure and is of interest in light of the permissive role of hypoventilation in the development of chronic mountain sickness, which is nearly absent among Tibetans. The existence of individuals with mixed Tibetan-Chinese ancestry (Han-Tibetans) residing at 3,658 m affords an opportunity to test this hypothesis. Eighteen men born in Lhasa, Tibet, China (3,658 m) to Tibetan mothers and Han fathers were compared with 27 Tibetan men and 30 Han men residing at 3,658 m who were previously studied. We used the same study procedures (minute ventilation was measured with a dry-gas flowmeter during room air breathing and hyperoxia and with a 13-liter spirometer-rebreathing system during the hypoxic and hypercapnic tests). During room air breathing at 3,658 m (inspired O2 pressure = 93 Torr), Han-Tibetans resembled Tibetans in ventilation (12.1 +/- 0.6 vs. 11.5+/- 0.5 l/min BTPS, respectively) but had HVR that were blunted (63 +/- 16 vs. 121 +/- 13, respectively, for HVR shape parameter A) and declined with increasing duration of high-altitude residence. During administered hyperoxia (inspired O2 pressure = 310 Torr) at 3,658 m, the paradoxical hyperventilation previously seen in Tibetan but not Han residents at 3,658 m (11.8 +/- 0.5 vs. 10.1 +/- 0.5 l/min BTPS) was absent in these Han-Tibetans (9.8 +/- 0.6 l/min BTPS). Thus, although longer duration of high-altitude residence appears to progressively blunt HVR among Han-Tibetans born and residing at 3, 658 m, their Tibetan ancestry appears protective in their maintenance of high resting ventilation levels despite

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.

Unlocking Solar for Low- and Moderate-Income Residents: A Matrix of Financing Options by Resident, Provider, and Housing Type

Energy Technology Data Exchange (ETDEWEB)

Cook, Jeffrey J. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, Lori A. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2018-01-02

Historically the low and moderate income (LMI) market has been underserved by solar photovoltaics (PV), in part due to the unique barriers LMI residents face to participation in the PV market. The intent of this report is to identify the most promising strategies state policymakers might consider to finance PV for LMI customers across three housing types: single family, multi-family, and manufactured housing. The result is a financing matrix that documents the first and second tier financing options states may consider for each housing type. The first tier options were selected based upon their potential impact on LMI PV deployment. Second tier financing approaches could also be used to achieve state policy goals, but may not have as much effect on the relevant LMI market segment. Nevertheless, each financing option comes with tradeoffs that state policymakers may wish to consider when they make decisions about which financing approaches are best suited to achieve their LMI PV deployment goals.

Altitude Training in Elite Swimmers for Sea Level Performance (Altitude Project).

Science.gov (United States)

Rodríguez, Ferran A; Iglesias, Xavier; Feriche, Belén; Calderón-Soto, Carmen; Chaverri, Diego; Wachsmuth, Nadine B; Schmidt, Walter; Levine, Benjamin D

2015-09-01

This controlled, nonrandomized, parallel-groups trial investigated the effects on performance, V˙O2 and hemoglobin mass (tHbmass) of four preparatory in-season training interventions: living and training at moderate altitude for 3 and 4 wk (Hi-Hi3, Hi-Hi), living high and training high and low (Hi-HiLo, 4 wk), and living and training at sea level (SL) (Lo-Lo, 4 wk). From 61 elite swimmers, 54 met all inclusion criteria and completed time trials over 50- and 400-m crawl (TT50, TT400), and 100 (sprinters) or 200 m (nonsprinters) at best stroke (TT100/TT200). Maximal oxygen uptake (V˙O2max) and HR were measured with an incremental 4 × 200 m test. Training load was estimated using cumulative training impulse method and session RPE. Initial measures (PRE) were repeated immediately (POST) and once weekly on return to SL (PostW1 to PostW4). tHbmass was measured in duplicate at PRE and once weekly during the camp with CO rebreathing. Effects were analyzed using mixed linear modeling. TT100 or TT200 was worse or unchanged immediately at POST, but improved by approximately 3.5% regardless of living or training at SL or altitude after at least 1 wk of SL recovery. Hi-HiLo achieved greater improvement 2 (5.3%) and 4 wk (6.3%) after the camp. Hi-HiLo also improved more in TT400 and TT50 2 (4.2% and 5.2%, respectively) and 4 wk (4.7% and 5.5%) from return. This performance improvement was not linked linearly to changes in V˙O2max or tHbmass. A well-implemented 3- or 4-wk training camp may impair performance immediately but clearly improves performance even in elite swimmers after a period of SL recovery. Hi-HiLo for 4 wk improves performance in swimming above and beyond altitude and SL controls through complex mechanisms involving altitude living and SL training effects.

Ocular morbidity among porters at high altitudes.

Science.gov (United States)

Gnyawali, Subodh; Shrestha, Gauri Shankar; Khanal, Safal; Dennis, Talisa; Spencer, John C

2017-01-01

High altitude, often characterized by settings over 2400m, can be detrimental to the human body and pose a significant risk to ocular health. Reports concerning various ocular morbidities occurring as a consequence of high altitude are limited in the current literature. This study was aimed at evaluating the ocular health of porters working at high altitudesof Himalayas in Nepal. A mobile eye clinic was set up in Ghat and patient data were collected from its out- patient unit by a team of seven optometrists which was run for five days. Ghat is a small village in north-eastern Nepal, located at 2860 m altitude. Travellers walking through the trekking route were invited to get their eyes checked at the clinic. Comprehensive ocular examinations were performed, including visual acuities, objective and subjective refraction, anterior and posterior segment evaluations, and intraocular pressure measurements; blood pressure and blood glucose levels were also measured as required. Ocular therapeutics, prescription glasses, sunglasses and ocular health referrals were provided free of cost as necessary. A total of 1890 people visited the eye clinic, among which 57.4% (n=1084) were porters. Almost half of the porters had an ocular morbidity. Correctable refractive error was most prevalent, with other ocular health-related complications, including dry eye disease, infectious disorders, glaucoma and cataract. Proper provision of regular and effective eye care services should be made more available for those residing at these high altitudes in Nepal. © NEPjOPH.

Do over 200 million healthy altitude residents really suffer from chronic Acid-base disorders?

Science.gov (United States)

Zubieta-Calleja, Gustavo; Zubieta-Castillo, Gustavo; Zubieta-Calleja, Luis; Ardaya-Zubieta, Gustavo; Paulev, Poul-Erik

2011-01-01

As the oxygen tension of inspired air falls with increasing altitude in normal subjects, hyperventilation ensues. This acute respiratory alkalosis, induces increased renal excretion of bicarbonate, returning the pH back to normal, giving rise to compensated respiratory alkalosis or chronic hypocapnia. It seems a contradiction that so many normal people at high altitude should permanently live as chronic acid-base patients. Blood gas analyses of 1,865 subjects at 3,510 m, reported a P(a)CO(2) (arterial carbon dioxide tension ± SEM) = 29.4 ± 0.16 mmHg and pH = 7.40 ± 0.005. Base excess, calculated with the Van Slyke sea level equation, is -5 mM (milliMolar or mmol/l) as an average, suggesting chronic hypocapnia. THID, a new term replacing "Base Excess" is determined by titration to a pH of 7.40 at a P(a)CO(2) of 5.33 kPa (40 mmHg) at sea level, oxygen saturated and at 37°C blood temperature. Since our new modified Van Slyke equations operate with normal values for P(a)CO(2) at the actual altitude, a calculation of THID will always result in normal values-that is, zero.

The effect of α1 -adrenergic blockade on post-exercise brachial artery flow-mediated dilatation at sea level and high altitude.

Science.gov (United States)

Tymko, Michael M; Tremblay, Joshua C; Hansen, Alex B; Howe, Connor A; Willie, Chris K; Stembridge, Mike; Green, Daniel J; Hoiland, Ryan L; Subedi, Prajan; Anholm, James D; Ainslie, Philip N

2017-03-01

Our objective was to quantify endothelial function (via brachial artery flow-mediated dilatation) at sea level (344 m) and high altitude (3800 m) at rest and following both maximal exercise and 30 min of moderate-intensity cycling exercise with and without administration of an α 1 -adrenergic blockade. Brachial endothelial function did not differ between sea level and high altitude at rest, nor following maximal exercise. At sea level, endothelial function decreased following 30 min of moderate-intensity exercise, and this decrease was abolished with α 1 -adrenergic blockade. At high altitude, endothelial function did not decrease immediately after 30 min of moderate-intensity exercise, and administration of α 1 -adrenergic blockade resulted in an increase in flow-mediated dilatation. Our data indicate that post-exercise endothelial function is modified at high altitude (i.e. prolonged hypoxaemia). The current study helps to elucidate the physiological mechanisms associated with high-altitude acclimatization, and provides insight into the relationship between sympathetic nervous activity and vascular endothelial function. We examined the hypotheses that (1) at rest, endothelial function would be impaired at high altitude compared to sea level, (2) endothelial function would be reduced to a greater extent at sea level compared to high altitude after maximal exercise, and (3) reductions in endothelial function following moderate-intensity exercise at both sea level and high altitude are mediated via an α 1 -adrenergic pathway. In a double-blinded, counterbalanced, randomized and placebo-controlled design, nine healthy participants performed a maximal-exercise test, and two 30 min sessions of semi-recumbent cycling exercise at 50% peak output following either placebo or α 1 -adrenergic blockade (prazosin; 0.05 mg kg  -1 ). These experiments were completed at both sea-level (344 m) and high altitude (3800 m). Blood pressure (finger photoplethysmography

Effect of phosphate supplementation on oxygen delivery at high altitude

Science.gov (United States)

Jain, S. C.; Singh, M. V.; Rawal, S. B.; Sharma, V. M.; Divekar, H. M.; Tyagi, A. K.; Panwar, M. R.; Swamy, Y. V.

1987-09-01

In the present communication, effect of low doses of phosphate supplementation on short-term high altitude adaptation has been examined. Studies were carried out in 36 healthy, male, sea-level residents divided in a double blind fashion into drug and placebo treated groups. 3.2 mmol of phosphate were given orally to each subject of the drug treated group once a day for 4 days on arrival at an altitude of 3,500 m. Sequential studies were done in the subjects in both groups on the 3rd, 7th, 14th and 21st day of their altitude stay. Haemoglobin, haematocrit, erythrocyte and reticulocyte counts increased to the similar extent in both groups. Blood pH, pO2 and adenosine tri-phosphate (ATP) did not differ between the two groups. On 3rd day of the altitude stay, inorganic phosphate and 2,3-diphosphoglycerate (2,3 DPG) levels in the drug treated group increased significantly as compared to the placebo group. No significant difference in inorganic phosphate and 2,3 DPG was observed later on in the two groups. Psychological and clinical tests also indicated that the drug treated subjects felt better as compared to the placebo treated subjects. The present study suggests that low doses of phosphate increases circulating 2,3-DPG concentration which in turn brings about beneficial effect towards short term high altitude adaptation.

Atmospheric Residence Times of Continental Aerosols.

Science.gov (United States)

Balkanski, Yves Jacques

The global atmospheric distributions of ^{222}Rn and ^{210 }Pb are simulated with a three-dimensional model of atmospheric transport based on the meteorology of the NASA GISS^1>=neral circulation model. The short-lived radioactive gas ^ {222}Rn (half-life = 3.8d) is emitted almost exclusively from land, at a relatively uniform rate; hence it is an excellent tracer of continental influences. Lead -210 is produced by decay of ^{222} Rn and immediately condenses to preexisting aerosol surfaces. It provides an excellent measure of aerosol residence times in the atmosphere because its source is accurately defined by the ^{222} Rn distribution. Results from the three-dimensional model are compared to measurements of ^ {222}Rn and ^{210 }Pb atmospheric concentrations to evaluate model's long-range transport over oceanic regions and to study the deposition mechanisms of atmospheric aerosols. Model results for ^{222} Rn are used to examine the long-range transport of continental air over two selected oceanic regions, the subantartic Indian Ocean and the North Pacific. It is shown that fast transport of air from southern Africa causes substantial continental pollution at southern mid-latitudes, a region usually regarded as pristine. Air over the North Pacific is heavily impacted by continental influences year round, but the altitude at which the transport occurs varies seasonally. Observations of aerosols at island sites, which are commonly used as diagnostics of continental influences, may be misleading because they do not account for influences at high altitude and because aerosols are efficiently scavenged by deposition during transport. The study of ^{210}Pb focuses on defining the residence times of submicron aerosols in the troposphere. Scavenging in wet convective updrafts is found to provide the dominant sink on a global scale. The globally averaged residence time for ^{210 }Pb-containing aerosols in the troposphere is 7 days. The average increase in residence time

Effects of erythrocyte infusion on VO2max at high altitude

DEFF Research Database (Denmark)

Young, Jette Feveile; Sawka, M N; Muza, S R

1996-01-01

This study investigated whether autologous erythrocyte infusion would ameliorate the decrement in maximal O2 uptake (VO2max) experienced by lowlanders when they ascend to high altitude. VO2max was measured in 16 men (treadmill running) at sea level (SL) and on the 1st (HA1) and 9th (HA9) days...... of high-altitude (4,300 m) residence. After VO2max was measured at SL, subjects were divided into two matched groups (n = 8). Twenty-four hours before ascent to high altitude, the experimental group received a 700-ml infusion of autologous erythrocytes and saline (42% hematocrit), whereas the control...... group received only saline. The VO2max of erythrocyte-infused [54 +/- 1 (SE) ml.kg-1.min-1] and control subjects (52 +/- 2 ml.kg-1.min-1) did not differ at SL before infusion. The decrement in VO2max on HA1 did not differ between groups, averaging 26% overall, despite higher (P

Year-to-year variability in haemoglobin mass response to two altitude training camps.

Science.gov (United States)

McLean, Blake D; Buttifant, David; Gore, Christopher J; White, Kevin; Kemp, Justin

2013-12-01

To quantify the year-to-year variability of altitude-induced changes in haemoglobin mass (Hb(mass)) in elite team-sport athletes. 12 Australian-Footballers completed a 19-day (ALT1) and 18-day (ALT2) moderate altitude (∼2100 m), training camp separated by 12 months. An additional 20 participants completed only one of the two training camps (ALT1 additional n=9, ALT2 additional n=11). Total Hb(mass) was assessed using carbon monoxide rebreathing before (PRE), after (POST₁) and 4 weeks after each camp. The typical error of Hb(mass) for the pooled data of all 32 participants was 2.6%. A contemporary statistics analysis was used with the smallest worthwhile change set to 2% for Hb(mass). POST₁ Hb(mass) was very likely increased in ALT1 (3.6 ± 1.6%, n=19; mean ± ∼90 CL) as well as ALT2 (4.4 ± 1.3%, n=23) with an individual responsiveness of 1.3% and 2.2%, respectively. There was a small correlation between ALT1 and ALT2 (R=0.21, p=0.59) for a change in Hb(mass), but a moderately inverse relationship between the change in Hb(mass) and initial relative Hb(mass) (g/kg (R=-0.51, p=0.04)). Two preseason moderate altitude camps 1 year apart yielded a similar (4%) mean increase in Hb(mass) of elite footballers, with an individual responsiveness of approximately half the group mean effect, indicating that most players gained benefit. Nevertheless, the same individuals generally did not change their Hb(mass) consistently from year to year. Thus, a 'responder' or 'non-responder' to altitude for Hb(mass) does not appear to be a fixed trait.

The lactate paradox revisited in lowlanders during acclimatization to 4100 m and in high-altitude natives

DEFF Research Database (Denmark)

Van Hall, Gerrit; Lundby, C; Araoz, M

2009-01-01

Chronic hypoxia has been proposed to induce a closer coupling in human skeletal muscle between ATP utilization and production in both lowlanders (LN) acclimatizing to high altitude and high-altitude natives (HAN), linked with an improved match between pyruvate availability and its use...... and remained at this higher level during the acclimatization period. HAN had similar high values; however, at the moment of exhaustion their muscle lactate, ADP and IMP content and Cr/PCr ratio were higher than in LN. In conclusion, sea-level residents in the course of acclimatization to high altitude did...... not exhibit a reduced capacity for the active muscle to produce lactate. Thus, the lactate paradox concept could not be demonstrated. High-altitude natives from the Andes actually exhibit a higher anaerobic energy production than lowlanders after 8 weeks of acclimatization reflected by an increased muscle...

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

Four Weeks of Classical Altitude Training Increases Resting Metabolic Rate in Highly Trained Middle-Distance Runners.

Science.gov (United States)

Woods, Amy L; Sharma, Avish P; Garvican-Lewis, Laura A; Saunders, Philo U; Rice, Anthony J; Thompson, Kevin G

2017-02-01

High altitude exposure can increase resting metabolic rate (RMR) and induce weight loss in obese populations, but there is a lack of research regarding RMR in athletes at moderate elevations common to endurance training camps. The present study aimed to determine whether 4 weeks of classical altitude training affects RMR in middle-distance runners. Ten highly trained athletes were recruited for 4 weeks of endurance training undertaking identical programs at either 2200m in Flagstaff, Arizona (ALT, n = 5) or 600m in Canberra, Australia (CON, n = 5). RMR, anthropometry, energy intake, and hemoglobin mass (Hb mass ) were assessed pre- and posttraining. Weekly run distance during the training block was: ALT 96.8 ± 18.3km; CON 103.1 ± 5.6km. A significant interaction for Time*Group was observed for absolute (kJ.day -1 ) (F-statistic, p-value: F (1,8) =13.890, p = .01) and relative RMR (F (1,8) =653.453, p = .003) POST-training. No significant changes in anthropometry were observed in either group. Energy intake was unchanged (mean ± SD of difference, ALT: 195 ± 3921kJ, p = .25; CON: 836 ± 7535kJ, p = .75). A significant main effect for time was demonstrated for total Hb mass (g) (F (1,8) =13.380, p = .01), but no significant interactions were observed for either variable [Total Hb mass (g): F (1,8) =1.706, p = .23; Relative Hb mass (g.kg -1 ): F (1,8) =0.609, p = .46]. These novel findings have important practical application to endurance athletes routinely training at moderate altitude, and those seeking to optimize energy management without compromising training adaptation. Altitude exposure may increase RMR and enhance training adaptation,. During training camps at moderate altitude, an increased energy intake is likely required to support an increased RMR and provide sufficient energy for training and performance.

The individual response to training and competition at altitude.

Science.gov (United States)

Chapman, Robert F

2013-12-01

Performance in athletic activities that include a significant aerobic component at mild or moderate altitudes shows a large individual variation. Physiologically, a large portion of the negative effect of altitude on exercise performance can be traced to limitations of oxygen diffusion, either at the level of the alveoli or the muscle microvasculature. In the lung, the ability to maintain arterial oxyhaemoglobin saturation (SaO₂) appears to be a primary factor, ultimately influencing oxygen delivery to the periphery. SaO₂ in hypoxia can be defended by increasing ventilatory drive; however, during heavy exercise, many athletes demonstrate limitations to expiratory flow and are unable to increase ventilation in hypoxia. Additionally, increasing ventilatory work in hypoxia may actually be negative for performance, if dyspnoea increases or muscle blood flow is reduced secondary to an increased sympathetic outflow (eg, the muscle metaboreflex response). Taken together, some athletes are clearly more negatively affected during exercise in hypoxia than other athletes. With careful screening, it may be possible to develop a protocol for determining which athletes may be the most negatively affected during competition and/or training at altitude.

Moderation of Genetic Influences on Alcohol Involvement by Rural Residency among Adolescents: Results from the 1962 National Merit Twin Study.

Science.gov (United States)

Davis, Christal N; Natta, Shanaliz S; Slutske, Wendy S

2017-11-01

Adolescents in rural and urban areas may experience different levels of environmental restrictions on alcohol use, with those in rural areas experiencing greater monitoring and less access to alcohol. Such restrictions may limit expression of genetic vulnerability for alcohol use, resulting in a gene-environment interaction (G × E). This phenomenon has previously been reported in Finnish and Minnesota adolescents. The current study used data from 839 same-sex twin pairs from the 1962 National Merit Scholarship Qualifying Test to determine whether the G × E interaction would be evident in this earlier time period. We also assessed whether the G × E interaction would be moderated by sex, and whether family socioeconomic status (SES; income and parental education) may mediate the G × E interaction. Findings showed the expected interaction among females, with a weaker contribution of genes (2 vs. 44%) and greater contribution of shared environment (62 vs. 29%) to variation in alcohol involvement among rural as compared to urban residents. The G × E interaction was not observed among males, and operated independently from differences in family SES among rural and urban adolescents. This study represents a partial replication in a novel setting of the moderation of the genetic contribution to alcohol use by rural/urban residency, and suggests that SES differences may not explain this effect.

Classical altitude training.

Science.gov (United States)

Friedmann-Bette, B

2008-08-01

For more than 40 years, the effects of classical altitude training on sea-level performance have been the subject of many scientific investigations in individual endurance sports. To our knowledge, no studies have been performed in team sports like football. Two well-controlled studies showed that living and training at an altitude of >or=1800-2700 m for 3-4 weeks is superior to equivalent training at sea level in well-trained athletes. Most of the controlled studies with elite athletes did not reveal such an effect. However, the results of some uncontrolled studies indicate that sea-level performance might be enhanced after altitude training also in elite athletes. Whether hypoxia provides an additional stimulus for muscular adaptation, when training is performed with equal intensity compared with sea-level training is not known. There is some evidence for an augmentation of total hemoglobin mass after classical altitude training with duration >or=3 weeks at an altitude >or=2000 m due to altitude acclimatization. Considerable individual variation is observed in the erythropoietic response to hypoxia and in the hypoxia-induced reduction of aerobic performance capacity during training at altitude, both of which are thought to contribute to inter-individual variation in the improvement of sea-level performance after altitude training.

Update in the understanding of altitude-induced limitations to performance in team-sport athletes.

Science.gov (United States)

Billaut, François; Aughey, Robert J

2013-12-01

The internationalism of field-based team sports (TS) such as football and rugby requires teams to compete in tournaments held at low to moderate altitude (∼1200-2500 m). In TS, acceleration, speed and aerobic endurance are physical characteristics associated with ball possession and, ultimately, scoring. While these qualities are affected by the development of neuromuscular fatigue at sea level, arterial hypoxaemia induced by exposure to altitude may further hinder the capacity to perform consecutive accelerations (CAC) or sprint endurance and thereby change the outcome of a match. The higher the altitude, the more severe the hypoxaemia, and thus, the larger the expected decline in aerobic endurance, CAC and match running performance. Therefore, it is critical for athletes and coaches to understand how arterial hypoxaemia affects aerobic endurance and CAC and the magnitude of decline they may face at altitude for optimal preparation and increased chances of success. This mini review summarises the effects of acute altitude/hypoxia exposure on aerobic endurance, CAC and activity profiles of TS athletes performing in the laboratory and during matches at natural altitude, and analyses the latest findings about the consequences of arterial hypoxaemia on the relationship between peripheral perturbations, neural adjustments and performance during repeated sprints or CAC. Finally, we briefly discuss how altitude training can potentially help athletes prepare for competition at altitude.

On-board measurement of particle numbers and their size distribution from a light-duty diesel vehicle: Influences of VSP and altitude.

Science.gov (United States)

Liu, Jia; Ge, Yunshan; Wang, Xin; Hao, Lijun; Tan, Jianwei; Peng, Zihang; Zhang, Chuanzhen; Gong, Huiming; Huang, Ying

2017-07-01

In this study, the particle size-resolved distribution from a China-3 certificated light-duty diesel vehicle was measured by using a portable emission measurement system (PEMS). In order to examine the influences of vehicle specific power (VSP) and high-altitude operation, measurements were conducted at 8 constant speeds, which ranged from 10 to 80km/hr at 10km/hr intervals, and two different high altitudes, namely 2200 and 3200m. The results demonstrated that the numbers of particles in all size ranges decreased significantly as VSP increased when the test vehicle was running at lower speeds (vehicle resulted in increased particle number emissions at low and high driving speeds; however, particle numbers obtained at moderate speeds decreased as altitude rose. When the test vehicle was running at moderate speeds, particle numbers measured at the two altitudes were very close, except for comparatively higher number concentrations of nanoparticles measured at 2200m. Copyright © 2017. Published by Elsevier B.V.

Physiological aspects of altitude training and the use of altitude simulators

OpenAIRE

Ranković Goran; Radovanović Dragan

2005-01-01

Altitude training in various forms is widely practiced by athletes and coaches in an attempt to improve sea level endurance. Training at high altitude may improve performance at sea level through altitude acclimatization, which improves oxygen transport and/or utilization, or through hypoxia, which intensifies the training stimulus. This basic physiological aspect allows three training modalities: live high and train high (classic high-altitude training), live low and train high (training thr...

The utility of immature reticulocyte fraction as an indicator of erythropoietic response to altitude training in elite cyclists.

Science.gov (United States)

Nadarajan, V S; Ooi, C H; Sthaneshwar, P; Thompson, M W

2010-02-01

Altitude training is sometimes employed by elite endurance athletes to improve their sea level performance. This improvement results from the increased red cell mass consequent upon the boost in erythropoietin (EPO) level that occurs as a response to the relatively hypoxic environment at high altitudes. We measured serum EPO levels together with various red cell and reticulocyte parameters including immature reticulocyte fraction (IRF) in eight national track-endurance cyclists, resident at sea-level, prior to and upon return from an altitude of approximately 1905 m. Reticulocytes and soluble transferrin receptor (sTfR) were significantly increased with reduction in ferritin levels immediately on return from high altitude indicating increased erythropoietic activity. IRF in particular showed a significant peak immediately on return but decline to sub-baseline levels by day 9, and recovery to baseline by day 16. Our results indicate that IRF is a sensitive marker of erythropoietic status in athletes undergoing altitude training and subsequent loss of EPO stimuli on return to sea level.

Athletes at High Altitude.

Science.gov (United States)

Khodaee, Morteza; Grothe, Heather L; Seyfert, Jonathan H; VanBaak, Karin

2016-01-01

Athletes at different skill levels perform strenuous physical activity at high altitude for a variety of reasons. Multiple team and endurance events are held at high altitude and may place athletes at increased risk for developing acute high altitude illness (AHAI). Training at high altitude has been a routine part of preparation for some of the high level athletes for a long time. There is a general belief that altitude training improves athletic performance for competitive and recreational athletes. A review of relevant publications between 1980 and 2015 was completed using PubMed and Google Scholar. Clinical review. Level 3. AHAI is a relatively uncommon and potentially serious condition among travelers to altitudes above 2500 m. The broad term AHAI includes several syndromes such as acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Athletes may be at higher risk for developing AHAI due to faster ascent and more vigorous exertion compared with nonathletes. Evidence regarding the effects of altitude training on athletic performance is weak. The natural live high, train low altitude training strategy may provide the best protocol for enhancing endurance performance in elite and subelite athletes. High altitude sports are generally safe for recreational athletes, but they should be aware of their individual risks. Individualized and appropriate acclimatization is an essential component of injury and illness prevention.

Assessment of indoor and outdoor PM species at schools and residences in a high-altitude Ecuadorian urban center.

Science.gov (United States)

Raysoni, Amit U; Armijos, Rodrigo X; Weigel, M Margaret; Montoya, Teresa; Eschanique, Patricia; Racines, Marcia; Li, Wen-Whai

2016-07-01

An air monitoring campaign to assess children's environmental exposures in schools and residences, both indoors and outdoors, was conducted in 2010 in three low-income neighborhoods in Z1 (north), Z2 (central), and Z3 (southeast) zones of Quito, Ecuador - a major urban center of 2.2 million inhabitants situated 2850 m above sea level in a narrow mountainous basin. Z1 zone, located in northern Quito, historically experienced emissions from quarries and moderate traffic. Z2 zone was influenced by heavy traffic in contrast to Z3 zone which experienced low traffic densities. Weekly averages of PM samples were collected at schools (one in each zone) and residences (Z1 = 47, Z2 = 45, and Z3 = 41) every month, over a twelve-month period at the three zones. Indoor PM2.5 concentrations ranged from 10.6 ± 4.9 μg/m(3) (Z1 school) to 29.0 ± 30.5 μg/m(3) (Z1 residences) and outdoor PM2.5 concentrations varied from 10.9 ± 3.2 μg/m(3) (Z1 school) to 14.3 ± 10.1 μg/m(3) (Z2 residences), across the three zones. The lowest values for PM10-2.5 for indoor and outdoor microenvironments were recorded at Z2 school, 5.7 ± 2.8 μg/m(3) and 7.9 ± 2.2 μg/m(3), respectively. Outdoor school PM concentrations exhibited stronger associations with corresponding indoor values making them robust proxies for indoor exposures in naturally ventilated Quito public schools. Correlation analysis between the school and residential PM size fractions and the various pollutant and meteorological parameters from central ambient monitoring (CAM) sites suggested varying degrees of temporal relationship. Strong positive correlation was observed for outdoor PM2.5 at Z2 school and its corresponding CAM site (r = 0.77) suggesting common traffic related emissions. Spatial heterogeneity in PM2.5 concentrations between CAM network and sampled sites was assessed using Coefficient of Divergence (COD) analysis. COD values were lower when CAM sites were paired with outdoor

Living for Six Days at 2200 M Improves Time-Trial Performance of Sea-Level Residents Exposed to 4300 M

National Research Council Canada - National Science Library

Fulco, Charles S; Muza, Stephen R; Beidleman, Beth; Jones, Juli; Lammi, Eric; Staab, Janet; Rock, Paul B; Kambis, Kenneth; Glickman, Ellen; Doan, Brandon K; Brothers, Michael D; Zupan, Michael F; Cymerman, Allen

2008-01-01

... and reducing acute mountain sickness incidence and severity during subsequent high altitude exposure The data presented here will be focused on the effects of staging at moderate altitude on prolonged endurance...

Changes in BOLD and ADC weighted imaging in acute hypoxia during sea-level and altitude adapted states

DEFF Research Database (Denmark)

Rostrup, Egill; Larsson, Henrik B.W.; Born, Alfred P.

2005-01-01

possible structural changes as measured by diffusion weighted imaging. Eleven healthy sea-level residents were studied after 5 weeks of adaptation to high altitude conditions at Chacaltaya, Bolivia (5260 m). The subjects were studied immediately after return to sea-level in hypoxic and normoxic conditions...... was slightly elevated in high altitude as compared to sea-level adaptation. It is concluded that hypoxia significantly diminishes the BOLD response, and the mechanisms underlying this finding are discussed. Furthermore, altitude adaptation may influence both the magnitude of the activation-related response......, and the examinations repeated 6 months later after re-adaptation to sea-level conditions. The BOLD response, measured at 1.5 T, was severely reduced during acute hypoxia both in the altitude and sea-level adapted states (50% reduction during an average S(a)O(2) of 75%). On average, the BOLD response magnitude was 23...

[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.

Natural Selection on Genes Related to Cardiovascular Health in High-Altitude Adapted Andeans.

Science.gov (United States)

Crawford, Jacob E; Amaru, Ricardo; Song, Jihyun; Julian, Colleen G; Racimo, Fernando; Cheng, Jade Yu; Guo, Xiuqing; Yao, Jie; Ambale-Venkatesh, Bharath; Lima, João A; Rotter, Jerome I; Stehlik, Josef; Moore, Lorna G; Prchal, Josef T; Nielsen, Rasmus

2017-11-02

The increase in red blood cell mass (polycythemia) due to the reduced oxygen availability (hypoxia) of residence at high altitude or other conditions is generally thought to be beneficial in terms of increasing tissue oxygen supply. However, the extreme polycythemia and accompanying increased mortality due to heart failure in chronic mountain sickness most likely reduces fitness. Tibetan highlanders have adapted to high altitude, possibly in part via the selection of genetic variants associated with reduced polycythemic response to hypoxia. In contrast, high-altitude-adapted Quechua- and Aymara-speaking inhabitants of the Andean Altiplano are not protected from high-altitude polycythemia in the same way, yet they exhibit other adaptive features for which the genetic underpinnings remain obscure. Here, we used whole-genome sequencing to scan high-altitude Andeans for signals of selection. The genes showing the strongest evidence of selection-including BRINP3, NOS2, and TBX5-are associated with cardiovascular development and function but are not in the response-to-hypoxia pathway. Using association mapping, we demonstrated that the haplotypes under selection are associated with phenotypic variations related to cardiovascular health. We hypothesize that selection in response to hypoxia in Andeans could have vascular effects and could serve to mitigate the deleterious effects of polycythemia rather than reduce polycythemia itself. Copyright © 2017. Published by Elsevier Inc.

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).

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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

Genomic scan reveals loci under altitude adaptation in Tibetan and Dahe pigs.

Directory of Open Access Journals (Sweden)

Kunzhe Dong

Full Text Available High altitude environments are of particular interest in the studies of local adaptation as well as their implications in physiology and clinical medicine in human. Some Chinese pig breeds, such as Tibetan pig (TBP that is well adapted to the high altitude and Dahe pig (DHP that dwells at the moderate altitude, provide ideal materials to study local adaptation to altitudes. Yet, it is still short of in-depth analysis and understanding of the genetic adaptation to high altitude in the two pig populations. In this study we conducted a genomic scan for selective sweeps using FST to identify genes showing evidence of local adaptations in TBP and DHP, with Wuzhishan pig (WZSP as the low-altitude reference. Totally, we identified 12 specific selective genes (CCBE1, F2RL1, AGGF1, ZFPM2, IL2, FGF5, PLA2G4A, ADAMTS9, NRBF2, JMJD1C, VEGFC and ADAM19 for TBP and six (OGG1, FOXM, FLT3, RTEL1, CRELD1 and RHOG for DHP. In addition, six selective genes (VPS13A, GNA14, GDAP1, PARP8, FGF10 and ADAMTS16 were shared by the two pig breeds. Among these selective genes, three (VEGFC, FGF10 and ADAMTS9 were previously reported to be linked to the local adaptation to high altitudes in pigs, while many others were newly identified by this study. Further bioinformatics analysis demonstrated that majority of these selective signatures have some biological functions relevant to the altitude adaptation, for examples, response to hypoxia, development of blood vessels, DNA repair and several hematological involvements. These results suggest that the local adaptation to high altitude environments is sophisticated, involving numerous genes and multiple biological processes, and the shared selective signatures by the two pig breeds may provide an effective avenue to identify the common adaptive mechanisms to different altitudes.

The Quality of Written Feedback by Attendings of Internal Medicine Residents.

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Jackson, Jeffrey L; Kay, Cynthia; Jackson, Wilkins C; Frank, Michael

2015-07-01

Attending evaluations are commonly used to evaluate residents. Evaluate the quality of written feedback of internal medicine residents. Retrospective. Internal medicine residents and faculty at the Medical College of Wisconsin from 2004 to 2012. From monthly evaluations of residents by attendings, a randomly selected sample of 500 written comments by attendings were qualitatively coded and rated as high-, moderate-, or low-quality feedback by two independent coders with good inter-rater reliability (kappa: 0.94). Small group exercises with residents and attendings also coded the utterances as high, moderate, or low quality and developed criteria for this categorization. In-service examination scores were correlated with written feedback. There were 228 internal medicine residents who had 6,603 evaluations by 334 attendings. Among 500 randomly selected written comments, there were 2,056 unique utterances: 29% were coded as nonspecific statements, 20% were comments about resident personality, 16% about patient care, 14% interpersonal communication, 7% medical knowledge, 6% professionalism, and 4% each on practice-based learning and systems-based practice. Based on criteria developed by group exercises, the majority of written comments were rated as moderate quality (65%); 22% were rated as high quality and 13% as low quality. Attendings who provided high-quality feedback rated residents significantly lower in all six of the Accreditation Council for Graduate Medical Education (ACGME) competencies (p service examination scores. Most attending written evaluation was of moderate or low quality. Attendings who provided high-quality feedback appeared to be more discriminating, providing significantly lower ratings of residents in all six ACGME core competencies, and across a greater range. Attendings' negative written comments on medical knowledge correlated with lower in-service training scores.

Structural modifications of the brain in acclimatization to high-altitude.

Directory of Open Access Journals (Sweden)

Jiaxing Zhang

Full Text Available Adaptive changes in respiratory and cardiovascular responses at high altitude (HA have been well clarified. However, the central mechanisms underlying HA acclimatization remain unclear. Using voxel-based morphometry (VBM and diffusion tensor imaging (DTI with fractional anisotropy (FA calculation, we investigated 28 Han immigrant residents (17-22 yr born and raised at HA of 2616-4200 m in Qinghai-Tibetan Plateau for at least 17 years and who currently attended college at sea-level (SL. Their family migrated from SL to HA 2-3 generations ago and has resided at HA ever since. Control subjects were matched SL residents. HA residents (vs. SL showed decreased grey matter volume in the bilateral anterior insula, right anterior cingulate cortex, bilateral prefrontal cortex, left precentral cortex, and right lingual cortex. HA residents (vs. SL had significantly higher FA mainly in the bilateral anterior limb of internal capsule, bilateral superior and inferior longitudinal fasciculus, corpus callosum, bilateral superior corona radiata, bilateral anterior external capsule, right posterior cingulum, and right corticospinal tract. Higher FA values in those regions were associated with decreased or unchanged radial diffusivity coinciding with no change of longitudinal diffusivity in HA vs. SL group. Conversely, HA residents had lower FA in the left optic radiation and left superior longitudinal fasciculus. Our data demonstrates that HA acclimatization is associated with brain structural modifications, including the loss of regional cortical grey matter accompanied by changes in the white matter, which may underlie the physiological adaptation of residents at HA.

Delaying cognitive and physical decline through multidomain interventions for residents with mild-to-moderate dementia in dementia care units in Taiwan: A prospective cohort study.

Science.gov (United States)

Liang, Chih-Kuang; Chou, Ming-Yueh; Chen, Liang-Yu; Wang, Kuei-Yu; Lin, Shih-Yi; Chen, Liang-Kung; Lin, Yu-Te; Liu, Tsung-Yun; Loh, Ching-Hui

2017-04-01

To develop experimental multi-domain interventions for older people with mild-to-moderate dementia, and to evaluate the effect of delaying cognitive and physical decline, and improvement or prevention of geriatric syndromes during 1-year follow up. Participants aged 65 years and older with mild-to-moderate dementia (clinical dementia rating [CDR] 1 or 2) were grouped as intervention in Jia-Li Veterans Home and usual care model in the community (Memory clinic). All residents in Jia-Li Veterans Home received comprehensive intervention, including Multi-disciplinary team consultation and intervention, Multi-component non-pharmacological management, geriatric syndromes survey and intervention by CGA, and a dementia friendly medical Green channel Approach (2MCGA). The decline of cognitive and physical function are determined by the change of Mini-Mental State Examination score, CDR and the sum of CDR box, as well as activities of daily living based on the Barthel Index. We also screened geriatric syndromes at baseline and 1 year later. Participants in the intervention group were older and had a lower educational level, lower body mass index, poor baseline activities of daily living function, lower visual impairment, and higher rates of hearing impairment, polypharmacy and risk of malnutrition. The residents receiving 2MCGA had lower baseline Mini-Mental State Examination scores, and higher CDR. For residents in Jia-Li Veterans Home, all cognitive measurements except Mini-Mental State Examination were significantly associated with delaying the decline of cognition after analyzing by multiple linear regression, and multivariate logistic regression also showed that patients living in the community was independently associated with a higher odds ratio for activities of daily living decline (3.180, 95% CI 1.384-7.308, P = 0.006). There are also more improvement in their baseline geriatric syndromes and suffered less from new geriatric syndromes, including falls, urinary

Genotype by environment interaction for growth due to altitude in United States Angus cattle.

Science.gov (United States)

Williams, J L; Bertrand, J K; Misztal, I; Łukaszewicz, M

2012-07-01

The objectives of this study were to determine if sires perform consistently across altitude and to quantify the genetic relationship between growth and survival at differing altitudes. Data from the American Angus Association included weaning weight (WW) adjusted to 205 (n = 77,771) and yearling weight adjusted to 365 (n = 39,450) d of age from 77,771 purebred Angus cattle born in Colorado between 1972 and 2007. Postweaning gain (PWG) was calculated by subtracting adjusted WW from adjusted yearling weight. Altitude was assigned to each record based upon the zip code of each herd in the database. Records for WW and PWG were each split into 2 traits measured at low and high altitude, with the records from medium altitude removed from the data due to inconsistencies between growth performance and apparent culling rate. A binary trait, survival (SV), was defined to account for censored records at yearling for each altitude. It was assumed that, at high altitude, individuals missing a yearling weight either died or required relocation to a lower altitude predominantly due to brisket disease, a condition common at high altitude. Model 1 considered each WW and PWG measured at 2 altitudes as separate traits. Model 2 treated PWG and SV measured as separate traits due to altitude. Models included the effects of weaning contemporary group, age of dam, animal additive genetic effects, and residual. Maternal genetic and maternal permanent environmental effects were included for WW. Heritability estimates for WW in Model 1 were 0.28 and 0.26 and for PWG were 0.26 and 0.19 with greater values in low altitude. Genetic correlations between growth traits measured at different altitude were moderate in magnitude: 0.74 for WW and 0.76 for PWG and indicate possibility of reranking of sires across altitude. Maternal genetic correlation between WW at varying altitude of 0.75 also indicates these may be different traits. In Model 2, heritabilities were 0.14 and 0.27 for PWG and 0.36 and

High altitude illness

Science.gov (United States)

Hartman-Ksycińska, Anna; Kluz-Zawadzka, Jolanta; Lewandowski, Bogumił

High-altitude illness is a result of prolonged high-altitude exposure of unacclimatized individuals. The illness is seen in the form of acute mountain sickness (AMS) which if not treated leads to potentially life-threatening high altitude pulmonary oedema and high-altitude cerebral oedema. Medical problems are caused by hypobaric hypoxia stimulating hypoxia-inducible factor (HIF) release. As a result, the central nervous system, circulation and respiratory system function impairment occurs. The most important factor in AMS treatment is acclimatization, withdrawing further ascent and rest or beginning to descent; oxygen supplementation, and pharmacological intervention, and, if available, a portable hyperbaric chamber. Because of the popularity of high-mountain sports and tourism better education of the population at risk is essential.

Assessment of oxidative stress biomarkers - neuroprostanes and dihomo-isoprostanes - in the urine of elite triathletes after two weeks of moderate-altitude training.

Science.gov (United States)

García-Flores, Libia Alejandra; Medina, Sonia; Cejuela, Roberto; Martínez-Sanz, José Miguel; Oger, Camille; Galano, Jean-Marie; Durand, Thierry; Casas-Pina, Teresa; Martínez-Hernández, Pedro; Ferreres, Federico; Gil-Izquierdo, Ángel

2016-01-01

This randomized and controlled trial investigated whether the increase in elite training at different altitudes altered the oxidative stress biomarkers of the nervous system. This is the first study to investigate four F4-neuroprostanes (F4-NeuroPs) and four F2-dihomo-isoprostanes (F2-dihomo-IsoPs) quantified in 24-h urine. The quantification was carried out by ultra high pressure liquid chromatography-triple quadrupole-tandem mass spectrometry (UHPLC-QqQ-MS/MS). Sixteen elite triathletes agreed to participate in the project. They were randomized in two groups, a group submitted to altitude training (AT, n = 8) and a group submitted to sea level training (SLT) (n = 8), with a control group (Cg) of non-athletes (n = 8). After the experimental period, the AT group triathletes gave significant data: 17-epi-17-F2t-dihomo-IsoP (from 5.2 ± 1.4 μg/mL 24 h(-1) to 6.6 ± 0.6 μg/mL 24 h(-1)), ent-7(RS)-7-F2t-dihomo-IsoP (from 6.6 ± 1.7 μg/mL 24 h(-1) to 8.6 ± 0.9 μg/mL 24 h(-1)), and ent-7-epi-7-F2t-dihomo-IsoP (from 8.4 ± 2.2 μg/mL 24 h(-1) to 11.3 ± 1.8 μg/mL 24 h(-1)) increased, while, of the neuronal degeneration-related compounds, only 10-epi-10-F4t-NeuroP (8.4 ± 1.7 μg/mL 24 h(-1)) and 10-F4t-NeuroP (5.2 ± 2.9 μg/mL 24 h(-1)) were detected in this group. For the Cg and SLT groups, no significant changes had occurred at the end of the two-week experimental period. Therefore, and as the main conclusion, the training at moderate altitude increased the F4-NeuroPs- and F2-dihomo-isoPs-related oxidative damage of the central nervous system compared to similar training at sea level.

Training at altitude in practice.

Science.gov (United States)

Dick, F W

1992-10-01

There can be little doubt that training at altitude is fundamental to preparing an athlete for competition at altitude. However the value of training at altitude for competition at sea level appears on the one hand to lack total acceptance amongst sports scientists; and on the other to hold some cloak of mystery for coaches who have yet to enjoy first hand experience. The fact is that very few endurance athletes will ignore the critical edge which altitude training affords. Each fraction of a percentage of performance advantage gained through methods which are within the rules of fair play in sport, may shift the balance between failure and achievement. Moreover, there is growing support for application of training at altitude for speed-related disciplines. This paper aims to demystify the subject by dealing with practical aspects of training at altitude. Such aspects include a checklist of what should and should not be done at altitude, when to use altitude relative to target competitions, and specific training examples.

Long-Term Intermittent Work at High Altitude: Right Heart Functional and Morphological Status and Associated Cardiometabolic Factors.

Science.gov (United States)

Brito, Julio; Siques, Patricia; López, Rosario; Romero, Raul; León-Velarde, Fabiola; Flores, Karen; Lüneburg, Nicole; Hannemann, Juliane; Böger, Rainer H

2018-01-01

Background: Living at high altitude or with chronic hypoxia implies functional and morphological changes in the right ventricle and pulmonary vasculature with a 10% prevalence of high-altitude pulmonary hypertension (HAPH). The implications of working intermittently (day shifts) at high altitude (hypobaric hypoxia) over the long term are still not well-defined. The aim of this study was to evaluate the right cardiac circuit status along with potentially contributory metabolic variables and distinctive responses after long exposure to the latter condition. Methods: A cross-sectional study of 120 healthy miners working at an altitude of 4,400-4,800 m for over 5 years in 7-day commuting shifts was designed. Echocardiography was performed on day 2 at sea level. Additionally, biomedical and biochemical variables, Lake Louise scores (LLSs), sleep disturbances and physiological variables were measured at altitude and at sea level. Results: The population was 41.8 ± 0.7 years old, with an average of 14 ± 0.5 (range 5-29) years spent at altitude. Most subjects still suffered from mild to moderate symptoms of acute mountain sickness (mild was an LLS of 3-5 points, including cephalea; moderate was LLS of 6-10 points) (38.3%) at the end of day 1 of the shift. Echocardiography showed a 23% mean pulmonary artery pressure (mPAP) >25 mmHg, 9% HAPH (≥30 mmHg), 85% mild increase in right ventricle wall thickness (≥5 mm), 64% mild right ventricle dilation, low pulmonary vascular resistance (PVR) and fairly good ventricle performance. Asymmetric dimethylarginine (ADMA) (OR 8.84 (1.18-66.39); p Working intermittently at high altitude involves a distinctive pattern. The most relevant and novel characteristics are a greater prevalence of elevated mPAP and HAPH than previously reported at chronic intermittent hypobaric hypoxia (CIHH), which is accompanied by subsequent morphological characteristics. These findings are associated with cardiometabolic factors (insulin and ADMA

Evaluation of transport ventilators at mild simulated altitude: a bench study in a hypobaric chamber.

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Boussen, Salah; Coulange, Mathieu; Fournier, Marc; Gainnier, Marc; Michelet, Pierre; Micoli, Christophe; Negrel, Lionel

2014-08-01

Previous studies on ventilators used for air transport showed significant effects of altitude, in particular with regard to accuracy of the tidal volume (VT) and breathing frequency. The aim of the study was to evaluate transport ventilators under hypobaric conditions. We conducted a bench study of 6 transport ventilators in a Comex hypobaric chamber to simulate mild altitude (1,500 m [4,920 feet] and 2,500 m [8,200 feet]). The ventilators were connected to a test lung to evaluate their accuracy: (1) to deliver a set VT under normal resistance and compliance conditions at F(IO2) = 0.6 and 1, (2) to establish a set PEEP (0, 5, 10, and 15 cm H2O), and (3) to establish a set inspiratory pressure in pressure controlled mode, (4) at a F(IO2) setting, and (5) and at a frequency setting. Four ventilators kept an average relative error in VT of ventilator was affected by the altitude only at F(IO2) = 1. The Osiris 3 ventilator had > 40% error even at 1,500 m. We found no change in frequency as a function of altitude for any ventilators studied. No clinically important differences were found between all altitudes with the PEEP or inspiratory pressure setting. Although F(IO2) was affected by altitude, the average error did not exceed 11%, and it is unclear whether this fact is an experimental artifact. We have shown that most of the new transport ventilators tested require no setting adjustment at moderate altitude and are as safe at altitude as at sea level under normal respiratory conditions. Older technologies still deliver more volume with altitude in volumetric mode.

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...... 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......, but even acclimatization for 8 wk is insufficient to achieve levels reached by high-altitude natives....

Dose-response of altitude training: how much altitude is enough?

Science.gov (United States)

Levine, Benjamin D; Stray-Gundersen, James

2006-01-01

Altitude training continues to be a key adjunctive aid for the training of competitive athletes throughout the world. Over the past decade, evidence has accumulated from many groups of investigators that the "living high--training low" approach to altitude training provides the most robust and reliable performance enhancements. The success of this strategy depends on two key features: 1) living high enough, for enough hours per day, for a long enough period of time, to initiate and sustain an erythropoietic effect of high altitude; and 2) training low enough to allow maximal quality of high intensity workouts, requiring high rates of sustained oxidative flux. Because of the relatively limited access to environments where such a strategy can be practically applied, numerous devices have been developed to "bring the mountain to the athlete," which has raised the key issue of the appropriate "dose" of altitude required to stimulate an acclimatization response and performance enhancement. These include devices using molecular sieve technology to provide a normobaric hypoxic living or sleeping environment, approaches using very high altitudes (5,500m) for shorter periods of time during the day, and "intermittent hypoxic training" involving breathing very hypoxic gas mixtures for alternating 5 minutes periods over the course of 60-90 minutes. Unfortunately, objective testing of the strategies employing short term (less than 4 hours) normobaric or hypobaric hypoxia has failed to demonstrate an advantage of these techniques. Moreover individual variability of the response to even the best of living high--training low strategies has been great, and the mechanisms behind this variability remain obscure. Future research efforts will need to focus on defining the optimal dosing strategy for these devices, and determining the underlying mechanisms of the individual variability so as to enable the individualized "prescription" of altitude exposure to optimize the performance of

On the altitude dependence of transversely heated O+ distributions in the cusp/cleft

Directory of Open Access Journals (Sweden)

L. Kistler

2004-04-01

Full Text Available The present paper focuses on the altitude dependence of oxygen ion conics in the dayside cusp/cleft region. Here, combining oxygen data from the Akebono, Interball-2 and Cluster satellites allows, for the first time, one to follow the global development of energetic (up to ~10keV ion outflow over a continuous and broad altitude range up to about 5.5 Earth radii (RE. According to earlier statistical studies, the results are consistent with a height-integrated energization of ions at altitudes up to 3.5 RE. Higher up, the results inferred from Cluster observations put forward evidence of a saturation of both a transverse energization rate and ion gyroradii. We suggest that such results may be interpreted as finite perpendicular wavelength effects (a few tens of km in the wave-particle interactions. To substantiate the suggestion, we carry out two-dimensional, Monte Carlo simulations of ion conic production that incorporate such effects and limited residence times due to the finite latitudinal extent of the heating region.Key words. Magnetospheric physics (auroral phenomena – Space plasma physics (charged particle motion and acceleration; wave-particle interactions

Physiological and performance responses to a preseason altitude-training camp in elite team-sport athletes.

Science.gov (United States)

McLean, Blake D; Buttifant, David; Gore, Christopher J; White, Kevin; Liess, Carsten; Kemp, Justin

2013-07-01

Little research has been done on the physiological and performance effects of altitude training on team-sport athletes. Therefore, this study examined changes in 2000-m time-trial running performance (TT), hemoglobin mass (Hbmass), and intramuscular carnosine content of elite Australian Football (AF) players after a preseason altitude camp. Thirty elite AF players completed 19 days of living and training at either moderate altitude (~2130 m; ALT, n = 21) or sea level (CON, n = 9). TT performance and Hbmass were assessed preintervention (PRE) and postintervention (POST1) in both groups and at 4 wk after returning to sea level (POST2) in ALT only. Improvement in TT performance after altitude was likely 1.5% (± 4.8-90%CL) greater in ALT than in CON, with an individual responsiveness of 0.8%. Improvements in TT were maintained at POST2 in ALT. Hbmass after altitude was very likely increased in ALT compared with CON (2.8% ± 3.5%), with an individual responsiveness of 1.3%. Hbmass returned to baseline at POST2. Intramuscular carnosine did not change in either gastrocnemius or soleus from PRE to POST1. A preseason altitude camp improved TT performance and Hbmass in elite AF players to a magnitude similar to that demonstrated by elite endurance athletes undertaking altitude training. The individual responsiveness of both TT and Hbmass was approximately half the group mean effect, indicating that most players gained benefit. The maintenance of running performance for 4 wk, despite Hbmass returning to baseline, suggests that altitude training is a valuable preparation for AF players leading into the competitive season.

Altitude and endurance training.

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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 (altitude training period (training effect at altitude may have been compromised due to insufficient training stimuli for enhancing the function of the neuromuscular and cardiovascular systems; and (3) enhanced 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.

Mediated moderation or moderated mediation: relationship between length of unemployment, resilience, coping and health.

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Sojo, Víctor; Guarino, Leticia

2011-05-01

The aim of the present research was to evaluate a model of mediated moderation vs. moderated mediation that could explain the relationship between length of unemployment, dispositional resilience, coping styles and depression and social functioning of Venezuelan unemployed individuals. Self-report measures were administered to a sample of 328 unemployed residents in Caracas, Venezuela. Results indicated that emotional coping acted as a mediator in the relationship between resilience and depression. Individuals with greater resilience used more detachment coping when unemployment was longer, while individuals with poorer resilience in the same situation used less avoidance coping. Resilience acted as a protective moderating factor between longer periods of unemployment and social functioning, a process mediated by detachment coping. Overall, results supported a mediated moderation model, with resilience as the moderating factor and coping as the mediator in the relation between stress due to the length of unemployment and well-being.

Long-Term Intermittent Work at High Altitude: Right Heart Functional and Morphological Status and Associated Cardiometabolic Factors

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Julio Brito

2018-03-01

Full Text Available Background: Living at high altitude or with chronic hypoxia implies functional and morphological changes in the right ventricle and pulmonary vasculature with a 10% prevalence of high-altitude pulmonary hypertension (HAPH. The implications of working intermittently (day shifts at high altitude (hypobaric hypoxia over the long term are still not well-defined. The aim of this study was to evaluate the right cardiac circuit status along with potentially contributory metabolic variables and distinctive responses after long exposure to the latter condition.Methods: A cross-sectional study of 120 healthy miners working at an altitude of 4,400–4,800 m for over 5 years in 7-day commuting shifts was designed. Echocardiography was performed on day 2 at sea level. Additionally, biomedical and biochemical variables, Lake Louise scores (LLSs, sleep disturbances and physiological variables were measured at altitude and at sea level.Results: The population was 41.8 ± 0.7 years old, with an average of 14 ± 0.5 (range 5–29 years spent at altitude. Most subjects still suffered from mild to moderate symptoms of acute mountain sickness (mild was an LLS of 3–5 points, including cephalea; moderate was LLS of 6–10 points (38.3% at the end of day 1 of the shift. Echocardiography showed a 23% mean pulmonary artery pressure (mPAP >25 mmHg, 9% HAPH (≥30 mmHg, 85% mild increase in right ventricle wall thickness (≥5 mm, 64% mild right ventricle dilation, low pulmonary vascular resistance (PVR and fairly good ventricle performance. Asymmetric dimethylarginine (ADMA (OR 8.84 (1.18–66.39; p < 0.05 and insulin (OR: 1.11 (1.02–1.20; p < 0.05 were associated with elevated mPAP and were defined as a cut-off. Interestingly, the correspondence analysis identified association patterns of several other variables (metabolic, labor, and biomedical with higher mPAP.Conclusions: Working intermittently at high altitude involves a distinctive pattern. The most relevant and

Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency?

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Raman, Tina; Alrabaa, Rami George; Sood, Amit; Maloof, Paul; Benevenia, Joseph; Berberian, Wayne

2016-04-01

More than 1000 candidates applied for orthopaedic residency positions in 2014, and the competition is intense; approximately one-third of the candidates failed to secure a position in the match. However, the criteria used in the selection process often are subjective and studies have differed in terms of which criteria predict either objective measures or subjective ratings of resident performance by faculty. Do preresidency selection factors serve as predictors of success in residency? Specifically, we asked which preresidency selection factors are associated or correlated with (1) objective measures of resident knowledge and performance; and (2) subjective ratings by faculty. Charts of 60 orthopaedic residents from our institution were reviewed. Preresidency selection criteria examined included United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, Medical College Admission Test (MCAT) scores, number of clinical clerkship honors, number of letters of recommendation, number of away rotations, Alpha Omega Alpha (AOA) honor medical society membership, fourth-year subinternship at our institution, and number of publications. Resident performance was assessed using objective measures including American Board of Orthopaedic Surgery (ABOS) Part I scores and Orthopaedics In-Training Exam (OITE) scores and subjective ratings by faculty including global evaluation scores and faculty rankings of residents. We tested associations between preresidency criteria and the subsequent objective and subjective metrics using linear correlation analysis and Mann-Whitney tests when appropriate. Objective measures of resident performance namely, ABOS Part I scores, had a moderate linear correlation with the USMLE Step 2 scores (r = 0.55, p communication skills" subsection of the global evaluations. We found that USMLE Step 2, number of honors in medical school clerkships, and AOA membership demonstrated the strongest correlations with resident performance. Our

Variation in aerodynamic coefficients with altitude

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Faiza Shahid

Full Text Available Precise aerodynamics performance prediction plays key role for a flying vehicle to get its mission completed within desired accuracy. Aerodynamic coefficients for same Mach number can be different at different altitude due to difference in Reynolds number. Prediction of these aerodynamics coefficients can be made through experiments, analytical solution or Computational Fluid Dynamics (CFD. Advancements in computational power have generated the concept of using CFD as a virtual Wind Tunnel (WT, hence aerodynamic performance prediction in present study is based upon CFD (numerical test rig. Simulations at different altitudes for a range of Mach numbers with zero angle of attack are performed to predict axial force coefficient behavior with altitude (Reynolds number. Similar simulations for a fixed Mach number ‘3’ and a range of angle of attacks are also carried out to envisage the variation in normal force and pitching moment coefficients with altitude (Reynolds number. Results clearly depict that the axial force coefficient is a function of altitude (Reynolds number and increase as altitude increases, especially for subsonic region. Variation in axial force coefficient with altitude (Reynolds number slightly increases for larger values of angle of attacks. Normal force and pitching moment coefficients do not depend on altitude (Reynolds number at smaller values of angle of attacks but show slight decrease as altitude increases. Present study suggests that variation of normal force and pitching moment coefficients with altitude can be neglected but the variation of axial force coefficient with altitude should be considered for vehicle fly in dense atmosphere. It is recommended to continue this study to more complex configurations for various Mach numbers with side slip and real gas effects. Keywords: Mach number, Reynolds number, Blunt body, Altitude effect, Angle of attacks

Haematology and erythrocyte metabolism in man at high altitude: an Aymara-Quechua comparison.

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Arnaud, J; Gutierrez, N; Tellez, W; Vergnes, H

1985-07-01

In the course of haematological and biological investigations among Aymara and Quechua populations in Bolivia, an anthropological study of the erythrocytary respiratory function was carried out on the two groups at two altitudes: 3,600 m and 450 m. A difference in the intensity of the biological variations of the two populations is observed at high altitude. In the Quechuas, as in any lowland native, the adaptative phenomena are totally and quickly reversible. In the Aymaras, we detected the existence of more marked haematological and biochemical characters: moderate polycythemia, hyperhaemoglobinemia, microcytosis, metabolical hyperactivity with accumulation of 2-3 di-phosphoglycerate and ATP, and methaemoglobinemia with a drop in the activity of the methaemoglobin reductases. The Aymaras preserve some of those characters (methaemoglobinemia excepted) when they settle in lowlands.

Gokyo Khumbu/Ama Dablam Trek 2012: effects of physical training and high-altitude exposure on oxidative metabolism, muscle composition, and metabolic cost of walking in women.

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Tam, E; Bruseghini, P; Calabria, E; Dal Sacco, L; Doria, C; Grassi, B; Pietrangelo, T; Pogliaghi, S; Reggiani, C; Salvadego, D; Schena, F; Toniolo, L; Verratti, V; Vernillo, G; Capelli, Carlo

2016-01-01

We investigated the effects of moderate-intensity training at low and high altitude on VO2 and QaO2 kinetics and on myosin heavy-chain expression (MyHC) in seven women (36.3 yy ± 7.1; 65.8 kg ± 11.7; 165 cm ± 8) who participated in two 12- to 14-day trekking expeditions at low (598 m) and high altitude (4132 m) separated by 4 months of recovery. Breath-by-breath VO2 and beat-by-beat QaO2 at the onset of moderate-intensity cycling exercise and energy cost of walking (Cw) were assessed before and after trekking. MyHC expression of vastus lateralis was evaluated before and after low-altitude and after high-altitude trekking; muscle fiber high-resolution respirography was performed at the beginning of the study and after high-altitude trekking. Mean response time of VO2 kinetics was faster (P = 0.002 and P = 0.001) and oxygen deficit was smaller (P = 0.001 and P = 0.0004) after low- and high-altitude trekking, whereas ˙ QaO2 kinetics and Cw did not change. Percentages of slow and fast isoforms of MyHC and mitochondrial mass were not affected by low- and high-altitude training. After training altitude, muscle fiber ADP-stimulated mitochondrial respiration was decreased as compared with the control condition (P = 0.016), whereas leak respiration was increased (P = 0.031), leading to a significant increase in the respiratory control ratio (P = 0.016). Although training did not significantly modify muscle phenotype, it induced beneficial adaptations of the oxygen transport-utilization systems witnessed by faster VO2 kinetics at exercise onset.

Variation in aerodynamic coefficients with altitude

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Shahid, Faiza; Hussain, Mukkarum; Baig, Mirza Mehmood; Haq, Ihtram ul

Precise aerodynamics performance prediction plays key role for a flying vehicle to get its mission completed within desired accuracy. Aerodynamic coefficients for same Mach number can be different at different altitude due to difference in Reynolds number. Prediction of these aerodynamics coefficients can be made through experiments, analytical solution or Computational Fluid Dynamics (CFD). Advancements in computational power have generated the concept of using CFD as a virtual Wind Tunnel (WT), hence aerodynamic performance prediction in present study is based upon CFD (numerical test rig). Simulations at different altitudes for a range of Mach numbers with zero angle of attack are performed to predict axial force coefficient behavior with altitude (Reynolds number). Similar simulations for a fixed Mach number '3' and a range of angle of attacks are also carried out to envisage the variation in normal force and pitching moment coefficients with altitude (Reynolds number). Results clearly depict that the axial force coefficient is a function of altitude (Reynolds number) and increase as altitude increases, especially for subsonic region. Variation in axial force coefficient with altitude (Reynolds number) slightly increases for larger values of angle of attacks. Normal force and pitching moment coefficients do not depend on altitude (Reynolds number) at smaller values of angle of attacks but show slight decrease as altitude increases. Present study suggests that variation of normal force and pitching moment coefficients with altitude can be neglected but the variation of axial force coefficient with altitude should be considered for vehicle fly in dense atmosphere. It is recommended to continue this study to more complex configurations for various Mach numbers with side slip and real gas effects.

High Altitude and Heart

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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

Reduced hypoxic ventilatory response with preserved blood oxygenation in yoga trainees and Himalayan Buddhist monks at altitude: evidence of a different adaptive strategy?

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Bernardi, Luciano; Passino, Claudio; Spadacini, Giammario; Bonfichi, Maurizio; Arcaini, Luca; Malcovati, Luca; Bandinelli, Gabriele; Schneider, Annette; Keyl, Cornelius; Feil, Paul; Greene, Richard E; Bernasconi, Carlo

2007-03-01

Yoga induces long-term changes in respiratory function and control. We tested whether it represents a successful strategy for high-altitude adaptation. We compared ventilatory, cardiovascular and hematological parameters in: 12 Caucasian yoga trainees and 12 control sea-level residents, at baseline and after 2-week exposure to high altitude (Pyramid Laboratory, Nepal, 5,050 m), 38 active lifestyle high-altitude natives (Sherpas) and 13 contemplative lifestyle high-altitude natives with practice of yoga-like respiratory exercises (Buddhist monks) studied at 5,050 m. At baseline, hypoxic ventilatory response (HVR), red blood cell count and hematocrit were lower in Caucasian yoga trainees than in controls. After 14 days at altitude, yoga trainees showed similar oxygen saturation, blood pressure, RR interval compared to controls, but lower HVR (-0.44 +/- 0.08 vs. -0.98 +/- 0.21 l/min/m/%SaO(2), P monks was lower than in Sherpas (-0.23 +/- 0.05 vs. -0.63 +/- 0.09 l/min/m/%SaO(2), P monks as compared to Sherpas. In conclusion, Caucasian subjects practicing yoga maintain a satisfactory oxygen transport at high altitude, with minimal increase in ventilation and with reduced hematological changes, resembling Himalayan natives. Respiratory adaptations induced by the practice of yoga may represent an efficient strategy to cope with altitude-induced hypoxia.

Acute high-altitude sickness

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Andrew M. Luks

2017-02-01

Full Text Available At any point 1–5 days following ascent to altitudes ≥2500 m, individuals are at risk of developing one of three forms of acute altitude illness: acute mountain sickness, a syndrome of nonspecific symptoms including headache, lassitude, dizziness and nausea; high-altitude cerebral oedema, a potentially fatal illness characterised by ataxia, decreased consciousness and characteristic changes on magnetic resonance imaging; and high-altitude pulmonary oedema, a noncardiogenic form of pulmonary oedema resulting from excessive hypoxic pulmonary vasoconstriction which can be fatal if not recognised and treated promptly. This review provides detailed information about each of these important clinical entities. After reviewing the clinical features, epidemiology and current understanding of the pathophysiology of each disorder, we describe the current pharmacological and nonpharmacological approaches to the prevention and treatment of these diseases.

Short-term cardiorespiratory adaptation to high altitude in children compared with adults.

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Kriemler, S; Radtke, T; Bürgi, F; Lambrecht, J; Zehnder, M; Brunner-La Rocca, H P

2016-02-01

As short-term cardiorespiratory adaptation to high altitude (HA) exposure has not yet been studied in children, we assessed acute mountain sickness (AMS), hypoxic ventilatory response (HVR) at rest and maximal exercise capacity (CPET) at low altitude (LA) and HA in pre-pubertal children and their fathers. Twenty father-child pairs (11 ± 1 years and 44 ± 4 years) were tested at LA (450 m) and HA (3450 m) at days 1, 2, and 3 after fast ascent (HA1/2/3). HVR was measured at rest and CPET was performed on a cycle ergometer. AMS severity was mild to moderate with no differences between generations. HVR was higher in children than adults at LA and increased at HA similarly in both groups. Peak oxygen uptake (VO2 peak) relative to body weight was similar in children and adults at LA and decreased significantly by 20% in both groups at HA; maximal heart rate did not change at HA in children while it decreased by 16% in adults (P < 0.001). Changes in HVR and VO2 peak from LA to HA were correlated among the biological child-father pairs. In conclusion, cardiorespiratory adaptation to altitude seems to be at least partly hereditary. Even though children and their fathers lose similar fractions of aerobic capacity going to high altitude, the mechanisms might be different. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

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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.

Efectos de la hipoxia en montañeros expuestos a altitudes extremas

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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.

QT interval changes in term pregnant women living at moderately ...

African Journals Online (AJOL)

Objective: 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). Materials and Methods: One‑hundred ten women (n = 55, for each group) with full‑term and single ...

U-Shaped Relationship between Years of Residence and Negative Mental Health Outcomes among Rural-to-Urban Children in Migrant Schools in Beijing, China: The Moderating Effects of Socioeconomic Factors.

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Cheng, Jin; Wang, Ri-Chu; Yin, Xing; Fu, Lin; Liu, Zheng-Kui

2017-01-01

This study aimed to test the relationship between length of residence and mental health in a school-based sample of migrant children who studied in migrant schools. A total of 7,296 rural-to-urban migrant children were recruited from 58 schools in Beijing and assessed by the State-Trait Anxiety Inventory and Children's Depression Inventory. A quadratic relationship was found between mental health and length of residence. The results suggested that the scores for anxiety and depression were high during the initial resettlement after migrating and then decreased. However, after approximately 8 years, the scores increased. Our findings also showed a significant moderating effect of family socioeconomic status on the relation between mental health and length of residence. This study provided empirical evidence for a better understanding of psychosocial factors on the mental health of migrant children during the process of urbanization in China.

Altitude Stress During Participation of Medical Congress

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

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 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. PMID:27621942

A comparison of the incidence and understanding of altitude illness between porters and trekkers in the Solu Khumbu Region of Nepal.

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Newcomb, Lauren; Sherpa, Chhewang; Nickol, Annabel; Windsor, Jeremy

2011-09-01

Altitude illness can occur in anyone who ascends to high altitude. Better understanding of altitude illness is associated with a lower incidence of acute mountain sickness (AMS). The purpose of this study is to compare, for the first time, the incidence and understanding of altitude illness between foreign trekkers and indigenous porters in Nepal. Interviews and questionnaires were completed at the International Porter Protection Group Rescue Post at Machermo (4470 m). Participants completed the Lake Louise acute mountain sickness self-assessment questionnaire. They were also asked about their actions in response to high altitude illness scenarios as well as their perception of the vulnerability of porters vs trekkers to altitude illness. Ascent profile, age, gender, ethnic origin, and altitude of home residence were also obtained. Trekkers (n=131) had a significantly higher incidence of AMS (21% vs 8%) than porters (n=92; P porters (whose home villages were below 3050 m, n=61) had a numerically higher, though not significantly different, incidence of AMS (10% vs 3%) compared to highland porters (n=31). The majority of trekkers and porters recognized the symptoms of altitude illness and the most appropriate action to be taken. Despite the lower incidence of AMS in porters, around half felt that they were at greater risk than trekkers. Porters had a lower incidence of AMS, which may be attributable to repeated ascents through the trekking season, or differences in reporting symptoms. Both trekkers and porters demonstrated appropriate knowledge of actions to be taken in response to altitude illness. Copyright © 2011 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

[Relationship between occupational stress and working ability of workers in a petroleum processing enterprise in high altitude area].

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Ma, X M; Kang, H L; Shi, C B; Li, Y; Wu, Y F; Liu, Z H; Wang, G; Lei, H Y

2017-12-20

Objective: To investigate the relationship between occupational stress and working ability of workers in a petroleum processing enterprise in a high altitude area. Methods: A total of 728 workers in a petroleum processing enterprise at an altitude of 2850 m were subjected to a survey using Occupational Stress Inventory (OSI) , Work Ability Index (WAI) Scale, Occupational Role Questionnaire (ORQ) , Personal Strain Questionnaire (PSQ) , and Personal Resource Questionnaire (PRQ) from May 2014 to August 2016. Results: Of the 728 workers, 55 (7.6%) had a poor working ability, moderate in 262 (35.9%) , and good in 411 (56.5%). There were significant differences in WAI between the workers with different types of work, sexes, ages, and working years ( P occupational stress groups ( P Occupational stress is an influencing factor for the working ability of workers in the petroleum processing enterprise in the high altitude area. Hypoxia in high altitude area may further reduce the working ability. In order to reduce occupational stress and improve work ability, it should be considered to strengthen skills training, improve the working environment, and pay attention to mental health.

Performance of portable ventilators at altitude.

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Blakeman, Thomas; Britton, Tyler; Rodriquez, Dario; Branson, Richard

2014-09-01

Aeromedical transport of critically ill patients requires continued, accurate performance of equipment at altitude. Changes in barometric pressure can affect the performance of mechanical ventilators calibrated for operation at sea level. Deploying ventilators that can maintain a consistent tidal volume (VT) delivery at various altitudes is imperative for lung protection when transporting wounded war fighters to each echelon of care. Three ventilators (Impact 731, Hamilton T1, and CareFusion Revel) were tested at pediatric (50 and 100 mL) and adult (250-750 mL) tidal VTs at 0 and 20 cm H₂O positive end expiratory pressure and at inspired oxygen of 0.21 and 1.0. Airway pressure, volume, and flow were measured at sea level as well as at 8,000, 16,000, and 22,000 ft (corresponding to barometric pressures of 760, 564, 412, and 321 mm Hg) using a calibrated pneumotachograph connected to a training test lung in an altitude chamber. Set VT and delivered VT as well as changes in VT at each altitude were compared by t test. The T1 delivered VT within 10% of set VT at 8,000 ft. The mean VT was less than set VT at sea level as a result of circuit compressible volume with the Revel and the 731. Changes in VT varied widely among the devices at sea level and at altitude. Increasing altitudes resulted in larger VT than set for the Revel and the T1. The 731 compensated for changes in altitude delivered VT within 10% at the adult settings at all altitudes. Altitude compensation is an active software algorithm. Only the 731 actively accounts for changes in barometric pressure to maintain the set VT at all tested altitudes.

Corona Onset Characteristics of Bundle Conductors in UHV AC Power Lines at 2200 m Altitude

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Shilong Huang

2018-04-01

Full Text Available The corona onset characteristic of bundle conductors is an important limiting factor for the design of UHV AC power lines in high-altitude areas. An experimental study on the corona characteristics of 8 × LGJ630, 6 × LGJ720, 8 × LGJ720 and 10 × LGJ720 bundle conductors commonly used in UHV power lines under dry and wet conductor conditions, as well as artificial moderate and heavy rain conditions, was conducted in Ping’an County, Xining City (elevation 2200 m. By using the tangent line method, the corona onset voltages and onset electric field of four types of conductors at high altitudes are obtained for the first time. In addition, the calculation model of corona onset voltage considering the outer strands’ effect on the electric field and the geometric factor in the corona cage in high altitude areas is established. The comparison of the calculation results and experimental results under dry conditions verifies the model’s correctness. Based on the results, an optimal selection scheme for high altitudes is proposed. The roughness coefficient was also calculated and analysed: the roughness coefficient of bundled conductors was between 0.59 and 0.77, and the roughness coefficient of the wet conductor was between the dry and rainy conditions. Both the experimental data and the calculation model can provide a reference for conductor selection for UHV AC power lines for use in high-altitude areas.

The Tarrytown Chief Residents Leadership Conference: a long-term follow-up.

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Schwartz, Bruce J; Blackmore, Michelle A; Weiss, Andrea

2014-02-01

Creating training opportunities for the development of effective leaders is an increasingly important goal in psychiatry residency training programs. This article examines the long-term perceived impact of the Tarrytown Chief Residents Leadership Conference on preparing psychiatric residents for future leadership positions. Self-report surveys from attendees who participated in the conference between 1998 and 2011 were examined. Five hundred and forty-one completed surveys were returned (43 % response rate). Eighty-six percent of respondents reported moderate to extreme improvement in leadership confidence post-conference. Most respondents indicated at least moderate improvement in self-awareness (93 %), understanding of group process (92 %), and willingness to address conflict (89 %). Ninety percent felt the conference was important to their residency training, and 80 % indicated increased interest in leadership post-conference. Responders reported lasting improvements in their confidence in and perceived ability to utilize skills necessary for effective leadership, demonstrating the value of this experiential learning opportunity.

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

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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.

Cardiovascular Effects of Altitude on Performance Athletes.

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Shah, Ankit B; Coplan, Neil

Altitude plays an important role in cardiovascular performance and training for athletes. Whether it is mountaineers, skiers, or sea-level athletes trying to gain an edge by training or living at increased altitude, there are many potential benefits and harms of such endeavors. Echocardiographic studies done on athletes at increased altitude have shown evidence for right ventricular dysfunction and pulmonary hypertension, but no change in left ventricular ejection fraction. In addition, 10% of athletes are susceptible to pulmonary hypertension and high-altitude pulmonary edema. Some studies suggest that echocardiography may be able to identify athletes susceptible to high-altitude pulmonary edema prior to competing or training at increased altitudes. Further research is needed on the long-term effects of altitude training, as repeated, transient episodes of pulmonary hypertension and right ventricular dysfunction may have long-term implications. Current literature suggests that performance athletes are not at higher risk for ventricular arrhythmias when training or competing at increased altitudes. For sea-level athletes, the optimal strategy for attaining the benefits while minimizing the harms of altitude training still needs to be clarified, although-for now-the "live high, train low" approach appears to have the most rationale.

ANALYSIS OF ACUTE RESPONSES OF YOUNG BIATHLON ATHLETES LIVING AT DIFFERENT ALTITUDES TO MAXIMAL AEROBIC EXERCISE AT 2000M

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Ozan Sever

2017-10-01

Full Text Available In the study, the acute response of the 2000m maximal aerobic test on the biathletes living at different altitudes was analyzed. A total of 67 athletes (Mean age = 14,69 ± 1,22, Mean BMI = 19.60 ± 2.29 consisting of boys and girls represent the sample of the study who were tested during the qualification process of Turkey national team. The athletes divided into two groups. Thirty-two of the athletes living above the altitude of 1500m (considered as the altitude where physiological adaptation occurs coded as the high-altitude group, and thirty-five living below 1500m coded as the low altitude group. A shuttle-run test was applied to measure the aerobic power of the athletes. During the test, the heart rates were monitored continuously. The athletes living above 1500m showed higher VO2max and total lap score in the shuttle-run test compared to the athletes living below 1500m. But this difference was found to be statistically insignificant. The Living altitude – VO2max – Total Laps variables had positive moderate correlation each other (r = 0,363, r = 0,355. As the altitude increases, the endurance score increases. When each stage of the shuttle-run test examined, it was seen that those who live at low altitudes tend to give up the shuttle-run test earlier, although there was no difference in the mean heart rates between groups. Findings showed that the physiological response of the biathletes who had similar training history was influenced by the altitude they live on. In this respect, altitude adaptation in biathletes is thought to affect the score in competitions and national team selections.

Diagnostic criteria of high-altitude de-adaptation for high-altitude migrants returning to the plains: a multicenter, randomized controlled trial

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Qi-quan ZHOU

2012-02-01

Full Text Available Objective  To investigate the diagnostic method of high-altitude de-adaptation and constitute the diagnostic criteria of high-altitude de-adaptation for people returning to the plains from high-altitude. Methods  Epidemiological survey and clinical multicenter randomized controlled studies were used to determine/perform blood picture, routine urine analysis, routine stool examination, myocardial enzymes, liver and kidney functions, nerve function, sex hormone, microalbuminuria, ECG, echocardiography, pulmonary function tests, and so on, in 3011 subjects after they returned to the plains from high-altitude. The diagnostic criteria of high-altitude de-adaptation were formulated by a comparative analysis of the obtained data with those of healthy subjects living in the same area, altitude, and age. The regularity and characteristics of high-altitude de-adaptation syndrome were found and diagnostic criteria for high-altitude de-adaptation was established based on the results. Results  The investigative results showed that the incidence of high-altitude de-adaptation syndrome was found in 84.36% of population returning to the plains from high-altitude. About 60% of them were considered to have mild reactions, 30% medium, and only 10% were severe. The lower the altitude they returned to, the longer the duration of stay in highland, and the heavier the labor they engaged in high altitude, the higher the incidence rate of high-altitude de-adaptation syndrome was. Patients with high-altitude de-adaptation syndrome exhibited hematological abnormality and abnormal ventricular function, especially the right ventricular diastolic function after returning for 1 year to 5 years. Long-term hypoxia exposure often caused obvious change in cardiac morphology with left and right ventricular hypertrophy, particularly the right ventricle. In addition, low blood pressure and low pulse pressure were found at times. Microalbuminuria was found in some high-altitude de

Is extreme climate or moderate climate more conducive to longevity in China?

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Huang, Yi; Rosenberg, Mark; Wang, Yingli

2018-02-01

Climate is closely related to human longevity. In China, there are many climate types. According to national population censuses from 1982 to 2000, most provinces with a high ratio of centenarians are located in western and northwestern China far from the sea; these areas are characterized by a dry, cold climate, very high altitude, very high daily temperature range, strong winds, and partial hypoxia. Meanwhile, provinces with a high ratio of nonagenarians from 1982 to 2000 are located in southern China near the sea. Previous studies have attributed the high ratio of centenarians in western and northwestern China to the extreme local climate. However, centenarians in these areas decreased greatly in 2010, whereas residents in southern China frequently reached 90 to 100 years old in 2010. This study aims to explain this strange phenomenon and find whether extreme climate in Tibetan plateau and northwestern China or moderate climate in southern China is more conducive to longevity. The study found that mortality rate in Tibetan plateau is much higher than southern China, then a population evolution experiment was proposed to compare longevity indicators between low mortality rate and high mortality rate and shows that longevity indicators will decrease in the near future and increase above their original levels after several decades when the mortality rate is decreased. Results of this study show individuals in northwestern China do not live as long as those in eastern and southern China. A moderate climate is more conducive to longevity than extreme climate in China. The longevity of a region should be judged by long-term longevity indicators.

Altitude Lab

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Federal Laboratory Consortium — The Altitude Lab evaluates the performance of complete oxygen systems operated in individually controlled hypobaric chambers, which duplicate pressures that would be...

ABOUT TRANSITION ALTITUDE IN RUSSIAN FEDERATION

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2016-01-01

Full Text Available This article is about establishing a common transition altitude over all territory of Russian Federation. The main objective is to prove the necessity of a common transition altitude in Russian airspace and to define, which variant of tran- sition altitude (low, medium, high is the most suitable to be implemented in Russia. ICAO and IFALPA points of view, data and experience from different states and regions all over the world were examined in order to show all the advantages and disadvantages of different approaches towards common transition altitude. The research showed that the most appro- priate common transition altitude in Russia will be 10000 feet (3050 meters, it will cover almost all the international aero- dromes and regions in the country. Only several exceptions are needed in mountainous areas. This article can be used to further study of the possibility of implementation of common transition altitude, because it can’t take into consideration all the local features of all the FIRs (Flight Information Regions in Russia. The conclusion is establishing a common transi- tion altitude over such a big part of the world as Russian Federation will lead to improvement of the flight safety, harmoni- zation with ICAO and IFALPA policies and flexibility in airspace design.

Changes in Running Economy, Respiratory Exchange Ratio and VO2max in Runners following a 10-day Altitude Training Camp.

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Diebel, Sebastian R; Newhouse, Ian; Thompson, David S; Johnson, Vineet B K

2017-01-01

Running economy (RE) and VO 2 max are important predictors of endurance performance for elite and semi-elite endurance athletes, with RE being an appropriate predictor in a homogenous running population. Altitude training has been observed to change RE (mL.kg -1 .min -1 ), and VO 2 max due to alterations resulting from acclimatization. This study tracked changes in RE and VO 2 max before and after a 10-day altitude training camp at 1828 meters. VO 2 max, RE expressed calorically, and respiratory exchange ratio (RER), were measured below anaerobic threshold (AT) to observe differences between pre-and post-altitude training. Eight varsity cross-country runners between the ages of 18 and 22 years performed an incremental treadmill test, pre- and post-10-day altitude training. Paired samples t-tests were used to statistically analyze the data. Average RE (VO 2 mL.kg -1 .min -1 ) improved following altitude intervention ( M = 56.44 ± 4.28) compared to pre-altitude training (61.30 ± 7.56). These differences were statistically significant t ( 7 )= 2.71, p =.014. RE expressed as kcals.kg -1 .km -1 improved following altitude training (16.73 ± 2.96) compared to (18.44 ± 4.04) pre-altitude training and was statistically significant t( 7 ) =3.08, p = .008. RER taken during the last minute of steady-state was higher (0.97, ± .019) post-altitude training, compared to (0.90 ± .043) pre-altitude. These differences were statistically significant t ( 7 ) -3.62, p =.008. VO 2 max (mL.kg -1 .min -1 ) was lower in 6 out of 8 participants (63.91, ± 8.65) post-altitude compared to (69.90, ± 10.80) pre-altitude and was statistically significant t( 7 ) = 2.33, p =.026. The observed improvements in RE may be beneficial for endurance athletes competing and/or training at moderate altitudes near 1828 meters.

Chemoreceptor Responsiveness at Sea Level Does Not Predict the Pulmonary Pressure Response to High Altitude.

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Hoiland, Ryan L; Foster, Glen E; Donnelly, Joseph; Stembridge, Mike; Willie, Chris K; Smith, Kurt J; Lewis, Nia C; Lucas, Samuel J E; Cotter, Jim D; Yeoman, David J; Thomas, Kate N; Day, Trevor A; Tymko, Mike M; Burgess, Keith R; Ainslie, Philip N

2015-07-01

The hypoxic ventilatory response (HVR) at sea level (SL) is moderately predictive of the change in pulmonary artery systolic pressure (PASP) to acute normobaric hypoxia. However, because of progressive changes in the chemoreflex control of breathing and acid-base balance at high altitude (HA), HVR at SL may not predict PASP at HA. We hypothesized that resting oxygen saturation as measured by pulse oximetry (Spo₂) at HA would correlate better than HVR at SL with PASP at HA. In 20 participants at SL, we measured normobaric, isocapnic HVR (L/min · -%Spo₂⁻¹) and resting PASP using echocardiography. Both resting Spo₂ and PASP measures were repeated on day 2 (n = 10), days 4 to 8 (n = 12), and 2 to 3 weeks (n = 8) after arrival at 5,050 m. These data were also collected at 5,050 m in life-long HA residents (ie, Sherpa [n = 21]). Compared with SL, Spo₂ decreased from 98.6% to 80.5% (P HVR at SL was not related to Spo₂ or PASP at any time point at 5,050 m (all P > .05). Sherpa had lower PASP (P .50), there was a weak relationship in the Sherpa (R² = 0.16, P = .07). We conclude that neither HVR at SL nor resting Spo₂ at HA correlates with elevations in PASP at HA.

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

Differential responses of autonomic function in sea level residents, acclimatized lowlanders at >3500 m and Himalayan high altitude natives at >3500 m: A cross-sectional study.

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Dhar, Priyanka; Sharma, Vijay K; Das, Saroj K; Barhwal, Kalpana; Hota, Sunil K; Singh, Shashi B

2018-04-09

We studied the differential responses of autonomic function in sea level residents (SLR), acclimatized lowlanders (ALH) in high altitude (HA) and HA natives (HAN) at >3500 m. Out of 771 male volunteers included in this cross-sectional study, SLR, ALH and HAN groups were comprised of 351, 307 and 113 volunteers, respectively. Our results showed persistent sympathetic dominance with significantly reduced (p < 0.05) parasympathetic response in ALH as compared to SLR and HAN populations. This may be attributed to significantly increased (p < 0.05) concentration of coronary risk factors and plasma catecholamines in ALH as compared to SLR and HAN. The ALH also showed significantly increased (p < 0.05) level of serum homocysteine as compared to SLR. The HAN exhibited no changes in autonomic function despite significantly elevated (p < 0.05) homocysteine level as compared to SLR. Our findings may have clinical relevance for assessment of susceptibility to cardiovascular risks in HA dwellers, native highlanders and patients with hypoxemia. Copyright © 2018 Elsevier B.V. All rights reserved.

Introduction to altitude/hypoxic training symposium.

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Wilber, Randall L

2007-09-01

Altitude/hypoxic training has traditionally been an intriguing and controversial area of research and sport performance. This controversial aspect was evident recently in the form of scholarly debates in highly regarded professional journals, as well as the World Anti-Doping Agency's (WADA) consideration of placing "artificially-induced hypoxic conditions" on the 2007 Prohibited List of Substances/Methods. In light of the ongoing controversy surrounding altitude/hypoxic training, this symposium was organized with the following objectives in mind: 1) to examine the primary physiological responses and underlying mechanisms associated with altitude/hypoxic training, including the influence of genetic predisposition; 2) to present evidence supporting the effect of altitude/hypoxic acclimatization on both hematological and nonhematological markers, including erythrocyte volume, skeletal muscle-buffering capacity, hypoxic ventilatory response, and physiological efficiency/economy; 3) to evaluate the efficacy of several contemporary simulated altitude modalities and training strategies, including hypoxic tents, nitrogen apartments, and intermittent hypoxic exposure (IHE) or training, and to address the legal and ethical issues associated with the use of simulated altitude; and 4) to describe different altitude/hypoxic training strategies used by elite-level athletes, including Olympians and military special forces. In addressing these objectives, papers will be presented on the topics of: 1) effect of hypoxic "dose" on physiological responses and sea-level performance (Drs. Benjamin Levine and James Stray-Gundersen), 2) nonhematological mechanisms of improved performance after hypoxic exposure (Dr. Christopher Gore), 3) application of altitude/hypoxic training by elite athletes (Dr. Randall Wilber), and 4) military applications of hypoxic training (Dr. Stephen Muza).

Associations between physical function and depression in nursing home residents with mild and moderate dementia: a cross-sectional study.

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Kvæl, Linda Aimée Hartford; Bergland, Astrid; Telenius, Elisabeth Wiken

2017-07-20

The primary aim of this study is to describe depression and physical function in nursing home residents with dementia, as well as to examine the associations between depression and balance function, lower limb muscle strength, mobility and activities of daily living. The secondary aim is to examine the differences in physical function between the groups classified as depressed and not depressed. The study has a cross-sectional design. A convenience sample of 18 nursing homes in, and around, Oslo, Norway, participated. We included 170 nursing home residents aged 60-100 years with mild or moderate degree of dementia defined by a score of 1 or 2 on the Clinical Dementia Rating Scale (CDR). Assessments used were Cornell Scale for Depression in Dementia (CSDD), Berg Balance Scale (BBS), 'the 6-metre walking test' (walking speed), 30 s Chair Stand Test (CST) and the Barthel Index (BI). Nursing home residents with dementia are a heterogeneous group in terms of physical function and depression. By applying the recommended cut-off of ≥8 on CSDD, 23.5% of the participants were classified as being depressed. The results revealed significant associations between higher scores on CSDD (indicating more symptoms of depression) and lower scores on BBS (95% CI -0.12 to -0.02, p=0.006), 30 s CST (95% CI -0.54 to -0.07, p=0.001) as well as maximum walking speed (95% CI -4.56 to -0.20, p=0.003) (indicating lower level of physical function). Better muscle strength, balance and higher walking speed were significantly associated with less depressive symptoms. The potential interaction of dementia with poor physical function and depression indicates an area to explore in future epidemiological studies with a prospective design. NCT02262104. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Altitude exposures during commercial flight: a reappraisal.

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Hampson, Neil B; Kregenow, David A; Mahoney, Anne M; Kirtland, Steven H; Horan, Kathleen L; Holm, James R; Gerbino, Anthony J

2013-01-01

Hypobaric hypoxia during commercial air travel has the potential to cause or worsen hypoxemia in individuals with pre-existing cardiopulmonary compromise. Knowledge of cabin altitude pressures aboard contemporary flights is essential to counseling patients accurately about flying safety. The objective of the study was to measure peak cabin altitudes during U.S. domestic commercial flights on a variety of aircraft. A handheld mountaineering altimeter was carried by the investigators in the plane cabin during commercial air travel and peak cabin altitude measured. The values were then compared between aircraft models, aircraft classes, and distances flown. The average peak cabin altitude on 207 flights aboard 17 different aircraft was 6341 +/- 1813 ft (1933 m +/- 553 m), significantly higher than when measured in a similar fashion in 1988. Peak cabin altitude was significantly higher for flights longer than 750 mi (7085 +/- 801 ft) compared to shorter flights (5160 +/- 2290 ft/1573 +/- 698 m). Cabin altitude increased linearly with flight distance for flights up to 750 mi in length, but was independent of flight distance for flights exceeding 750 mi. Peak cabin altitude was less than 5000 ft (1524 m) in 70% of flights shorter than 500 mi. Peak cabin altitudes greater than 8000 ft (2438 m) were measured on approximately 10% of the total flights. Peak cabin altitude on commercial aircraft flights has risen over time. Cabin altitude is lower with flights of shorter distance. Physicians should take these factors into account when determining an individual's need for supplemental oxygen during commercial air travel.

Atmospheric residence times of continental aerosols

International Nuclear Information System (INIS)

Balkanski, Y.J.

1991-01-01

The global atmospheric distributions of Rn-222 are simulated with a three-dimensional model of atmospheric transport based on the meteorology of the NASA Goddard Institute for Space Studies (GISS) general circulation model. The short-lived radioactive gas Rn-222 (half-life = 3.8d) is emitted almost exclusively from land, at a relatively uniform rate; hence it is an excellent tracer of continental influences. Lead-210 is produced by decay of Rn-222 and immediately condenses to preexisting aerosol surfaces. It provides an excellent measure of aerosol residence times in the atmosphere because its source is accurately defined by the Rn-222 distribution. Results from the three-dimensional model are compared to measurements of Rn-222 and Pb-210 atmospheric concentrations to evaluate model's long-range transport over oceanic regions and to study the deposition mechanisms of atmospheric aerosols. Model results for Rn-222 are used to examine the long-range transport of continental air over two selected oceanic regions, the subantarctic Indian Ocean and the North Pacific. It is shown that the fast transport of air from southern Africa causes substantial continental pollution at southern mid-latitudes, a region usually regarded as pristine. Air over the North Pacific is heavily impacted by continental influences year round, but the altitude at which the transport occurs varies seasonally. Observations of aerosols at island sites, which are commonly used as diagnostics of continental influences, may be misleading because they do not account for influences at high altitude and because aerosols are efficiently scavenged by deposition during transport. The study of Pb-210 focuses on defining the residence times of submicron aerosols in the troposphere. Scavenging in wet convective updrafts is found to provide the dominant sink on a global scale

Glycated haemoglobin (HbA1c ) and fasting plasma glucose relationships in sea-level and high-altitude settings.

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Bazo-Alvarez, J C; Quispe, R; Pillay, T D; Bernabé-Ortiz, A; Smeeth, L; Checkley, W; Gilman, R H; Málaga, G; Miranda, J J

2017-06-01

Higher haemoglobin levels and differences in glucose metabolism have been reported among high-altitude residents, which may influence the diagnostic performance of HbA 1c . This study explores the relationship between HbA 1c and fasting plasma glucose (FPG) in populations living at sea level and at an altitude of > 3000 m. Data from 3613 Peruvian adults without a known diagnosis of diabetes from sea-level and high-altitude settings were evaluated. Linear, quadratic and cubic regression models were performed adjusting for potential confounders. Receiver operating characteristic (ROC) curves were constructed and concordance between HbA 1c and FPG was assessed using a Kappa index. At sea level and high altitude, means were 13.5 and 16.7 g/dl (P > 0.05) for haemoglobin level; 41 and 40 mmol/mol (5.9% and 5.8%; P < 0.01) for HbA 1c ; and 5.8 and 5.1 mmol/l (105 and 91.3 mg/dl; P < 0.001) for FPG, respectively. The adjusted relationship between HbA 1c and FPG was quadratic at sea level and linear at high altitude. Adjusted models showed that, to predict an HbA 1c value of 48 mmol/mol (6.5%), the corresponding mean FPG values at sea level and high altitude were 6.6 and 14.8 mmol/l (120 and 266 mg/dl), respectively. An HbA 1c cut-off of 48 mmol/mol (6.5%) had a sensitivity for high FPG of 87.3% (95% confidence interval (95% CI) 76.5 to 94.4) at sea level and 40.9% (95% CI 20.7 to 63.6) at high altitude. The relationship between HbA 1c and FPG is less clear at high altitude than at sea level. Caution is warranted when using HbA 1c to diagnose diabetes mellitus in this setting. © 2017 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

High Altitude Launch for a Practical SSTO

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Landis, Geoffrey A.; Denis, Vincent

2003-01-01

Existing engineering materials allow the constuction of towers to heights of many kilometers. Orbital launch from a high altitude has significant advantages over sea-level launch due to the reduced atmospheric pressure, resulting in lower atmospheric drag on the vehicle and allowing higher rocket engine performance. High-altitude launch sites are particularly advantageous for single-stage to orbit (SSTO) vehicles, where the payload is typically 2% of the initial launch mass. An earlier paper enumerated some of the advantages of high altitude launch of SSTO vehicles. In this paper, we calculate launch trajectories for a candidate SSTO vehicle, and calculate the advantage of launch at launch altitudes 5 to 25 kilometer altitudes above sea level. The performance increase can be directly translated into increased payload capability to orbit, ranging from 5 to 20% increase in the mass to orbit. For a candidate vehicle with an initial payload fraction of 2% of gross lift-off weight, this corresponds to 31% increase in payload (for 5-km launch altitude) to 122% additional payload (for 25-km launch altitude).

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

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.

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

Analysis of high-altitude de-acclimatization syndrome after exposure to high altitudes: a cluster-randomized controlled trial.

Science.gov (United States)

He, Binfeng; Wang, Jianchun; Qian, Guisheng; Hu, Mingdong; Qu, Xinming; Wei, Zhenghua; Li, Jin; Chen, Yan; Chen, Huaping; Zhou, Qiquan; Wang, Guansong

2013-01-01

The syndrome of high-altitude de-acclimatization commonly takes place after long-term exposure to high altitudes upon return to low altitudes. The syndrome severely affects the returnee's quality of life. However, little attention has been paid to careful characterization of the syndrome and their underlying mechanisms. Male subjects from Chongqing (n = 67, 180 m) and Kunming (n = 70, 1800 m) visited a high-altitude area (3650 m) about 6 months and then returned to low-altitude. After they came back, all subjects were evaluated for high-altitude de-acclimatization syndrome on the 3(rd), 50(th), and 100(th). Symptom scores, routine blood and blood gas tests, and myocardial zymograms assay were used for observation their syndrome. The results showed that the incidence and severity of symptoms had decreased markedly on the 50(th) and 100(th) days, compared with the 3(rd) day. The symptom scores and incidence of different symptoms were lower among subjects returning to Kunming than among those returning to Chongqing. On the 3(rd) day, RBC, Hb, Hct, CK, CK-MB, and LDH values were significantly lower than values recorded at high altitudes, but they were higher than baseline values. On the 50(th) day, these values were not different from baseline values, but LDH levels did not return to baseline until the 100(th) day. These data show that, subjects who suffered high-altitude de-acclimatization syndrome, the recovery fully processes takes a long time (≥ 100(th) days). The appearance of the syndrome is found to be related to the changes in RBC, Hb, Hct, CK, CK-MB, and LDH levels, which should be caused by reoxygenation after hypoxia.

UBC-Nepal expedition: markedly lower cerebral blood flow in high-altitude Sherpa children compared with children residing at sea level.

Science.gov (United States)

Flück, Daniela; Morris, Laura E; Niroula, Shailesh; Tallon, Christine M; Sherpa, Kami T; Stembridge, Mike; Ainslie, Philip N; McManus, Ali M

2017-10-01

Developmental cerebral hemodynamic adaptations to chronic high-altitude exposure, such as in the Sherpa population, are largely unknown. To examine hemodynamic adaptations in the developing human brain, we assessed common carotid (CCA), internal carotid (ICA), and vertebral artery (VA) flow and middle cerebral artery (MCA) velocity in 25 (9.6 ± 1.0 yr old, 129 ± 9 cm, 27 ± 8 kg, 14 girls) Sherpa children (3,800 m, Nepal) and 25 (9.9 ± 0.7 yr old, 143 ± 7 cm, 34 ± 6 kg, 14 girls) age-matched sea level children (344 m, Canada) during supine rest. Resting gas exchange, blood pressure, oxygen saturation and heart rate were assessed. Despite comparable age, height and weight were lower (both P sea level children. Mean arterial pressure, heart rate, and ventilation were similar, whereas oxygen saturation (95 ± 2 vs. 99 ± 1%, P sea level children. This was reflected in a lower ICA flow (283 ± 108 vs. 333 ± 56 ml/min, P = 0.05), VA flow (78 ± 26 vs. 118 ± 35 ml/min, P sea level children (425 ± 92 vs. 441 ± 81 ml/min, P = 0.52). Scaling flow and oxygen uptake for differences in vessel diameter and body size, respectively, led to the same findings. A lower cerebral blood flow in Sherpa children may reflect specific cerebral hemodynamic adaptations to chronic hypoxia. NEW & NOTEWORTHY Cerebral blood flow is lower in Sherpa children compared with children residing at sea level; this may reflect a cerebral hemodynamic pattern, potentially due to adaptation to a hypoxic environment. Copyright © 2017 the American Physiological Society.

Incidence and Symptoms of High Altitude Illness in South Pole Workers: Antarctic Study of Altitude Physiology (ASAP

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Paul J. Anderson

2011-01-01

Full Text Available Introduction Each year, the US Antarctic Program rapidly transports scientists and support personnel from sea level (SL to the South Pole (SP, 2835 m providing a unique natural laboratory to quantify the incidence of acute mountain sickness (AMS, patterns of altitude related symptoms and the field effectiveness of acetazolamide in a highly controlled setting. We hypothesized that the combination of rapid ascent (3 hr, accentuated hypobarism (relative to altitude, cold, and immediate exertion would increase altitude illness risk. Methods Medically screened adults (N = 246, age = 37 ± 11 yr, 30% female, BMI = 26 ± 4 kg/m 2 were recruited. All underwent SL and SP physiological evaluation, completed Lake Louise symptom questionnaires (LLSQ, to define AMS, and answered additional symptom related questions (eg, exertional dyspnea, mental status, cough, edema and general health, during the 1st week at altitude. Acetazolamide, while not mandatory, was used by 40% of participants. Results At SP, the barometric pressure resulted in physiological altitudes that approached 3400 m, while T ° C averaged -42, humidity 0.03%. Arterial oxygen saturation averaged 89% ± 3%. Overall, 52% developed LLSQ defined AMS. The most common symptoms reported were exertional dyspnea-(87%, sleeping difficulty-(74%, headache-(66%, fatigue-(65%, and dizziness/lightheadedness-(46%. Symptom severity peaked on days 1-2, yet in >20% exertional dyspnea, fatigue and sleep problems persisted through day 7. AMS incidence was similar between those using acetazolamide and those abstaining (51 vs. 52%, P = 0.87. Those who used acetazolamide tended to be older, have less altitude experience, worse symptoms on previous exposures, and less SP experience. Conclusion The incidence of AMS at SP tended to be higher than previously reports in other geographic locations at similar altitudes. Thus, the SP constitutes a more intense altitude exposure than might be expected considering physical

Early history of high-altitude physiology.

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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. © 2015 New York Academy of Sciences.

Test de caminata de 6 minutos en pacientes de rehabilitación cardiaca de altitud moderada

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Nelson F. González

2017-11-01

walk test in cardiac rehabilitation is and effective and safe tool for the evaluation of functional status, as well of the effectiveness of the therapy, the adjustment of training methods, and to establish the morbidity and mortality prognosis. Objective: To investigate the aspects that affect the physiological response in the 6-minute walk test in cardiovascular rehabilitation patients at moderate altitudes (2,550 metres above sea level, and determine the clinical importance. Material and methods: A descriptive study was conducted on 487 six-minute walks by patients with ages between 18 and 80 years, enrolled in cardiac rehabilitation programme and who lived at a moderate altitude. Results: The Colombian cardiovascular patients covered shorter distances than those demonstrated in other populations and other diseases. The heart rate during the test increased by 40 beats per minute and reached 65% of the maximum heart rate, as such that the systolic blood pressure increased by 20 mmHg. The perception of central and peripheral effort also increased up to 4 points on the Borg scale, as well as a mean decrease of 3% in oxygen saturation. Conclusion: The 6-minute test is safe and well-tolerated in cardiovascular patients living at moderate altitudes. Significant changes were seen during the walk as regards chronotropic response, pressure, perception of effort, oxygen saturation levels, which were different from the results found at sea level. This phenomenon provides reference values for tests performed on cardiovascular patients at moderate altitudes, as well as for the clinical approach to the evaluation of the functional capacity, physical independence, falls risk, adjustments to medication, and an integral assessment of comorbidities. Palabras clave: Enfermedad cardiovascular, Rehabilitación, Test, Ejercicio, Hipoxia, Keywords: Cardiovascular disease, Rehabilitation, Test, Exercise, Hypoxia

Atmospheric Sampling of Aerosols to Stratospheric Altitudes using High Altitude Balloons

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Jerde, E. A.; Thomas, E.

2010-12-01

Although carbon dioxide represents a long-lived atmospheric component relevant to global climate change, it is also understood that many additional contributors influence the overall climate of Earth. Among these, short-lived components are more difficult to incorporate into models due to uncertainties in the abundances of these both spatially and temporally. Possibly the most significant of these short-lived components falls under the heading of “black carbon” (BC). There are numerous overlapping definitions of BC, but it is basically carbonaceous in nature and light absorbing. Due to its potential as a climate forcer, an understanding of the BC population in the atmosphere is critical for modeling of radiative forcing. Prior measurements of atmospheric BC generally consist of airplane- and ground-based sampling, typically below 5000 m and restricted in time and space. Given that BC has a residence time on the order of days, short-term variability is easily missed. Further, since the radiative forcing is a result of BC distributed through the entire atmospheric column, aircraft sampling is by definition incomplete. We are in the process of planning a more comprehensive sampling of the atmosphere for BC using high-altitude balloons. Balloon-borne sampling is a highly reliable means to sample air through the entire troposphere and into the lower stratosphere. Our system will incorporate a balloon and a flight train of two modules. One module will house an atmospheric sampler. This sampler will be single-stage (samples all particle sizes together), and will place particles directly on an SEM sample stub for analysis. The nozzle depositing the sample will be offset from the center of the stub, placing the aerosol particles toward the edge. At various altitudes, the stub will be rotated 45 degrees, providing 6-8 sample “cuts” of particle populations through the atmospheric column. The flights will reach approximately 27 km altitude, above which the balloons

Perinatal hypoxia increases susceptibility to high-altitude polycythemia and attendant pulmonary vascular dysfunction.

Science.gov (United States)

Julian, Colleen Glyde; Gonzales, Marcelino; Rodriguez, Armando; Bellido, Diva; Salmon, Carlos Salinas; Ladenburger, Anne; Reardon, Lindsay; Vargas, Enrique; Moore, Lorna G

2015-08-15

Perinatal exposures exert a profound influence on physiological function, including developmental processes vital for efficient pulmonary gas transfer throughout the lifespan. We extend the concept of developmental programming to chronic mountain sickness (CMS), a debilitating syndrome marked by polycythemia, ventilatory impairment, and pulmonary hypertension that affects ∼10% of male high-altitude residents. We hypothesized that adverse perinatal oxygenation caused abnormalities of ventilatory and/or pulmonary vascular function that increased susceptibility to CMS in adulthood. Subjects were 67 male high-altitude (3,600-4,100 m) residents aged 18-25 yr with excessive erythrocytosis (EE, Hb concentration ≥18.3 g/dl), a preclinical form of CMS, and 66 controls identified from a community-based survey (n = 981). EE subjects not only had higher Hb concentrations and erythrocyte counts, but also lower alveolar ventilation, impaired pulmonary diffusion capacity, higher systolic pulmonary artery pressure, lower pulmonary artery acceleration time, and more frequent right ventricular hypertrophy, than controls. Compared with controls, EE subjects were more often born to mothers experiencing hypertensive complications of pregnancy and hypoxia during the perinatal period, with each increasing the risk of developing EE (odds ratio = 5.25, P = 0.05 and odds ratio = 6.44, P = 0.04, respectively) after other factors known to influence EE status were taken into account. Adverse perinatal oxygenation is associated with increased susceptibility to EE accompanied by modest abnormalities of the pulmonary circulation that are independent of increased blood viscosity. The association between perinatal hypoxia and EE may be due to disrupted alveolarization and microvascular development, leading to impaired gas exchange and/or pulmonary hypertension. Copyright © 2015 the American Physiological Society.

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

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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.

Correlations between the simulated military tasks performance and physical fitness tests at high altitude

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Eduardo Borba Neves

2017-11-01

Full Text Available The aim of this study was to investigate the Correlations between the Simulated Military Tasks Performance and Physical Fitness Tests at high altitude. This research is part of a project to modernize the physical fitness test of the Colombian Army. Data collection was performed at the 13th Battalion of Instruction and Training, located 30km south of Bogota D.C., with a temperature range from 1ºC to 23ºC during the study period, and at 3100m above sea level. The sample was composed by 60 volunteers from three different platoons. The volunteers start the data collection protocol after 2 weeks of acclimation at this altitude. The main results were the identification of a high positive correlation between the 3 Assault wall in succession and the Simulated Military Tasks performance (r = 0.764, p<0.001, and a moderate negative correlation between pull-ups and the Simulated Military Tasks performance (r = -0.535, p<0.001. It can be recommended the use of the 20-consecutive overtaking of the 3 Assault wall in succession as a good way to estimate the performance in operational tasks which involve: assault walls, network of wires, military Climbing Nets, Tarzan jump among others, at high altitude.

Altitude Compensating Nozzle

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Ruf, Joseph H.; Jones, Daniel

2015-01-01

The dual-bell nozzle (fig. 1) is an altitude-compensating nozzle that has an inner contour consisting of two overlapped bells. At low altitudes, the dual-bell nozzle operates in mode 1, only utilizing the smaller, first bell of the nozzle. In mode 1, the nozzle flow separates from the wall at the inflection point between the two bell contours. As the vehicle reaches higher altitudes, the dual-bell nozzle flow transitions to mode 2, to flow full into the second, larger bell. This dual-mode operation allows near optimal expansion at two altitudes, enabling a higher mission average specific impulse (Isp) relative to that of a conventional, single-bell nozzle. Dual-bell nozzles have been studied analytically and subscale nozzle tests have been completed.1 This higher mission averaged Isp can provide up to a 5% increase2 in payload to orbit for existing launch vehicles. The next important step for the dual-bell nozzle is to confirm its potential in a relevant flight environment. Toward this end, NASA Marshall Space Flight Center (MSFC) and Armstrong Flight Research Center (AFRC) have been working to develop a subscale, hot-fire, dual-bell nozzle test article for flight testing on AFRC's F15-D flight test bed (figs. 2 and 3). Flight test data demonstrating a dual-bell ability to control the mode transition and result in a sufficient increase in a rocket's mission averaged Isp should help convince the launch service providers that the dual-bell nozzle would provide a return on the required investment to bring a dual-bell into flight operation. The Game Changing Department provided 0.2 FTE to ER42 for this effort in 2014.

Levels of Organochlorine Pesticides in Blood Plasma from Residents of Malaria-Endemic Communities in Chiapas, Mexico

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Luz E. Ruiz-Suárez

2014-10-01

Full Text Available Organochlorine (OC pesticides have been extensively used for pest control in agriculture and against malaria vectors in the region of Soconusco, Chiapas, in southern Mexico. Our study aimed to identify whether the inhabitants of four Soconusco communities at different locations (i.e., altitudes and with different history of use of OC pesticides, have been similarly exposed to residues of these pesticides. In particular, we analyzed the potential relationship between levels of OC pesticides in plasma and the age, gender, and residence of the study population (n = 60. We detected seven pesticides in total (γ-HCH, β-HCH, heptachlor, p,pʹ-DDE, p,p'-DDT, β-endosulfan, endrin aldehyde. Of these, p,pʹ-DDE and β-endosulfan were the most frequently found (in 98% and 38% of the samples, respectively. The low-altitude (<20 m above sea level; masl and mid-altitude (520 masl locations had the highest levels of p,pʹ-DDE, with geometric means of 50.6 µg/L and 44.46 µg/L, respectively. The oldest subjects (>60 years had the highest p,pʹ-DDE level (56.94 ± 57.81 µg/L of all age groups, while men had higher p,pʹ-DDE (34.00 ± 46.76 µg/L than women. Our results demonstrate that residents of the Soconusco region are exposed to p,pʹ-DDE because of high exposure to DDT in the past and current environmental exposure to this DDT-breakdown product.

Short-term adaptation and chronic cardiac remodelling to high altitude in lowlander natives and Himalayan Sherpa.

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Stembridge, Mike; Ainslie, Philip N; Shave, Rob

2015-11-01

What is the topic of this review? At high altitude, the cardiovascular system must adapt in order to meet the metabolic demand for oxygen. This review summarizes recent findings relating to short-term and life-long cardiac adaptation to high altitude in the context of exercise capacity. What advances does it highlight? Both Sherpa and lowlanders exhibit smaller left ventricular volumes at high altitude; however, myocardial relaxation, as evidenced by diastolic untwist, is reduced only in Sherpa, indicating that short-term hypoxia does not impair diastolic relaxation. Potential remodelling of systolic function, as evidenced by lower left ventricular systolic twist in Sherpa, may facilitate the requisite sea-level mechanical reserve required during exercise, although this remains to be confirmed. Both short-term and life-long high-altitude exposure challenge the cardiovascular system to meet the metabolic demand for O2 in a hypoxic environment. As the demand for O2 delivery increases during exercise, the circulatory component of oxygen transport is placed under additional stress. Acute adaptation and chronic remodelling of cardiac structure and function may occur to facilitate O2 delivery in lowlanders during sojourn to high altitude and in permanent highland residents. However, our understanding of cardiac structural and functional adaption in Sherpa remains confined to a higher maximal heart rate, lower pulmonary vascular resistance and no differences in resting cardiac output. Ventricular form and function are intrinsically linked through the left ventricular (LV) mechanics that facilitate efficient ejection, minimize myofibre stress during contraction and aid diastolic recoil. Recent examination of LV mechanics has allowed detailed insight into fundamental cardiac adaptation in high-altitude Sherpa. In this symposium report, we review recent advances in our understanding of LV function in both lowlanders and Sherpa at rest and discuss the potential consequences

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

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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.

Preacclimatization in hypoxic chambers for high altitude sojourns.

Science.gov (United States)

Küpper, Thomas E A H; Schöffl, Volker

2010-09-01

Since hypoxic chambers are more and more available, they are used for preacclimatization to prepare for sojourns at high altitude. Since there are different protocols and the data differ, there is no general consensus about the standard how to perform preacclimatization by simulated altitude. The paper reviews the different types of exposure and focuses on the target groups which may benefit from preacclimatization. Since data about intermittent hypoxia for some hours per day to reduce the incidence of acute mountain sickness differ, it is suggested to perform preacclimatization by sleeping some nights at a simulated altitude which follows the altitude profile of the "gold standard" for high altitude acclimatization.

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

2013-12-01

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. 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. 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. 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.

High-Altitude Illnesses: Physiology, Risk Factors, Prevention, and Treatment

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Andrew T. Taylor

2011-01-01

Full Text Available High-altitude illnesses encompass the pulmonary and cerebral syndromes that occur in non-acclimatized individuals after rapid ascent to high altitude. The most common syndrome is acute mountain sickness (AMS which usually begins within a few hours of ascent and typically consists of headache variably accompanied by loss of appetite, nausea, vomiting, disturbed sleep, fatigue, and dizziness. With millions of travelers journeying to high altitudes every year and sleeping above 2,500 m, acute mountain sickness is a wide-spread clinical condition. Risk factors include home elevation, maximum altitude, sleeping altitude, rate of ascent, latitude, age, gender, physical condition, intensity of exercise, pre-acclimatization, genetic make-up, and pre-existing diseases. At higher altitudes, sleep disturbances may become more profound, mental performance is impaired, and weight loss may occur. If ascent is rapid, acetazolamide can reduce the risk of developing AMS, although a number of high-altitude travelers taking acetazolamide will still develop symptoms. Ibuprofen can be effective for headache. Symptoms can be rapidly relieved by descent, and descent is mandatory, if at all possible, for the management of the potentially fatal syndromes of high-altitude pulmonary and cerebral edema. The purpose of this review is to combine a discussion of specific risk factors, prevention, and treatment options with a summary of the basic physiologic responses to the hypoxia of altitude to provide a context for managing high-altitude illnesses and advising the non-acclimatized high-altitude traveler.

System for indicating fuel-efficient aircraft altitude

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Gary, B. L. (Inventor)

1984-01-01

A method and apparatus are provided for indicating the altitude at which an aircraft should fly so the W/d ratio (weight of the aircraft divided by the density of air) more closely approaches the optimum W/d for the aircraft. A passive microwave radiometer on the aircraft is directed at different angles with respect to the horizon to determine the air temperature, and therefore the density of the air, at different altitudes. The weight of the aircraft is known. The altitude of the aircraft is changed to fly the aircraft at an altitude at which is W/d ratio more closely approaches the optimum W/d ratio for that aircraft.

Prevalence of photodermatosis in four regions at different altitudes in Yunnan province, China.

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Deng, Danqi; Hang, Yuntao; Chen, Hao; Li, Hanying

2006-08-01

Idiopathic photodermatoses are common diseases in dermatology clinics that are associated with ultraviolet (UV) irradiation. The group includes a few dermatoses such as polymorphous light eruption (PLE) and chronic actinic dermatitis (CAD). The prevalence of PLE and CAD in China has not been previously reported. To investigate the population-based prevalence of polymorphous light eruption (PLE) and chronic actinic dermatitis (CAD) in six minority groups living in four regions with significantly different altitudes in the Yunnan province, a questionnaire survey was administered to 4899 residents of random villages in Yuanjiang county (Dai and Hani minorities), Kunming city (Han people and Yi minority), Lijiang county (Naxi minority), and Shangri-La county (Zang minority). The altitudes of these counties are 380 m, 1870 m, 2410 m and 3280 m a.s.l., respectively. The results showed that, first, there were 2400 males (49.0%) and 2499 females (51.0%). The prevalence of PLE was 0.65% (32/4899), and the prevalence of CAD was 0.18% (9/4899). PLE was higher among females than males (3.8 vs 1, P 0.05). Second, the prevalence of PLE was increased in higher elevations regions compared to lower elevations (P 0.05). Third, the mean times of sun exposure for PLE and CAD were 6.0 and 6.5 h/day, respectively. The mean durations of PLE and CAD were 5.8 years, and 6.6 years, respectively. The study demonstrated that the prevalence of PLE is higher than that of CAD in Yunnan, and that the prevalence of PLE is correlated with altitude.

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

, the results show that increased BF during one-leg exercise in moderate hypoxia is confined only to the contracting muscles, and the working muscle hyperemia appears not to be directly mediated by adenosine. Increased flow heterogeneity in noncontracting muscles likely reflects sympathetic nervous constraints...... 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...... to curtail BF increments in areas other than working skeletal muscles, but this effect is not potentiated in moderate systemic hypoxia during small muscle mass exercise....

Application of altitude/hypoxic training by elite athletes.

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Wilber, Randall L

2007-09-01

At the Olympic level, differences in performance are typically less than 0.5%. This helps explain why many contemporary elite endurance athletes in summer and winter sport incorporate some form of altitude/hypoxic training within their year-round training plan, believing that it will provide the "competitive edge" to succeed at the Olympic level. The purpose of this paper is to describe the practical application of altitude/hypoxic training as used by elite athletes. Within the general framework of the paper, both anecdotal and scientific evidence will be presented relative to the efficacy of several contemporary altitude/hypoxic training models and devices currently used by Olympic-level athletes for the purpose of legally enhancing performance. These include the three primary altitude/hypoxic training models: 1) live high+train high (LH+TH), 2) live high+train low (LH+TL), and 3) live low+train high (LL+TH). The LH+TL model will be examined in detail and will include its various modifications: natural/terrestrial altitude, simulated altitude via nitrogen dilution or oxygen filtration, and hypobaric normoxia via supplemental oxygen. A somewhat opposite approach to LH+TL is the altitude/hypoxic training strategy of LL+TH, and data regarding its efficacy will be presented. Recently, several of these altitude/hypoxic training strategies and devices underwent critical review by the World Anti-Doping Agency (WADA) for the purpose of potentially banning them as illegal performance-enhancing substances/methods. This paper will conclude with an update on the most recent statement from WADA regarding the use of simulated altitude devices.

Respiratory Muscle Training and Exercise Endurance at Altitude.

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Helfer, Samuel; Quackenbush, Joseph; Fletcher, Michael; Pendergast, David R

2016-08-01

Climbing and trekking at altitude are common recreational and military activities. Physiological effects of altitude are hypoxia and hyperventilation. The hyperventilatory response to altitude may cause respiratory muscle fatigue and reduce sustained submaximal exercise. Voluntary isocapnic hyperpnea respiratory muscle training (VIHT) improves exercise endurance at sea level and at depth. The purpose of this study was to test the hypothesis that VIHT would improve exercise time at altitude [3600 m (11,811 ft)] compared to control and placebo groups. Subjects pedaled an ergometer until exhaustion at simulated altitude in a hypobaric chamber while noninvasive arterial saturation (Sao2), ventilation (VE), and oxygen consumption (Vo2) were measured. As expected, Sao2 decreased to 88 ± 4% saturation at rest and to 81 ± 2% during exercise, and was not affected by VIHT. VIHT resulted in a 40% increase in maximal training VE compared to pre-VIHT. Exercise endurance significantly increased 44% after VIHT (P = altitude post-VIHT increased more (49%) for longer (21 min) and decreased less (11% at 25.4 ± 6.7 min). VIHT improved exercise time at altitude and sustained VE. This suggests that VIHT reduced respiratory muscle fatigue and would be useful to trekkers and military personnel working at altitude. Helfer S, Quackenbush J, Fletcher M, Pendergast DR. Respiratory muscle training and exercise endurance at altitutde. Aerosp Med Hum Perform. 2016; 87(8):704-711.

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

Acute high-altitude illness | Hofmeyr | South African Medical Journal

African Journals Online (AJOL)

A substantial proportion of South Africa (SA)'s population lives at high altitude (>1 500 m), and many travel to very high altitudes (>3 500 m) for tourism, business, recreation or religious pilgrimages every year. Despite this, knowledge of acute altitude illnesses is poor among SA doctors. At altitude, the decreasing ambient ...

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.

Transcatheter closure of a small atrial septal defect with an Amplatzer™ patent foramen ovale occluder in a working dog with cyanosis and exercise intolerance at high altitude.

Science.gov (United States)

Shelden, A; Wesselowski, S; Gordon, S G; Saunders, A B

2017-12-01

A 6.5-year-old male Border Collie presented for transcatheter closure of an atrial septal defect due to exercise intolerance and cyanosis while working and training at altitude. A small, left-to-right shunting secundum atrial septal defect was confirmed with no evidence of significant right-sided volume overload. Pulmonary hypertension with subsequent right-to-left interatrial shunting occurring during exercise at high altitude was suspected and prompted the closure of the defect due to the dog's continued athletic requirements. The anatomy of the defect prompted use of a patent foramen ovale occluder rather than an atrial septal defect occluder, which was deployed using a combination of fluoroscopic and transesophageal echocardiographic guidance. The owner did not report continued exercise intolerance or cyanosis and the dog's lifestyle and residence at altitude was unchanged. Copyright © 2017 Elsevier B.V. All rights reserved.

Numerical simulation of altitude impact on pulverized coal combustion

Energy Technology Data Exchange (ETDEWEB)

Pei, Xiaohui; He, Boshu; Ling, Ling; Wang, Lei [Beijing Jiaotong Univ., Beijing (China). Inst. of Mechanical, Electronic and Control Engineering

2013-07-01

A drop-tube Furnace simulation model has been developed to investigate the pulverized coal combustion characteristics under different altitudes using the commercially available software Fluent. The altitude conditions of 0, 500, 1,000, 1,500 m have been discussed. The results included the fields of temperature, pressure, velocity, the coal burnout, CO burnout and NO emission in the tube furnace. The variation of these parameters with altitude has been analyzed. The coal combustion characteristics were affected by the altitude. The time and space for coal burnout should be increased with the rise of altitude. The valuable results could be referenced in the design of coal- fired furnaces for the high altitude areas.

Altitude variations of ionospheric currents at auroral latitudes

International Nuclear Information System (INIS)

Kamide, Y.; Brekke, A.

1993-01-01

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

The Quechua manta pouch: a caretaking practice for buffering the Peruvian infant against the multiple stressors of high altitude.

Science.gov (United States)

Tronick, E Z; Thomas, R B; Daltabuit, M

1994-08-01

The manta pouch--a caretaking practice of tightly swaddling and enclosing the infant in a set of cloths and blankets--and other caretaking practices are described for high-altitude resident (> 4,000 m) Quechua mother-infant pairs (N = 14). The manta pouch modifies the microenvironment inside the pouch so that, compared to the ambient environment, the temperature is higher and more stable, the humidity is higher, the partial pressure of O2 is lower, and stimulation levels are reduced. As the infant gets older, the characteristics of the pouch are modified such that the infant is increasingly exposed to ambient conditions. These caretaking practices may benefit the infant by buffering the infant from the multiple ecological stressors of high altitude, but they may also incur costs by exposing the infant to additional microenvironmental stressors (e.g., higher CO2 levels) and by reducing stimulation and limiting infant movement.

Comparison of an Intermittent Hypoxic Exposure Acclimatization Program to Staging at Moderate Altitude on Endurance Performance at 4300 m

Science.gov (United States)

2009-10-01

Endurance Performance at 4300 m 7 - 6 RTO-MP-HFM-181 breakfast volunteers were provided with two commercially available energy bars and fruit juice ...food composition = 510 kcal, 14 gm fat, 65 gm carbohydrate, 32 gm protein) at 1 to 2 hrs prior to the beginning of each of the cycle endurance test...JE, Robinson SR, Skrinar GS, Lewis SF and Sawka MN. Intermittent altitude exposures improve muscular performance at 4,300 m. J Appl Physiol 95

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.

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....

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.

Relationship Between Vertical Jump Height and Swimming Start Performance Before and After an Altitude Training Camp.

Science.gov (United States)

García-Ramos, Amador; Padial, Paulino; de la Fuente, Blanca; Argüelles-Cienfuegos, Javier; Bonitch-Góngora, Juan; Feriche, Belén

2016-06-01

This study aimed (a) to analyze the development in the squat jump height and swimming start performance after an altitude training camp, (b) to correlate the jump height and swimming start performance before and after the altitude training period, and (c) to correlate the percent change in the squat jump height with the percent change in swimming start performance. Fifteen elite male swimmers from the Spanish Junior National Team (17.1 ± 0.8 years) were tested before and after a 17-day training camp at moderate altitude. The height reached in the squat jump exercise with additional loads of 0, 25, 50, 75, and 100% of swimmers' pretest body weight and swimming start performance (time to 5, 10, and 15 m) were the dependent variables analyzed. Significant increases in the jump height (p ≤ 0.05; effect size [ES]: 0.35-0.48) and swimming start performance (p jump height before training (r = -0.56 to -0.77) and after training (r = -0.50 to -0.71). The change in the squat jump height was inversely correlated with the change in the start time at 5 m (r = -0.47), 10 m (r = -0.73), and 15 m (r = -0.62). These results suggest that altitude training can be suitable to enhance explosive performance. The correlations obtained between the squat jump height and start time in the raw and change scores confirm the relevance of having high levels of lower-body muscular power to optimize swimming start performance.

AltitudeOmics: Resetting of cerebrovascular CO2 reactivity following acclimatization to high altitude

Directory of Open Access Journals (Sweden)

Jui-Lin eFan

2016-01-01

Full Text Available Previous studies reported enhanced cerebrovascular CO2 reactivity upon ascent to high altitude using linear models. However, there is evidence that this response may be sigmoidal in nature. Moreover, it was speculated that these changes at high altitude are mediated by alterations in acid-base buffering. Accordingly, we reanalyzed previously published data to assess middle cerebral blood flow velocity (MCAv responses to modified rebreathing at sea level (SL, upon ascent (ALT1 and following 16 days of acclimatization (ALT16 to 5,260 m in 21 lowlanders. Using sigmoid curve fitting of the MCAv responses to CO2, we found the amplitude (95% vs. 129%, SL vs. ALT1, 95% confidence intervals (CI [77, 112], [111, 145], respectively, P=0.024 and the slope of the sigmoid response (4.5 vs. 7.5 %/mmHg, SL vs. ALT1, 95% CIs [3.1, 5.9], [6.0, 9.0], respectively, P=0.026 to be enhanced at ALT1, which persisted with acclimatization at ALT16 (amplitude: 177%, 95% CI [139, 215], P<0.001; slope: 10.3 %/mmHg, 95% CI [8.2, 12.5], P=0.003 compared to SL. Meanwhile, the sigmoidal response midpoint was unchanged at ALT1 (SL: 36.5 mmHg; ALT1: 35.4 mmHg, 95% CIs [34.0, 39.0], [33.1, 37.7], respectively, P=0.982, while it was reduced by ~7 mmHg at ALT16 (28.6 mmHg, 95% CI [26.4, 30.8], P=0.001 vs. SL, indicating leftward shift of the cerebrovascular CO2 response to a lower arterial partial pressure of CO2 (PaCO2 following acclimatization to altitude. Sigmoid fitting revealed a leftward shift in the midpoint of the cerebrovascular response curve which could not be observed with linear fitting. These findings demonstrate that there is resetting of the cerebrovascular CO2 reactivity operating point to a lower PaCO2 following acclimatization to high altitude. This cerebrovascular resetting is likely the result of an altered acid-base buffer status resulting from prolonged exposure to the severe hypocapnia associated with ventilatory acclimatization to high altitude.

Improving estimation of flight altitude in wildlife telemetry studies

Science.gov (United States)

Poessel, Sharon; Duerr, Adam E.; Hall, Jonathan C.; Braham, Melissa A.; Katzner, Todd

2018-01-01

Altitude measurements from wildlife tracking devices, combined with elevation data, are commonly used to estimate the flight altitude of volant animals. However, these data often include measurement error. Understanding this error may improve estimation of flight altitude and benefit applied ecology.There are a number of different approaches that have been used to address this measurement error. These include filtering based on GPS data, filtering based on behaviour of the study species, and use of state-space models to correct measurement error. The effectiveness of these approaches is highly variable.Recent studies have based inference of flight altitude on misunderstandings about avian natural history and technical or analytical tools. In this Commentary, we discuss these misunderstandings and suggest alternative strategies both to resolve some of these issues and to improve estimation of flight altitude. These strategies also can be applied to other measures derived from telemetry data.Synthesis and applications. Our Commentary is intended to clarify and improve upon some of the assumptions made when estimating flight altitude and, more broadly, when using GPS telemetry data. We also suggest best practices for identifying flight behaviour, addressing GPS error, and using flight altitudes to estimate collision risk with anthropogenic structures. Addressing the issues we describe would help improve estimates of flight altitude and advance understanding of the treatment of error in wildlife telemetry studies.

Myocellular limitations of human performance and their modification through genome-dependent responses at altitude.

Science.gov (United States)

Flueck, Martin

2010-03-01

Human muscle operates along a continuum of power output, which is set through bioenergetic and anatomical principles. In turn, environmental and intrinsic factors during contractile work exert pronounced control over muscle performance by instructing muscle remodelling. This phenotypic control is specifically indicated with intense exercise at altitude, when extra strain is put on energy supply and the temperature-dependent mechanical efficiency of contraction. While it is classically thought that chronic exposure to hypoxia is maladaptive, repeated short episodes of reduced oxygenation alone or in combination with intense endurance work is now understood to preserve exercise performance when atmospheric oxygen levels are low. Endurance training at moderate altitude exploits the temperature-dependent malleability of energy supply that may maximize metabolic flux at altitude. The contribution of genomic mechanisms is important to the plasticity of metabolic pathways in exercised muscle. This is highlighted by the association of distinct gene polymorphisms in master governors of mitochondrial and vascular growth with exercise phenotypes. Feedforward control of human locomoter muscle by exercise involves the transient upregulation of transcript expression for metabolic processes. The response of the mitochondrial transcriptome to intense exercise is graded with respect to mitochondrial content and deoxygenation during muscle work and reflects exercise-induced mitochondrial biogenesis. This supports the notion that genome-mediated muscle malleability is under feedback control by design constraints of the pathway of oxygen. Thus, activity-dependent and genetic mechanisms contribute to the interindividual difference in the metabolic bottlenecks in athletes performing in exceptional environmental conditions.

Quantitative analysis of formal caregivers' use of communication strategies while assisting individuals with moderate and severe Alzheimer's disease during oral care.

Science.gov (United States)

Wilson, Rozanne; Rochon, Elizabeth; Mihailidis, Alex; Leonard, Carol

2013-01-01

This cross-sectional observational study examined formal caregivers' use of task-focused and social communication strategies while assisting individuals with moderate and severe Alzheimer's disease residing in a long-term care facility during a basic activity of daily living: toothbrushing. Thirteen formal caregiver-resident dyads were observed during a total of 78 separate toothbrushing sessions. All caregiver utterances occurring during the task were transcribed and coded for type of communication strategy utilizing a multidimensional observational coding scheme, which was developed a priori. Overall, the majority of residents, irrespective of disease severity, successfully completed toothbrushing with the support of caregiver assistance. Caregivers assisting residents with moderate and severe AD were found to use a variety of communication strategies, with task-focused strategies accounting for the majority of use. For the most part, the communicative strategies employed did not differ across disease severity. However, some differences were identified including the use of one proposition, paraphrased repetition, using the resident's name, and provision of full assistance, with these strategies being used more often when assisting individuals with severe AD. This study adds to the emerging literature supporting the use of specific communication strategies while assisting residents with AD during the completion of daily tasks. From reviewing this study, readers will be able to identify a variety of communication strategies, both task-focused and relational, that formal caregivers utilize while assisting residents with moderate and severe Alzheimer's disease (AD) during a basic activity of daily living. Furthermore, the reader will be able to distinguish between communication strategies that are optimal when assisting individuals with moderate AD as compared to assisting individuals with severe AD. Copyright © 2013 Elsevier Inc. All rights reserved.

Acute and Chronic Altitude-Induced Cognitive Dysfunction in Children and Adolescents.

Science.gov (United States)

Rimoldi, Stefano F; Rexhaj, Emrush; Duplain, Hervé; Urben, Sébastien; Billieux, Joël; Allemann, Yves; Romero, Catherine; Ayaviri, Alejandro; Salinas, Carlos; Villena, Mercedes; Scherrer, Urs; Sartori, Claudio

2016-02-01

To assess whether exposure to high altitude induces cognitive dysfunction in young healthy European children and adolescents during acute, short-term exposure to an altitude of 3450 m and in an age-matched European population permanently living at this altitude. We tested executive function (inhibition, shifting, and working memory), memory (verbal, short-term visuospatial, and verbal episodic memory), and speed processing ability in: (1) 48 healthy nonacclimatized European children and adolescents, 24 hours after arrival at high altitude and 3 months after return to low altitude; (2) 21 matched European subjects permanently living at high altitude; and (3) a matched control group tested twice at low altitude. Short-term hypoxia significantly impaired all but 2 (visuospatial memory and processing speed) of the neuropsychological abilities that were tested. These impairments were even more severe in the children permanently living at high altitude. Three months after return to low altitude, the neuropsychological performances significantly improved and were comparable with those observed in the control group tested only at low altitude. Acute short-term exposure to an altitude at which major tourist destinations are located induces marked executive and memory deficits in healthy children. These deficits are equally marked or more severe in children permanently living at high altitude and are expected to impair their learning abilities. Copyright © 2016 Elsevier Inc. All rights reserved.

Cold moderators at ORNL

International Nuclear Information System (INIS)

Lucas, A. T.

1997-09-01

The Advanced Neutron Source (ANS) cold moderators were not an 'Oak Ridge first', but would have been the largest both physically and in terms of cold neutron flux. Two cold moderators were planned each 410 mm in diameter and containing about 30L of liquid deuterium. They were to be completely independent of each other. A modular system design was used to provide greater reliability and serviceability. When the ANS was terminated, upgrading of the resident High Flux Isotope Reactor (HFIR) was examined and an initial study was made into the feasibility of adding a cold source. Because the ANS design was modular, it was possible to use many identical design features. Sub-cooled liquid at 4 bar abs was initially chosen for the HFIR design concept, but this was subsequently changed to 15 bar abs to operate above the critical pressure. As in the ANS, the hydrogen will operate at a constant pressure throughout the temperature range and a completely closed loop with secondary containment was adopted. The heat load of 2 kW made the heat flux comparable with that of the ANS. Subsequent studies into the construction of cryogenic moderators for the proposed new Synchrotron Neutron source indicated that again many of the same design concepts could be used. By connecting the two cold sources together in series, the total heat load of 2 kW is very close to that of the HFIR allowing a very similar supercritical hydrogen system to be configured. The two hydrogen moderators of the SNS provide a comparable heat load to the HFIR moderator. It is subsequently planned to connect the two in series and operate from a single cold loop system, once again using supercritical hydrogen. The spallation source also provided an opportunity to re-examine a cold pellet solid methane moderator operating at 20K.

Levels of organochlorine pesticides in blood plasma from residents of malaria-endemic communities in Chiapas, Mexico.

Science.gov (United States)

Ruiz-Suárez, Luz E; Castro-Chan, Ricardo A; Rivero-Pérez, Norma E; Trejo-Acevedo, Antonio; Guillén-Navarro, Griselda K; Geissen, Violette; Bello-Mendoza, Ricardo

2014-10-10

Organochlorine (OC) pesticides have been extensively used for pest control in agriculture and against malaria vectors in the region of Soconusco, Chiapas, in southern Mexico. Our study aimed to identify whether the inhabitants of four Soconusco communities at different locations (i.e., altitudes) and with different history of use of OC pesticides, have been similarly exposed to residues of these pesticides. In particular, we analyzed the potential relationship between levels of OC pesticides in plasma and the age, gender, and residence of the study population (n = 60). We detected seven pesticides in total (γ-HCH, β-HCH, heptachlor, p,p'-DDE, p,p'-DDT, β-endosulfan, endrin aldehyde). Of these, p,p'-DDE and β-endosulfan were the most frequently found (in 98% and 38% of the samples, respectively). The low-altitude (60 years) had the highest p,p'-DDE level (56.94 ± 57.81 µg/L) of all age groups, while men had higher p,p'-DDE (34.00 ± 46.76 µg/L) than women. Our results demonstrate that residents of the Soconusco region are exposed to p,p'-DDE because of high exposure to DDT in the past and current environmental exposure to this DDT-breakdown product.

Pressure breathing in fighter aircraft for G accelerations and loss of cabin pressurization at altitude--a brief review.

Science.gov (United States)

Lauritzsen, Lars P; Pfitzner, John

2003-04-01

The purpose of this brief review is to outline the past and present use of pressure breathing, not by patients but by fighter pilots. Of the historical and recent references quoted, most are from aviation-medicine journals that are not often readily available to anesthesiologists. Pressure breathing at moderate levels of airway pressure gave World War II fighter pilots a tactical altitude advantage. With today's fast and highly maneuverable jet fighters, very much higher airway pressures of the order of 8.0 kPa (identical with 60 mmHg) are used. They are used in conjunction with a counterpressure thoracic vest and an anti-G suit for the abdomen and lower body. Pressurization is activated automatically in response to +Gz accelerations, and to a potentially catastrophic loss of cabin pressurization at altitude. During +Gz accelerations, pressure breathing has been shown to maintain cerebral perfusion by raising the systemic arterial pressure, so increasing the level of G-tolerance that is afforded by the use of anti-G suits and seat tilt-back angles alone. This leaves the pilot less reliant on rigorous, and potentially distracting, straining maneuvers. With loss of cabin pressurization at altitude, pressure breathing of 100% oxygen at high airway pressures enables the pilot's alveolar PO(2) to be maintained at a safe level during emergency descent. Introduced in military aviation, pressure breathing for G-tolerance and pressure breathing for altitude presented as concepts that may be of general physiological interest to many anesthesiologists.

Spatial and temporal distribution of ionospheric currents-4: altitude ...

African Journals Online (AJOL)

(a) The continuous distribution of current density model reproduces the altitude distribution parameters of EEJ current density very well, (b) the altitude distribution parameters of EEJ current density in India and Peru are not significantly different and (c) The altitude distribution parameters of EEJ current density from rockets ...

Evaluation of Intensive Care Unit Ventilators at Altitude.

Science.gov (United States)

Blakeman, Thomas; Rodriquez, Dario; Petro, Michael; Branson, Richard

Devices may forgo US military air worthiness and safety testing in an attempt to expedite the availability of critical assets such as mechanical ventilators with a waiver for one-time use in extenuating circumstances. We evaluated two Intensive Care Unit (ICU) level ventilators: Drager Evita XL and Puritan Bennett (PB) 840 in an altitude chamber at sea level and altitudes of 8,000 and 16,000 feet. Altitude affected delivered tidal volumes (VTs) in volume control mode (VCV) and Pressure Regulated Volume Controlled (PRVC) mode at altitude with the Evita XL but the differences were not considered clinically important with the PB 840. Sixty-seven percent of the V T s were outside the ASTM standard of ± 10% of set V T with the Evita XL at altitude. The PB 840 did not deliver V T s that were larger than the ASTM standard up to an altitude of 16,000 feet while the majority of the delivered V T s with the Därger XL were greater than the ASTM standard. This could present a patient safety issue. Caregivers must be aware of the capabilities and limitations of ICU ventilators when utilized in a hypobaric environment in order to provide safe care. Copyright © 2017 Air Medical Journal Associates. All rights reserved.

Pathology of high altitude pulmonary oedema

International Nuclear Information System (INIS)

Saleem, N.

2014-01-01

Objective: To describe autopsy findings in fatal cases of high altitude pulmonary oedema. Study Design: Descriptive study. Place and Duration of Study: The study was carried out between 1999 and 2002 at an army field medical unit in Baltistan, Armed Forces Institute of Pathology, Rawalpindi and Army Medical College, Rawalpindi, Pakistan. Patients and Methods:Autopsies were performed in 17 fatal cases of High Altitude Pulmonary Edema (HAPE) occurring among soldiers serving in Siachen. Results:All cases were males with a mean age of 26.8 years (19-35). The mean altitude at which HAPE occurred was 5192 meters (2895-6492), and the mean duration of stay at these altitudes was 15.3 days (1-30). Eleven individuals had undergone proper acclimatization. The commonest clinical findings were cough (70%), dyspnoea (53%), nausea (47%), headache (41%), vomiting (35%), chest pain (35%) and tightness in chest (24%). Cyanosis and frothy secretions in the nostrils and mouth were present in all but one case. Mean combined weight of lungs was 1470 grams (1070-1810). There was marked congestion of outer and cut surfaces. Interstitial oedema was present in all cases. RBCs and leukocyte infiltrates were seen in 13 and alveolar hyaline membranes in 9 cases. Thrombi were seen in 2 cases. Cerebral oedema was present in 9 cases. Conclusion:HAPE can occur after more than two weeks of stay at high altitudes despite proper acclimatization. Concomitant cerebral oedema is frequently present. Our autopsy findings are consistent with what has been reported previously. (author)

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.

The impact of a resident-run review curriculum and USMLE scores on the Otolaryngology in-service exam.

Science.gov (United States)

Redmann, Andrew J; Tawfik, Kareem O; Myer, Charles M

2018-01-01

Describe the association of USMLE Step 1 scores and the institution of a dedicated board review curriculum with resident performance on the Otolaryngology training examination. Retrospective cross sectional study. We reviewed American Board of Otolaryngology Training Examination (OTE) scores for an otolaryngology residency program between 2005 and 2016. USMLE Step 1 scores were collected. In 2011 a resident-run OTE review curriculum was instituted with the goal of improving test preparation. Scores were compared before and after curriculum institution. Linear regression was performed to identify predictors of OTE scores. 47 residents were evaluated, 24 before and 23 after instituting the curriculum. There was a moderate correlation between USMLE step 1 scores and OTE scores for all years. For PGY-2 residents, mean OTE scores improved from 25th percentile to 41st percentile after institution of the review curriculum (p = 0.05). PGY 3-5 residents demonstrated no significant improvement. On multivariate linear regression, after controlling for USMLE step 1 scores, a dedicated board review curriculum predicted a 23-point percentile improvement in OTE scores for PGY-2 residents (p = 0.003). For other post-graduate years, the review curriculum did not predict score improvement. USMLE step 1 scores are moderately correlated with OTE performance. A dedicated OTE review curriculum may improve OTE scores for PGY-2 residents, but such a curriculum may have less benefit for intermediate- and senior-level residents. 4. Copyright © 2017 Elsevier B.V. All rights reserved.

Usefulness of training camps at high altitude for well-trained adolescents

Directory of Open Access Journals (Sweden)

Jiří Suchý

2015-03-01

Full Text Available Objective: Opinions on the suitability of sports training at altitudes of 1800-2200 m above sea level (ASL for increasing performance in youth are not unanimous. The objective of this study was to test the influence of a ten day altitude training camp on performance in well-trained adolescent cross-country skiers. Methods: A running test of 3 × 2 km (aerobic, anaerobic and critical intensity was used with a rest interval of 10 minutes. The test was performed 4 times - an initial test at a lowland (900 m ASL prior to departure for altitude, two tests at altitude (1850 m ASL, a final test ten days after returning to lower altitudes. The aerobic, anaerobic and critical load intensities were set by graded a load test. For all individual tests, the participants maintained the same heart rate individually defined for the various segments using a heart rate monitor. Changes in speed between the tests were compared. The body's internal response was also monitored by the concentration of lactate (2 and 8 minutes after each exertion. Participants: Well-trained adolescent cross-country skiers (N = 11, age: 14.4 ± 1.2 years, weight: 54.4 ± 8.6 kg, height: 170 ± 7 cm, fat: 13 ± 2.6%. Results: The average times attained in the first altitude test for aerobic and anaerobic load were higher (p < .05 than in the entry test at low altitude. In the second altitude test the average times for all intensities were significantly (p < .05 higher than in the first altitude test. In the tests after returning to the lower altitudes the times attained for all intensities were on average higher than at altitude. The average lactate concentration levels following the various intensities were similar (p > .05. The dynamics of the cool-down monitored via the lactate value at the eighth minute after completing the relevant segment showed that at altitude the adolescents cooled down significantly (p < .05 slower rate following the aerobic and anaerobic intensity than at

The Moderating Effect of Religion on the Relationship Between Depression and Suicidal Ideation in the Elderly.

Science.gov (United States)

Jung, JaeHoon; Roh, Daeyoung; Moon, Yoo Sun; Kim, Do Hoon

2017-08-01

This article aimed to compare the level of suicidal ideation in the religiously affiliated and nonaffiliated groups and identify the moderating effect of religion variables on the relationship between depression and suicidal ideation. The sample in this study was 1180 residents who were older than 60 years and who resided in Gangwon Province, South Korea. We studied the cross-sectional relationships among religions and studied variables including organizational religious activity (ORA), non-ORA (NORA), intrinsic religiosity (IR), depression, well-being, and suicidal ideation. After controlling for sociodemographic variables, the depression, well-being, and suicidal ideation level in the religiously affiliated group were not significantly different from that of the religiously nonaffiliated group and the variables also were not significantly different between Christians and Buddhists. The effect of depression on suicidal ideation was significantly moderated by ORA and IR, and the effect showed different patterns by religion; ORA was a moderator only among the Buddhist group, and IR only moderated the relationships among the Christians.

Nutrição para os praticantes de exercício em grandes altitudes Nutritional strategy for exercising in high altitudes

Directory of Open Access Journals (Sweden)

Caroline Buss

2006-02-01

Full Text Available Quando o atleta ascende a uma grande altitude, ele é exposto a uma pressão barométrica reduzida, e os efeitos fisiológicos que acompanham estas mudanças da pressão atmosférica podem ter grande influência sobre o seu organismo e seu desempenho físico. Acredita-se que a hipóxia seja responsável pelo início de uma cascata de eventos sinalizadores que, ao final, levam à adaptação à altitude. A exposição aguda à hipóxia provoca sonolência, fadiga mental e muscular e prostração. Cefaléia, náusea e anorexia são sintomas provocados pela Doença Aguda das Montanhas, que pode ocorrer nos primeiros dias de permanência na altitude. Uma estratégia nutricional adequada é fundamental para que o organismo não sofra nenhum estresse adicional. O objetivo deste trabalho foi apresentar os principais efeitos da altitude sobre o organismo e sobre o desempenho físico, discutir e/ou sugerir recomendações nutricionais para esta situação e, se possível, apresentar uma orientação nutricional prática para o atleta na altitude. Algumas das principais conclusões encontradas foram: o consumo energético deve ser aumentado; é fundamental monitorar a quantidade de líquidos ingeridos e escolher alimentos agradáveis ao paladar, ricos em energia e nutrientes. Recomenda-se trabalhar com um nutricionista do esporte com antecedência, para que um plano alimentar individual seja elaborado e colocado em prática antes mesmo da viagem à altitude.When athletes are subject to high altitudes, they are exposed to a lower barometric pressure and the physiological effects that accompany these atmospheric pressure changes can have a strong influence on their bodies and performance. Hypoxia is thought to be responsible for triggering a cascade of signaling events that eventually leads to altitude acclimatization. Acute exposure to hypoxia causes sleepiness, mental and muscle fatigue and prostration. Headache, nausea and anorexia are some of the

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...

The Study of a Super Low Altitude Satellite

Science.gov (United States)

Noda, Atsushi; Homma, Masanori; Utashima, Masayoshi

This paper reports the result of a study for super low altitude satellite. The altitude of this satellite's orbit is lower than ever. The altitude of a conventional earth observing satellite is generally around from 600km to 900km. The lowest altitude of earth observing satellite launched in Japan was 350km; the Tropical Rainfall Measuring Mission (TRMM). By comparison, the satellite reported in this paper is much lower than that and it is planned to orbit below 200km. Furthermore, the duration of the flight planned is more than two years. Any satellite in the world has not achieved to keep such a low altitude that long term. The satellite in such a low orbit drops quickly because of the strong air drag. Our satellite will cancel the air drag effect by ion engine thrust. To realize this idea, a drag-free system will be applied. This usually leads a complicated and expensive satellite system. We, however, succeeded in finding a robust control law for a simple system even under the unpredictable change of air drag. When the altitude of the satellite is lowered successfully, the spatial resolution of an optical sensor can be highly improved. If a SAR is equipped with the satellite, it enables the drastic reduction of electric power consumption and the fabulous spatial resolution improvement at the same time.

Management of HAPE with bed rest and supplemental oxygen in hospital setting at high altitude (11,500 ft: A review of 43 cases

Directory of Open Access Journals (Sweden)

Sanjay Singhal

2017-01-01

Full Text Available Objectives: To evaluate the safety and efficacy of treating high-altitude pulmonary edema (HAPE by bed rest and supplemental oxygen in hospital setting at high altitude. Materials and Methods: In a prospective case series, all patients who were diagnosed clinically with HAPE on admission to our hospital located at a height of 11,500 ft were evaluated and managed with bed rest and oxygen supplementation. Results: A total of 43 patients of HAPE with mean age of 31 years (range 20–48 years were admitted to our hospital. Infections followed by unaccustomed physical exertion were the predominant risk factors. 95.35% of the patients improved successfully with oxygen and bed rest alone with mean hospital stay of 2.67 ± 1.06 (1–6 days. Two patients (4.65% required nifedipine and evacuation to lower altitude. Of this, one patient suffering from concomitant viral infection expired 4 days after evacuation to near sea level. Conclusion: Majority of the patients with HAPE where medical facilities are available can be safely treated with bed rest and oxygen supplementation at moderate high altitude without descent.

[Hemoglobin and testosterone: importance on high altitude acclimatization and adaptation].

Science.gov (United States)

Gonzales, Gustavo F

2011-03-01

The different types of response mechanisms that the organism uses when exposed to hypoxia include accommodation, acclimatization and adaptation. Accommodation is the initial response to acute exposure to high altitude hypoxia and is characterized by an increase in ventilation and heart rate. Acclimatization is observed in individuals temporarily exposed to high altitude, and to some extent, it enables them to tolerate the high altitudes. In this phase, erythropoiesis is increased, resulting in higher hemoglobin and hematocrit levels to improve oxygen delivery capacity. Adaptation is the process of natural acclimatization where genetical variations and acclimatization play a role in allowing subjects to live without any difficulties at high altitudes. Testosterone is a hormone that regulates erythropoiesis and ventilation and could be associated to the processes of acclimatization and adaptation to high altitude. Excessive erythrocytosis, which leads to chronic mountain sickness, is caused by low arterial oxygen saturation, ventilatory inefficiency and reduced ventilatory response to hypoxia. Testosterone increases during acute exposure to high altitude and also in natives at high altitude with excessive erythrocytosis. Results of current research allow us to conclude that increase in serum testosterone and hemoglobin is adequate for acclimatization, as they improve oxygen transport, but not for high altitude adaptation, since high serum testosterone levels are associated to excessive erythrocytosis.

Personal and Professional Well-Being of Surgical Residents in New England.

Science.gov (United States)

Yoo, Peter S; Tackett, John J; Maxfield, Mark W; Fisher, Rosemarie; Huot, Stephen J; Longo, Walter E

2017-06-01

Although there is increasing literature about burnout and attrition among surgeons, little is known about personal and professional well-being of surgical trainees. General surgery residents from the 6 New England states participated in a cross-sectional, qualitative, self-reported survey to assess the domains of personal health maintenance, personal finance, work environment, and fatigue management as they relate to surgical training. All surgical residency programs in the New England region were invited to participate. Of these 19 programs, 10 elected to participate in the study. Three hundred and sixty-three total trainees were contacted with requests to participate, and 166 completed responses to the survey, resulting in a response rate of 44.9%. Ninety percent of respondents identified their programs as "university or academic." Substantial cohorts reported that during training they lacked basic healthcare maintenance visits (54%) and had undesired weight gain (44%). Although most found their stipends adequate, three-quarters worried about their finances (75%) and reported substantial educational debt (45%). Most residents enjoyed coming to work; however, the vast majority reported that work-related stress is moderate to extreme (92%). Most also reported that work-related stress negatively affects their overall well-being (72%). The mean Epworth Sleepiness Scale score among respondents was 14, consistent with moderate excessive daytime sleepiness. Surgical trainee well-being is critical to optimal patient care, career development, and burnout reduction. Surgical residents attend to their own preventive health maintenance, finances, sleep, and stress reduction with variable success. Residency programs should make modest programmatic accommodations to allow trainees to tend to various aspects of their personal well-being. Copyright © 2017. Published by Elsevier Inc.

Teaching the Healthcare Economics Milestones to Radiology Residents: Our Pilot Curriculum Experience.

Science.gov (United States)

Prober, Allen S; Mehan, William A; Bedi, Harprit S

2016-07-01

Since July 2013, the Accreditation Council for Graduate Medical Education (ACGME) has required radiology residency programs to implement a set of educational milestones to track residents' educational advancement in six core competencies, including Systems-based Practice. The healthcare economics subcompetency of Systems-based Practice has traditionally been relatively neglected, and given the new increased ACGME oversight, will specifically require greater focused attention. A multi-institutional health-care economics pilot curriculum combining didactic and practical components was implemented across five residency programs. The didactic portion included a package of online recorded presentations, reading, and testing materials developed by the American College of Radiology (ACR's) Radiology Leadership Institute. The practical component involved a series of local meetings led by program faculty with the production of a deliverable based on research of local reimbursement for a noncontrast head computed tomography. The capstone entailed the presentation of each program's deliverable during a live teleconference webcast with a Radiology Leadership Institute content expert acting as moderator and discussion leader. The pilot curriculum was well received by residents and faculty moderators, with 100% of survey respondents agreeing that the pilot met its objective of introducing how reimbursement works in American radiology in 2015 and how business terminology applies to their particular institutions. A health-care economics curriculum in the style of a Massive Open Online Course has strong potential to serve as many residency programs' method of choice in meeting the health-care economics milestones. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Predicting Resident Performance from Preresidency Factors: A Systematic Review and Applicability to Neurosurgical Training.

Science.gov (United States)

Zuckerman, Scott L; Kelly, Patrick D; Dewan, Michael C; Morone, Peter J; Yengo-Kahn, Aaron M; Magarik, Jordan A; Baticulon, Ronnie E; Zusman, Edie E; Solomon, Gary S; Wellons, John C

2018-02-01

Neurosurgical educators strive to identify the best applicants, yet formal study of resident selection has proved difficult. We conducted a systematic review to answer the following question: What objective and subjective preresidency factors predict resident success? PubMed, ProQuest, Embase, and the CINAHL databases were queried from 1952 to 2015 for literature reporting the impact of preresidency factors (PRFs) on outcomes of residency success (RS), among neurosurgery and all surgical subspecialties. Due to heterogeneity of specialties and outcomes, a qualitative summary and heat map of significant findings were constructed. From 1489 studies, 21 articles met inclusion criteria, which evaluated 1276 resident applicants across five surgical subspecialties. No neurosurgical studies met the inclusion criteria. Common objective PRFs included standardized testing (76%), medical school performance (48%), and Alpha Omega Alpha (43%). Common subjective PRFs included aggregate rank scores (57%), letters of recommendation (38%), research (33%), interviews (19%), and athletic or musical talent (19%). Outcomes of RS included faculty evaluations, in-training/board exams, chief resident status, and research productivity. Among objective factors, standardized test scores correlated well with in-training/board examinations but poorly correlated with faculty evaluations. Among subjective factors, aggregate rank scores, letters of recommendation, and athletic or musical talent demonstrated moderate correlation with faculty evaluations. Standardized testing most strongly correlated with future examination performance but correlated poorly with faculty evaluations. Moderate predictors of faculty evaluations were aggregate rank scores, letters of recommendation, and athletic or musical talent. The ability to predict success of neurosurgical residents using an evidence-based approach is limited, and few factors have correlated with future resident performance. Given the importance of

Does 'altitude training' increase exercise performance in elite athletes?

Science.gov (United States)

Lundby, Carsten; Robach, Paul

2016-07-01

What is the topic of this review? The aim is to evaluate the effectiveness of various altitude training strategies as investigated within the last few years. What advances does it highlight? Based on the available literature, the foundation to recommend altitude training to athletes is weak. Athletes may use one of the various altitude training strategies to improve exercise performance. The scientific support for such strategies is, however, not as sound as one would perhaps imagine. The question addressed in this review is whether altitude training should be recommended to elite athletes or not. © 2016 The Authors. Experimental Physiology © 2016 The Physiological Society.

Effect of oxygen supplementation in a hatchery at high altitude and ...

African Journals Online (AJOL)

The objective of this study was to investigate the effect of oxygen supplementation on broiler eggs in a hatchery at high altitude on the growth performance and ascites syndrome of broilers reared at low altitude. The treatment groups were low altitude with no oxygen supplemented in the hatchery (LA-NOX); high altitude with ...

[Dolichomegacolon of the Andes and intestinal volvulus due to altitude].

Science.gov (United States)

Frisancho, Oscar

2008-01-01

Sigmoid volvulus is a frequent cause of emergencies in hospitals in the Andean area, representing more than 50% of all intestinal obstructions. Andean dolichomegacolon (DCMA) and retractile mesocolonitis are the main contributing factors for volvulus. The mesocolonitis nears the proximal and distal segment of the sigmoid handle, favoring its torsion. Copious intake of fermentable food is the precipitating factor for volvulus. The majority of patients are seen during sowing and harvest periods, in which the consumption of this type of food increases. Andean people who live at an altitude of 3,000 m have a larger and thicker colon than coastal residents. We call this acquired characteristic the Andean dolichomegacolon (DCMA). A fiber-rich diet may inhibit the histological phenomenon known as elastogenesis, developing--over the years--the megacolon. Another important factor may be the lower atmospheric pressure in the altitude, and according to Boyle and Mariotte's physical law, the expansion of intraluminal gas may have an influence on intestinal enlargement. DCMA has many special anatomic, clinical, radiological, histological and serological features which make it different from the . chagasic megacolon. Mild emergency procedures may be performed to treat the sigmoid volvulus, such as endoscopic disvolvulation. Changing the colon rotation is helpful in diminishing abdominal pressure and restore complete blood circulation. An emergency surgery treatment must take the patient's general condition and the colon handle condition during surgery as a guiding point. High rates of mortality are found in relation to elderly patients, disease evolution time and stage of intestinal ischemia. Other new therapeutic procedures such as percutaneous sigmoidpexy, laparoscopic sigmoidectomy and mesosigmoplasty are under review, and have precise indications. Wider series are needed to evaluate them better.

Respiratory Muscle Training and Cognitive Function Exercising at Altitude.

Science.gov (United States)

Quackenbush, Joseph; Duquin, Aubrey; Helfer, Samuel; Pendergast, David R

2016-01-01

Hiking and trekking often occur at altitudes up to 12,000 ft altitude. The hypoxia-induced hyperventilation at altitude paradoxically reduces arterial CO2 (Paco2). A reduction in Paco2 results in vasoconstriction of the blood vessels of the brain and thus in local hypoxia. The local hypoxia likely affects cognitive function, which may result in reduced performance and altitude accidents. Recent publications have demonstrated that voluntary isocapnic hyperventilatory training of the respiratory muscles (VIHT) can markedly enhance exercise endurance as it is associated with reduced ventilation and its energy cost. VIHT may be useful in blunting the altitude-induced hyperventilation leading to higher Paco2 and improved cognitive function. This study examined the effects of VIHT, compared to control (C) and placebo (PVIHT) groups, on selected measures of executive functioning, including working memory and processing speed (i.e., Stroop Test, Symbol Digit Modalities Test, and Digit Span Forward) at simulated altitude up to 12,000 ft. Associated physiological parameters were also measured. The Digit Span Forward Test did not show improvements after VIHT in any group. The VIHT group, but not C or PVIHT groups, improved significantly (17-30%) on the Stroop Test. Similarly the VIHT group, but not the C and PVIHT groups, improved correct responses (26%) and number of attempts (24%) on the Symbol Digit Modalities Test. In addition, reaction time was also improved (16%). VIHT improved processing speed and working memory during exercise at altitude.

Young and burnt? Italian contribution to the international BurnOut Syndrome Study (BOSS) among residents in psychiatry.

Science.gov (United States)

Ferrari, Silvia; Cuoghi, Giulia; Mattei, Giorgio; Carra, Elena; Volpe, Umberto; Jovanovic, Nikolina; Beezhold, J; Rigatelli, Marco; Galeazzi, Gian Maria; Pingani, Luca

2015-05-04

The Burnout Syndrome (BS) is a common condition among health care professionals, yet data concerning its prevalence and associated factors among psychiatric residents are lacking. To report the results of the Italian contribution to "BOSS", an international multicentre research project aiming at estimating the burden of BS among residents in psychiatry, and at identifying factors contributing to its development and prevention. Cross-sectional study. The BOSS online questionnaire, which collected socio-demographic data and five psychometric tools (MBI-GS, AWLS, PHQ-9, SIBQ, BFI), was administered electronically to 180 Italian residents in psychiatry. Simple and multiple linear regressions were performed to analyse data. 108 questionnaires provided data for the study (response rate: 60%). Mean age: 30.5 ± 3.7 years. Eighty percent of the sample were female. A moderate level of BS emerged, related to work conditions, absence of major depression, satisfaction with pay or less academic activity. Only 0.9% (N=1) of the sample showed PHQ-9 scores suggestive of major depression, while lifetime suicidal ideation was admitted by 16% of residents. For the three dimensions of the MBI-GS, Italian sample scores were consistent with previously published results concerning pooled data in a French-Croatian sample, reporting moderate levels of BS. Higher workload, symptoms of depression and lower satisfaction predicted higher levels of Emotional Exhaustion and Cynicism. Italian residents in psychiatry showed overall moderate levels of BS, related to workload and work organization. Other alerts of psychic distress were found among participants, namely symptoms of depression, suicidal ideation and use of psychotropic medications.

Social support as moderator of the stress on unemployed people’s health

OpenAIRE

Guarino, Leticia Rosaria; Universidad Simón Bolívar; Sojo, Victor; Universidad Central de Venezuela, Caracas

2011-01-01

The aim of this research was to assess moderating role of two indexes of social support in the relationship between the length of unemployment and the physical and mental health of Venezuelan unemployed. Self-report measures were administered to a sample of 328 unemployed residents in Caracas, Venezuela. Results indicated that perceived social support acted as moderator in predicting better general health and lower somatization in the unemployed, acting as buffer of longer periods of unemploy...

Characterizing the Relationship Between Surgical Resident and Faculty Perceptions of Autonomy in the Operating Room.

Science.gov (United States)

Young, Katelyn A; Lane, Samantha M; Widger, John E; Neuhaus, Nina M; Dove, James T; Fluck, Marcus; Hunsinger, Marie A; Blansfield, Joseph A; Shabahang, Mohsen M

Characterize the concordance among faculty and resident perceptions of surgical case complexity, resident technical performance, and autonomy in a diverse sample of general surgery procedures using case-specific evaluations. A prospective study was conducted in which a faculty surgeon and surgical resident independently completed a postoperative assessment examining case complexity, resident operative performance (Milestone assessment) and autonomy (Zwisch model). Pearson correlation coefficients (r) reaching statistical significance (p autonomy demonstrated a moderate correlation (r = 0.56, p autonomy and operative performance, respectively. General surgery residents generally demonstrated high correlations with faculty perceptions of case complexity, technical performance, and operative autonomy. This generalized accord supports the use of the Milestone and Zwisch assessments in residency programs. However, discordance among perceptions of midlevel resident autonomy and chief resident operative performance suggests that these trainees may need more direct communication from the faculty. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Altitude valve for railway suspension control system

Science.gov (United States)

Zhang, Xuan; Zhang, Lihao; Li, Qingxuan; Chen, WanSong

2017-09-01

With the variation of people and material during vehicle service, the gravity of vehicle could be unbalanced. As a result it might cause accident. In order to solve this problem, altitude valve is assembled on board. It can adjust the gravity of vehicle by the intake and outlet progress of the spring in the altitude valve to prevent the tilt of vehicles.

Postoperative electrolyte management: Current practice patterns of surgeons and residents.

Science.gov (United States)

Angarita, Fernando A; Dueck, Andrew D; Azouz, Solomon M

2015-07-01

Managing postoperative electrolyte imbalances often is driven by dogma. To identify areas of improvement, we assessed the practice pattern of postoperative electrolyte management among surgeons and residents. An online survey was distributed among attending surgeons and surgical residents at the University of Toronto. The survey was designed according to a systematic approach for formulating self-administered questionnaires. Questions addressed workload, decision making in hypothetical clinical scenarios, and improvement strategies. Of 232 surveys distributed, 156 were completed (response rate: 67%). The majority stated that junior residents were responsible for managing electrolytes at 13 University of Toronto-affiliated hospitals. Supervision was carried out predominately by senior residents (75%). Thirteen percent reported management went unsupervised. Approximately 59% of residents were unaware how often attending surgeons assessed patients' electrolytes. Despite the majority of residents (53.7%) reporting they were never given tools or trained in electrolyte replacement, they considered themselves moderately or extremely confident. The management of hypothetical clinical scenarios differed between residents and attending surgeons. The majority (50.5%) of respondents considered that an electrolyte replacement protocol is the most appropriate improvement strategy. Electrolyte replacement represents an important component of surgeons' workload. Despite reporting that formal training in electrolyte management is limited, residents consider themselves competent; however, their practice is highly variable and often differs from pharmacologic-directed recommendations. Optimizing how postoperative electrolytes are managed in surgical wards requires building a framework that improves knowledge, training, and limits unnecessary interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

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...... (noradrenaline and adrenaline) and day 7 (adrenaline), but not at sea level. 4. In conclusion, insulin action decreases markedly in response to two days of altitude hypoxia, but improves with more prolonged exposure. HGP is always unchanged. The changes in insulin action may in part be explained by the changes...

APOLLO 16 COMMANDER JOHN YOUNG ENTERS ALTITUDE CHAMBER FOR TESTS

Science.gov (United States)

1971-01-01

Apollo 16 commander John W. Young prepares to enter the lunar module in an altitude chamber in the Manned Spacecraft Operations Building at the spaceport prior to an altitude run. During the altitude run, in which Apollo 16 lunar module pilot Charles M. Duke also participated, the chamber was pumped down to simulate pressure at an altitude in excess of 200,000 feet. Young, Duke and command module pilot Thomas K. Mattingly II, are training at the Kennedy Space Center for the Apollo 16 mission. Launch is scheduled from Pad 39A, March 17, 1972.

Angiotensin-converting enzyme genotype and arterial oxygen saturation at high altitude in Peruvian Quechua.

Science.gov (United States)

Bigham, Abigail W; Kiyamu, Melisa; León-Velarde, Fabiola; Parra, Esteban J; Rivera-Ch, Maria; Shriver, Mark D; Brutsaert, Tom D

2008-01-01

The I-allele of the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism has been associated with performance benefits at high altitude (HA). In n = 142 young males and females of largely Quechua origins in Peru, we evaluated 3 specific hypotheses with regard to the HA benefits of the I-allele: (1) the I-allele is associated with higher arterial oxygen saturation (Sa(O(2))) at HA, (2) the I-allele effect depends on the acclimatization state of the subjects, and (3) the putative I-allele effect on Sa(O(2)) is mediated by the isocapnic hypoxic ventilatory response (HVR, l/min(1)/% Sa(O(2))(1)). The subject participants comprised two different study groups including BLA subjects (born at low altitude) who were lifelong sea-level residents transiently exposed to hypobaric hypoxia (<24 h) and BHA subjects (born at HA) who were lifelong residents of HA. To control for the possibility of population stratification, Native American ancestry proportion (NAAP) was estimated as a covariate for each individual using a panel of 70 ancestry-informative molecular markers (AIMS). At HA, resting and exercise Sa(O(2)) was strongly associated with the ACE genotype, p = 0.008 with approximately 4% of the total variance in Sa(O(2)) attributed to ACE genotype. Moreover, I/I individuals maintained approximately 2.3 percentage point higher Sa(O(2)) compared to I/D and D/D. This I-allele effect was evident in both BLA and BHA groups, suggesting that acclimatization state has little influence on the phenotypic expression of the ACE gene. Finally, ACE genotype was not associated with the isocapnic HVR, although HVR had a strong independent effect on Sa(O(2)) (p = 0.001). This suggests that the I-allele effect on Sa(O(2)) is not mediated by the peripheral control of breathing, but rather by some other central cardiopulmonary effect of the ACE gene on the renin-angiotensin-aldosterone system (RAAS).

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.

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

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

Inappropriate Fentanyl Prescribing Among Nursing Home Residents in the United States.

Science.gov (United States)

Fain, Kevin M; Castillo-Salgado, Carlos; Dore, David D; Segal, Jodi B; Zullo, Andrew R; Alexander, G Caleb

2017-02-01

We quantified transdermal fentanyl prescribing in elderly nursing home residents without prior opioid use or persistent pain, and the association of individual and facility traits with opioid-naïve prescribing. Cross-sectional study. Linked Minimum Data Set (MDS) assessments; Online Survey, Certification and Reporting (OSCAR) records; and Medicare Part D claims. From a cross-section of all long-stay US nursing home residents in 2008 with an MDS assessment and Medicare Part D enrollment, we identified individuals (≥65 years old) who initiated transdermal fentanyl, excluding those with Alzheimer disease, severe cognitive impairment, cancer, or receipt of hospice care. We used Medicare Part D to select beneficiaries initiating transdermal fentanyl in 2008 and determined whether they were "opioid-naïve," defined as no opioid dispensing during the previous 60 days. We obtained resident and facility characteristics from MDS and OSCAR records and defined persistent pain as moderate-to-severe, daily pain on consecutive MDS assessments at least 90 days apart. We estimated associations of patient and facility attributes and opioid-naïve fentanyl initiation using multilevel mixed effects logistic regression modeling. Among 17,052 residents initiating transdermal fentanyl, 6190 (36.3%) were opioid-naïve and 15,659 (91.8%) did not have persistent pain. In the regression analysis with adjustments, residents who were older (ages ≥95 odds ratio [OR] 1.69, 95% confidence interval [CI] 1.46-1.95) or more cognitively impaired (moderate-to-severe cognitive impairment, OR 1.99, 95% CI 1.73-2.29) were more likely to initiate transdermal fentanyl without prior opioid use. Most nursing home residents initiating transdermal fentanyl did not have persistent pain and many were opioid-naïve. Changes in prescribing practices may be necessary to ensure Food and Drug Administration warnings are followed, particularly for vulnerable subgroups, such as the cognitively impaired

The relationship between faculty performance assessment and results on the in-training examination for residents in an emergency medicine training program.

Science.gov (United States)

Ryan, James G; Barlas, David; Pollack, Simcha

2013-12-01

Medical knowledge (MK) in residents is commonly assessed by the in-training examination (ITE) and faculty evaluations of resident performance. We assessed the reliability of clinical evaluations of residents by faculty and the relationship between faculty assessments of resident performance and ITE scores. We conducted a cross-sectional, observational study at an academic emergency department with a postgraduate year (PGY)-1 to PGY-3 emergency medicine residency program, comparing summative, quarterly, faculty evaluation data for MK and overall clinical competency (OC) with annual ITE scores, accounting for PGY level. We also assessed the reliability of faculty evaluations using a random effects, intraclass correlation analysis. We analyzed data for 59 emergency medicine residents during a 6-year period. Faculty evaluations of MK and OC were highly reliable (κ  =  0.99) and remained reliable after stratification by year of training (mean κ  =  0.68-0.84). Assessments of resident performance (MK and OC) and the ITE increased with PGY level. The MK and OC results had high correlations with PGY level, and ITE scores correlated moderately with PGY. The OC and MK results had a moderate correlation with ITE score. When residents were grouped by PGY level, there was no significant correlation between MK as assessed by the faculty and the ITE score. Resident clinical performance and ITE scores both increase with resident PGY level, but ITE scores do not predict resident clinical performance compared with peers at their PGY level.

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.

A comparison of resident fish assemblages in managed and unmanaged coastal wetlands in North Carolina and South Carolina

Science.gov (United States)

Robinson, Kelly F.; Jennings, Cecil A.

2014-01-01

The dominant fish species within impounded coastal wetlands in the southeastern US may be different from the species that dominate natural marshes. We tested the hypothesis that resident fish assemblages inhabiting impounded coastal wetlands in South Carolina would differ from resident assemblages in natural marshes of the southeastern United States. We used rarefied species richness, Shannon's H' diversity,J' evenness, Morisita's index of similarity, and the percent similarity index to compare resident fish assemblages from two impoundments to 12 open-marsh resident fish assemblages from previously published studies in North and South Carolina. We used rotenone to sample fish assemblages in impoundments. The assemblages in natural marsh habitat had been sampled with rotenone and seines. We classified comparisons yielding a similarity index ≥0.50 as moderately similar and those with an index ≥0.75 as very similar. Fifty-three percent of the among-impoundment comparisons (Morisita's index) were at least moderately similar, whereas 7% of impoundment—natural marsh comparisons were moderately similar. A difference in tidal influence was the only parameter in the best-fitting model describing the observed Morisita's indices. The index of similarity decreased by 63% when tidal influence differed between compared assemblages. Species richness and diversity were greater in impoundments than natural marshes, but evenness was similar between habitat types. Our results support the hypothesis that resident fish assemblages in impounded wetlands and natural marshes are different, and suggest that a degree of tidal influence is the most important factor behind the difference.

CAMEX-4 ER-2 HIGH ALTITUDE DROPSONDE V1

Data.gov (United States)

National Aeronautics and Space Administration — The CAMEX-4 ER-2 High Altitude Dropsonde dataset was collected by the ER-2 High Altitude Dropsonde System (EHAD), which used dropwinsondes fitted with Global...

Chernobyl radioactivity and high altitude air-particulate monitoring at Islamabad

International Nuclear Information System (INIS)

Bhatti, M.S.; Ihsanullah; Shafiq, M.; Perveen, N.; Orfi, S.D.

1987-11-01

High altitude sampling of air particulates for radioactivity monitoring was conducted at Islamabad after the CHERNOBYL accident. Smears from aeroplanes flying at varying altitudes were collected and analysed for fresh fission products mainly gamma emitters e.g. Ru-103 and Cs-137 etc. The maximum radioactivity observed was of the order of 15Bq/sample for Ru-103 and 9Bq/sample for Cs-137 respectively. The study was purely qualitative in nature indicated the presence of fresh fission radioactivity at high altitudes over Islamabad. For quantitative measurements at high altitudes sophisticated instrumentation/procedure needs to be adopted. (author)

Atmospheric electron flux at airplane altitude

International Nuclear Information System (INIS)

Enomoto, R.; Chiba, J.; Ogawa, K.; Sumiyoshi, T.; Takasaki, F.; Kifune, T.; Matsubara, Y.; Nishimura, J.

1991-01-01

We have developed a new detector to systematically measure the cosmic-ray electron flux at airplane altitudes. We loaded a lead-glass-based electron telescope onto a commercial cargo airplane. The first experiment was carried out using the air route between Narita (Japan) and Sydney (Australia); during this flight we measured the electron flux at various altitudes and latitudes. The thresholds of the electron energies were 1, 2, and 4 GeV. The results agree with a simple estimation using one-dimensional shower theory. A comparison with a Monte Carlo calculation was made

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.

Prevalence of dry eye syndrome in residents of surgical specialties.

Science.gov (United States)

Castellanos-González, José Alberto; Torres-Martínez, Verónica; Martínez-Ruiz, Adriana; Fuentes-Orozco, Clotilde; Rendón-Félix, Jorge; Irusteta-Jiménez, Leire; Márquez-Valdez, Aída Rebeca; Cortés-Lares, José Antonio; González-Ojeda, Alejandro

2016-07-16

The aim of this study was to determine the prevalence and severity of dry eye syndrome in a group of Mexican residents of different surgical specialties. A cross-sectional descriptive study where the residents were studied using the Ocular Surface Disease Index, together with diagnostic tests for dry eye syndrome, such as tear breakup time, Oxford Schema, Schirmer's test I, and meibomian gland dysfunction testing. Statistical analyses were performed by Pearson's chi-squared test for categorical variables and student's t-test for quantitative variables. Any P value eyes); 90 (73 %) were male and 33 (27 %) were female. The mean age was 27.8 ± 2.1 years. A higher number of residents with dry eye syndrome was found in the cardiothoracic surgery (75 %) and otorhinolaryngology (71 %) specialties; 70 % of them reported ocular symptoms, with teardrop quality involvement in >50 % of them. We found a prevalence of 56 % for mild-to-moderate/severe stages of the condition. Their presence in the operating room predisposes surgical residents to dry eye syndrome because of environmental conditions.

Increase of cerebral blood flow at high altitude

DEFF Research Database (Denmark)

Lassen, N A

1992-01-01

but rather somewhat sharpened over five days at almost 4000 meters of altitude. This, along with other evidence, shows that CBF does not in itself adapt to chronic hypoxia. Nevertheless, a decrease in CBF is seen over days at constant altitude primarily due to increase in the hematocrit. The cerebral...

Numerical simulation of the ionization effects of low- and high-altitude nuclear explosions

International Nuclear Information System (INIS)

Zhao Zhengyu; Wang Xiang

2007-01-01

Low-altitude and high-altitude nuclear explosions are sources of intensive additional ionization in ionosphere. In this paper, in terms of the ionization equilibrium equation system and the equation of energy deposition of radiation in atmosphere, and considering the influence of atmosphere, the temporal and spatial distribution of ionization effects caused by atmospheric nuclear detonation are investigated. The calculated results show that the maximum of additional free electron density produced by low-altitude nuclear explosion is greater than that by the high-altitude nuclear burst. As to the influence of instant nuclear radiation, there is obvious difference between the low-altitude and the high-altitude explosions. The influence range and the continuance time caused by delayed nuclear radiation is less for the low-altitude nuclear detonation than that for the high-altitude one. (authors)

Empathy, Sense of Power, and Personality: Do They Change During Pediatric Residency?

Science.gov (United States)

Greenberg, Larrie; Agrawal, Dewesh; Toto, Regina; Blatt, Benjamin

2015-08-01

Empathy is a critical competency in medicine. Prior studies demonstrate a longitudinal decrease in empathy during residency; however, they have not included pediatric residents. The relations among the expression of empathy, sense of power (ability to influence other's behavior), and personality traits in residents also have not been addressed. Lastly, there are no data on how residents compare with the general nonmedical population in their expression of empathy. The purposes of our study were to assess whether empathy, sense of power, and personality type were statistically correlated; if resident empathy declines over time; and how resident empathy compares with that of nonmedical peers. In 2010, a cohort of individuals entering pediatric residency were given three validated survey instruments at the beginning of their first and third years of training to explore longitudinal changes in empathy, sense of power, and major personality traits. We found no decrease in resident empathy in 2 years of pediatric training, no changes in their sense of power, and no statistically significant correlation between empathetic tendencies and sense of power. When compared with the general nonmedical population, pediatric residents rated themselves higher in empathy. As expected, the two components of empathy (empathic concern and perspective taking) were moderately correlated. Of the major personality traits, only agreeableness showed significant correlation with empathy. Pediatric resident empathy did not decrease longitudinally, unlike studies in other residents. There was no inverse relation between self-perceptions of sense of power and empathy as is present in the business literature. Finally, pediatric resident empathy was significantly higher when compared with a general nonmedical population.

High altitude pulmonary edema among "Amarnath Yatris"

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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.

Structure optimization of CFB reactor for moderate temperature FGD

Energy Technology Data Exchange (ETDEWEB)

Li, Yuan; Zhang, Jie; Zheng, Kai; You, Changfu [Tsinghua Univ., Beijing (China). Dept. of Thermal Engineering; Ministry of Education, Beijing (China). Key Lab. for Thermal Science and Power Engineering

2013-07-01

The gas velocity distribution, sorbent particle concentration distribution and particle residence time in circulating fluidized bed (CFB) reactors for moderate temperature flue gas desulfurization (FGD) have significant influence on the desulfurization efficiency and the sorbent calcium conversion ratio for sulfur reaction. Experimental and numerical methods were used to investigate the influence of the key reactor structures, including the reactor outlet structure, internal structure, feed port and circulating port, on the gas velocity distribution, sorbent particle concentration distribution and particle residence time. Experimental results showed that the desulfurization efficiency increased 5-10% when the internal structure was added in the CFB reactor. Numerical analysis results showed that the particle residence time of the feed particles with the average diameter of 89 and 9 {mu}m increased 40% and 17% respectively, and the particle residence time of the circulating particles with the average diameter of 116 {mu}m increased 28% after reactor structure optimization. The particle concentration distribution also improved significantly, which was good for improving the contact efficiency between the sorbent particles and SO{sub 2}. In addition, the optimization guidelines were proposed to further increase the desulfurization efficiency and the sorbent calcium conversion ratio.

High altitude organic gold

DEFF Research Database (Denmark)

Pouliot, Mariève; Pyakurel, Dipesh; Smith-Hall, Carsten

2018-01-01

Ethnopharmacological relevance Ophiocordyceps sinensis (Berk.) G.H.Sung, J.M.Sung, Hywel-Jones & Spatafora, a high altitude Himalayan fungus-caterpillar product found in alpine meadows in China, Bhutan, Nepal, and India, has been used in the Traditional Chinese Medicine system for over 2000 years...

Exploring the Limits of High Altitude GPS for Future Lunar Missions

Science.gov (United States)

Ashman, Benjamin W.; Parker, Joel J. K.; Bauer, Frank H.; Esswein, Michael

2018-01-01

An increasing number of spacecraft are relying on the Global Positioning System (GPS) for navigation at altitudes near or above the GPS constellation itself - the region known as the Space Service Volume (SSV). While the formal definition of the SSV ends at geostationary altitude, the practical limit of high-altitude space usage is not known, and recent missions have demonstrated that signal availability is sufficient for operational navigation at altitudes halfway to the moon. This paper presents simulation results based on a high-fidelity model of the GPS constellation, calibrated and validated through comparisons of simulated GPS signal availability and strength with flight data from recent high-altitude missions including the Geostationary Operational Environmental Satellite 16 (GOES-16) and the Magnetospheric Multiscale (MMS) mission. This improved model is applied to the transfer to a lunar near-rectilinear halo orbit (NRHO) of the class being considered for the international Deep Space Gateway concept. The number of GPS signals visible and their received signal strengths are presented as a function of receiver altitude in order to explore the practical upper limit of high-altitude space usage of GPS.

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.

Prevalence of Pain in Nursing Home Residents: The Role of Dementia Stage and Dementia Subtypes.

Science.gov (United States)

van Kooten, Janine; Smalbrugge, Martin; van der Wouden, Johannes C; Stek, Max L; Hertogh, Cees M P M

2017-06-01

To study pain prevalence, pain type, and its pharmacological treatment in Dutch nursing home residents in relation to dementia subtype and dementia severity. Data were collected as part of the PAINdemiA study, an observational cross-sectional study conducted between May 2014 and December 2015. Ten nursing homes in the Netherlands. A total of 199 nursing home residents in various stages of dementia. We collected data on pain (by observation: MOBID-2 Pain Scale and by self-report scales), pain type, pain medication, dementia subtype, dementia severity (GDS), and demographic features. In the whole sample, the prevalence of pain was 43% (95% confidence interval 36%-50%) using the MOBID-2 Pain Scale. Regardless of regularly scheduled analgesics, approximately one-third of the residents with pain suffered from moderate to severe pain. Pain assessment with the MOBID-2 Pain Scale showed no difference in pain between dementia subtypes, but residents with more severe dementia experienced pain more often than those with less severe dementia (27% vs 15%). The prevalence of self-reported pain was significantly higher in residents with vascular dementia (VaD) (54%) compared with those with Alzheimer disease (18%) and other dementia subtypes (14%). Nociceptive pain was the predominant type of pain (72%) followed by mixed pain (25%). Acetaminophen was the most prescribed analgesic (80%). Most of the participating nursing home residents had no pain; however, pain was observed more often in residents with severe dementia, whereas residents in the early stages of VaD self-reported pain more often that those with other dementia subtypes. As one-third of the residents with clinically relevant pain had moderate to severe pain regardless of using pain medication, more focus should be on how pain management could use more tailored approaches and be regularly adjusted to individual needs. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by

Multifaceted nutritional intervention among nursing-home residents has a positive influence on nutrition and function

DEFF Research Database (Denmark)

Beck, Anne Marie; Damkjær, Karin; Beyer, Nina

2008-01-01

intervention study with nutrition (chocolate and homemade oral supplements), group exercise twice a week (45-60 min, moderate intensity), and oral care intervention one to two times a week, with the aim of improving nutritional status and function in elderly nursing-home residents. A follow-up visit was made 4......-home residents by means of a multifaceted intervention consisting of chocolate, homemade supplements, group exercise, and oral care. (C) 2008 Elsevier Inc. All rights reserved....

Effect of altitude on physiological performance: a statistical analysis using results of international football games.

Science.gov (United States)

McSharry, Patrick E

2007-12-22

To assess the effect of altitude on match results and physiological performance of a large and diverse population of professional athletes. Statistical analysis of international football (soccer) scores and results. FIFA extensive database of 1460 football matches in 10 countries spanning over 100 years. Altitude had a significant (Pnegative impact on physiological performance as revealed through the overall underperformance of low altitude teams when playing against high altitude teams in South America. High altitude teams score more and concede fewer goals with increasing altitude difference. Each additional 1000 m of altitude difference increases the goal difference by about half of a goal. The probability of the home team winning for two teams from the same altitude is 0.537, whereas this rises to 0.825 for a home team with an altitude difference of 3695 m (such as Bolivia v Brazil) and falls to 0.213 when the altitude difference is -3695 m (such as Brazil v Bolivia). Altitude provides a significant advantage for high altitude teams when playing international football games at both low and high altitudes. Lowland teams are unable to acclimatise to high altitude, reducing physiological performance. As physiological performance does not protect against the effect of altitude, better predictors of individual susceptibility to altitude illness would facilitate team selection.

Research progress on high altitude retinopathy and application of Traditional Chinese Medicine

Directory of Open Access Journals (Sweden)

Hai-Xiang Huang

2014-11-01

Full Text Available High altitude retinopathy(HARrefers to the body which can't adapt to the hypobaric hypoxia environment at high altitude leading to retinal diseases, which typically manifested as retinal hemorrhages, optic disc edema and cotton wool spots. With the development of high altitude medicine, HAR become a hot topic of eye research in recent years. New researches show a significantly higher incidence of HAR, and HAR has a close contact with acute mountain sickness, high altitude cerebral edema and high altitude pulmonary edema. A further study in pathogenesis and prevention measures of HAR will promote the prevention of altitude sickness. Traditional Chinese Medicine has achieved good effects in the prevention of altitude sickness, but the effect and mechanism of herbs on HAR has not been reported. Through read and summarize the relevant literatures and reports, the author will give an overview of the research advances on HAR's pathogenesis and application of Traditional Chinese Medicine.

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…

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.

Hemoglobin and testosterone: importance on high altitude acclimatization and adaptation

OpenAIRE

Gonzales, Gustavo F.; Jefe de la Unidad de Reproducción, Instituto de Investigaciones de la Altura y Jefe del Laboratorio de Endocrinología y Reproducción, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia. Doctor en Medicina y Doctor en Ciencias. Especialista en Endocrinología.

2011-01-01

The different types of response mechanisms that the organism uses when exposed to hypoxia include accommodation, acclimatization and adaptation. Accommodation is the initial response to acute exposure to high altitude hypoxia and is characterized by an increase in ventilation and heart rate. Acclimatization is observed in individuals temporarily exposed to high altitude, and to some extent, it enables them to tolerate the high altitudes. In this phase, erythropoiesis is increased, resulti...

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.

Investigating the scope of resident patient care handoffs within neurosurgery.

Science.gov (United States)

Babu, Maya A; Nahed, Brian V; Heary, Robert F

2012-01-01

Handoffs are defined as verbal and written communications during patient care transitions. With the passage of recent ACMGE work hour rules further limiting the hours interns can spend in the hospital, many fear that more handoffs will occur, putting patient safety at risk. The issue of handoffs has not been studied in the neurosurgical literature. A validated, 20-question online-survey was sent to neurosurgical residents in all 98 accredited U.S. neurosurgery programs. Survey results were analyzed using tabulations. 449 surveys were completed yielding a 56% response rate. 63% of neurosurgical residents surveyed had not received formal instruction in what constitutes an effective handoff; 24% believe there is high to moderate variability among their co-residents in terms of the quality of the handoff provided; 55% experience three or more interruptions during handoffs on average. 90% of neurosurgical residents surveyed say that handoff most often occurs in a quiet, private area and 56% report a high level of comfort for knowing the potential acute, critical issues affecting a patient when receiving a handoff. There needs to be more focused education devoted to learning effective patient-care handoffs in neurosurgical training programs. Increasingly, handing off a patient adequately and safely is becoming a required skill of residency.

Investigating the scope of resident patient care handoffs within neurosurgery.

Directory of Open Access Journals (Sweden)

Maya A Babu

Full Text Available INTRODUCTION: Handoffs are defined as verbal and written communications during patient care transitions. With the passage of recent ACMGE work hour rules further limiting the hours interns can spend in the hospital, many fear that more handoffs will occur, putting patient safety at risk. The issue of handoffs has not been studied in the neurosurgical literature. METHODS: A validated, 20-question online-survey was sent to neurosurgical residents in all 98 accredited U.S. neurosurgery programs. Survey results were analyzed using tabulations. RESULTS: 449 surveys were completed yielding a 56% response rate. 63% of neurosurgical residents surveyed had not received formal instruction in what constitutes an effective handoff; 24% believe there is high to moderate variability among their co-residents in terms of the quality of the handoff provided; 55% experience three or more interruptions during handoffs on average. 90% of neurosurgical residents surveyed say that handoff most often occurs in a quiet, private area and 56% report a high level of comfort for knowing the potential acute, critical issues affecting a patient when receiving a handoff. CONCLUSIONS: There needs to be more focused education devoted to learning effective patient-care handoffs in neurosurgical training programs. Increasingly, handing off a patient adequately and safely is becoming a required skill of residency.

Experimental verification of altitude effect over thermal power in an atmospheric burner

International Nuclear Information System (INIS)

Amell Arrieta, Andres; Agudelo, John Ramiro; Cortes, Jaime

1992-01-01

Colombian national massive gasification plan is carried out in a variety of geographic altitudes ranging from 0 to 2.600 meter. The biggest market is located in the Andinan Region, which is characterized by great urban centres located at high altitudes. Commercial, domestic and industrial applications are characterized by the utilization of appliances using atmospheric burners. The thermal power of these burners is affected by altitude. This paper shows experimental results of thermal power reduction in atmospheric burners due to altitude changes. It was found that thermal power is reduced by 1,5% each 304 meters of altitude

Hemorrhages and hemostasis in guinea-pigs exposed to irradiation at high altitude

International Nuclear Information System (INIS)

Tartakovskij, V.N.; Daniyarov, S.B.

1988-01-01

Hemorrhagic intensity, hemostasis and blood vessel wall resistance to mechanical effects were studied in guinea-pigs exposed to whole-body irradiation (3.0 Gy). The animals were irradiated at low altitude (760 m above sea level) and at high altitude (3200 m above sea level) after 1 and 31 days of adaptation. It was demonstrated that hemorrhagic intensity in both groups of guinea-pigs irradiated at high altitude was significantly reduced in comparison with that at low altitude. The decrease of radiation-induced hemorrhages at high altitude is associated with less severe changes in thrombopoiesis, blood vessel wall and blood coagulation

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

Metabolic characteristics and response to high altitude in Phrynocephalus erythrurus (Lacertilia: Agamidae, a lizard dwell at altitudes higher than any other living lizards in the world.

Directory of Open Access Journals (Sweden)

Xiaolong Tang

Full Text Available Metabolic response to high altitude remains poorly explored in reptiles. In the present study, the metabolic characteristics of Phrynocephaluserythrurus (Lacertilia: Agamidae, which inhabits high altitudes (4500 m and Phrynocephalusprzewalskii (Lacertilia: Agamidae, which inhabits low altitudes, were analysed to explore the metabolic regulatory strategies for lizards living at high-altitude environments. The results indicated that the mitochondrial respiratory rates of P. erythrurus were significantly lower than those of P. przewalskii, and that proton leak accounts for 74~79% of state 4 and 7~8% of state3 in P. erythrurus vs. 43~48% of state 4 and 24~26% of state3 in P. przewalskii. Lactate dehydrogenase (LDH activity in P. erythrurus was lower than in P. przewalskii, indicating that at high altitude the former does not, relatively, have a greater reliance on anaerobic metabolism. A higher activity related to β-hydroxyacyl coenzyme A dehydrogenase (HOAD and the HOAD/citrate synthase (CS ratio suggested there was a possible higher utilization of fat in P. erythrurus. The lower expression of PGC-1α and PPAR-γ in P. erythrurus suggested their expression was not influenced by cold and low PO2 at high altitude. These distinct characteristics of P. erythrurus are considered to be necessary strategies in metabolic regulation for living at high altitude and may effectively compensate for the negative influence of cold and low PO2.

Acúmulo de nutrientes em frutos de cafeeiro em duas altitudes de cultivo: micronutrientes Nutrient accumulation in coffee fruits at two at two plantation altitudes: micronutrients

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Bruno Galvêas Laviola

2007-12-01

Full Text Available Dado à importância de se conhecer a exportação de micronutrientes pelos frutos, bem como, as épocas em que são mais demandados pelo cafeeiro, estudou-se o acúmulo de B, Cu, Fe, Mn e Zn em frutos de Coffea arabica L da antese à maturação, em lavouras estabelecidas em duas altitudes. Estudou-se também a variação no teor desses elementos. Estudou-se o acúmulo de B, Cu, Fe, Mn e Zn em frutos de cafeeiro arábico da antese à maturação em duas altitudes, bem como a variação na concentração dos elementos em folhas dos ramos produtivos. O experimento foi constituído da variedade de cafeeiro (Coffea arabica L. Catuaí IAC 44 cultivada a 720 e 950 m de altitude, no município de Martins Soares-MG. O delineamento experimental foi inteiramente ao acaso, com três repetições, usando um esquema de parcela subdividida no tempo. O aumento da altitude influenciou o ciclo reprodutivo do cafeeiro, demandando maior tempo para formação dos frutos. O consumo de nutrientes pelos frutos, assim como o enchimento de grãos, foi mais crítico em condições de menor altitude, já que a planta necessitou completar esses processos em menor espaço de tempo. No estádio de expansão rápida, a percentagem de acúmulo de micronutrientes foi maior na altitude de 720 m, comparada à de 950 m. De modo geral, a altitude influenciou a variação das concentrações foliares de nutrientes, apesar de não se ter observado resposta-padrão da concentração foliar ao aumento da altitude. Conclui-se que a altitude teve influência na extensão do ciclo, bem como no acúmulo de micronutrientes em frutos e na variação, das concentrações foliares destes elementos em folhas de cafeeiro.In view of the importance of knowing fruit micronutrients export from the soil, and the season in which its coffee-plant demand is higher, the accumulation of B, Cu, Fe, Mn and Zn in fruits as well as the variation in the leaf content of the elements in productive branches of

Inverse association between altitude and obesity: A prevalence study among Andean and low-altitude adult individuals of Peru

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Woolcott, Orison O.; Gutierrez, Cesar; Castillo, Oscar A.; Elashoff, Robert M.; Stefanovski, Darko; Bergman, Richard N.

2015-01-01

Objective To determine the association between altitude and obesity in a nationally representative sample of the Peruvian adult population. Design and Methods This is a cross-sectional analysis of publicly available data from the Food and Nutrition National Center (CENAN, Peru), period 2009-2010. Prevalence ratio of obesity and abdominal obesity was determined as a measure of association. Obesity and abdominal obesity were diagnosed based on direct anthropometric measurements. Results The final dataset consisted of 31,549 individuals ≥20 years old. The prevalence ratio of obesity was as follows: 1.00 between 0–499 m (reference category), 1.00 (95% confidence interval 0.87-1.16) between 500–1,499 m, 0.74 (0.63-0.86) between 1,500–2,999, and 0.54 (0.45-0.64) at ≥3,000 m, adjusting for age, sex, self-reported physical activity, out-migration rate, urbanization, poverty, education, and geographical latitude and longitude. In the same order, the adjusted prevalence ratio of abdominal obesity was 1.00, 1.01 (0.94-1.07), 0.93 (0.87-0.99), and 0.89 (0.82-0.95), respectively. We found an interaction between altitude and sex and between altitude and age (P<0.001, for both interactions) on the association with obesity and abdominal obesity. Conclusions Among Peruvian adult individuals, we found an inverse association between altitude and obesity, adjusting for multiple covariates. This adjusted association varied by sex and age. PMID:26935008

Inverse association between altitude and obesity: A prevalence study among andean and low-altitude adult individuals of Peru.

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Woolcott, Orison O; Gutierrez, Cesar; Castillo, Oscar A; Elashoff, Robert M; Stefanovski, Darko; Bergman, Richard N

2016-04-01

To determine the association between altitude and obesity in a nationally representative sample of the Peruvian adult population. This is a cross-sectional analysis of publicly available data from the Food and Nutrition National Center (CENAN, Peru), period 2009-2010. The Prevalence ratio of obesity and abdominal obesity was determined as a measure of association. Obesity and abdominal obesity were diagnosed based on direct anthropometric measurements. The final data set consisted of 31,549 individuals ≥20 years old. The prevalence ratio of obesity was as follows: 1.00 between 0 and 499 m (reference category), 1.00 (95% confidence interval 0.87-1.16) between 500-1,499 m, 0.74 (0.63-0.86) between 1,500-2,999 m, and 0.54 (0.45-0.64) at ≥3,000 m, adjusting for age, sex, self-reported physical activity, out-migration rate, urbanization, poverty, education, and geographical latitude and longitude. In the same order, the adjusted prevalence ratio of abdominal obesity was 1.00, 1.01 (0.94-1.07), 0.93 (0.87-0.99), and 0.89 (0.82-0.95), respectively. We found an interaction between altitude and sex and between altitude and age (P association with obesity and abdominal obesity. Among Peruvian adult individuals, we found an inverse association between altitude and obesity, adjusting for multiple covariates. This adjusted association varied by sex and age. © 2016 The Obesity Society.

Can people with Raynaud's phenomenon travel to high altitude?

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Luks, Andrew M; Grissom, Colin K; Jean, Dominique; Swenson, Erik R

2009-01-01

To determine whether high altitude travel adversely affects mountain enthusiasts with Raynaud's phenomenon. Volunteers with Raynaud's phenomenon were recruited using announcements disseminated by organizations dedicated to climbing or wilderness travel and Internet discussion boards dedicated to mountain activities to complete an online, anonymous survey. Survey questions addressed demographic variables, aspects of their Raynaud's phenomenon, and features of their mountain activities. Respondents compared experiences with Raynaud's phenomenon between high (>2440 m; 8000 feet) and low elevations and rated agreement with statements concerning their disease and the effects of high altitude. One hundred forty-two people, 98% of whom had primary Raynaud's phenomenon, completed the questionnaire. Respondents spent 5 to 7 days per month at elevations above 2440 m and engaged in 5.4 +/- 2.0 different activities. Eighty-nine percent of respondents engaged in winter sports and only 22% reported changing their mountain activities because of Raynaud's phenomenon. Respondents reported a variety of tactics to prevent and treat Raynaud's attacks, but only 12% used prophylactic medications. Fifteen percent of respondents reported an episode of frostbite following a Raynaud's phenomenon attack at high altitude. There was considerable heterogeneity in participants' perceptions of the frequency, duration, and severity of attacks at high altitude compared to their home elevation. Motivated individuals with primary Raynaud's phenomenon, employing various prevention and treatment strategies, can engage in different activities, including winter sports, at altitudes above 2440 m. Frostbite may be common in this population at high altitude, and care must be taken to prevent its occurrence.

The risk of cardiovascular events during leisure time activities at altitude.

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Burtscher, Martin; Ponchia, Andrea

2010-01-01

Annually, more than 100 million tourists are attracted by the mountainous areas around the world. On the one hand, leisure time activities at altitude may well contribute to the well-established beneficial effects of exercise; on the other hand, these activities are also associated with a relatively high risk of death. Sudden cardiac death (SCD) is the most frequent cause of nontraumatic death in males older than 34 years at altitude during leisure time activities such as downhill skiing and hiking. Whereas prior myocardial infarction is the most important risk factor for SCD, particularly relevant in downhill skiers, the unusual physical activity during the first days at altitude and the prolonged abstinence from food and fluid intake during exercise at altitude are the most important triggers. Unaccustomed physical activity seems more likely to trigger SCD than altitude per se. The detection of subjects at risk, evidence-based therapy, and advice on adequate behavior during the altitude sojourn will help to prevent SCD and to increase the health benefits generated by mountaineering activities.

The FAA altitude chamber training flight profile : a survey of altitude reactions, 1965-1989.

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1990-09-01

Reactions from 1,161 trainees out of 12,759 trainees subjected to the FAA altitude chamber training flights from 1965-1989 are annotated in this survey. Although there were some mild and expected reactions, these training profiles appear to provide a...

Autophagy Is a Promoter for Aerobic Exercise Performance during High Altitude Training

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Ying Zhang

2018-01-01

Full Text Available High altitude training is one of the effective strategies for improving aerobic exercise performance at sea level via altitude acclimatization, thereby improving oxygen transport and/or utilization. But its underlying molecular mechanisms on physiological functions and exercise performance of athletes are still vague. More recent evidence suggests that the recycling of cellular components by autophagy is an important process of the body involved in the adaptive responses to exercise. Whether high altitude training can activate autophagy or whether high altitude training can improve exercise performance through exercise-induced autophagy is still unclear. In this narrative review article, we will summarize current research advances in the improvement of exercise performance through high altitude training and its reasonable molecular mechanisms associated with autophagy, which will provide a new field to explore the molecular mechanisms of adaptive response to high altitude training.

Change and predictors of change in social skills of nursing home residents with dementia.

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Chappell, Neena L; Kadlec, Helena; Reid, Colin

2014-02-01

Social skills are of primary importance for those with dementia and their care providers, yet we know little about the extent to which basic social skills can be maintained over time and the predictors of change. A total of 18 nursing homes with 149 newly admitted residents with moderate to severe dementia, 195 direct care staff, and 135 family members, in British Columbia, Canada, contributed data on change in social skills from admission to 6 months and 1 year later. Three-quarters of residents maintained or improved their basic social skills during both the time periods. Decline was explained primarily by cognitive status at the time of admission, notably present orientation. However, staff-to-resident communication becomes more important over time. Social skills appear to present an opportunity to maintain interaction with these residents. The findings also suggest that a focus on the present orientation before and following admission and on staff-to-resident communication may be beneficial.

Phenotypic plasticity and genetic adaptation to high-altitude hypoxia in vertebrates.

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Storz, Jay F; Scott, Graham R; Cheviron, Zachary A

2010-12-15

High-altitude environments provide ideal testing grounds for investigations of mechanism and process in physiological adaptation. In vertebrates, much of our understanding of the acclimatization response to high-altitude hypoxia derives from studies of animal species that are native to lowland environments. Such studies can indicate whether phenotypic plasticity will generally facilitate or impede adaptation to high altitude. Here, we review general mechanisms of physiological acclimatization and genetic adaptation to high-altitude hypoxia in birds and mammals. We evaluate whether the acclimatization response to environmental hypoxia can be regarded generally as a mechanism of adaptive phenotypic plasticity, or whether it might sometimes represent a misdirected response that acts as a hindrance to genetic adaptation. In cases in which the acclimatization response to hypoxia is maladaptive, selection will favor an attenuation of the induced phenotypic change. This can result in a form of cryptic adaptive evolution in which phenotypic similarity between high- and low-altitude populations is attributable to directional selection on genetically based trait variation that offsets environmentally induced changes. The blunted erythropoietic and pulmonary vasoconstriction responses to hypoxia in Tibetan humans and numerous high-altitude birds and mammals provide possible examples of this phenomenon. When lowland animals colonize high-altitude environments, adaptive phenotypic plasticity can mitigate the costs of selection, thereby enhancing prospects for population establishment and persistence. By contrast, maladaptive plasticity has the opposite effect. Thus, insights into the acclimatization response of lowland animals to high-altitude hypoxia can provide a basis for predicting how altitudinal range limits might shift in response to climate change.

Energy efficiency and comfort conditions in passive solar buildings: Effect of thermal mass at equatorial high altitudes

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Ogoli, David Mwale

This dissertation is based on the philosophy that architectural design should not just be a function of aesthetics, but also of energy-efficiency, advanced technologies and passive solar strategies. A lot of published literature is silent regarding buildings in equatorial highland regions. This dissertation is part of the body of knowledge that attempts to provide a study of energy in buildings using thermal mass. The objectives were to establish (1) effect of equatorial high-altitude climate on thermal mass, (2) effect of thermal mass on moderating indoor temperatures, (3) effect of thermal mass in reducing heating and cooling energy, and (4) the amount of time lag and decrement factor of thermal mass. Evidence to analyze the effect of thermal mass issues came from three sources. First, experimental physical models involving four houses were parametrically conducted in Nairobi, Kenya. Second, energy computations were made using variations in thermal mass for determining annual energy usage and costs. Third, the data gathered were observed, evaluated, and compared with currently published research. The findings showed that: (1) Equatorial high-altitude climates that have diurnal temperature ranging about 10--15°C allow thermal mass to moderate indoor temperatures; (2) Several equations were established that indicate that indoor mean radiant temperatures can be predicted from outdoor temperatures; (3) Thermal mass can reduce annual energy for heating and cooling by about 71%; (4) Time lag and decrement of 200mm thick stone and concrete thermal mass can be predicted by a new formula; (5) All windows on a building should be shaded. East and west windows when shaded save 51% of the cooling energy. North and south windows when fully shaded account for a further 26% of the cooling energy; (6) Insulation on the outside of a wall reduces energy use by about 19.6% below the levels with insulation on the inside. The basic premise of this dissertation is that decisions that

Fit for high altitude: are hypoxic challenge tests useful?

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Matthys Heinrich

2011-02-01

Full Text Available Abstract Altitude travel results in acute variations of barometric pressure, which induce different degrees of hypoxia, changing the gas contents in body tissues and cavities. Non ventilated air containing cavities may induce barotraumas of the lung (pneumothorax, sinuses and middle ear, with pain, vertigo and hearing loss. Commercial air planes keep their cabin pressure at an equivalent altitude of about 2,500 m. This leads to an increased respiratory drive which may also result in symptoms of emotional hyperventilation. In patients with preexisting respiratory pathology due to lung, cardiovascular, pleural, thoracic neuromuscular or obesity-related diseases (i.e. obstructive sleep apnea an additional hypoxic stress may induce respiratory pump and/or heart failure. Clinical pre-altitude assessment must be disease-specific and it includes spirometry, pulsoximetry, ECG, pulmonary and systemic hypertension assessment. In patients with abnormal values we need, in addition, measurements of hemoglobin, pH, base excess, PaO2, and PaCO2 to evaluate whether O2- and CO2-transport is sufficient. Instead of the hypoxia altitude simulation test (HAST, which is not without danger for patients with respiratory insufficiency, we prefer primarily a hyperoxic challenge. The supplementation of normobaric O2 gives us information on the acute reversibility of the arterial hypoxemia and the reduction of ventilation and pulmonary hypertension, as well as about the efficiency of the additional O2-flow needed during altitude exposure. For difficult judgements the performance of the test in a hypobaric chamber with and without supplemental O2-breathing remains the gold standard. The increasing numbers of drugs to treat acute pulmonary hypertension due to altitude exposure (acetazolamide, dexamethasone, nifedipine, sildenafil or to other etiologies (anticoagulants, prostanoids, phosphodiesterase-5-inhibitors, endothelin receptor antagonists including mechanical aids to

Fit for high altitude: are hypoxic challenge tests useful?

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Matthys, Heinrich

2011-02-28

Altitude travel results in acute variations of barometric pressure, which induce different degrees of hypoxia, changing the gas contents in body tissues and cavities. Non ventilated air containing cavities may induce barotraumas of the lung (pneumothorax), sinuses and middle ear, with pain, vertigo and hearing loss. Commercial air planes keep their cabin pressure at an equivalent altitude of about 2,500 m. This leads to an increased respiratory drive which may also result in symptoms of emotional hyperventilation. In patients with preexisting respiratory pathology due to lung, cardiovascular, pleural, thoracic neuromuscular or obesity-related diseases (i.e. obstructive sleep apnea) an additional hypoxic stress may induce respiratory pump and/or heart failure. Clinical pre-altitude assessment must be disease-specific and it includes spirometry, pulsoximetry, ECG, pulmonary and systemic hypertension assessment. In patients with abnormal values we need, in addition, measurements of hemoglobin, pH, base excess, PaO2, and PaCO2 to evaluate whether O2- and CO2-transport is sufficient.Instead of the hypoxia altitude simulation test (HAST), which is not without danger for patients with respiratory insufficiency, we prefer primarily a hyperoxic challenge. The supplementation of normobaric O2 gives us information on the acute reversibility of the arterial hypoxemia and the reduction of ventilation and pulmonary hypertension, as well as about the efficiency of the additional O2-flow needed during altitude exposure. For difficult judgements the performance of the test in a hypobaric chamber with and without supplemental O2-breathing remains the gold standard. The increasing numbers of drugs to treat acute pulmonary hypertension due to altitude exposure (acetazolamide, dexamethasone, nifedipine, sildenafil) or to other etiologies (anticoagulants, prostanoids, phosphodiesterase-5-inhibitors, endothelin receptor antagonists) including mechanical aids to reduce periodical or

Influence of the altitude on the burning velocity of the natural gas

International Nuclear Information System (INIS)

Arrieta, Andres Amell; Garcia Posada, Jorge Mario; Quilindo Valencia, Arvey; Henao Vallejo, Diego Alberto

2004-01-01

By the increasing use of natural gas in cities of Latin America located to high altitude, is necessary to study the effect of the altitude on the combustion, for example the burning velocity. This work is an experimental study of as it changes to the burning velocity with the altitude, being made test in sites with altitude of 40, 550, 1.020, 1.550, 2.040 and 2.550 meters. The result was that the variations are slight

Radiation exposure and high-altitude flight. NCRP Commentary No. 12

International Nuclear Information System (INIS)

1995-01-01

Enhanced air crew and public radiation exposure while flying at current altitudes and speeds has not been adequately addressed. However, the commercial aircraft industry continues to expand with greater numbers of passengers and more air crews year by year. With the expected expansions in high-altitude flight in the next two decades there will be many more people exposed to higher levels of ionizing radiation than currently. The equivalent dose rates at the higher altitudes are of the order of two to three times those received at current aircraft altitudes, but are not known very well, partly because of limitations in the knowledge of the component radiations, especially the high-energy neutron component. The risks are also more uncertain than for low-LET exposures on the ground because of uncertainty in an average W R to use for high-LET radiations. Exposures of current air crew are presently comparable with the average exposures of other radiation workers on the ground (EPA, 1995). Substantially higher exposures must be expected at high altitudes to air crew (perhaps approaching or possibly exceeding the current limit for workers on the ground). Higher exposures to sensitive groups of the population such as the fetuses carried by pregnant women are of special concern. Therefore, steps must be taken to improve our knowledge base with respect to dose levels and risks at these high altitudes. Following acquisition of this knowledge, modifications in radiation protection practices with respect to air crew and passengers will need to be considered and recommended to assure that adequate radiation protection is provided with respect to high-altitude flight

Iron Supplementation and Altitude: Decision Making Using a Regression Tree

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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

Mechanisms of Memory Dysfunction during High Altitude Hypoxia Training in Military Aircrew.

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Nation, Daniel A; Bondi, Mark W; Gayles, Ellis; Delis, Dean C

2017-01-01

Cognitive dysfunction from high altitude exposure is a major cause of civilian and military air disasters. Pilot training improves recognition of the early symptoms of altitude exposure so that countermeasures may be taken before loss of consciousness. Little is known regarding the nature of cognitive impairments manifesting within this critical window when life-saving measures may still be taken. Prior studies evaluating cognition during high altitude simulation have predominantly focused on measures of reaction time and other basic attention or motor processes. Memory encoding, retention, and retrieval represent critical cognitive functions that may be vulnerable to acute hypoxic/ischemic events and could play a major role in survival of air emergencies, yet these processes have not been studied in the context of high altitude simulation training. In a series of experiments, military aircrew underwent neuropsychological testing before, during, and after brief (15 min) exposure to high altitude simulation (20,000 ft) in a pressure-controlled chamber. Acute exposure to high altitude simulation caused rapid impairment in learning and memory with relative preservation of basic visual and auditory attention. Memory dysfunction was predominantly characterized by deficiencies in memory encoding, as memory for information learned during high altitude exposure did not improve after washout at sea level. Retrieval and retention of memories learned shortly before altitude exposure were also impaired, suggesting further impairment in memory retention. Deficits in memory encoding and retention are rapidly induced upon exposure to high altitude, an effect that could impact life-saving situational awareness and response. (JINS, 2017, 23, 1-10).

Nutrition and psychological well-being among long-term care residents with dementia.

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Muurinen, S; Savikko, N; Soini, H; Suominen, M; Pitkälä, K

2015-02-01

To examine the relationship between nutritional status of service housing and nursing home residents with dementia and their psychological well-being (PWB), and the associations of nutritional care and PWB. This cross-sectional nutrition study was carried out in 2011. The study included all older long-term care residents (N=4966) living in nursing homes and service housing units (N=61) in Helsinki. The response rate of was 72%. Of the respondents, only persons who had a diagnosis of dementia were included in this analysis (N=2379). The Mini Nutritional Assessment (MNA) tool and a structured questionnaire were used in assessing the residents. Six dimensions of PWB were included in the questionnaire. Information was also retrieved from medical records. Of residents 9% were well-nourished and 28% malnourished according to the MNA. PWB was good in 50% (score ≥ 0.80) and poor in 10% (score snacks were associated with poor PWB. Mild cognitive impairment was more often associated with poor PWB, whereas moderate or severe impairment was more often associated with good PWB. Nutritional status and nutritional care of residents with dementia were significantly associated with their psychological well-being. The residents suffering from malnutrition had the poorest psychological well-being.

Resident fatigue in otolaryngology residents: a Web based survey.

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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.

Use of a policy debate to teach residents about health care reform.

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Nguyen, Vu Q C; Hirsch, Mark A

2011-09-01

Resident education involves didactics and pedagogic strategies using a variety of tools and technologies in order to improve critical thinking skills. Debating is used in educational settings to improve critical thinking skills, but there have been no reports of its use in residency education. The present paper describes the use of debate to teach resident physicians about health care reform. We aimed to describe the method of using a debate in graduate medical education. Second-year through fourth-year physical medicine and rehabilitation residents participated in a moderated policy debate in which they deliberated whether the United States has one of the "best health care system(s) in the world." Following the debate, the participants completed an unvalidated open-ended questionnaire about health care reform. Although residents expressed initial concerns about participating in a public debate on health care reform, all faculty and residents expressed that the debate was robust, animated, and enjoyed by all. Components of holding a successful debate on health care reform were noted to be: (1) getting "buy-in" from the resident physicians; (2) preparing the debate; and (3) follow-up. The debate facilitated the study of a large, complex topic like health care reform. It created an active learning process. It encouraged learners to keenly attend to an opposing perspective while enthusiastically defending their position. We conclude that the use of debates as a teaching tool in resident education is valuable and should be explored further.

The Gravity Field of Mercury After the Messenger Low-Altitude Campaign

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Mazarico, Erwan; Genova, Antonio; Goossens, Sander; Lemoine, Frank G.; Smith, David E.; Zuber, Maria T.; Neumann, Gary A.; Solomon, Sean C.

2015-01-01

The final year of the MESSENGER mission was designed to take advantage of the remaining propellant onboard to provide a series of lowaltitude observation campaigns and acquire novel scientific data about the innermost planet. The lower periapsis altitude greatly enhances the sensitivity to the short-wavelength gravity field, but only when the spacecraft is in view of Earth. After more than 3 years in orbit around Mercury, the MESSENGER spacecraft was tracked for the first time below 200-km altitude on 5 May 2014 by the NASA Deep Space Network (DSN). Between August and October, periapsis passages down to 25-km altitude were routinely tracked. These periods considerably improved the quality of the data coverage. Before the end of its mission, MESSENGER will fly at very low altitudes for extended periods of time. Given the orbital geometry, however the periapses will not be visible from Earth and so no new tracking data will be available for altitudes lower than 75 km. Nevertheless, the continuous tracking of MESSENGER in the northern hemisphere will help improve the uniformity of the spatial coverage at altitudes lower than 150 km, which will further improve the overall quality of the Mercury gravity field.

Shape memory alloy resistance behaviour at high altitude for feedback control

Science.gov (United States)

Ng, W. T.; Sedan, M. F.; Abdullah, E. J.; Azrad, S.; Harithuddin, A. S. M.

2017-12-01

Many recent aerospace technologies are using smart actuators to reduce the system's complexity and increase its reliability. One such actuator is shape memory alloy (SMA) actuator, which is lightweight, produces high force and large deflection. However, some disadvantages in using SMA actuators have been identified and they include nonlinear response of the strain to input current, hysteresis characteristic that results in inaccurate control and less than optimum system performance, high operating temperatures, slow response and also high requirement of electrical power to obtain the desired actuation forces. It is still unknown if the SMA actuators can perform effectively at high altitude with low surrounding temperature. The work presented here covers the preliminary process of verifying the feasibility of using resistance as feedback control at high altitude for aerospace applications. Temperature and resistance of SMA actuator at high altitude is investigated by conducting an experiment onboard a high altitude balloon. The results from the high altitude experiment indicate that the resistance or voltage drop of the SMA wire is not significantly affected by the low surrounding temperature at high altitude as compared to the temperature of SMA. Resistance feedback control for SMA actuators may be suitable for aerospace applications.

Perseus A High Altitude Remotely Piloted Aircraft being Towed in Flight

Science.gov (United States)

1994-01-01

Perseus A, a remotely piloted, high-altitude research vehicle designed by Aurora Flight Sciences Corp., takes off from Rogers Dry Lake at the Dryden Flight Research Center, Edwards, California. The Perseus was towed into the air by a ground vehicle. At about 700 ft. the aircraft was released and the engine turned the propeller to take the plane to its desired altitude. Perseus B is a remotely piloted aircraft developed as a design-performance testbed under NASA's Environmental Research Aircraft and Sensor Technology (ERAST) project. Perseus is one of several flight vehicles involved in the ERAST project. A piston engine, propeller-powered aircraft, Perseus was designed and built by Aurora Flight Sciences Corporation, Manassas, Virginia. The objectives of Perseus B's ERAST flight tests have been to reach and maintain horizontal flight above altitudes of 60,000 feet and demonstrate the capability to fly missions lasting from 8 to 24 hours, depending on payload and altitude requirements. The Perseus B aircraft established an unofficial altitude record for a single-engine, propeller-driven, remotely piloted aircraft on June 27, 1998. It reached an altitude of 60,280 feet. In 1999, several modifications were made to the Perseus aircraft including engine, avionics, and flight-control-system improvements. These improvements were evaluated in a series of operational readiness and test missions at the Dryden Flight Research Center, Edwards, California. Perseus is a high-wing monoplane with a conventional tail design. Its narrow, straight, high-aspect-ratio wing is mounted atop the fuselage. The aircraft is pusher-designed with the propeller mounted in the rear. This design allows for interchangeable scientific-instrument payloads to be placed in the forward fuselage. The design also allows for unobstructed airflow to the sensors and other devices mounted in the payload compartment. The Perseus B that underwent test and development in 1999 was the third generation of the

Influence of altitude training modality on performance and total haemoglobin mass in elite swimmers.

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Gough, Clare E; Saunders, Philo U; Fowlie, John; Savage, Bernard; Pyne, David B; Anson, Judith M; Wachsmuth, Nadine; Prommer, Nicole; Gore, Christopher J

2012-09-01

We compared changes in performance and total haemoglobin mass (tHb) of elite swimmers in the weeks following either Classic or Live High:Train Low (LHTL) altitude training. Twenty-six elite swimmers (15 male, 11 female, 21.4 ± 2.7 years; mean ± SD) were divided into two groups for 3 weeks of either Classic or LHTL altitude training. Swimming performances over 100 or 200 m were assessed before altitude, then 1, 7, 14 and 28 days after returning to sea-level. Total haemoglobin mass was measured twice before altitude, then 1 and 14 days after return to sea-level. Changes in swimming performance in the first week after Classic and LHTL were compared against those of Race Control (n = 11), a group of elite swimmers who did not complete altitude training. In addition, a season-long comparison of swimming performance between altitude and non-altitude groups was undertaken to compare the progression of performances over the course of a competitive season. Regardless of altitude training modality, swimming performances were substantially slower 1 day (Classic 1.4 ± 1.3% and LHTL 1.6 ± 1.6%; mean ± 90% confidence limits) and 7 days (0.9 ± 1.0% and 1.9 ± 1.1%) after altitude compared to Race Control. In both groups, performances 14 and 28 days after altitude were not different from pre-altitude. The season-long comparison indicated that no clear advantage was obtained by swimmers who completed altitude training. Both Classic and LHTL elicited ~4% increases in tHb. Although altitude training induced erythropoeisis, this physiological adaptation did not transfer directly into improved competitive performance in elite swimmers.

[Acute health effects of the Hebei oil spill on the residents of Taean, Korea].

Science.gov (United States)

Lee, Cheol-Heon; Kang, Young-A; Chang, Kyu-Jin; Kim, Chang-Hoon; Hur, Jong-Il; Kim, Jae-Youn; Lee, Jong-Koo

2010-03-01

On December 7, 2007, the Hebei Spirit oil tanker spilled out 12,547 kl of crude oil on the Yellow Sea 10 km away from the cost of Taean Province, Korea. As the coastline has been contaminated, local residents have been exposed to crude oil. Because the residents were showing many symptoms, we investigated the acute health effects of this oil spill on them. We conducted a cross-sectional study consisting of the heavy and moderately oil soaked area in Taean and the lightly oil soaked area in Seocheon. Ten seashore villages were selected from each area, and 10 male and female adults were selected from each village. We interviewed the subjects using a structured questionnaire on the characteristics of residents, the cleanup activities, the perception of oil hazard, depression and anxiety, and the physical symptoms. The odds ratios and 95% confidence intervals were analyzed using logistic regression analysis. The logistic regression model was adjusted for age, gender, education, smoking, the perception of oil hazard and anxiousness. The more highly contaminated the area, the more likely it was for residents to be engaged in cleanup activities and have a greater chance of exposure to oil. The indexes of anxiety and depression were higher in the heavy and moderately oil soaked areas. The increased risks of headache, nausea, dizziness, fatigue, tingling of limb, hot flushing, sore throat, cough, runny nose, shortness of breath, itchy skin, rash, and sore eyes were significant. The results suggest that exposure to crude oil is associated with various acute physical symptoms. Long-term investigation is required to monitor the residents' health.

EFECTO DEL ASCENSO SÚBITO A UNA ALTITUD MODERADA SOBRE LA PERCEPCIÓN SUBJETIVA DE ESFUERZO A DIFERENTES INTENSIDADES DE EJERCICIO

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P. Rodríguez

2010-09-01

Full Text Available

RESUMEN

Dieciséis sujetos varones y sanos (VO2max de 4,06 ± 0,7 l.min-1, fueron sometidos a un protocolo incremental máximo en sendas condiciones de normoxia (N y altitud aguda moderada (Alt en días diferentes. La percepción subjetiva de esfuerzo (RPE y demás parámetros máximos y los relacionados con el umbral de lactato (UL, fueron registrados y comparados entre ambas condiciones. No se observaron diferencias significativas entre los RPEL, RPEC y RPET entre ambas condiciones ni para la máxima capacidad de trabajo ni en el UL. Tampoco se observaron cambios significativos en las potencias de trabajo, VO2 (l.min-1, Ve (l.min-1 y Lac (mMol.l-1 a las intensidades estudiadas. Sin embargo, aunque la Fc registrada al UL no mostró diferencias con la obtenida en Alt, sí se observó una reducción importante en la Fc a la máxima carga de trabajo alcanzada en condiciones de hipoxia (188 ± 9 vs 182 ± 7 ppm para una p<0.001. El ascenso súbito a una altitud moderada no altera la percepción subjetiva de esfuerzo en el UL ni a la máxima capacidad de trabajo. En estas condiciones, la Fc no se muestra tan buen indicador de la intensidad de ejercicio como la percepción de esfuerzo.
PALABRAS CLAVE: RPE, altitud, hipoxia, umbral láctico.

ABSTRACT

Sixteen healthy males, were submitted to a maximum incremental test in conditions of normoxia (N and of moderate acute altitude (Alt in two different days. Rating of perceived exertion (RPE, respiratory data, heart rate and lactate were measured during the test. The values at maximum work and at the lactate thresold (LT were compared between both conditions. Meaningful differences between the work, RPE, VO2 (l.min-1, Ve (l.min-1 y Lac (mMol.l-1 were not observed at

Altitude training: an up-to-date approach and implementation in practice

OpenAIRE

Issurin, Vladimir

2007-01-01

This article overviews current comprehension of altitude training, which is quite contradictory: many sources declare that altitude training provides no benefits to sea level performances compared to appropriate conventional training while others consider altitude training to be an efficacious and proven tool to enhance high-performance preparation. This contradiction can be partly explained by the variety of individual training responses, i.e., individual predispositions among some athletes ...

Outdoor Activity and High Altitude Exposure During Pregnancy: A Survey of 459 Pregnancies.

Science.gov (United States)

Keyes, Linda E; Hackett, Peter H; Luks, Andrew M

2016-06-01

To evaluate whether women engage in outdoor activities and high altitude travel during pregnancy; the health care advice received regarding high altitude during pregnancy; and the association between high altitude exposure and self-reported pregnancy complications. An online survey of women with at least 1 pregnancy distributed on websites and e-mail lists targeting mothers and/or mountain activities. Outcome measures were outdoor activities during pregnancy, high altitude (>2440 m) exposure during pregnancy, and pregnancy and perinatal complications. Hiking, running, and swimming were the most common activities performed during pregnancy. Women traveled to high altitude in over half of the pregnancies (244/459), and most did not receive counseling regarding altitude (355, 77%), although a small proportion (14, 3%) were told not to go above 2440 m. Rates of miscarriage and most other complications were similar between pregnancies with and without travel above 2440 m. Pregnancies with high altitude exposure were more likely to have preterm labor (odds ratio [OR] 2.3; 95% CI 0.97-5.4; P = .05). Babies born to women who went to high altitude during pregnancy were more likely to need oxygen at birth (OR 2.34; 95% CI 1.04-5.26; P sports and travel to high altitude have a low rate of complications. Given the limitations of our data, further research is necessary on the risks associated with high altitude travel and physical activity and how these apply to the general population. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

A brief introduction to high altitude nuclear explosion and a review on high altitude nuclear tests of usa and former USSR

International Nuclear Information System (INIS)

Sun Jingwen

1999-11-01

The author briefly introduces some knowledge about high altitude nuclear explosion (HANE) and presents a general review on high altitude nuclear tests of USA and former USSR. Physical phenomenon generated by HANE is given. The effects of HANE on space flyer, artificial satellite and communication are discussed. Some aspects of a mechanism of antimissile for HANE are described and the effect and role of HANE for USA and USSR are reviewed

The radiation protection problems of high altitude and space flight

International Nuclear Information System (INIS)

Fry, R.J.M.

1993-01-01

This paper considers the radiation environment in aircraft at high altitudes and spacecraft in low earth orbit and in deep space and the factors that influence the dose equivalents. Altitude, latitude and solar cycle are the major influences for flights below the radiation belts. In deep space, solar cycle and the occurrence of solar particle events are the factors of influence. The major radiation effects of concern are cancer and infertility in males. In high altitude aircraft the radiation consists mainly of protons and neutrons, with neutrons contributing about half the equivalent dose. The average dose rate at altitudes of transcontinental flights that approach the polar regions are greater by a factor of about 2.5 than on routes at low latitudes. Current estimates of does to air crews suggest they are well within the ICRP (1990) recommended dose limits for radiation workers

Residents Perceptions of Friendship and Positive Social Networks Within a Nursing Home.

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

2016-10-01

(i) To describe nursing home residents' perceptions of their friendship networks using social network analysis (SNA) and (ii) to contribute to theory regarding resident friendship schema, network structure, and connections between network ties and social support. Cross-sectional interviews, standardized assessments, and observational data were collected in three care units, including a Dementia Specific Unit (DSU), of a 94-bed Sydney nursing home. Full participation consent was obtained for 36 residents aged 63-94 years. Able residents answered open-ended questions about friendship, identified friendship ties, and completed measures of nonfamily social support. Residents retained clear concepts of friendship and reported small, sparse networks. Nonparametric pairwise comparisons indicated that DSU residents reported less perceived social support (median = 7) than residents from the other units (median = 17; U = 10.0, p = .034, r = -.51), (median = 14; U = 0.0, p = .003, r = -.82). Greater perceived social support was moderately associated with higher number of reciprocated ties [ρ(25) = .49, p = .013]. Though some residents had friendships, many reported that nursing home social opportunities did not align with their expectations of friendship. Relationships with coresidents were associated with perceptions of social support. SNA's relational perspective elucidated network size, tie direction, and density, advancing understanding of the structure of residents' networks and flow of subjective social support through that structure. Understanding resident expectations and perceptions of their social networks is important for care providers wishing to improve quality of life in nursing homes. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The association of neuropsychiatric symptoms and environment with quality of life in assisted living residents with dementia.

Science.gov (United States)

Samus, Quincy M; Rosenblatt, Adam; Steele, Cynthia; Baker, Alva; Harper, Michael; Brandt, Jason; Mayer, Lawrence; Rabins, Peter V; Lyketsos, Constantine G

2005-10-01

We conducted this study to determine whether neuropsychiatric symptoms and environmental characteristics are associated with quality of life in assisted living residents with dementia. We used a cross-sectional study of 134 residents from 22 facilities and employed the Alzheimer's Disease-Related Quality of Life Scale and the Neuropsychiatric Inventory. A scale was developed to capture the homelike climate of each facility. Linear regression analyses were used to estimate the relationship of neuropsychiatric symptoms and homelike climate with quality of life, controlling for sociodemographics, cognition, functional dependence, and physical health. Exploratory analyses and graphical techniques were employed to test for environmental-level moderating effects. Agitation, depression, apathy, and irritability were significant predictors of quality of life, explaining 29% of the variance. Neither facility size nor homelike environment was significantly associated with quality of life in univariate analyses. Size of facility moderated the relationship between agitation and quality of life. Neuropsychiatric symptoms impair quality of life in residents with dementia. Further research should investigate the role of other environmental aspects.

HIGH ALTITUDES EFFECTS ON HEMATOLOGIC BLOOD PARAMETERS

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Hasim Rushiti

2015-05-01

Full Text Available The approach and the objective of this experiment are consistent with the determination of changes of blood parameters after the stay of the students at an altitude of 1800-2300 meters, for a ten-day long ski course. In this paper are included a total of 64 students of the Faculty of Sport Sciences in Prishtina, of the age group of 19-25 (the average age is 21. All students previously have undergone a medical check for TA, arterial pulse and respiratory rate. In particular, the health situation is of subjects was examined, then, all students, at the same time, gave blood for analysis. In this experiment, three main hematologic parameters were taken in consideration: such as hemoglobin, hematocrit and red blood cells. The same analyses were carried out after the 10-day stay at a high altitude. The results of the experiment have shown significant changes after the ten-day stay at high altitude, despite the previous results that show changes only after the twenty-day stay in such elevations.

Monocular Vision System for Fixed Altitude Flight of Unmanned Aerial Vehicles

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Kuo-Lung Huang

2015-07-01

Full Text Available The fastest and most economical method of acquiring terrain images is aerial photography. The use of unmanned aerial vehicles (UAVs has been investigated for this task. However, UAVs present a range of challenges such as flight altitude maintenance. This paper reports a method that combines skyline detection with a stereo vision algorithm to enable the flight altitude of UAVs to be maintained. A monocular camera is mounted on the downside of the aircraft’s nose to collect continuous ground images, and the relative altitude is obtained via a stereo vision algorithm from the velocity of the UAV. Image detection is used to obtain terrain images, and to measure the relative altitude from the ground to the UAV. The UAV flight system can be set to fly at a fixed and relatively low altitude to obtain the same resolution of ground images. A forward-looking camera is mounted on the upside of the aircraft’s nose. In combination with the skyline detection algorithm, this helps the aircraft to maintain a stable flight pattern. Experimental results show that the proposed system enables UAVs to obtain terrain images at constant resolution, and to detect the relative altitude along the flight path.

The effects of classic altitude training on hemoglobin mass in swimmers.

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Wachsmuth, N B; Völzke, C; Prommer, N; Schmidt-Trucksäss, A; Frese, F; Spahl, O; Eastwood, A; Stray-Gundersen, J; Schmidt, W

2013-05-01

Aim of the study was to determine the influence of classic altitude training on hemoglobin mass (Hb-mass) in elite swimmers under the following aspects: (1) normal oscillation of Hb-mass at sea level; (2) time course of adaptation and de-adaptation; (3) sex influences; (4) influences of illness and injury; (5) interaction of Hb-mass and competition performance. Hb-mass of 45 top swimmers (male 24; female 21) was repeatedly measured (~6 times) over the course of 2 years using the optimized CO-rebreathing method. Twenty-five athletes trained between one and three times for 3-4 weeks at altitude training camps (ATCs) at 2,320 m (3 ATCs) and 1,360 m (1 ATC). Performance was determined by analyzing 726 competitions according to the German point system. The variation of Hb-mass without hypoxic influence was 3.0 % (m) and 2.7 % (f). At altitude, Hb-mass increased by 7.2 ± 3.3 % (p altitude. In conclusion, the altitude (2,320 m) effect on Hb-mass is still present 3 weeks after return, it decisively depends on the health status, but is not influenced by sex. In healthy subjects it exceeds by far the oscillation occurring at sea level. After return from altitude performance increases after a delay of 3 weeks.

"Living high - training low" vs. "living high - training high": erythropoietic responses and performance of adolescent cross-country skiers.

Science.gov (United States)

Christoulas, K; Karamouzis, M; Mandroukas, K

2011-03-01

To determine and compare the erythropoietic response and exercise performance of adolescent cross-country skiers, as a result of "living high-training high" (HH) and "living high-training low" (HL). Nine female and six male adolescent cross-country skiers volunteered to participate in separate trials. In the first trial (HH), the skiers lived and trained for 21 days at 1550-2050 m, while in the second trial (HL) they trained near sea level (450-500 m) but resided at 1550 m. All participants underwent maximal cycle ergometer tests for the determination of VO2max and cardiorespiratory parameters via an open circuit system at sea level before ascent to altitude, and 1-2 days after descent from altitude. Blood samples were drawn prior to and immediately after maximal cycle exercise testing, at sea level prior to ascent, on days 1 (D1) and 21 (D21) at altitude (1740 m), and 1-2 days post-altitude, for the determination of serum erythropoietin (EPO) concentration, haemoglobin (Hb), hematocrit (Ht), and red blood cell (RBC) volume. The results showed that both boys and girls cross-country skiers, significantly improved their sea level VO2max after 21 days of living at moderate altitude and training near sea level. The present study demonstrates that living at moderate altitude, 1550-2050 m and training low, near sea level (450-500 m) significantly increases VO2max and RBC mass for both boys and girls. Results indicate that applying the training concept "living high - training low" in adolescent athletes may improve their endurance performance.

High altitude medicine education in China: exploring a new medical education reform.

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Luo, Yongjun; Luo, Rong; Li, Weiming; Huang, Jianjun; Zhou, Qiquan; Gao, Yuqi

2012-03-01

China has the largest plateau in the world, which includes the whole of Tibet, part of Qinghai, Xinjiang, Yunnan, and Sichuan. The plateau area is about 257.2×10(4) km(2), which accounts for about 26.8% of the total area of China. According to data collected in 2006, approximately twelve million people were living at high altitudes, between 2200 to 5200 m high, on the Qinghai-Tibetan Plateau. Therefore, there is a need for medical workers who are trained to treat individuals living at high altitudes. To train undergraduates in high altitude medicine, the College of High Altitude Military Medicine was set up at the Third Military Medical University (TMMU) in Chongqing in 1999. This is the only school to teach high altitude medicine in China. Students at TMMU study natural and social sciences, basic medical sciences, clinical medical sciences, and high altitude medicine. In their 5(th) year, students work as interns at the General Hospital of Tibet Military Command in Lhasa for 3 months, where they receive on-site teaching. The method of on-site teaching is an innovative approach for training in high altitude medicine for undergraduates. Three improvements were implemented during the on-site teaching component of the training program: (1) standardization of the learning progress; (2) integration of formal knowledge with clinical experience; and (3) coaching students to develop habits of inquiry and to engage in ongoing self-improvement to set the stage for lifelong learning. Since the establishment of the innovative training methods in 2001, six classes of high altitude medicine undergraduates, who received on-site teaching, have graduated and achieved encouraging results. This evidence shows that on-site teaching needs to be used more widely in high altitude medicine education.

Orthopaedic Resident Practice Management and Health Policy Education: Evaluation of Experience and Expectations.

Science.gov (United States)

Stautberg Iii, Eugene F; Romero, Jose; Bender, Sean; DeHart, Marc

2018-04-11

Introduction Practice management and health policy have generally not been considered integral to orthopaedic resident education. Our objective was to evaluate residents' current experience and knowledge, formal training, and desire for further education in practice management and health policy. Methods We developed a 29-question survey that was divided into three sections: practice management, initial employment opportunity, and health policy. Within each section, questions were directed at a resident's current experience and knowledge, formal training, and interest in further education. The survey was distributed at the end of the academic year through an Internet-based survey tool (www.surveymonkey.com) to orthopaedic residents representing multiple programs and all postgraduate years. Results The survey was distributed to 121 residents representing eight residency programs. Of those, 87 residents responded, resulting in a 72% response rate. All postgraduate years were represented. Regarding practice management, 66% had "no confidence" or "some confidence" in coding clinical encounters. When asked if practice models, finance management, and coding should be taught in residency, 95%, 93%, and 97% responded "yes," respectively. When evaluating first employment opportunities, the three most important factors were location, operating room block time, and call. Regarding health policy, 28% were "moderately familiar" or "very familiar" with the Physician Payments Sunshine Act, and 72% were "not familiar" or "somewhat familiar" with bundled payments for arthroplasty. Finally, when asked if yearly lectures in political activities would enhance resident education, 90% responded "yes." Discussion and conclusion Regarding practice management, the survey suggests that current orthopaedic residents are not familiar with basic topics, do not receive formal training, and want further education. The survey suggests that residents also receive minimal training in health policy

Transcriptome and network changes in climbers at extreme altitudes.

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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.

Cerebral venous system and anatomical predisposition to high-altitude headache

NARCIS (Netherlands)

Wilson, Mark H.; Davagnanam, Indran; Holland, Graeme; Dattani, Raj S.; Tamm, Alexander; Hirani, Shashivadan P.; Kolfschoten, Nicky; Strycharczuk, Lisa; Green, Cathy; Thornton, John S.; Wright, Alex; Edsell, Mark; Kitchen, Neil D.; Sharp, David J.; Ham, Timothy E.; Murray, Andrew; Holloway, Cameron J.; Clarke, Kieran; Grocott, Mike P. W.; Montgomery, Hugh; Imray, Chris; Ahuja, V.; Aref-Adib, G.; Burnham, R.; Chisholm, A.; Clarke, K.; Coates, D.; Coates, M.; Cook, D.; Cox, M.; Dhillon, S.; Dougall, C.; Doyle, P.; Duncan, P.; Edsell, M.; Edwards, L.; Evans, L.; Gardiner, P.; Grocott, M.; Gunning, P.; Hart, N.; Harrington, J.; Harvey, J.; Holloway, C.; Howard, D.; Hurlbut, D.; Imray, C.; Ince, C.; Jonas, M.; van der Kaaij, J.

2013-01-01

As inspired oxygen availability falls with ascent to altitude, some individuals develop high-altitude headache (HAH). We postulated that HAH results when hypoxia-associated increases in cerebral blood flow occur in the context of restricted venous drainage, and is worsened when cerebral compliance

Fatalities in high altitude mountaineering: a review of quantitative risk estimates.

Science.gov (United States)

Weinbruch, Stephan; Nordby, Karl-Christian

2013-12-01

Quantitative estimates for mortality in high altitude mountaineering are reviewed. Special emphasis is placed on the heterogeneity of the risk estimates and on confounding. Crude estimates for mortality are on the order of 1/1000 to 40/1000 persons above base camp, for both expedition members and high altitude porters. High altitude porters have mostly a lower risk than expedition members (risk ratio for all Nepalese peaks requiring an expedition permit: 0.73; 95 % confidence interval 0.59-0.89). The summit bid is generally the most dangerous part of an expedition for members, whereas most high altitude porters die during route preparation. On 8000 m peaks, the mortality during descent from summit varies between 4/1000 and 134/1000 summiteers (members plus porters). The risk estimates are confounded by human and environmental factors. Information on confounding by gender and age is contradictory and requires further work. There are indications for safety segregation of men and women, with women being more risk averse than men. Citizenship appears to be a significant confounder. Prior high altitude mountaineering experience in Nepal has no protective effect. Commercial expeditions in the Nepalese Himalayas have a lower mortality than traditional expeditions, though after controlling for confounding, the difference is not statistically significant. The overall mortality is increasing with increasing peak altitude for expedition members but not for high altitude porters. In the Nepalese Himalayas and in Alaska, a significant decrease of mortality with calendar year was observed. A few suggestions for further work are made at the end of the article.

High-altitude haematology: Quechua-Aymara comparisons.

Science.gov (United States)

Arnaud, J; Quilici, J C; Rivière, G

1981-01-01

Haematological studies have been carried out at various altitudes between 450 m and 4800 m, on two separate human groups (Quechuas and Aymaras) living in South America. Changes in the haematological parameters do not develop linearly in relation to the attitude. Th impact of chronic hypoxia on erythropoiesis is greater above 3000 m. The haemogram varies quantitatively and not qualitatively (mean corpuscular volume and mean haemoglobin concentration remain constant). The haematological study also reveals the greater adaptability to high altitude of the Aymaras, an adaptability characterized by an increase in red cell count and concentration and a decrease in red cell volume. The adaptative phenomena observed in the Quechuas are reversible, whereas they persist in the Aymaras when they migrate to the lowlands (450 m).

A unique, intuitive, creative, innovative, bold scientist in endless quest of the truth and a giant in high-altitude medicine: Prof. Dr. Gustavo Zubieta-Castillo, "The Parvatha Guru" (May 20, 1926-September 17, 2015

Directory of Open Access Journals (Sweden)

Gustavo Zubieta-Calleja

2016-01-01

Full Text Available Professor Gustavo Zubieta-Castillo - The Mountain Guru, Bolivian visionary, loved art and science. He was a word class pioneer and defender of life and medicine at high altitude. In 1964, after his observations of the perfused heart in dogs, he affirmed that the hearts of high-altitude residents are much more resistant to hypoxia than those at sea level. He clarified misconceptions about lung diseases at high altitude, which were improperly termed "loss of adaptation." His original and unique views on what was called chronic mountain sickness (CMS, a term he proposed be discarded and be rather expressed as polyerythrocythemia (as a more precise symptomatic description of multiple pathologies in the hypoxic environment of high altitude. He created the "triple hypoxia syndrome," an essential description to explain the momentary decrease of PaO 2 in polyerythrocythemic patients. His concepts of hypoxia gave rise to the formulation of the high-altitude adaptation formula. On his obituary, legendary respiratory physiologist Prof. John B. West stated, "He was a remarkable man and our discipline has lost a giant." Renowned Environmental scientist Prof. Thuppil Venkatesh, a long-time friend of Prof. Gustavo Sr., stated, "We lost one of the most valuable and precious personalities… a great loss to the world scientific community." Prof. Gustavo′s son Prof. Dr. Gustavo Zubieta Calleja is also a renowned pulmonologist like his legendary father and keeping his illustrious father′s legacy with pride and honor at his "High Altitude Pulmonary and Pathology Institute," La Paz, Bolivia.

Impact of Residency Training Redesign on Residents' Clinical Knowledge.

Science.gov (United States)

Waller, Elaine; Eiff, M Patrice; Dexter, Eve; Rinaldo, Jason C B; Marino, Miguel; Garvin, Roger; Douglass, Alan B; Phillips, Robert; Green, Larry A; Carney, Patricia A

2017-10-01

The In-training Examination (ITE) is a frequently used method to evaluate family medicine residents' clinical knowledge. We compared family medicine ITE scores among residents who trained in the 14 programs that participated in the Preparing the Personal Physician for Practice (P4) Project to national averages over time, and according to educational innovations. The ITE scores of 802 consenting P4 residents who trained in 2007 through 2011 were obtained from the American Board of Family Medicine. The primary analysis involved comparing scores within each academic year (2007 through 2011), according to program year (PGY) for P4 residents to all residents nationally. A secondary analysis compared ITE scores among residents in programs that experimented with length of training and compared scores among residents in programs that offered individualized education options with those that did not. Release of ITE scores was consented to by 95.5% of residents for this study. Scores of P4 residents were higher compared to national scores in each year. For example, in 2011, the mean P4 score for PGY1 was 401.2, compared to the national average of 386. For PGY2, the mean P4 score was 443.1, compared to the national average of 427, and for PGY3, the mean P4 score was 477.0, compared to the national PGY3 score of 456. Scores of residents in programs that experimented with length of training were similar to those in programs that did not. Scores were also similar between residents in programs with and without individualized education options. Family medicine residency programs undergoing substantial educational changes, including experiments in length of training and individualized education, did not appear to experience a negative effect on resident's clinical knowledge, as measured by ITE scores. Further research is needed to study the effect of a wide range of residency training innovations on ITE scores over time.

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

Altitude Performance Characteristics of Tail-pipe Burner with Variable-area Exhaust Nozzle

Science.gov (United States)

Jansen, Emmert T; Thorman, H Carl

1950-01-01

An investigation was conducted in the NACA Lewis altitude wind tunnel to determine effect of altitude and flight Mach number on performance of tail-pipe burner equipped with variable-area exhaust nozzle and installed on full-scale turbojet engine. At a given flight Mach number, with constant exhaust-gas and turbine-outlet temperatures, increasing altitude lowered the tail-pipe combustion efficiency and raised the specific fuel consumption while the augmented thrust ratio remained approximately constant. At a given altitude, increasing flight Mach number raised the combustion efficiency and augmented thrust ratio and lowered the specific fuel consumption.

An Analysis of Publication Productivity During Residency for 1506 Neurosurgical Residents and 117 Residency Departments in North America.

Science.gov (United States)

Khan, Nickalus R; Saad, Hassan; Oravec, Chesney S; Norrdahl, Sebastian P; Fraser, Brittany; Wallace, David; Lillard, Jock C; Motiwala, Mustafa; Nguyen, Vincent N; Lee, Siang Liao; Jones, Anna V; Ajmera, Sonia; Kalakoti, Piyush; Dave, Pooja; Moore, Kenneth A; Akinduro, Olutomi; Nyenwe, Emmanuel; Vaughn, Brandy; Michael, L Madison; Klimo, Paul

2018-05-30

Bibliometrics is defined as the study of statistical and mathematical methods used to quantitatively analyze scientific literature. The application of bibliometrics in neurosurgery continues to evolve. To calculate a number of publication productivity measures for almost all neurosurgical residents and departments within North America. These measures were correlated with survey results on the educational environment within residency programs. During May to June 2017, data were collected from departmental websites and Scopus to compose a bibliometric database of neurosurgical residents and residency programs. Data related to authorship value and study content were collected on all articles published by residents. A survey of residency program research and educational environment was administered to program directors and coordinators; results were compared with resident academic productivity. The median number of publications in residency was 3; median h-index and Resident index were 1 and 0.17 during residency, respectively. There was a statistically significant difference in academic productivity among male neurosurgical residents compared with females. The majority of articles published were tier 1 clinical articles. Residency program research support was significantly associated with increased resident productivity (P productivity. This study represents the most comprehensive bibliometric assessment of neurosurgical resident academic productivity during training to date. New benchmarks for individual and department academic productivity are provided. A supportive research environment for neurosurgical residents is associated with increased academic productivity, but a scholarly activity requirement was, surprisingly, not shown to have a positive effect.

Results of the 2004 Association of Residents in Radiation Oncology (ARRO) Survey

International Nuclear Information System (INIS)

Patel, Shilpen; Jagsi, Reshma; Wilson, John; Frank, Steven; Thakkar, Vipul V.; Hansen, Eric K.

2006-01-01

Purpose: The aim of this study was to document adequacy of training, career plans after residency, use of the in-service examination, and motivation for choice of radiation oncology as a specialty. Methods and Materials: In 2004, the Association of Residents in Radiation Oncology (ARRO) conducted a nationwide survey of all radiation oncology residents in the United States. Results: The survey was returned by 297 residents (response rate, 54%). Of the respondents, 29% were female and 71% male. The most popular career choice was joining an established private practice (38%), followed by a permanent academic career (29%). Residents for whom a permanent academic career was not their first choice were asked whether improvements in certain areas would have led them to be more likely to pursue an academic career. The most commonly chosen factors that would have had a strong or moderate influence included higher salary (81%), choice of geographic location (76%), faculty encouragement (68%), and less time commitment (68%). Of respondents in the first 3 years of training, 78% believed that they had received adequate training to proceed to the next level of training. Of those in their fourth year of training, 75% believed that they had received adequate training to enter practice. Conclusions: Multiple factors affect the educational environment of physicians in training. Data describing concerns unique to resident physicians in radiation oncology are limited. The current survey was designed to explore a variety of issues confronting radiation oncology residents. Training programs and the Residency Review Committee should consider these results when developing new policies to improve the educational experiences of residents in radiation oncology

Erythropoietin, 2,3 DPG, oxygen transport capacity, and altitude training in adolescent Alpine skiers.

Science.gov (United States)

Son, Hee Jeong; Kim, Hyo Jeong; Kim, Jin Hae; Ohno, Hideki; Kim, Chang Keun

2012-01-01

Rapid growth during adolescence caused by metabolic changes and their metabolic response to anaerobic and aerobic exercise differs considerably from that in adults and this is especially true in the responses to stresses, such as altitude exposure. However, there is little information on the suitability of exercise training at altitude for young athletes. Six male Korean adolescent alpine skiers (13-17 yr), with a skiing career of 3-5 yr, participated in the study. All subjects were exposed to an altitude of 2700 m (8858 ft) for 5 wk and altitude exposure consisted of 6 d/wk of training (4-5 h/d), with living quarters at 2100 m (-6890 ft) (Tignes, France). The 5 wk of ski training at altitude were maintained at the same level (the same number of slalom and giant slalom skiing trials) as at sea level. There was a significant increase in oxygen transport capacity, despite decreased erythropoietin (EPO) production (-31%) after altitude training. Red blood cell (RBC), hemoglobin (Hb), hematocrit (Hct), and 2,3 DPG concentrations increased significantly during altitude exposure and after return to sea level. Results indicate that applying altitude training in adolescent skiers may improve their endurance performance. However, EPO production during altitude training needs to be evaluated in larger future studies.

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

High Altitude Emissions of Black Carbon Aerosols: Potential Climate Implications

Science.gov (United States)

Satheesh, S. K.

2017-12-01

Synthesizing a series of ground-based and airborne measurements of aerosols over the Indian region during summer and pre-monsoon seasons have revealed the persistence of elevated absorbing aerosol layers over most of the Indian region; more than 50% of which located above clouds. Subsequent, in situ measurements of black carbon (BC) using high-altitude balloons, showed surprising layers with high concentrations in the middle and upper troposphere even at an altitude of 8 to 10 kms. Simultaneous measurements of the vertical thermal structure have shown localized warming due to BC absorption leading to large reduction in lapse rate and sharp temperature inversion, which in turn increases the atmospheric stability. This aerosol-induced stable layer is conducive for maintaining the black carbon layer longer at that level, leading thereby to further solar absorption and subsequently triggering dry convection. These observations support the `solar escalator' concept through which absorption-warming-convection cycles lead to self-lifting of BC to upper troposphere or even to lower stratosphere under favorable conditions in a matter of a few days. Employing an on-line regional chemistry transport model (WRF-Chem), incorporating aircraft emissions, it is shown that emissions from high-flying aircrafts as the most likely source of these elevated black carbon layers. These in-situ injected particles, produce significant warming of the thin air in those heights and lift these layers to even upper tropospheric/lower stratospheric heights, aided by the strong monsoonal convection occurring over the region, which are known to overshoot the tropical tropopause leading to injection of tropospheric air mass (along with its constituent aerosols) into the stratosphere, especially during monsoon season when the tropical tropopause layer is known to be thinnest. These simulations are further supported by the CALIPSO space-borne LIDAR derived extinction coefficient profiles. Based on

Effect of high altitude cosmic irradiation upon cell generation time

International Nuclear Information System (INIS)

Soleilhavoup, J.P.; Croute, F.; Tixador, R.; Blanquet, Y.; Planel, H.

1975-01-01

Paramecia cultures placed at 3800 meter altitude show a proliferating activity acceleration compared to control cultures placed at low altitude under the same environment conditions. These results confirm the cosmic irradiation influence upon the activating effect produced by the natural ionizing radiations on living organisms [fr

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.

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

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......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...

Incorporating resident research into the dermatology residency program

Science.gov (United States)

Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

2013-01-01

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 residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education. PMID:23901305

Incorporating resident research into the dermatology residency program.

Science.gov (United States)

Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

2013-01-01

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 residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education.

Altitude training for elite endurance athletes: A review for the travel medicine practitioner.

Science.gov (United States)

Flaherty, Gerard; O'Connor, Rory; Johnston, Niall

2016-01-01

High altitude training is regarded as an integral component of modern athletic preparation, especially for endurance sports such as middle and long distance running. It has rapidly achieved popularity among elite endurance athletes and their coaches. Increased hypoxic stress at altitude facilitates key physiological adaptations within the athlete, which in turn may lead to improvements in sea-level athletic performance. Despite much research in this area to date, the exact mechanisms which underlie such improvements remain to be fully elucidated. This review describes the current understanding of physiological adaptation to high altitude training and its implications for athletic performance. It also discusses the rationale and main effects of different training models currently employed to maximise performance. Athletes who travel to altitude for training purposes are at risk of suffering the detrimental effects of altitude. Altitude illness, weight loss, immune suppression and sleep disturbance may serve to limit athletic performance. This review provides an overview of potential problems which an athlete may experience at altitude, and offers specific training recommendations so that these detrimental effects are minimised. Copyright © 2016 Elsevier Ltd. All rights reserved.

County-level heat vulnerability of urban and rural residents in Tibet, China.

Science.gov (United States)

Bai, Li; Woodward, Alistair; Cirendunzhu; Liu, Qiyong

2016-01-12

Tibet is especially vulnerable to climate change due to the relatively rapid rise of temperature over past decades. The effects on mortality and morbidity of extreme heat in Tibet have been examined in previous studies; no heat adaptation initiatives have yet been implemented. We estimated heat vulnerability of urban and rural populations in 73 Tibetan counties and identified potential areas for public health intervention and further research. According to data availability and vulnerability factors identified previously in Tibet and elsewhere, we selected 10 variables related to advanced age, low income, illiteracy, physical and mental disability, small living spaces and living alone. We separately created and mapped county-level cumulative heat vulnerability indices for urban and rural residents by summing up factor scores produced by a principal components analysis (PCA). For both study populations, PCA yielded four factors with similar structure. The components for rural and urban residents explained 76.5 % and 77.7 % respectively of the variability in the original vulnerability variables. We found spatial variability of heat vulnerability across counties, with generally higher vulnerability in high-altitude counties. Although we observed similar median values and ranges of the cumulative heat vulnerability index values among urban and rural residents overall, the pattern varied strongly from one county to another. We have developed a measure of population vulnerability to high temperatures in Tibet. These are preliminary findings, but they may assist targeted adaptation plans in response to future rapid warming in Tibet.

Risk Stratification for Athletes and Adventurers in High-Altitude Environments: Recommendations for Preparticipation Evaluation.

Science.gov (United States)

Campbell, Aaron D; McIntosh, Scott E; Nyberg, Andy; Powell, Amy P; Schoene, Robert B; Hackett, Peter

2015-12-01

High-altitude athletes and adventurers face a number of environmental and medical risks. Clinicians often advise participants or guiding agencies before or during these experiences. Preparticipation evaluation (PPE) has the potential to reduce risk of high-altitude illnesses in athletes and adventurers. Specific conditions susceptible to high-altitude exacerbation also important to evaluate include cardiovascular and lung diseases. Recommendations by which to counsel individuals before participation in altitude sports and adventures are few and of limited focus. We reviewed the literature, collected expert opinion, and augmented principles of a traditional sport PPE to accommodate the high-altitude wilderness athlete/adventurer. We present our findings with specific recommendations on risk stratification during a PPE for the high-altitude athlete/adventurer. Copyright © 2015. Published by Elsevier Inc.

Discrepancies in Cornell Scale for Depression in Dementia (CSDD items between residents and caregivers, and the CSDD's factor structure

Directory of Open Access Journals (Sweden)

Wongpakaran N

2013-06-01

Full Text Available Nahathai Wongpakaran,1 Tinakon Wongpakaran,1 Robert van Reekum2,3 1Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand; 2Department of Psychiatry, 3Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada Purpose: This validation study aims to examine Cornell Scale for Depression in Dementia (CSDD items in terms of the agreement found between residents and caregivers, and also to compare alternative models of the Thai version of the CSDD. Patients and methods: A cross-sectional study was conducted of 84 elderly residents (46 women, 38 men, age range 60–94 years in a long-term residential home setting in Thailand between March and June 2011. The selected residents went through a comprehensive geriatric assessment that included use of the Mini-Mental State Examination, Mini-International Neuropsychiatric Interview, and CSDD instruments. Intraclass correlation (ICC was calculated in order to establish the level of agreement between the residents and caregivers, in light of the residents' cognitive status. Confirmatory factor analysis (CFA was adopted to evaluate the alternative CSDD models. Results: The CSDD yielded a high internal consistency (Cronbach's alpha = 0.87 and moderate agreement between residents and caregivers (ICC = 0.55; however, it was stronger in cognitively impaired subjects (ICC = 0.71. CFA revealed that there was no difference between the four-factor model, in which factors A (mood-related signs and E (ideational disturbance were collapsed into a single factor, and the five-factor model as per the original theoretical construct. Both models were found to be similar, and displayed a poor fit. Conclusion: The CSDD demonstrated a moderate level of interrater agreement between residents and caregivers, and was more reliable when used with cognitively impaired residents. CFA indicated a poorly fitting model in this sample. Keywords: Cornell Scale for Depression in Dementia (CSDD, factor structure

Space environment monitoring by low-altitude operational satellites

International Nuclear Information System (INIS)

Kroehl, H.W.

1982-01-01

The primary task of the Defense Meteorological Satellite Program (DMSP) is the acquisition of meteorological data in the visual and infrared spectral regions. The Air Weather Service operates two satellites in low-altitude, sun-synchronous, polar orbits at 850 km altitude, 98.7 deg inclination, 101.5 minute period and dawn-dusk or noon-midnight equatorial crossing times. Special DMSP sensors of interest to the space science community are the precipitating electron spectrometer, the terrestrial noise receiver, and the topside ionosphere plasma monitor. Data from low-altitude, meteorological satellites can be used to build empirical models of precipitating electron characteristics of the auroral zone and polar cap. The Tiros-NOAA satellite program complements the DMSP program. The orbital elements are the same as DMSP's, except for the times of equatorial crossing, and the tilt of the orbital plane. The Tiros-NOAA program meets the civilian community's needs for meteorological data as the DMSP program does for the military

Reduced oxygen at high altitude limits maximum size.

Science.gov (United States)

Peck, L S; Chapelle, G

2003-11-07

The trend towards large size in marine animals with latitude, and the existence of giant marine species in polar regions have long been recognized, but remained enigmatic until a recent study showed it to be an effect of increased oxygen availability in sea water of a low temperature. The effect was apparent in data from 12 sites worldwide because of variations in water oxygen content controlled by differences in temperature and salinity. Another major physical factor affecting oxygen content in aquatic environments is reduced pressure at high altitude. Suitable data from high-altitude sites are very scarce. However, an exceptionally rich crustacean collection, which remains largely undescribed, was obtained by the British 1937 expedition from Lake Titicaca on the border between Peru and Bolivia in the Andes at an altitude of 3809 m. We show that in Lake Titicaca the maximum length of amphipods is 2-4 times smaller than other low-salinity sites (Caspian Sea and Lake Baikal).

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.

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

Tropical temperature altitude amplification in the hiatus period (1998-2012

Directory of Open Access Journals (Sweden)

Ducić Vladan D.

2015-01-01

Full Text Available In the period 1998-2012 there was a stagnation in temperature rise, despite the GHGs radiation forcing is increased (hiatus period. According to Global Circulation Models simulations, expected response on the rise of GHGs forcing is tropical temperature altitude amplification - temperature increases faster in higher troposphere than in lower troposphere. In this paper, two satellite data sets, UAH MSU and RSS, were used to test altitude temperature amplification in tropic (20°N-20°S in the hiatus period. We compared data from satellite data sets from lower troposphere (TLT and middle troposphere (TMT in general and particularly for land and ocean (for UAH MSU. The results from both satellite measurements showed the presence of hiatus, i.e. slowdown of the temperature rise in the period 1998-2012 compared to period 1979-2012 (UAH MSU and temperature fall for RSS data. Smaller increase, i.e. temperature fall over ocean showed that hiatus is an ocean phenomenon above all. Data for UAH MSU showed that temperature altitude amplification in tropic was not present either for period 1979-2012, or 1998-2012. RSS data set also do not show temperature altitude amplification either for longer (1979-2012, or for shorter period (1998-2012. RSS data for successive 15-year periods from 1979-1993 till 1998-2012 does not show tropical temperature altitude amplification and in one case negative trend is registered in TLT and in two cases in TMT. In general, our results do not show presence of temperature altitude amplification in tropic in the hiatus period. [Projekat Ministarstva nauke Republike Srbije, br. III47007

Nutritional Strategies for the Preservation of Fat Free Mass at High Altitude

Directory of Open Access Journals (Sweden)

Stacie L. Wing-Gaia

2014-02-01

Full Text Available Exposure to extreme altitude presents many physiological challenges. In addition to impaired physical and cognitive function, energy imbalance invariably occurs resulting in weight loss and body composition changes. Weight loss, and in particular, loss of fat free mass, combined with the inherent risks associated with extreme environments presents potential performance, safety, and health risks for those working, recreating, or conducting military operations at extreme altitude. In this review, contributors to muscle wasting at altitude are highlighted with special emphasis on protein turnover. The article will conclude with nutritional strategies that may potentially attenuate loss of fat free mass during high altitude exposure.

Women at Altitude: Effects of Menstrual Cycle Phase and Alpha-Adrenergic Blockade on High Altitude Acclimatization

National Research Council Canada - National Science Library

Moore, Lorna

1998-01-01

.... Results indicated that the effects of the menstrual cycle were modest. In year 2, we evaluated the safety and efficacy of administering an a-adrenergic blocker and made selected observations during a brief exposure to an altitude of 4300 m...

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...

Length of Residence and Vehicle Ownership in Relation to Physical Activity Among U.S. Immigrants.

Science.gov (United States)

Terasaki, Dale; Ornelas, India; Saelens, Brian

2017-04-01

Physical activity among U.S. immigrants over time is not well understood. Transportation may affect this trajectory. Using a survey of documented immigrants (N = 7240), we performed simple, then multivariable logistic regression to calculate ORs and 95 % CIs between length of residence (LOR) and both light-to-moderate (LPA) and vigorous (VPA) activity. We adjusted for demographic variables, then vehicle ownership to assess changes in ORs. Compared to new arrivals, all four LOR time-intervals were associated with lower odds of LPA and higher odds of VPA in simple analysis. All ORs for LPA remained significant after including demographics, but only one remained significant after adding vehicle ownership. Two ORs for VPA remained significant after including demographics and after adding vehicle ownership. Immigrants lower their light-to-moderate activity the longer they reside in the U.S., partly from substituting driving for walking. Efforts to maintain walking for transportation among immigrants are warranted.

Remediation in the Context of the Competencies: A Survey of Pediatrics Residency Program Directors

Science.gov (United States)

Riebschleger, Meredith P.; Haftel, Hilary M.

2013-01-01

Background The 6 competencies defined by the Accreditation Council for Graduate Medical Education provide the framework of assessment for trainees in the US graduate medical education system, but few studies have investigated their impact on remediation. Methods We obtained data via an anonymous online survey of pediatrics residency program directors. For the purposes of the survey, remediation was defined as “any form of additional training, supervision, or assistance above that required for a typical resident.” Respondents were asked to quantify 3 groups of residents: (1) residents requiring remediation; (2) residents whose training was extended for remediation purposes; and (3) residents whose training was terminated owing to issues related to remediation. For each group, the proportion of residents with deficiencies in each of the 6 competencies was calculated. Results In all 3 groups, deficiencies in medical knowledge and patient care were most common; deficiencies in professionalism and communication were moderately common; and deficiencies in systems-based practice and practice-based learning and improvement were least common. Residents whose training was terminated were more likely to have deficiencies in multiple competencies. Conclusion Although medical knowledge and patient care are reported most frequently, deficiencies in any of the 6 competencies can lead to the need for remediation in pediatrics residents. Residents who are terminated are more likely to have deficits in multiple competencies. It will be critical to develop and refine tools to measure achievement in all 6 competencies as the graduate medical education community may be moving further toward individualized training schedules and competency-based, rather than time-based, training. PMID:24404228

Temporal and spatial changes in Western Himalayan firn line altitudes from 1998 to 2009

Science.gov (United States)

Guo, Zhongming; Wang, Ninglian; Kehrwald, Natalie M.; Mao, Ruijuan; Wu, Hongbo; Wu, Yuwei; Jiang, Xi

2014-07-01

Understanding changes in glacier mass balance is important because it is indicative of changes in climate and the hydrologic cycle. The latter also has particular influence on people living near glaciers and/or glacier-fed rivers. The Western Himalayas remain one of the regions where recent changes in glacier mass balance are not well-known. The temporal and spatial changes in firn line altitudes are an indicator of equilibrium line altitudes and thus reflect changes in glacier mass balance. Here, we use Himalayan Landsat TM/ETM + data in July and August (the late summer melt season) to quantify changes in firn line altitudes from 1998 to 2009. We produced reflectance maps through radiometric calibration and atmospheric correction and use topographic correction to remove or reduce terrain or shadow effects. The real ‘surface albedo’ is obtained by narrowband-to-broadband (NTB) albedo conversion from the combined solar radiation. The firn line altitude was then extracted by combining the ‘surface albedo’ with pre-registered digital elevation model. The individual firn line altitude varies by region. The Western Himalayas display the largest range of firn line variability, where the firn line altitudes vary from 4840 m a.s.l. to 5770 m a.s.l. The individual glacier mean firn line altitude from 1998 to 2009 rose from 5072 ± 77 m a.s.l. to 5640 ± 74 m a.s.l. in the Western Himalayas. The mean firn line altitude increased from 1998 to 2009. The lowest mean recorded firn line altitude recorded was 5237 ± 166 m a.s.l. in 1998, whereas the highest was 5397 ± 135 m a.s.l. in 2000. We also observed a difference between the changes in fine line altitudes of northern and southern slopes of the western Himalayans, as the northern slope glaciers display a greater increase in firn line altitudes than the southern slope glaciers. In the southern slope, changes in firn line altitudes correlate with NCDC-NOAA temperature and precipitation data. This sustained increase of

A virtual reality endoscopic simulator augments general surgery resident cancer education as measured by performance improvement.

Science.gov (United States)

White, Ian; Buchberg, Brian; Tsikitis, V Liana; Herzig, Daniel O; Vetto, John T; Lu, Kim C

2014-06-01

Colorectal cancer is the second most common cause of death in the USA. The need for screening colonoscopies, and thus adequately trained endoscopists, particularly in rural areas, is on the rise. Recent increases in required endoscopic cases for surgical resident graduation by the Surgery Residency Review Committee (RRC) further emphasize the need for more effective endoscopic training during residency to determine if a virtual reality colonoscopy simulator enhances surgical resident endoscopic education by detecting improvement in colonoscopy skills before and after 6 weeks of formal clinical endoscopic training. We conducted a retrospective review of prospectively collected surgery resident data on an endoscopy simulator. Residents performed four different clinical scenarios on the endoscopic simulator before and after a 6-week endoscopic training course. Data were collected over a 5-year period from 94 different residents performing a total of 795 colonoscopic simulation scenarios. Main outcome measures included time to cecal intubation, "red out" time, and severity of simulated patient discomfort (mild, moderate, severe, extreme) during colonoscopy scenarios. Average time to intubation of the cecum was 6.8 min for those residents who had not undergone endoscopic training versus 4.4 min for those who had undergone endoscopic training (p Virtual reality endoscopic simulation is an effective tool for both augmenting surgical resident endoscopy cancer education and measuring improvement in resident performance after formal clinical endoscopic training.

[Relationship between baroreflex function and training effects on altitude training].

Science.gov (United States)

Yanagida, Ryo; Ogawa, Yojiro; Mizuochi, Fumio; Suzuki, Tsukasa; Takahashi, Masanori; Iwasaki, Kenichi

2012-05-01

Altitude training is frequently used for athletes requiring competitive endurance in an attempt to improve their sea-level performance. However, there has been no study in which the mechanisms by which spontaneous arterial-cardiac baroreflex function changes was examined in responders or nonresponders of altitude training. The purpose of this study was to clarify the different effects of altitude training on baroreflex function between responders and nonresponders. Twelve university student cross-country skiers (6 men, 6 women; age, 19±1 years) participated in the altitude training in a camp for 3 weeks, which was carried out in accordance with the method of Living High-Training Low. Baroreflex function was estimated by transfer function analysis before and after the training. The responders of the training were 3 men and 2 women, and the nonresponders were 3 men and 4 women. In the responders, the transfer function gain in the high-frequency range significantly increased after the training (28.9→46.5 ms/mmHg p=0.021). On the other hand, no significant change in this index was observed in the nonresponders (25.9→21.2 ms/mmHg p=0.405). As indicated by the results of transfer function gain in the high-frequency range, the baroreflex function in the responders increased significantly after the altitude training, whereas no significant change was observed in the nonresponders.

The performance of Dräger Oxylog ventilators at simulated altitude.

Science.gov (United States)

Flynn, J G; Singh, B

2008-07-01

Ventilated patients frequently require transport by air in a hypobaric environment. Previous studies have demonstrated significant changes in the performance of ventilators with changes in cabin pressure (altitude) but no studies have been published on the function of modem ventilators at altitude. This experiment set out to evaluate ventilatory parameters (tidal volume and respiratory rate) of three commonly used transport ventilators (the Dräger Oxylog 1000, 2000 and 3000) in a simulated hypobaric environment. Ventilators were assessed using either air-mix (60% oxygen) or 100% oxygen and tested against models simulating a normal lung, a low compliance (Acute Respiratory Distress Syndrome) lung and a high-resistance (asthma) lung. Ventilators were tested at a range of simulated altitudes between sea level and 3048 m. Over this range, tidal volume delivered by the Oxylog 1000 increased by 68% and respiratory rate decreased by 28%. Tidal volume delivered by the Oxylog 2000 ventilator increased by 29% over the same range of altitudes but there was no significant change in respiratory rate. Tidal volume and respiratory rate remained constant with the Oxylog 3000 over the same range of altitudes. Changes were consistent with each ventilator regardless of oxygen content or lung model. It is important that clinicians involved in critical care transport in a hypobaric environment are aware that individual ventilators perform differently at altitude and that they are aware of the characteristics of the particular ventilator that they are using.

No Change in Running Mechanics With Live High-Train Low Altitude Training in Elite Distance Runners.

Science.gov (United States)

Stickford, Abigail S L; Wilhite, Daniel P; Chapman, Robert F

2017-01-01

Investigations into ventilatory, metabolic, and hematological changes with altitude training have been completed; however, there is a lack of research exploring potential gait-kinematic changes after altitude training, despite a common complaint of athletes being a lack of leg "turnover" on return from altitude training. To determine if select kinematic variables changed in a group of elite distance runners after 4 wk of altitude training. Six elite male distance runners completed a 28-d altitude-training intervention in Flagstaff, AZ (2150 m), following a modified "live high-train low" model, wherein higherintensity runs were performed at lower altitudes (945-1150 m) and low-intensity sessions were completed at higher altitudes (1950-2850 m). Gait parameters were measured 2-9 d before departure to altitude and 1 to 2 d after returning to sea level at running speeds of 300-360 m/min. No differences were found in ground-contact time, swing time, or stride length or frequency after altitude training (P > .05). Running mechanics are not affected by chronic altitude training in elite distance runners. The data suggest that either chronic training at altitude truly has no effect on running mechanics or completing the live high-train low model of altitude training, where higher-velocity workouts are completed at lower elevations, mitigates any negative mechanical adaptations that may be associated with chronic training at slower speeds.

Air to muscle O2 delivery during exercise at altitude

DEFF Research Database (Denmark)

Calbet, J.A.; Lundby, C.

2009-01-01

, diffusion limitation explains most of the additional Pao2-Pao2. With altitude, acclimatization exercise (Pao2-Pao2) is reduced, but does not reach the low values observed in high altitude natives, who possess an exceptionally high DLo2. Convective O2 transport depends on arterial O2 content (Cao2), cardiac...

Effects of Intermittent Altitude Exposures on Acclimatization of 4,300 M

National Research Council Canada - National Science Library

Beidleman, Beth

2001-01-01

This study examined the effects of 3 wk of intermittent exposures (4 h/d, 5 d/wk) to 4,300 m altitude-equivalent, in combination with either passive sitting or exercise training, on the process of altitude acclimatization...

Air Quality Standards for Particulate Matter (PM) at high altitude cities

International Nuclear Information System (INIS)

Bravo Alvarez, H.; Sosa Echeverria, R.; Sanchez Alvarez, P.; Krupa, S.

2013-01-01

The Air Quality Standards for Particulate Matter (PM) at high altitude urban areas in different countries, must consider the pressure and temperature due to the effect that these parameters have on the breath volume. This paper shows the importance to correct Air Quality Standards for PM considering pressure and temperature at different altitudes. Specific factors were suggested to convert the information concerning PM, from local to standard conditions, and adjust the Air Quality Standards for different high altitudes cities. The correction factors ranged from: 1.03 for Santiago de Chile to 1.47 for El Alto Bolivia. Other cities in this study include: Mexico City, México; La Paz, Bolivia; Bogota, Cali and Medellin, Colombia; Quito, Ecuador and Cuzco, Peru. If these corrections are not considered, the atmospheric concentrations will be underestimated. - Highlights: ► AQS for particulate matter concentrations adjusted by pressure and temperature. ► Particulate matter concentrations can be underestimated in high altitude Cities. ► Particulate matter concentrations must be compared under the same conditions. - In order to compare high altitude atmospheric PM concentrations with AQS, one must consider T and P of the sampling site.

Design study for remotely piloted, high-altitude airplanes powered by microwave energy

Science.gov (United States)

Morris, C. E. K., Jr.

1983-01-01

A design study has been conducted for unmanned, microwave-powered airplanes that must fly with long endurance at high altitude. They are proposed to conduct communications-relay, observation, or various scientific missions above approximately 55,000 feet altitude. The special characteristics of the microwave-power system and high-altitude, low-speed vehicle are reviewed. Examples of both sizing and performance analysis are used to suggest design procedure guidelines.

Nasal variation in relation to high-altitude adaptations among Tibetans and Andeans.

Science.gov (United States)

Butaric, Lauren N; Klocke, Ross P

2018-05-01

High-altitude (>2500 m) populations face several pressures, including hypoxia and cold-dry air, resulting in greater respiratory demand to obtain more oxygen and condition inspired air. While cardiovascular and pulmonary adaptations to high-altitude hypoxia have been extensively studied, adaptations of upper-respiratory structures, e.g., nasal cavity, remain untested. This study investigates whether nasal morphology presents adaptations to hypoxic (larger noses) and/or cold-dry (tall/narrow noses) conditions among high-altitude samples. CT scans of two high- and four low-altitude samples from diverse climates were collected (n = 130): high-altitude Tibetans and Peruvians; low-altitude Peruvians, Southern Chinese (temperate), Mongolian-Buriats (cold-dry), and Southeast Asians (hot-wet). Facial and nasal distances were calculated from 3D landmarks placed on digitally-modeled crania. Temperature, precipitation, and barometric pressure data were also obtained. Principal components analysis and analyses of variance primarily indicate size-related differences among the cold-dry (Mongolian-Buriats) and hot-wet (Southeast Asians) adapted groups. Two-block partial least squares (PLS) analysis show weak relationships between size-standardized nasal dimensions and environmental variables. However, among PLS1 (85.90% of covariance), Tibetans display relatively larger nasal cavities related to lower temperatures and barometric pressure; regression analyses also indicate high-altitude Tibetans possess relatively larger internal nasal breadths and heights for their facial size. Overall, nasal differences relate to climate among the cold-dry and hot-wet groups. Specific nasal adaptations were not identified among either Peruvian group, perhaps due to their relatively recent migration history and population structure. However, high-altitude Tibetans seem to exhibit a compromise in nasal morphology, serving in increased oxygen uptake, and air-conditioning processes. © 2018

Hyperbaric oxygen therapy ameliorates acute brain injury after porcine intracerebral hemorrhage at high altitude.

Science.gov (United States)

Zhu, Hai-tao; Bian, Chen; Yuan, Ji-chao; Liao, Xiao-jun; Liu, Wei; Zhu, Gang; Feng, Hua; Lin, Jiang-kai

2015-06-15

Intracerebral hemorrhage (ICH) at high altitude is not well understood to date. This study investigates the effects of high altitude on ICH, and examines the acute neuroprotection of hyperbaric oxygen (HBO) therapy against high-altitude ICH. Minipigs were placed in a hypobaric chamber for 72 h before the operation. ICH was induced by an infusion of autologous arterial blood (3 ml) into the right basal ganglia. Animals in the high-altitude ICH group received HBO therapy (2.5 ATA for 60 min) 30 min after ICH. Blood gas, blood glucose and brain tissue oxygen partial pressure (PbtO2) were monitored continuously for animals from all groups, as were microdialysis products including glucose, lactate, pyruvate and glutamate in perihematomal tissue from 3 to 12 h post-ICH. High-altitude ICH animals showed significantly lower PbtO2, higher lactate/pyruvate ratio (LPR) and glutamate levels than low-altitude ICH animals. More severe neurological deficits, brain edema and neuronal damage were also observed in high-altitude ICH. After HBO therapy, PbtO2 was significantly increased and LPR and glutamate levels were significantly decreased. Brain edema, neurological deficits and neuronal damage were also ameliorated. The data suggested a more serious disturbance of tissue oxygenation and cerebral metabolism in the acute stage after ICH at high altitude. Early HBO treatment reduced acute brain injury, perhaps through a mechanism involving the amelioration of the derangement of cerebral oxygenation and metabolism following high-altitude ICH.

Depression recognition and capacity for self-report among ethnically diverse nursing homes residents: Evidence of disparities in screening.

Science.gov (United States)

Chun, Audrey; Reinhardt, Joann P; Ramirez, Mildred; Ellis, Julie M; Silver, Stephanie; Burack, Orah; Eimicke, Joseph P; Cimarolli, Verena; Teresi, Jeanne A

2017-12-01

To examine agreement between Minimum Data Set clinician ratings and researcher assessments of depression among ethnically diverse nursing home residents using the 9-item Patient Health Questionnaire. Although depression is common among nursing homes residents, its recognition remains a challenge. Observational baseline data from a longitudinal intervention study. Sample of 155 residents from 12 long-term care units in one US facility; 50 were interviewed in Spanish. Convergence between clinician and researcher ratings was examined for (i) self-report capacity, (ii) suicidal ideation, (iii) at least moderate depression, (iv) Patient Health Questionnaire severity scores. Experiences by clinical raters using the depression assessment were analysed. The intraclass correlation coefficient was used to examine concordance and Cohen's kappa to examine agreement between clinicians and researchers. Moderate agreement (κ = 0.52) was observed in determination of capacity and poor to fair agreement in reporting suicidal ideation (κ = 0.10-0.37) across time intervals. Poor agreement was observed in classification of at least moderate depression (κ = -0.02 to 0.24), lower than the maximum kappa obtainable (0.58-0.85). Eight assessors indicated problems assessing Spanish-speaking residents. Among Spanish speakers, researchers identified 16% with Patient Health Questionnaire scores of 10 or greater, and 14% with thoughts of self-harm whilst clinicians identified 6% and 0%, respectively. This study advances the field of depression recognition in long-term care by identification of possible challenges in assessing Spanish speakers. Use of the Patient Health Questionnaire requires further investigation, particularly among non-English speakers. Depression screening for ethnically diverse nursing home residents is required, as underreporting of depression and suicidal ideation among Spanish speakers may result in lack of depression recognition and referral for evaluation and

Low-resolution ship detection from high-altitude aerial images

Science.gov (United States)

Qi, Shengxiang; Wu, Jianmin; Zhou, Qing; Kang, Minyang

2018-02-01

Ship detection from optical images taken by high-altitude aircrafts such as unmanned long-endurance airships and unmanned aerial vehicles has broad applications in marine fishery management, ship monitoring and vessel salvage. However, the major challenge is the limited capability of information processing on unmanned high-altitude platforms. Furthermore, in order to guarantee the wide detection range, unmanned aircrafts generally cruise at high altitudes, resulting in imagery with low-resolution targets and strong clutters suffered by heavy clouds. In this paper, we propose a low-resolution ship detection method to extract ships from these high-altitude optical images. Inspired by a recent research on visual saliency detection indicating that small salient signals could be well detected by a gradient enhancement operation combined with Gaussian smoothing, we propose the facet kernel filtering to rapidly suppress cluttered backgrounds and delineate candidate target regions from the sea surface. Then, the principal component analysis (PCA) is used to compute the orientation of the target axis, followed by a simplified histogram of oriented gradient (HOG) descriptor to characterize the ship shape property. Finally, support vector machine (SVM) is applied to discriminate real targets and false alarms. Experimental results show that the proposed method actually has high efficiency in low-resolution ship detection.

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

Interactions of carbon monoxide and hemoglobin at high altitude

Energy Technology Data Exchange (ETDEWEB)

Collier, C.R. (Univ. of Southern California Medical Center, Los Angeles); Goldsmith, J.R.

1983-01-01

The health risks to U.S. populations who are exposed to ambient carbon monoxide and live at altitudes (such as Denver, Salt Lake City, and Albuquerque) were evaluated using a set of mathematical models. The assumption that a given increase in carboxyhemoglobin would require a more stringent volumetric air quality standard was tested. The results using the model predict that the 8-h or 1-h standards adopted for sea level condition need not be altered to protect individuals against health risks at altitude, if the standards are in volumetric terms. They would need to be reduced if the standards are left in gravimetric terms. If the guideline is to be based on a given decrement of oxygen tension, many other variables must be specified, but expected differences in ambient carbon monoxide have a small impact compared to the effect of altitude itself.

Effects of repetitive training at low altitude on erythropoiesis in 400 and 800 m runners.

Science.gov (United States)

Frese, F; Friedmann-Bette, B

2010-06-01

Classical altitude training can cause an increase in total hemoglobin mass (THM) if a minimum "dose of hypoxia" is reached (altitude >or=2,000 m, >or=3 weeks). We wanted to find out if repetitive exposure to mild hypoxia during living and training at low altitude (training camps at low altitude interspersed by 3 weeks of sea-level training and at the same time points in a control group (CG) of 5 well-trained runners. EPO, sTfR and ferritin were also repeatedly measured during the altitude training camps. Repeated measures ANOVA revealed significant increases in EPO- and sTfR-levels during both training camps and a significant decrease in ferritin indicating enhanced erythropoietic stimulation during living and training at low altitude. Furthermore, significant augmentation of THM by 5.1% occurred in the course of the 2 altitude training camps. In conclusion, repetitive living and training at low altitude leads to a hypoxia-induced increase in erythropoietic stimulation in elite 400 m and 800 m runners and, apparently, might also cause a consecutive augmentation of THM.

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. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Observation of a 27-day solar signature in noctilucent cloud altitude

Science.gov (United States)

Köhnke, Merlin C.; von Savigny, Christian; Robert, Charles E.

2018-05-01

Previous studies have identified solar 27-day signatures in several parameters in the Mesosphere/Lower thermosphere region, including temperature and Noctilucent cloud (NLC) occurrence frequency. In this study we report on a solar 27-day signature in NLC altitude with peak-to-peak variations of about 400 m. We use SCIAMACHY limb-scatter observations from 2002 to 2012 to detect NLCs. The superposed epoch analysis method is applied to extract solar 27-day signatures. A 27-day signature in NLC altitude can be identified in both hemispheres in the SCIAMACHY dataset, but the signature is more pronounced in the northern hemisphere. The solar signature in NLC altitude is found to be in phase with solar activity and temperature for latitudes ≳ 70 ° N. We provide a qualitative explanation for the positive correlation between solar activity and NLC altitude based on published model simulations.

Defining the "dose" of altitude training: how high to live for optimal sea level performance enhancement.

Science.gov (United States)

Chapman, Robert F; Karlsen, Trine; Resaland, Geir K; Ge, R-L; Harber, Matthew P; Witkowski, Sarah; Stray-Gundersen, James; Levine, Benjamin D

2014-03-15

Chronic living at altitudes of ∼2,500 m causes consistent hematological acclimatization in most, but not all, groups of athletes; however, responses of erythropoietin (EPO) and red cell mass to a given altitude show substantial individual variability. We hypothesized that athletes living at higher altitudes would experience greater improvements in sea level performance, secondary to greater hematological acclimatization, compared with athletes living at lower altitudes. After 4 wk of group sea level training and testing, 48 collegiate distance runners (32 men, 16 women) were randomly assigned to one of four living altitudes (1,780, 2,085, 2,454, or 2,800 m). All athletes trained together daily at a common altitude from 1,250-3,000 m following a modified live high-train low model. Subjects completed hematological, metabolic, and performance measures at sea level, before and after altitude training; EPO was assessed at various time points while at altitude. On return from altitude, 3,000-m time trial performance was significantly improved in groups living at the middle two altitudes (2,085 and 2,454 m), but not in groups living at 1,780 and 2,800 m. EPO was significantly higher in all groups at 24 and 48 h, but returned to sea level baseline after 72 h in the 1,780-m group. Erythrocyte volume was significantly higher within all groups after return from altitude and was not different between groups. These data suggest that, when completing a 4-wk altitude camp following the live high-train low model, there is a target altitude between 2,000 and 2,500 m that produces an optimal acclimatization response for sea level performance.

Use of social media by residency program directors for resident selection.

Science.gov (United States)

Cain, Jeff; Scott, Doneka R; Smith, Kelly

2010-10-01

Pharmacy residency program directors' attitudes and opinions regarding the use of social media in residency recruitment and selection were studied. A 24-item questionnaire was developed, pilot tested, revised, and sent to 996 residency program directors via SurveyMonkey.com. Demographic, social media usage, and opinions on social media data were collected and analyzed. A total of 454 residency program directors completed the study (response rate, 46.4%). The majority of respondents were women (58.8%), were members of Generation X (75.4%), and worked in a hospital or health system (80%). Most respondents (73%) rated themselves as either nonusers or novice users of social media. Twenty percent indicated that they had viewed a pharmacy residency applicant's social media information. More than half (52%) had encountered e-professionalism issues, including questionable photos and posts revealing unprofessional attitudes, and 89% strongly agreed or agreed that information voluntarily published online was fair game for judgments on character, attitudes, and professionalism. Only 4% of respondents had reviewed applicants' profiles for residency selection decisions. Of those respondents, 52% indicated that the content had no effect on resident selection. Over half of residency program directors were unsure whether they will use social media information for future residency selection decisions. Residency program directors from different generations had different views regarding social media information and its use in residency applicant selections. Residency program directors anticipated using social media information to aid in future decisions for resident selection and hiring.

A method for sampling microbial aerosols using high altitude balloons.

Science.gov (United States)

Bryan, N C; Stewart, M; Granger, D; Guzik, T G; Christner, B C

2014-12-01

Owing to the challenges posed to microbial aerosol sampling at high altitudes, very little is known about the abundance, diversity, and extent of microbial taxa in the Earth-atmosphere system. To directly address this knowledge gap, we designed, constructed, and tested a system that passively samples aerosols during ascent through the atmosphere while tethered to a helium-filled latex sounding balloon. The sampling payload is ~ 2.7 kg and comprised of an electronics box and three sampling chambers (one serving as a procedural control). Each chamber is sealed with retractable doors that can be commanded to open and close at designated altitudes. The payload is deployed together with radio beacons that transmit GPS coordinates (latitude, longitude and altitude) in real time for tracking and recovery. A cut mechanism separates the payload string from the balloon at any desired altitude, returning all equipment safely to the ground on a parachute. When the chambers are opened, aerosol sampling is performed using the Rotorod® collection method (40 rods per chamber), with each rod passing through 0.035 m3 per km of altitude sampled. Based on quality control measurements, the collection of ~ 100 cells rod(-1) provided a 3-sigma confidence level of detection. The payload system described can be mated with any type of balloon platform and provides a tool for characterizing the vertical distribution of microorganisms in the troposphere and stratosphere. Copyright © 2014 Elsevier B.V. All rights reserved.

A 45-year-old man with excessive daytime somnolence, and witnessed apnea at altitude

Directory of Open Access Journals (Sweden)

Welsh CH

2011-04-01

Full Text Available A sleepy man without sleep apnea at 1609m (5280 feet had disturbed sleep at his home altitude of 3200m (10500 feet. In addition to common disruptors of sleep such as psychophysiologic insomnia, restless leg syndrome, alcohol and excessive caffeine use, central sleep apnea with periodic breathing can be a significant cause of disturbed sleep at altitude. In symptomatic patients living at altitude, a sleep study at their home altitude should be considered to accurately diagnose the presence and magnitude of sleep disordered breathing as sleep studies performed at lower altitudes may miss this diagnosis. Treatments options differ from those to treat obstructive apnea. Supplemental oxygen is considered by many to be first-line therapy.

Altitude training for elite endurance performance: a 2012 update.

Science.gov (United States)

Fudge, Barry W; Pringle, Jamie S M; Maxwell, Neil S; Turner, Gareth; Ingham, Stephen A; Jones, Andrew M

2012-01-01

Altitude training is commonly used by endurance athletes and coaches in pursuit of enhancement of performance on return to sea level. The purpose of the current review article was to update and evaluate recent literature relevant to the practical application of altitude training for endurance athletes. Consequently, the literature can be considered in either of two categories: performance-led investigations or mechanistic advancements/insights. Each section discusses the relevant literature and proposes future directions where appropriate.

Altitude training and haemoglobin mass from the optimised carbon monoxide rebreathing method determined by a meta-analysis.

Science.gov (United States)

Gore, Christopher J; Sharpe, Ken; Garvican-Lewis, Laura A; Saunders, Philo U; Humberstone, Clare E; Robertson, Eileen Y; Wachsmuth, Nadine B; Clark, Sally A; McLean, Blake D; Friedmann-Bette, Birgit; Neya, Mitsuo; Pottgiesser, Torben; Schumacher, Yorck O; Schmidt, Walter F

2013-12-01

To characterise the time course of changes in haemoglobin mass (Hbmass) in response to altitude exposure. This meta-analysis uses raw data from 17 studies that used carbon monoxide rebreathing to determine Hbmass prealtitude, during altitude and postaltitude. Seven studies were classic altitude training, eight were live high train low (LHTL) and two mixed classic and LHTL. Separate linear-mixed models were fitted to the data from the 17 studies and the resultant estimates of the effects of altitude used in a random effects meta-analysis to obtain an overall estimate of the effect of altitude, with separate analyses during altitude and postaltitude. In addition, within-subject differences from the prealtitude phase for altitude participant and all the data on control participants were used to estimate the analytical SD. The 'true' between-subject response to altitude was estimated from the within-subject differences on altitude participants, between the prealtitude and during-altitude phases, together with the estimated analytical SD. During-altitude Hbmass was estimated to increase by ∼1.1%/100 h for LHTL and classic altitude. Postaltitude Hbmass was estimated to be 3.3% higher than prealtitude values for up to 20 days. The within-subject SD was constant at ∼2% for up to 7 days between observations, indicative of analytical error. A 95% prediction interval for the 'true' response of an athlete exposed to 300 h of altitude was estimated to be 1.1-6%. Camps as short as 2 weeks of classic and LHTL altitude will quite likely increase Hbmass and most athletes can expect benefit.

Mitochondrial function in human skeletal muscle following high-altitude exposure

DEFF Research Database (Denmark)

Jacobs, Robert A; Boushel, Robert; Wright-Paradis, Cynthia

2013-01-01

Studies regarding mitochondrial modifications in human skeletal muscle following acclimatization to high altitude are conflicting, and these inconsistencies may be due to the prevalence of representing mitochondrial function through static and isolated measurements of specific mitochondrial...... characteristics. The aim of this study, therefore, was to investigate mitochondrial function in response to high-altitude acclimatization through measurements of respiratory control in the vastus lateralis muscle. Skeletal muscle biopsies were obtained from 10 lowland natives prior to and again after a total of 9......-11 days of exposure to 4559 m. High-resolution respirometry was performed on the muscle samples to compare respiratory chain function and respiratory capacities. Respirometric analysis revealed that mitochondrial function was largely unaffected, because high-altitude exposure did not affect the capacity...

Study on Oxygen Supply Standard for Physical Health of Construction Personnel of High-Altitude Tunnels

Directory of Open Access Journals (Sweden)

Chun Guo

2015-12-01

Full Text Available The low atmospheric pressure and low oxygen content in high-altitude environment have great impacts on the functions of human body. Especially for the personnel engaged in complicated physical labor such as tunnel construction, high altitude can cause a series of adverse physiological reactions, which may result in multiple high-altitude diseases and even death in severe cases. Artificial oxygen supply is required to ensure health and safety of construction personnel in hypoxic environments. However, there are no provisions for oxygen supply standard for tunnel construction personnel in high-altitude areas in current tunnel construction specifications. As a result, this paper has theoretically studied the impacts of high-altitude environment on human bodies, analyzed the relationship between labor intensity and oxygen consumption in high-altitude areas and determined the critical oxygen-supply altitude values for tunnel construction based on two different standard evaluation systems, i.e., variation of air density and equivalent PIO2. In addition, it has finally determined the oxygen supply standard for construction personnel in high-altitude areas based on the relationship between construction labor intensity and oxygen consumption.

Control of breathing and the circulation in high-altitude mammals and birds.

Science.gov (United States)

Ivy, Catherine M; Scott, Graham R

2015-08-01

Hypoxia is an unremitting stressor at high altitudes that places a premium on oxygen transport by the respiratory and cardiovascular systems. Phenotypic plasticity and genotypic adaptation at various steps in the O2 cascade could help offset the effects of hypoxia on cellular O2 supply in high-altitude natives. In this review, we will discuss the unique mechanisms by which ventilation, cardiac output, and blood flow are controlled in high-altitude mammals and birds. Acclimatization to high altitudes leads to some changes in respiratory and cardiovascular control that increase O2 transport in hypoxia (e.g., ventilatory acclimatization to hypoxia). However, acclimatization or development in hypoxia can also modify cardiorespiratory control in ways that are maladaptive for O2 transport. Hypoxia responses that arose as short-term solutions to O2 deprivation (e.g., peripheral vasoconstriction) or regional variation in O2 levels in the lungs (i.e., hypoxic pulmonary vasoconstriction) are detrimental at in chronic high-altitude hypoxia. Evolved changes in cardiorespiratory control have arisen in many high-altitude taxa, including increases in effective ventilation, attenuation of hypoxic pulmonary vasoconstriction, and changes in catecholamine sensitivity of the heart and systemic vasculature. Parallel evolution of some of these changes in independent highland lineages supports their adaptive significance. Much less is known about the genomic bases and potential interactive effects of adaptation, acclimatization, developmental plasticity, and trans-generational epigenetic transfer on cardiorespiratory control. Future work to understand these various influences on breathing and circulation in high-altitude natives will help elucidate how complex physiological systems can be pushed to their limits to maintain cellular function in hypoxia. Copyright © 2014 Elsevier Inc. All rights reserved.

Novel drugs in the management of acute mountain sickness and high altitude pulmonary edema

Directory of Open Access Journals (Sweden)

Sikri G

2015-12-01

Full Text Available Gaurav Sikri, Anirban Bhattacharya Department of Physiology, Armed Forces Medical College, Wanowarie, Pune, IndiaWe read with great interest the review article titled “Wilderness medicine at high altitude: recent developments in the field” by Shah et al.1 The authors have comprehensively summarized the recent advances in the field of high altitude medicine relevant to sports and travel medicine. However, Shah et al have described potential drugs for management of high-altitude illnesses, such as acute mountain sickness (AMS, high altitude cerebral edema, and high altitude pulmonary edema (HAPE as one group under the section “Novel drug treatment for AMS”. The pathophysiologies of these two sets of diseases (AMS/high altitude cerebral edema as one and HAPE as another set are different2 and hence it would have been nice to have had the novel drugs described separately to elucidate the therapeutic approach for the two different classes of diseases.View original paper by Shah et al.

Cognitive Changes during Prolonged Stay at High Altitude and Its Correlation with C-Reactive Protein.

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Sheng Li Hu

Full Text Available Hypersensitive C-reaction protein (hsCRP may be a risk factor for cognitive impairment resulting from Alzheimer's disease (AD, stroke, and vascular dementia. This study explored the correlation of peripheral blood hsCRP level with cognitive decline due to high altitude exposure. The study was conducted on 100 male military participants who had never been to high altitude. Cerebral oxygen saturation monitoring, event related potentials (P300, N200 detection, and neurocognitive assessment was performed and total hsCRP, interleukin-6 (IL-6, and homocysteine was estimated at 500 m altitude, 3650 m altitude, 3 day, 1, and 3 month post arriving at the base camp (4400 m, and 1 month after coming back to the 500 m altitude. High altitude increased brain oxygen saturation, prolonged P300 and N200 latencies, injured cognitive functions, and raised plasma hsCRP levels. But they all recovered in varying degrees at 1 and 3 month post arriving at the base camp (4400 m. P300 latencies and hsCRP levels were strongly correlated to cognitive performances. These results suggested that cognitive deterioration occurred during the acute period of exposure to high altitude and may recover probably owning to acclimatization after extended stay at high altitude. Plasma hsCRP is inversely correlated to neurological cognition and it may be a potential biomarker for the prediction of high altitude induced cognitive dysfunction.

What is the impact of altitude on energy demand? A step towards developing specialized energy policy for mountainous areas

International Nuclear Information System (INIS)

Katsoulakos, Nikolas M.; Kaliampakos, Dimitris C.

2014-01-01

Specific strategies for the energy sector should be a central part of a sustainable mountain policy. However, there is a lack of research on the energy issues of mountainous areas and specialized energy policy measures cannot be effectively supported. The determination of the energy demand in mountainous areas, which is an essential step in the direction of developing mountain energy policy, is analyzed in this paper. Greece has been selected as a case study. The results show that altitude is the decisive factor affecting degree-days and energy needs, within the geographical range of Greece. It is proved that the thermal, as well as the total energy demand are significantly increased in mountain settlements. The annual energy expenditure of a typical residence lying at an altitude of 1000 m proved to be 85% higher than the corresponding cost at sea level. This makes mountainous populations vulnerable to energy poverty. It is also proved that the subsidy policy for heating oil, in Greece, cannot alleviate energy poverty. The results of the present study can be utilized in the direction of re-designing the present policy and this is a completely necessary step for creating a sustainable policy for mountainous areas, in general. - Highlights: • The altitude’s influence on degree-days and energy needs in Greece was quantified. • Altitude affects heating degree-days 3.5 times more intensely than latitude in Greece. • A typical home has two times more thermal needs at 800 m than at sea-level in Greece. • The subsidy policy for heating oil is inadequate for Greek mountainous territories. • More than 85% of the households located over 800 m are energy poor in Greece

Comparison of Emergency Medicine Malpractice Cases Involving Residents to Non-Resident Cases.

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Gurley, Kiersten L; Grossman, Shamai A; Janes, Margaret; Yu-Moe, C Winnie; Song, Ellen; Tibbles, Carrie D; Shapiro, Nathan I; Rosen, Carlo L

2018-04-17

Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013. The CBS database is a national repository that contains professional liability data on > 400 hospitals and > 165,000 physicians, representing over 30% of all malpractice cases in the U.S (> 350,000 claims). We compared cases naming residents (either alone or in combination with an attending) to those that did not involve a resident (non-resident cohort). We reported the case statistics, allegation categories, severity scores, procedural data, final diagnoses and contributing factors. Fisher's exact test or t-test was used for comparisons (alpha set at 0.05). Eight hundred and forty-five EM cases were identified of which 732 (87%) did not name a resident (non-resident cases), while 113 (13%) included a resident (resident cases) (Figure 1). There were higher total incurred losses for non-resident cases (Table 1). The most frequent allegation categories in both cohorts were "Failure or Delay in Diagnosis/Misdiagnosis" and "Medical Treatment" (non-surgical procedures or treatment regimens i.e. central line placement). Allegation categories of Safety and Security, Patient Monitoring, Hospital Policy and Procedure and Breach of Confidentiality were found in the non-resident cases. Resident cases incurred lower payments on average ($51,163 vs. $156,212 per case). Sixty six percent (75) of resident vs 57% (415) of non-resident cases were high severity claims

Turbojet Performance and Operation at High Altitudes with Hydrogen and Jp-4 Fuels

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Fleming, W A; Kaufman, H R; Harp, J L , Jr; Chelko, L J

1956-01-01

Two current turbojet engines were operated with gaseous-hydrogen and JP-4 fuels at very high altitudes and a simulated Mach number of 0.8. With gaseous hydrogen as the fuel stable operation was obtained at altitudes up to the facility limit of about 90,000 feet and the specific fuel consumption was only 40 percent of that with JP-4 fuel. With JP-4 as the fuel combustion was unstable at altitudes above 60,000 to 65,000 feet and blowout limits were reached at 75,000 to 80,000 feet. Over-all performance, component efficiencies, and operating range were reduced considerable at very high altitudes with both fuels.

Mast cells in the human lung at high altitude

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Heath, Donald

1992-12-01

Mast cell densities in the lung were measured in five native highlanders of La Paz (3600 m) and in one lowlander dying from high-altitude pulmonary oedema (HAPO) at 3440 m. Two of the highlanders were mestizos with normal pulmonary arteries and the others were Aymara Indians with muscular remodelling of their pulmonary vasculature. The aim of the investigation was to determine if accumulation of mast cells in the lung at high altitude (HA) is related to alveolar hypoxia alone, to a combination of hypoxia and muscularization of the pulmonary arterial tree, or to oedema of the lung. The lungs of four lowlanders were used as normoxic controls. The results showed that the mast cell density of the two Mestizos was in the normal range of lowlanders (0.6-8.8 cells/mm2). In the Aymara Indians the mast cell counts were raised (25.6-26.0 cells/mm2). In the lowlander dying from HAPO the mast cell count was greatly raised to 70.1 cells/mm2 lung tissue. The results show that in native highlanders an accumulation of mast cells in the lung is not related to hypoxia alone but to a combination of hypoxia and muscular remodelling of the pulmonary arteries. However, the most potent cause of increased mast cell density in the lung at high altitude appears to be high-altitude pulmonary oedema.

Scientific Approach for Optimising Performance, Health and Safety in High-Altitude Observatories

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Böcker, Michael; Vogy, Joachim; Nolle-Gösser, Tanja

2008-09-01

The ESO coordinated study “Optimising Performance, Health and Safety in High-Altitude Observatories” is based on a psychological approach using a questionnaire for data collection and assessment of high-altitude effects. During 2007 and 2008, data from 28 staff and visitors involved in APEX and ALMA were collected and analysed and the first results of the study are summarised. While there is a lot of information about biomedical changes at high altitude, relatively few studies have focussed on psychological changes, for example with respect to performance of mental tasks, safety consciousness and emotions. Both, biomedical and psychological changes are relevant factors in occupational safety and health. The results of the questionnaire on safety, health and performance issues demonstrate that the working conditions at high altitude are less detrimental than expected.

A quantitative analysis of TIMS data obtained on the Learjet 23 at various altitudes

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Jaggi, S.

1992-01-01

A series of Thermal Infrared Multispectral Scanner (TIMS) data acquisition flights were conducted on the NASA Learjet 23 at different altitudes over a test site. The objective was to monitor the performance of the TIMS (its estimation of the brightness temperatures of the ground scene) with increasing altitude. The results do not show any significant correlation between the brightness temperatures and the altitude. The analysis indicates that the estimation of the temperatures is a function of the accuracy of the atmospheric correction used for each altitude.

Severe negative energy balance during 21 d at high altitude decreases fat-free mass regardless of dietary protein intake: a randomized controlled trial.

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Berryman, Claire E; Young, Andrew J; Karl, J Philip; Kenefick, Robert W; Margolis, Lee M; Cole, Renee E; Carbone, John W; Lieberman, Harris R; Kim, Il-Young; Ferrando, Arny A; Pasiakos, Stefan M

2018-02-01

In this 2-phase randomized controlled study, we examined whether consuming a higher-protein (HP) diet would attenuate fat-free mass (FFM) loss during energy deficit (ED) at high altitude (HA) in 17 healthy males (mean ± sd: 23 ± 6 yr; 82 ± 14 kg). During phase 1 at sea level (SL, 55 m), participants consumed a eucaloric diet providing standard protein (SP; 1.0 g protein/kg,) for 21 d. During phase 2, participants resided at HA (4300 m) for 22 d and were randomly assigned to either an SP or HP (2.0 g protein/kg) diet designed to elicit a 40% ED. Body composition, substrate oxidation, and postabsorptive whole-body protein kinetics were measured. Participants were weight stable during SL and lost 7.9 ± 1.9 kg ( P Berryman, C. E., Young, A. J., Karl, J. P., Kenefick, R. W., Margolis, L. M., Cole, R. E., Carbone, J. W., Lieberman, H. R., Kim, I.-Y., Ferrando, A. A., Pasiakos, S. M. Severe negative energy balance during 21 d at high altitude decreases fat-free mass regardless of dietary protein intake: a randomized controlled trial.

A Comparitive Analysis of the Influence of Weather on the Flight Altitudes of Birds.

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Shamoun-Baranes, Judy; van Loon, Emiel; van Gasteren, Hans; van Belle, Jelmer; Bouten, Willem; Buurma, Luit

2006-01-01

Birds pose a serious risk to flight safety worldwide. A Bird Avoidance Model (BAM) is being developed in the Netherlands to reduce the risk of bird aircraft collisions. In order to develop a temporally and spatially dynamic model of bird densities, data are needed on the flight-altitude distribution of birds and how this is influenced by weather. This study focuses on the dynamics of flight altitudes of several species of birds during local flights over land in relation to meteorological conditions.We measured flight altitudes of several species in the southeastern Netherlands using tracking radar during spring and summer 2000. Representatives of different flight strategy groups included four species: a soaring species (buzzard ), an obligatory aerial forager (swift Apus apus), a flapping and gliding species (blackheaded gull Larus ridibundus), and a flapping species (starling Sturnus vulgaris).Maximum flight altitudes varied among species, during the day and among days. Weather significantly influenced the flight altitudes of all species studied. Factors such as temperature, relative humidity, atmospheric instability, cloud cover, and sea level pressure were related to flight altitudes. Different combinations of factors explained 40% 70% of the variance in maximum flight altitudes. Weather affected flight strategy groups differently. Compared to flapping species, buzzards and swifts showed stronger variations in maximum daily altitude and f lew higher under conditions reflecting stronger thermal convection. The dynamic vertical distributions of birds are important for risk assessment and mitigation measures in flight safety as well as wind turbine studies.

Residents' experiences of abuse, discrimination and sexual harassment during residency training. McMaster University Residency Training Programs.

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Cook, D J; Liutkus, J F; Risdon, C L; Griffith, L E; Guyatt, G H; Walter, S D

1996-06-01

To assess the prevalence of psychological abuse, physical assault, and discrimination on the basis of gender and sexual orientation, and to examine the prevalence and impact of sexual harassment in residency training programs. Self-administered questionnaire. McMaster University, Hamilton, Ont. Residents in seven residency training programs during the academic year from July 1993 to June 1994. Of 225 residents 186 (82.7%) returned a completed questionnaire, and 50% of the respondents were women. Prevalence of psychological abuse, physical assault and discrimination on the basis of gender and sexual orientation experienced by residents during medical training, prevalence and residents' perceived frequency of sexual harassment. Psychological abuse was reported by 50% of the residents. Some of the respondents reported physical assault, mostly by patients and their family members (14.7% reported assaults by male patients and family members, 9.8% reported assaults by female patients and family members), 5.4% of the female respondents reported assault by male supervising physicians. Discrimination on the basis of gender was reported to be common and was experienced significantly more often by female residents than by male residents (p sexual orientation. Most of the respondents experienced sexual harassment, especially in the form of sexist jokes, flirtation and unwanted compliments on their dress or figure. On average, 40% of the respondents, especially women (p sexual harassment to someone (p sexual harassment were embarassment (reported by 24.0%), anger (by 23.4%) and frustration (20.8%). Psychological abuse, discrimination on the basis of gender and sexual harassment are commonly experienced by residents in training programs. A direct, progressive, multidisciplinary approach is needed to label and address these problems.

Thoraco-abdominal coordination and performance during uphill running at altitude.

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Eva Bernardi

Full Text Available 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.To investigate the relationships between thoraco-abdominal coordination, ventilatory pattern, oxygen saturation (SpO2, and endurance performance in runners during high-intensity uphill exercise.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.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, p<0.001. Lower SpO2 values were associated with lower speeds at 20%≥slope≤40% (r = 0.335, p<0.001 for horizontal and r = 0.36, p<0.001 for vertical. The reduced thoraco-abdominal coordination and consequent reduction in SpO2 were associated with interstitial pulmonary edema.Reductions in thoraco-abdominal coordination are associated

Maximal exercise and muscle oxygen extraction in acclimatizing lowlanders and high altitude natives

DEFF Research Database (Denmark)

Lundby, Carsten; Sander, Mikael; van Hall, Gerrit

2006-01-01

, and is the focus of the present study. We have studied six lowlanders during maximal exercise at sea level (SL) and with acute (AH) exposure to 4,100 m altitude, and again after 2 (W2) and 8 weeks (W8) of altitude sojourn, where also eight high altitude native (Nat) Aymaras were studied. Fractional arterial muscle...... O(2) extraction at maximal exercise was 90.0+/-1.0% in the Danish lowlanders at sea level, and remained close to this value in all situations. In contrast to this, fractional arterial O(2) extraction was 83.2+/-2.8% in the high altitude natives, and did not change with the induction of normoxia....... The capillary oxygen conductance of the lower extremity, a measure of oxygen diffusing capacity, was decreased in the Danish lowlanders after 8 weeks of acclimatization, but was still higher than the value obtained from the high altitude natives. The values were (in ml min(-1) mmHg(-1)) 55.2+/-3.7 (SL), 48...

Anesthesiology resident personality type correlates with faculty assessment of resident performance.

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Schell, Randall M; Dilorenzo, Amy N; Li, Hsin-Fang; Fragneto, Regina Y; Bowe, Edwin A; Hessel, Eugene A

2012-11-01

To study the association between anesthesiology residents' personality preference types, faculty evaluations of residents' performance, and knowledge. Convenience sample and prospective study. Academic department of anesthesiology. Consenting anesthesiology residents (n = 36). All participants completed the Myers Briggs Type Indicator® (MBTI®). All residents' 6-month summation of daily focal evaluations completed by faculty [daily performance score (DPS); 1 = unsatisfactory, 2 = needs improvement, 3 = meets expectations, 4 = exceeds expectations], as well as a global assessment of performance (GAP) score based on placement of each resident into perceived quartile compared with their peers (ie,1 = first, or top, quartile) by senior faculty (n = 7) who also completed the MBTI, were obtained. The resident MBTI personality preferences were compared with the DPS and GAP scores, the United States Medical Licensing Examination (USMLE) I and II scores, and faculty MBTI personality type. There was no association between personality preference type and performance on standardized examinations (USMLE I, II). The mean GAP score was better (higher quartile score) for Extraverts than Introverts (median 2.0 vs 2.6, P = 0.0047) and for Sensing versus Intuition (median 2.0 vs 2.6, P = 0.0206) preference. Faculty evaluator MBTI preference type did not influence the GAP scores they assigned residents. Like GAP, the DPS was better for residents with Sensing versus Intuition preference (median 3.5 vs 3.3, P = 0.0111). No difference in DPS was noted between Extraverts and Introverts. Personality preference type was not associated with resident performance on standardized examinations, but it was associated with faculty evaluations of resident performance. Residents with Sensing personality preference were evaluated more favorably on global and focal faculty evaluations than those residents who chose the Intuition preference. Extraverted residents were evaluated more favorably on

Effect of egg composition and oxidoreductase on adaptation of Tibetan chicken to high altitude.

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Jia, C L; He, L J; Li, P C; Liu, H Y; Wei, Z H

2016-07-01

Tibetan chickens have good adaptation to hypoxic conditions, which can be reflected by higher hatchability than lowland breeds when incubated at high altitude. The objective of this trial was to study changes in egg composition and metabolism with regards the adaptation of Tibetan chickens to high altitude. We measured the dry weight of chicken embryos, egg yolk, and egg albumen, and the activity of lactate dehydrogenase (LDH) and succinic dehydrogenase (SDH) in breast muscle, heart, and liver from embryos of Tibetan chicken and Dwarf chicken (lowland breed) incubated at high (2,900 m) and low (100 m) altitude. We found that growth of chicken embryos was restricted at high altitude, especially for Dwarf chicken embryos. In Tibetan chicken, the egg weight was lighter, but the dry weight of egg yolk was heavier than that of Dwarf chicken. The LDH activities of the three tissues from the high altitude groups were respectively higher than those of the lowland groups from d 15 to hatching, except for breast muscle of Tibetan chicken embryos on d 15. In addition, under the high altitude environment, the heart tissue from Tibetan chicken had lower LDH activity than that from Dwarf chicken at d 15 and 18. The lactic acid content of blood from Tibetan chicken embryos was lower than that of Dwarf chicken at d 12 and 15 of incubation at high altitude. There was no difference in SDH activity in the three tissues between the high altitude groups and the lowland groups except in three tissues of hatchlings and at d 15 of incubation in breast muscle, nor between the two breeds at high altitude except in the heart of hatchlings. Consequently, the adaptation of Tibetan chicken to high altitude may be associated with higher quantities of yolk in the egg and a low metabolic oxygen demand in tissue, which illuminate the reasons that the Tibetan chicken have higher hatchability with lower oxygen transport ability. © 2016 Poultry Science Association Inc.

Impact of a Newly Constructed Motor Vehicle Road on Altitude Illness in the Nepal Himalayas.

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Reisman, Jonathan; Deonarain, Dinesh; Basnyat, Buddha

2017-12-01

This study investigated the impact that motor vehicle travel along a newly constructed road has on altitude illness (including acute mountain sickness, high-altitude cerebral edema, and high-altitude pulmonary edema). The new road from Besisahar (760 m) to Manang (3540 m) in Nepal was completed in December 2014. We enrolled all patients diagnosed with altitude illness at the Himalayan Rescue Association Manang clinic in fall 2016. Phi coefficients were calculated to test for an association between Nepali ethnicity and rapid ascent by motor vehicle. A retrospective review looked at all patients with altitude illness from fall (September-November) 2010 to spring (February-May) 2016. In fall 2016, more than half (54%) of patients with altitude illness traveled to Manang by motor vehicle, and one-third (33%) reached Manang from low altitude (Besisahar) in less than 48 hours. Nepali nationality had a significant association with motor vehicle travel (phi +0.69, P road (P constructed road from Besisahar to Manang appears to be related to a significant increase in the number of patients with all forms of altitude illness, especially among Nepalis. The authors believe that educational interventions emphasizing prevention are urgently needed. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Physiological Changes to the Cardiovascular System at High Altitude and Its Effects on Cardiovascular Disease.

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Riley, Callum James; Gavin, Matthew

2017-06-01

Riley, Callum James, and Matthew Gavin. Physiological changes to the cardiovascular system at high altitude and its effects on cardiovascular disease. High Alt Med Biol. 18:102-113, 2017.-The physiological changes to the cardiovascular system in response to the high altitude environment are well understood. More recently, we have begun to understand how these changes may affect and cause detriment to cardiovascular disease. In addition to this, the increasing availability of altitude simulation has dramatically improved our understanding of the physiology of high altitude. This has allowed further study on the effect of altitude in those with cardiovascular disease in a safe and controlled environment as well as in healthy individuals. Using a thorough PubMed search, this review aims to integrate recent advances in cardiovascular physiology at altitude with previous understanding, as well as its potential implications on cardiovascular disease. Altogether, it was found that the changes at altitude to cardiovascular physiology are profound enough to have a noteworthy effect on many forms of cardiovascular disease. While often asymptomatic, there is some risk in high altitude exposure for individuals with certain cardiovascular diseases. Although controlled research in patients with cardiovascular disease was largely lacking, meaning firm conclusions cannot be drawn, these risks should be a consideration to both the individual and their physician.

Text mining and network analysis to find functional associations of genes in high altitude diseases.

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Bhasuran, Balu; Subramanian, Devika; Natarajan, Jeyakumar

2018-05-02

Travel to elevations above 2500 m is associated with the risk of developing one or more forms of acute altitude illness such as acute mountain sickness (AMS), high altitude cerebral edema (HACE) or high altitude pulmonary edema (HAPE). Our work aims to identify the functional association of genes involved in high altitude diseases. In this work we identified the gene networks responsible for high altitude diseases by using the principle of gene co-occurrence statistics from literature and network analysis. First, we mined the literature data from PubMed on high-altitude diseases, and extracted the co-occurring gene pairs. Next, based on their co-occurrence frequency, gene pairs were ranked. Finally, a gene association network was created using statistical measures to explore potential relationships. Network analysis results revealed that EPO, ACE, IL6 and TNF are the top five genes that were found to co-occur with 20 or more genes, while the association between EPAS1 and EGLN1 genes is strongly substantiated. The network constructed from this study proposes a large number of genes that work in-toto in high altitude conditions. Overall, the result provides a good reference for further study of the genetic relationships in high altitude diseases. Copyright © 2018 Elsevier Ltd. All rights reserved.

Butterflies of the high altitude Atacama Desert: habitat use and conservation

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Emma eDespland

2014-09-01

Full Text Available The butterfly fauna of the high-altitude desert of Northern Chile, though depauperate, shows high endemism, is poorly known and is of considerable conservation concern. This study surveys butterflies along the Andean slope between 2400 and 500 m asl (prepuna, puna and Andean steppe habitats as well as in high and low altitude wetlands and in the neoriparian vegetation of agricultural sites. We also include historical sightings from museum records. We compare abundances between altitudes, between natural and impacted sites, as well as between two sampling years with different precipitation regimes. The results confirm high altitudinal turnover and show greatest similarity between wetland and slope faunas at similar altitudes. Results also underscore vulnerability to weather fluctuations, particularly in the more arid low-altitude sites, where abundances were much lower in the low precipitation sampling season and several species were not observed at all. Finally, we show that some species have shifted to the neoriparian vegetation of the agricultural landscape, whereas others were only observed in less impacted habitats dominated by native plants. These results suggest that acclimation to novel habitats depends on larval host plant use. The traditional agricultural environment can provide habitat for many, but not all, native butterfly species, but an estimation of the value of these habitats requires better understanding of butterfly life-history strategies and relationships with host plants.

Difference in blood microcirculation recovery between normal frostbite and high-altitude frostbite

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Ming-ke JIAO

2017-02-01

Full Text Available Objective　To determine the difference in blood microcirculation recovery between normal frostbite and high-altitude frostbite during the wound healing. Methods　Twenty four male rats were randomly divided into control group (n=8, normal frostbite group (n=8, and high-altitude group (n=8. The normal frostbite group rats were frozen to produce mid-degree frostbite models by controlling the freezing time with liquid nitrogen penetration equipment. The high-altitude frostbite group rats were acclimated to a hypoxic and low-pressure environment for 1 week, and then the high-altitude frostbite models were constructed by the same way with liquid nitrogen penetration apparatus. On days 3, 7, 11, 15, 19, and 23 after modeling, the recovery situation of blood circulation of each group was observed with contrast ultrasonography by injecting SonoVue micro-bubble into rats' tail. Finally, the micro-bubble concentration (MC was calculated to confirm the blood circulation recovery with software Image Pro. Results　At different time points, the wound area of the high-altitude frostbite group was bigger than that of the normal frostbite group, and the MC of control group was always about (27±0.2×109/ml. On day 3, 7, 11, 15, 19, and 23, the MC was significantly lower in the high-altitude frostbite group than in the control group and normal frostbite group (P<0.05. The MC of normal frostbite group was significantly lower than that of the control group on day 3, 7, 11, 15 and 19 (P<0.05. In addition, no obvious difference in MC was found between normal group and control group on the 23th day (P<0.05. Conclusion　The blood microcirculation recovery after high-altitude frostbite is significantly slower than the normal frostbite. DOI: 10.11855/j.issn.0577-7402.2017.01.13

The structure of high altitude O+ energization and outflow: a case study

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H. Nilsson

2004-07-01

Full Text Available Multi-spacecraft observations from the CIS ion spectrometers on board the Cluster spacecraft have been used to study the structure of high-altitude oxygen ion energization and outflow. A case study taken from 12 April 2004 is discussed in more detail. In this case the spacecraft crossed the polar cap, mantle and high-altitude cusp region at altitudes between 4RE and 8RE and 2 of the spacecraft provided data. The oxygen ions were seen as a beam with narrow energy distribution, and increasing field-aligned velocity and temperature at higher altitude further in the upstream flow direction. The peak O+ energy was typically just above the highest energy of observed protons. The observed energies reached the upper limit of the CIS ion spectrometer, i.e. 38keV. Moment data from the spacecraft have been cross-correlated to determine cross-correlation coefficients, as well as the phase delay between the spacecraft. Structures in ion density, temperature and field-aligned flow appear to drift with the observed field-perpendicular drift. This, together with a velocity dispersion analysis, indicates that much of the structure can be explained by transverse heating well below the spacecraft. However, temperature isotropy and the particle flux as a function of field-aligned velocity are inconsistent with a single altitude Maxwellian source. Heating over extended altitude intervals, possibly all the way up to the observation point, seem consistent with the observations.

High altitude-induced albuminuria in normal man is enhanced by infusion of low-dose dopamine

DEFF Research Database (Denmark)

Hansen, J M; Kanstrup, I L; Richalet, J P

1996-01-01

-85) (median with quartiles in parentheses) at high altitude. High altitude hypoxia increased Ualb from 3.2 micrograms min-1 (2.7-3.5) to 5.0 micrograms min-1 (3.3-6.6) (p ... flow (ERPF) from 465 ml min-1 (412-503) to 410 ml min-1 (385-451) (p high altitude. Dopamine...... increased ERPF, GFR, CLi, CNa, and decreased the filtration fraction in both environments. Infusion of dopamine further increased Ualb to 10.5 micrograms min-1 (5.5-64.8) (p high altitude, but had no effect on Ualb at sea level. In conclusion, high altitude hypoxia per se increases the urinary...

Carcass yields of two different strains of ducks raised in different altitude

Science.gov (United States)

Dillak, St. Y. F. G.; Mulyantini, N. G. A.; Sipahelut, G. M.; Lole, U. R.

2018-02-01

The objective of this research was to determine if there is a difference in performance and carcass yield between ducks of two different strains raised in different altitude. Ducks different strains (Muscovy vs Pekin ducks) and they raised either in high or low altitude (high altitude which was between 500 and 1000m vs low altitude which was below 500m). All ducks were given one of two different diet s and provided water ad libitum. The diets were: 1) commercial diet, and 2) local diet. There were three replicate per treatment and there were 5 ducks per replication. Ducks from each strain were standardized to a similar weight. The results show that Pekin ducks carcass performance was significantly better than Muscovy ducks. Ducks given diet 2 had significantly (Pabdominal fat percentage in Pekin ducks is significantly (Pabdominal fat percentage in Muscovy ducks.

Measuring resident well-being: impostorism and burnout syndrome in residency.

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Legassie, Jenny; Zibrowski, Elaine M; Goldszmidt, Mark A

2008-07-01

Assessing resident well-being is becoming increasingly important from a programmatic standpoint. Two measures that have been used to assess this are the Clance Impostor Scale (CIS) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). However, little is known about the relationship between the two phenomena. To explore the prevalence and association between impostorism and burnout syndrome in a sample of internal medicine residents. Anonymous, cross-sectional postal survey. Forty-eight internal medicine residents (postgraduate year [PGY] 1-3) at the Schulich School of Medicine & Dentistry (62.3% response rate). Short demographic questionnaire, CIS and MBI-HSS. Impostorism and burnout syndrome were identified in 43.8% and 12.5% of residents, respectively. With the exception of a negative correlation between CIS scores and the MBI's personal accomplishment subscale (r = -.30; 95% CI -.54 to -.02), no other significant relations were identified. Foreign-trained residents were more likely to score as impostors (odds ratio [OR] 10.7; 95% CI 1.2 to 98.2) while senior residents were more likely to experience burnout syndrome (OR 16.5 95% CI 1.6 to 168.5). Both impostorism and burnout syndrome appear to be threats to resident well-being in our program. The lack of relationship between the two would suggest that programs and researchers wishing to address the issue of resident distress should consider using both measures. The finding that foreign-trained residents appear to be more susceptible to impostorism warrants further study.

Optic neuropathy following an altitude exposure.

Science.gov (United States)

Steigleman, Allan; Butler, Frank; Chhoeu, Austin; O'Malley, Timothy; Bower, Eric; Giebner, Stephen

2003-09-01

This case report describes a 20-yr-old man who presented with retro-orbital pain and blurred vision in his left eye 3 wk after an altitude exposure in a hypobaric chamber. He was found to have significant deficits in color vision and visual fields consistent with an optic neuropathy in his left eye. The patient was diagnosed with decompression sickness and treated with hyperbaric oxygen with a U.S. Navy Treatment Table VI. All signs and symptoms resolved with a single hyperbaric oxygen treatment but recurred. A head MRI revealed a left frontoethmoid sinus opacity. A concomitant sinusitis was diagnosed. The patient had full resolution of symptoms after a total of four hyperbaric oxygen treatments and antibiotic therapy at 6-wk follow-up. Although a para-infectious etiology for this patient's optic neuropathy cannot be excluded, his history of altitude exposure and significant, rapid response to hyperbaric oxygen treatment strongly implies decompression sickness in this case.

Does clinical exposure matter? Pilot assessment of patient visits in an urban family medicine residency program.

Science.gov (United States)

Iglar, Karl; Murdoch, Stuart; Meaney, Christopher; Krueger, Paul

2018-01-01

To determine the number of patient visits, patient demographic information, and diagnoses in an urban ambulatory care setting in a family medicine residency program, and assess the correlation between the number of patient visits and residents' in-training examination (ITE) scores. Retrospective analysis of data from resident practice profiles, electronic medical records, and residents' final ITE scores. Family medicine teaching unit in a community hospital in Barrie, Ont. Practice profile data were from family medicine residents enrolled in the program from July 1, 2013, to June 30, 2014, and electronic medical record and ITE data were from those enrolled in the program from July 1, 2010, to June 30, 2015. Number of patient visits, patient characteristics (eg, sex, age), priority topics addressed in clinic, resident characteristics (eg, age, sex, level of residency), and residents' final ITE scores. Between July 1, 2013, and June 30, 2014, there were 11 115 patient visits. First-year residents had a mean of 5.48 patient visits per clinic, and second-year residents had a mean of 5.98 patient visits per clinic. A Pearson correlation coefficient of 0.68 was found to exist between the number of patients seen and the final ITE scores, with a 10.5% difference in mean score between residents who had 1251 or more visits and those who had 1150 or fewer visits. Three diagnoses (ie, epistaxis, meningitis, and neck pain) deemed important for Certification by the College of Family Physicians of Canada were not seen by any of the residents in clinic. There is a moderate correlation between the number of patients seen by residents in ambulatory care and ITE scores in family medicine. It is important to assess patients' demographic information and diagnoses made in resident practices to ensure an adequate clinical experience. Copyright© the College of Family Physicians of Canada.

The GRAD high-altitude balloon flight over Antarctica

International Nuclear Information System (INIS)

Eichhorn, G.; Coldwell, R.L.; Dunnam, F.E.; Rester, A.C.; Trombka, J.I.; Starr, R.; Lasche, G.P.

1989-01-01

The Gamma Ray Advanced Detector(GRAD) consists of a n-type germanium detector inside an active bismuth-germanate Compton and charged particle shield with additional active plastic shielding across the aperture. It will be flown on a high altitude balloon at 36 km altitude at a latitude of 78 degree S over Antarctica for observations of gamma radiation emitted by the radioactive decay of 56 Co in the Supernova SN1987A, for assessment of the performance of bismuth-germanate scintillation material in the radiation environment of near space, for gathering information on the gamma-ray background over Antarctica, and for testing fault-tolerant software

Occupational health of miners at altitude: adverse health effects, toxic exposures, pre-placement screening, acclimatization, and worker surveillance.

Science.gov (United States)

Vearrier, David; Greenberg, Michael I

2011-08-01

Mining operations conducted at high altitudes provide health challenges for workers as well as for medical personnel. To review the literature regarding adverse health effects and toxic exposures that may be associated with mining operations conducted at altitude and to discuss pre-placement screening, acclimatization issues, and on-site surveillance strategies. We used the Ovid ( http://ovidsp.tx.ovid.com ) search engine to conduct a MEDLINE search for "coal mining" or "mining" and "altitude sickness" or "altitude" and a second MEDLINE search for "occupational diseases" and "altitude sickness" or "altitude." The search identified 97 articles of which 76 were relevant. In addition, the references of these 76 articles were manually reviewed for relevant articles. CARDIOVASCULAR EFFECTS: High altitude is associated with increased sympathetic tone that may result in elevated blood pressure, particularly in workers with pre-existing hypertension. Workers with a history of coronary artery disease experience ischemia at lower work rates at high altitude, while those with a history of congestive heart failure have decreased exercise tolerance at high altitude as compared to healthy controls and are at higher risk of suffering an exacerbation of their heart failure. PULMONARY EFFECTS: High altitude is associated with various adverse pulmonary effects, including high-altitude pulmonary edema, pulmonary hypertension, subacute mountain sickness, and chronic mountain sickness. Mining at altitude has been reported to accelerate silicosis and other pneumoconioses. Miners with pre-existing pneumoconioses may experience an exacerbation of their condition at altitude. Persons traveling to high altitude have a higher incidence of Cheyne-Stokes respiration while sleeping than do persons native to high altitude. Obesity increases the risk of pulmonary hypertension, acute mountain sickness, and sleep-disordered breathing. NEUROLOGICAL EFFECTS: The most common adverse neurological

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

Proton isotropy boundaries as measured on mid- and low-altitude satellites

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N. Yu. Ganushkina

2005-07-01

Full Text Available Polar CAMMICE MICS proton pitch angle distributions with energies of 31-80 keV were analyzed to determine the locations where anisotropic pitch angle distributions (perpendicular flux dominating change to isotropic distributions. We compared the positions of these mid-altitude isotropic distribution boundaries (IDB for different activity conditions with low-altitude isotropic boundaries (IB observed by NOAA 12. Although the obtained statistical properties of IDBs were quite similar to those of IBs, a small difference in latitudes, most pronounced on the nightside and dayside, was found. We selected several events during which simultaneous observations in the same local time sector were available from Polar at mid-altitudes, and NOAA or DMSP at low-altitudes. Magnetic field mapping using the Tsyganenko T01 model with the observed solar wind input parameters showed that the low- and mid-altitude isotropization boundaries were closely located, which leads us to suggest that the Polar IDB and low-altitude IBs are related. Furthermore, we introduced a procedure to control the difference between the observed and model magnetic field to reduce the large scatter in the mapping. We showed that the isotropic distribution boundary (IDB lies in the region where Rc/ρ~6, that is at the boundary of the region where the non-adiabatic pitch angle scattering is strong enough. We therefore conclude that the scattering in the large field line curvature regions in the nightside current sheet is the main mechanism producing isotropization for the main portion of proton population in the tail current sheet. This mechanism controls the observed positions of both IB and IDB boundaries. Thus, this tail region can be probed, in its turn, with observations of these isotropy boundaries. Keywords. Magnetospheric physics (Energetic particles, Precipitating; Magnetospheric configuration and dynamics; Magnetotail

Proton isotropy boundaries as measured on mid- and low-altitude satellites

Directory of Open Access Journals (Sweden)

N. Yu. Ganushkina

2005-07-01

Full Text Available Polar CAMMICE MICS proton pitch angle distributions with energies of 31-80 keV were analyzed to determine the locations where anisotropic pitch angle distributions (perpendicular flux dominating change to isotropic distributions. We compared the positions of these mid-altitude isotropic distribution boundaries (IDB for different activity conditions with low-altitude isotropic boundaries (IB observed by NOAA 12. Although the obtained statistical properties of IDBs were quite similar to those of IBs, a small difference in latitudes, most pronounced on the nightside and dayside, was found. We selected several events during which simultaneous observations in the same local time sector were available from Polar at mid-altitudes, and NOAA or DMSP at low-altitudes. Magnetic field mapping using the Tsyganenko T01 model with the observed solar wind input parameters showed that the low- and mid-altitude isotropization boundaries were closely located, which leads us to suggest that the Polar IDB and low-altitude IBs are related. Furthermore, we introduced a procedure to control the difference between the observed and model magnetic field to reduce the large scatter in the mapping. We showed that the isotropic distribution boundary (IDB lies in the region where R_c/ρ~6, that is at the boundary of the region where the non-adiabatic pitch angle scattering is strong enough. We therefore conclude that the scattering in the large field line curvature regions in the nightside current sheet is the main mechanism producing isotropization for the main portion of proton population in the tail current sheet. This mechanism controls the observed positions of both IB and IDB boundaries. Thus, this tail region can be probed, in its turn, with observations of these isotropy boundaries.

Keywords. Magnetospheric physics (Energetic particles, Precipitating; Magnetospheric configuration and dynamics; Magnetotail

Variation in the isotopic content of precipitation with altitude

International Nuclear Information System (INIS)

Stowhas, L.; Silva, C.; Moser, H.; Stichler, W.

1975-03-01

Monthly precipitation and single storms have been collected during three years at 12 stations along a W-E profile in Chile, going from Juan Fernandez Islands to Valparaiso, Santiago and Infiernillo in the Andes, and analysed for their deuterium content. The deltaD values are correlated with the altitude of the station, the mean temperature - which also largely depends on the altitude - and the distance from the sea. The correlation parameters show however important variations from year to year and even more from month to month. For instance, in the stretch Santiago (520 m a.s.l.) - La Parva (2680 m) the mean isotopic gradient with altitude were: -1.84 deltaD per mil/100 m in 1970, -1.09 in 1971 and -2.0 in 1972. The low value observed in 1971 could be a consequence of the peculiar weather characteristics of this unusually dry year. In the stretch from the coast to Santiago the trend of the isotopic composition of precipitation is more complicated, because the so-called continental effect is superimposed to the altitude effect. The deuterium content variations have been also determined in snowpack profiles at La Parva station. The results show that snow melting occurs slowly at the bottom during the whole winter, at the expenses of the heat stored during summer in the soil. The melting of the surface snow layers only starts at the end of the winter and then proceeds very fast

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.

Science.gov (United States)

Markham, Wolfgang A; Lopez, Maria Luisa; Aveyard, Paul; Herrero, Pablo; Bridle, Christopher; Comas, Angel; Charlton, Anne; Thomas, Hywel

2009-06-04

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. 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. 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-efficacy, on the other hand, would possibly have a greater

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

Albuminuria and overall capillary permeability of albumin in acute altitude hypoxia

DEFF Research Database (Denmark)

Hansen, J M; Olsen, Niels Vidiendal; Feldt-Rasmussen, B

1994-01-01

The mechanism of proteinuria at high altitude is unclear. Renal function and urinary excretion rate of albumin (Ualb) at rest and during submaximal exercise and transcapillary escape rate of 125I-labeled albumin (TERalb) were investigated in 12 normal volunteers at sea level and after rapid...... and passive ascent to 4,350 m. The calcium antagonist isradipine (5 mg/day; n = 6) or placebo (n = 6) was administered to abolish hypoxia-induced rises in blood pressure. Lithium clearance and urinary excretion of beta 2-microglobulin were used to evaluate renal tubular function. High altitude increased Ualb...... from 2.8 to > 5.0 micrograms/min in both groups (P high altitude significantly increased filtration fraction (P

Air pollution from biodegradable wastes and non-specific health symptoms among residents

DEFF Research Database (Denmark)

Blanes-Vidal, Victoria

2015-01-01

Adverse health effects of exposure to high levels of air pollutants from biodegradable wastes have been well-studied. However, few investigations have examined the potential effects of chronic exposure to low-to-moderate levels on non-specific health symptoms among residents. Besides, most studies...... have relied on distances to waste sites to assign exposure status, and have not investigated whether the exposure-symptoms associations are direct or mediated by odor annoyance. In this study, individual-level exposures to a proxy indicator of biodegradable waste pollution (ammonia, NH3) in non......-urban residences (n=454) during 2005-2010 were characterized by data from emission-dispersion validated models. Logistic regression and mediating analyses were used to examine associations between exposures and questionnaire-based data on annoyance and non-specific symptoms, after adjusting by person...

Alcohol consumption in relation to residence status and ethnicity in college students.

Science.gov (United States)

Cacciola, Eleanora E T; Nevid, Jeffrey S

2014-12-01

The present study examined the roles of gender, ethnicity, and residence status in an ethnically diverse sample of undergraduate students who completed the Core Alcohol and Drug Survey. Gender, ethnicity, and residential status were associated with likelihood of binge drinking among students who reported consuming alcohol (non-Hispanic). White students were more likely to report using alcohol than Black students and Asian students. Ethnicity moderated the effects of both residence status and gender on alcohol consumption. Living with one's parents was associated with a lower likelihood of reported alcohol use among Hispanic students, but not among (non-Hispanic) White students. Hispanic women were more likely to report using alcohol than were Hispanic men, but no gender difference in likelihood of alcohol consumption was found among (non-Hispanic) White students.

Modeling of Air Attenuation Effects on Gamma Detection at Altitude

International Nuclear Information System (INIS)

Detwiler, R. S.

2002-01-01

This paper focuses on modeling the detection capabilities of NaI sensor systems at high altitudes for ground sources. The modeling was done with the Monte Carlo N-Transport (MCNP) code developed at Los Alamos National Laboratory. The specific systems modeled were the fixed wing and helicopter aircraft sensor systems, assets of the U. S. Department of Energy's National Nuclear Security Administration Nevada Operations Office (NNSA/NV) Aerial Measuring System (AMS). In previous (2001) modeling, Sodium Iodine (NaI) detector responses were simulated for both point and distributed surface sources as a function of gamma energy and altitude. For point sources, photo-peak efficiencies were calculated for a zero radial distance and an offset equal to the altitude. For distributed sources approximating an infinite plane, gross count efficiencies were calculated and normalized to a uniform surface deposition of 1 (micro)Ci/m 2 . To validate the calculations, benchmark measurements were made for simple source-detector configurations. The 2002 continuation of the modeling presented here includes checking models against available data, and modifications to allow more effective and accurate directional biasing of ground point and distributed sources. Fixed-wing data results will be shown for two point sources as a function of altitude

Needs Assessment for Incoming PGY-1 Residents in Neurosurgical Residency.

Science.gov (United States)

Brandman, David M; Haji, Faizal A; Matte, Marie C; Clarke, David B

2015-01-01

Residents must develop a diverse range of skills in order to practice neurosurgery safely and effectively. The purpose of this study was to identify the foundational skills required for neurosurgical trainees as they transition from medical school to residency. Based on the CanMEDS competency framework, a web-based survey was distributed to all Canadian academic neurosurgical centers, targeting incoming and current PGY-1 neurosurgical residents as well as program directors. Using Likert scale and free-text responses, respondents rated the importance of various cognitive (e.g. management of raised intracranial pressure), technical (e.g. performing a lumbar puncture) and behavioral skills (e.g. obtaining informed consent) required for a PGY-1 neurosurgical resident. Of 52 individuals contacted, 38 responses were received. Of these, 10 were from program directors (71%), 11 from current PGY-1 residents (58%) and 17 from incoming PGY-1 residents (89%). Respondents emphasized operative skills such as proper sterile technique and patient positioning; clinical skills such as lesion localization and interpreting neuro-imaging; management skills for common scenarios such as raised intracranial pressure and status epilepticus; and technical skills such as lumbar puncture and external ventricular drain placement. Free text answers were concordant with the Likert scale results. We surveyed Canadian neurosurgical program directors and PGY-1 residents to identify areas perceived as foundational to neurosurgical residency education and training. This information is valuable for evaluating the appropriateness of a training program's goals and objectives, as well as for generating a national educational curriculum for incoming PGY-1 residents.

Are macroinvertebrates in high altitude streams affected by oxygen deficiency?

DEFF Research Database (Denmark)

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

2003-01-01

1. The solubility of oxygen in water increases with decreasing temperature. This has led to a general perception of cold, high mountain streams as more oxygen rich than warmer lowland streams, and that macroinvertebrates inhabiting high altitude streams have had no need to adapt to critical oxygen...... 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...... the mean weight-specific respiratory rate of macroinvertebrates declined by only 50%, from 400 to 3800 m. We suggest that this disproportionately large gap between availability and demand of oxygen at high altitudes may imply a potential oxygen deficiency for the fauna, and we discuss how oxygen deficiency...

A Robust Photogrammetric Processing Method of Low-Altitude UAV Images

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Mingyao Ai

2015-02-01

Full Text Available Low-altitude Unmanned Aerial Vehicles (UAV images which include distortion, illumination variance, and large rotation angles are facing multiple challenges of image orientation and image processing. In this paper, a robust and convenient photogrammetric approach is proposed for processing low-altitude UAV images, involving a strip management method to automatically build a standardized regional aerial triangle (AT network, a parallel inner orientation algorithm, a ground control points (GCPs predicting method, and an improved Scale Invariant Feature Transform (SIFT method to produce large number of evenly distributed reliable tie points for bundle adjustment (BA. A multi-view matching approach is improved to produce Digital Surface Models (DSM and Digital Orthophoto Maps (DOM for 3D visualization. Experimental results show that the proposed approach is robust and feasible for photogrammetric processing of low-altitude UAV images and 3D visualization of products.

SPLENIC INFARCTION: an intriguing and important cause of pain abdomen in high altitude

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P. K. Hota

2015-01-01

Full Text Available Background: Patients with Sickle cell trait (SCT are usually asymptomatic. They are usually unaware of their condition unless they have a family history. There are specific situations, where these people suffer from the effects of sickle cell trait. Splenic syndrome at high altitude is one of the specific problems. It is usually seen after a patient with SCT has been inducted to high altitude like in case of mountaineers and military personnel deployed in high altitude warfare. Pain abdomen due to splenic infarction in individuals with SCT is one of the manifestations. These patients, if diagnosed in time, they can be spared from unnecessary surgical interventions. We present herewith our experience of splenic infarction due to SCT in high altitude and their management.

[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

Variability of Diurnal Temperature Range During Winter Over Western Himalaya: Range- and Altitude-Wise Study

Science.gov (United States)

Shekhar, M. S.; Devi, Usha; Dash, S. K.; Singh, G. P.; Singh, Amreek

2018-04-01

The current trends in diurnal temperature range, maximum temperature, minimum temperature, mean temperature, and sun shine hours over different ranges and altitudes of Western Himalaya during winter have been studied. Analysis of 25 years of data shows an increasing trend in diurnal temperature range over all the ranges and altitudes of Western Himalaya during winter, thereby confirming regional warming of the region due to present climate change and global warming. Statistical studies show significant increasing trend in maximum temperature over all the ranges and altitudes of Western Himalaya. Minimum temperature shows significant decreasing trend over Pir Panjal and Shamshawari range and significant increasing trend over higher altitude of Western Himalaya. Similarly, sunshine hours show significant decreasing trend over Karakoram range. There exists strong positive correlation between diurnal temperature range and maximum temperature for all the ranges and altitudes of Western Himalaya. Strong negative correlation exists between diurnal temperature range and minimum temperature over Shamshawari and Great Himalaya range and lower altitude of Western Himalaya. Sunshine hours show strong positive correlation with diurnal temperature range over Pir Panjal and Great Himalaya range and lower and higher altitudes.

A dictionary of altitudes in the United States (second edition)

Science.gov (United States)

Gannett, Henry

1891-01-01

I have the honor to transmit herewith the manuscript of a second edition of a Dictionary of Altitudes, the first edition having been published in 1884. The present work is considerably enlarged, mainly by the addition of determinations of altitudes by railroads. Besides the additions of matter, the principal change from the earlier edition consists in the substitution of a single alphabetic arrangement throughout the work for an alphabetic arrangement by States.

Can changes in psychosocial factors and residency explain the decrease in physical activity during the transition from high school to college or university?

Science.gov (United States)

Van Dyck, Delfien; De Bourdeaudhuij, Ilse; Deliens, Tom; Deforche, Benedicte

2015-04-01

When students make the transition from high school to college or university, their physical activity (PA) levels decrease strongly. Consequently, it is of crucial importance to identify the determinants of this decline in PA. The study aims were to (1) examine changes in psychosocial factors in students during the transition from high school to college/university, (2) examine if changes in psychosocial factors and residency can predict changes in PA, and (3) investigate the moderating effects of residency on the relationship between changes in psychosocial factors and changes in PA. Between March 2008 and October 2010, 291 Flemish students participated in a longitudinal study, with baseline measurements during the final year of high school and follow-up measurements at the start of second year of college/university. At both time points, participants completed a questionnaire assessing demographics, active transportation, leisure-time sports, psychosocial variables, and residency. Repeated measures MANOVA analyses and multiple moderated hierarchic regression analyses were conducted. Modeling, self-efficacy, competition-related benefits, and health-related, external and social barriers decreased, while health-related benefits and time-related barriers increased from baseline to follow-up. Decreases in modeling and time-related barriers were associated with a decrease in active transportation (adjusted R(2) = 3.2%); residency, decreases in self-efficacy, competition-related benefits, and increases in health- and time-related barriers predicted a decrease in leisure-time sports (adjusted R(2) = 29.3%). Residency only moderated two associations between psychosocial factors and changes in PA. Residency and changes in psychosocial factors were mainly important to explain the decrease in leisure-time sports. Other factors such as distance to college/university are likely more important to explain the decrease in active transportation; these are worth exploring in

Does the care dependency of nursing home residents influence their health-related quality of life?-A cross-sectional study.

Science.gov (United States)

Tabali, Manuela; Ostermann, Thomas; Jeschke, Elke; Dassen, Theo; Heinze, Cornelia

2013-03-11

Studies on health-related quality of life (HRQOL) are missing for nursing home residents independent from their health conditions or interventions after admission. Our aim was to analyse if the care dependency of nursing home residents influence their HRQOL and to describe HRQOL of nursing home residents at the time of admission. Eleven German nursing homes were randomly selected for a cross-sectional multicentre study from April 2008 until December 2009. HRQOL was measured with the Nottingham Health Profile (NHP) in the six domains "Physical Mobility", "Energy", "Pain", "Social Isolation", "Emotional Reaction" and "Sleep". Domain scores range from zero (good subjective health status) to 100 (poor subjective health status). Care dependency was evaluated using the Care Dependency Scale, age, sex, cognitive status and diseases were documented by the research assistants. Multivariate regression analysis was performed to quantify the influence of care dependency on HRQOL. 120 residents were included in total. HRQOL was mostly reduced in the domains "Physical Mobility" and "Energy" (mean scores >43.0), while impairment differences in the domains "Pain", "Social Isolation", "Emotional Reaction" and "Sleep" were only moderate (≤25.0). HRQOL was not influenced by the age. Women (n = 85) had a significantly poorer HRQOL in the domain "Pain" than men (mean score women: 29.5 ± 31.5; males: 14.9 ± 17.2; p = 0.011). Care dependency had an influence on the domain "Sleep" (ß = -0.195, p = 0.031), while the other domains were not influenced by care dependency. Residents with a low care dependency scored significantly lower (better HRQOL) in the domain "Sleep" than residents with a high care dependency (mean score 15.3; SD ± 19.0 versus mean score 32.8 SD ± 33.2; p dependency has no influence on the HRQOL from the nursing home residents' perspective apart from the domain "Sleep". High care dependency residents have a lower HRQOL in the

Quantifying altitude of human habitation in studies of human health using geographical name server data

Directory of Open Access Journals (Sweden)

Stephen Thielke

2016-11-01

Full Text Available Almost all studies examining the effects of altitude on human health have estimated the geographical altitude of defined regions, yet the primary interest lies in where people live, not the land around them. Populations are not homogenously distributed across altitudes. We propose a straightforward and computationally simple method for estimating the average altitude of habitation within the regional units for which health statistics are typically reported (such as counties. The United States Board on Geographical Names database contains records for over 2.7 million places, which can be processed to select places that are associated with human habitation. These points can easily be averaged by region yielding a representative altitude of human habitation within city, county, state regions, or by longitude and latitude zones. We provide an example of using this approach in a study of human health, and compare it with three other previously used methods of estimating altitude for counties.

High Altitude Balloons as a Platform for Space Radiation Belt Science

Science.gov (United States)

Mazzino, L.; Buttenschoen, A.; Farr, Q.; Hodgson, C.; Johnson, W.; Mann, I. R.; Rae, J.; University of Alberta High Altitude Balloons (UA-HAB)

2011-12-01

The goals of the University of Alberta High Altitude Balloons Program (UA-HAB) are to i) use low cost balloons to address space radiation science, and ii) to utilise the excitement of "space mission" involvement to promote and facilitate the recruitment of undergraduate and graduate students in physics, engineering, and atmospheric sciences to pursue careers in space science and engineering. The University of Alberta High Altitude Balloons (UA-HAB) is a unique opportunity for University of Alberta students (undergraduate and graduate) to engage in the hands-on design, development, build, test and flight of a payload to operate on a high altitude balloon at around 30km altitude. The program development, including formal design and acceptance tests, reports and reviews, mirror those required in the development of an orbital satellite mission. This enables the students to gain a unique insight into how space missions are flown. UA-HAB is a one and half year program that offers a gateway into a high-altitude balloon mission through hands on experience, and builds skills for students who may be attracted to participate in future space missions in their careers. This early education will provide students with the experience necessary to better assess opportunities for pursuing a career in space science. Balloons offer a low-cost alternative to other suborbital platforms which can be used to address radiation belt science goals. In particular, the participants of this program have written grant proposal to secure funds for this project, have launched several 'weather balloon missions', and have designed, built, tested, and launched their particle detector called "Maple Leaf Particle Detector". This detector was focussed on monitoring cosmic rays and space radiation using shielded Geiger tubes, and was flown as one of the payloads from the institutions participating in the High Altitude Student Platform (HASP), organized by the Louisiana State University and the Louisiana

Correlates of University Students’ Soft and Energy Drink Consumption According to Gender and Residency

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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. Four hundred twenty-five university students completed a self-reported on-line questionnaire assessing socio-demographics, health status, soft and energy drink consumption, as well as personal and environmental factors related to soft and energy drink consumption. Multiple linear regression analyses were conducted. Students believing soft drink intake should be minimized (individual subjective norm), finding it less difficult to avoid soft drinks (perceived behavioral control), being convinced they could avoid soft drinks in different situations (self-efficacy), having family and friends who rarely consume soft drinks (modelling), and having stricter family rules about soft drink intake were less likely to consume soft drinks. Students showing stronger behavioral control, having stricter family rules about energy drink intake, and reporting lower energy drink availability were less likely to consume energy drinks. Gender and residency moderated several associations between psychosocial constructs and consumption. Future research should investigate whether interventions focusing on the above personal and environmental correlates can indeed improve university students’ beverage choices. PMID:26258790

Solar Cell Short Circuit Current Errors and Uncertainties During High Altitude Calibrations

Science.gov (United States)

Snyder, David D.

2012-01-01

High altitude balloon based facilities can make solar cell calibration measurements above 99.5% of the atmosphere to use for adjusting laboratory solar simulators. While close to on-orbit illumination, the small attenuation to the spectra may result in under measurements of solar cell parameters. Variations of stratospheric weather, may produce flight-to-flight measurement variations. To support the NSCAP effort, this work quantifies some of the effects on solar cell short circuit current (Isc) measurements on triple junction sub-cells. This work looks at several types of high altitude methods, direct high altitude meas urements near 120 kft, and lower stratospheric Langley plots from aircraft. It also looks at Langley extrapolation from altitudes above most of the ozone, for potential small balloon payloads. A convolution of the sub-cell spectral response with the standard solar spectrum modified by several absorption processes is used to determine the relative change from AMO, lscllsc(AMO). Rayleigh scattering, molecular scatterin g from uniformly mixed gases, Ozone, and water vapor, are included in this analysis. A range of atmosph eric pressures are examined, from 0. 05 to 0.25 Atm to cover the range of atmospheric altitudes where solar cell calibrations a reperformed. Generally these errors and uncertainties are less than 0.2%

Increased Hypoxic Dose After Training at Low Altitude with 9h Per Night at 3000m Normobaric Hypoxia.

Science.gov (United States)

Carr, Amelia J; Saunders, Philo U; Vallance, Brent S; Garvican-Lewis, Laura A; Gore, Christopher J

2015-12-01

This study examined effects of low altitude training and a live-high: train-low protocol (combining both natural and simulated modalities) on haemoglobin mass (Hbmass), maximum oxygen consumption (VO2max), time to exhaustion, and submaximal exercise measures. Eighteen elite-level race-walkers were assigned to one of two experimental groups; lowHH (low Hypobaric Hypoxia: continuous exposure to 1380 m for 21 consecutive days; n = 10) or a combined low altitude training and nightly Normobaric Hypoxia (lowHH+NHnight: living and training at 1380 m, plus 9 h.night(-1) at a simulated altitude of 3000 m using hypoxic tents; n = 8). A control group (CON; n = 10) lived and trained at 600 m. Measurement of Hbmass, time to exhaustion and VO2max was performed before and after the training intervention. Paired samples t-tests were used to assess absolute and percentage change pre and post-test differences within groups, and differences between groups were assessed using a one-way ANOVA with least significant difference post-hoc testing. Statistical significance was tested at p altitude (1380 m) combined with sleeping in altitude tents (3000 m) as one effective alternative to traditional altitude training methods, which can improve Hbmass. Key pointsIn some countries, it may not be possible to perform classical altitude training effectively, due to the low elevation at altitude training venues. An additional hypoxic stimulus can be provided by simulating higher altitudes overnight, using altitude tents.Three weeks of combined (living and training at 1380 m) and simulated altitude exposure (at 3000 m) can improve haemoglobin mass by over 3% in comparison to control values, and can also improve time to exhaustion by ~9% in comparison to baseline.We recommend that, in the context of an altitude training camp at low altitudes (~1400 m) the addition of a relatively short exposure to simulated altitudes of 3000 m can elicit physiological and performance benefits, without compromise to

Elective time during dermatology residency: A survey of residents and program directors.

Science.gov (United States)

Uppal, Pushpinder; Shantharam, Rohini; Kaufmann, Tara Lynn

2017-12-15

Elective time during residency training provides residents with exposure to different subspecialties. This opportunity gives residents the chance tonurture growth in particular areas of interest and broaden their knowledge base in certain topics in dermatology by having the chance to work withexperts in the field. The purpose of this study was to assess the views of residency program directors and dermatology residents on the value of elective time through a cross sectional survey. An eight-questionIRB exempt survey was sent out to 113 residency program directors via email through the American Professors of Dermatology (APD) program director listserv. Program directors were asked to forward a separate set of 9 questions to their residents. The majority of programs that responded allowed for some elective time within their schedule, often duringthe PGY 4 (3rd year of dermatology training), but the amount of time allowed widely varied among many residency programs. Overall, residents and program directors agree that elective is important in residencytraining, but no standardization is established across programs.

Maltreatment, Coping, and Substance Use in Youth in Foster Care: Examination of Moderation Models.

Science.gov (United States)

Gabrielli, Joy; Jackson, Yo; Huffhines, Lindsay; Stone, Katie

2018-05-01

Child maltreatment is associated with negative outcomes such as substance use (SU). This study tested relations among maltreatment history, coping behavior, and SU behavior in youth residing in foster care. Participants were 210 youth ( M age = 12.71 years; SD = 2.95) in foster care who completed self-report measures through an audio computer-assisted self-interview program. Using a structural equation modeling framework and latent measurement constructs, positive associations were identified between maltreatment at baseline and coping behavior outcomes as well as SU behavior outcome approximately 4.5 months later. Specifically, greater severity and chronicity of maltreatment was associated with greater SU behavior as well as indirect action, prosocial, and asocial coping behavior. Maltreatment was not significantly related to direct action coping behavior. In moderation tests, only asocial coping provided a significant interaction effect for SU behavior outcomes; SU behavior did not moderate pathways between maltreatment and coping behavior. For youth in foster care, the coping approach may be varied and relate differentially to SU behavior outcomes, with asocial approaches to coping acting as a buffer for the maltreatment/SU relation. Additionally, SU remains an important target for intervention and prevention in youth residing in foster care.

A Systematic Review of the Effects of Resident Duty Hour Restrictions in Surgery

Science.gov (United States)

Devitt, Katharine S.; Keshet, Itay; Spicer, Jonathan; Imrie, Kevin; Feldman, Liane; Cools-Lartigue, Jonathan; Kayssi, Ahmed; Lipsman, Nir; Elmi, Maryam; Kulkarni, Abhaya V.; Parshuram, Chris; Mainprize, Todd; Warren, Richard J.; Fata, Paola; Gorman, M. Sean; Feinberg, Stan; Rutka, James

2014-01-01

Background: In 2003, the Accreditation Council for Graduate Medical Education (ACGME) mandated 80-hour resident duty limits. In 2011 the ACGME mandated 16-hour duty maximums for PGY1 (post graduate year) residents. The stated goals were to improve patient safety, resident well-being, and education. A systematic review and meta-analysis were performed to evaluate the impact of resident duty hours (RDH) on clinical and educational outcomes in surgery. Methods: A systematic review (1980–2013) was executed on CINAHL, Cochrane Database, Embase, Medline, and Scopus. Quality of articles was assessed using the GRADE guidelines. Sixteen-hour shifts and night float systems were analyzed separately. Articles that examined mortality data were combined in a random-effects meta-analysis to evaluate the impact of RDH on patient mortality. Results: A total of 135 articles met the inclusion criteria. Among these, 42% (N = 57) were considered moderate-high quality. There was no overall improvement in patient outcomes as a result of RDH; however, some studies suggest increased complication rates in high-acuity patients. There was no improvement in education related to RDH restrictions, and performance on certification examinations has declined in some specialties. Survey studies revealed a perception of worsened education and patient safety. There were improvements in resident wellness after the 80-hour workweek, but there was little improvement or negative effects on wellness after 16-hour duty maximums were implemented. Conclusions: Recent RDH changes are not consistently associated with improvements in resident well-being, and have negative impacts on patient outcomes and performance on certification examinations. Greater flexibility to accommodate resident training needs is required. Further erosion of training time should be considered with great caution. PMID:24662409

Metabolic Effects of High Altitude Trekking in Patients With Type 2 Diabetes

NARCIS (Netherlands)

de Mol, Pieter; Fokkert, Marion J.; de Vries, Suzanna T.; de Koning, Eelco J. P.; Dikkeschei, Bert D.; Gans, Rijnold O. B.; Tack, Cees J.; Bilo, Henk J. G.

2012-01-01

OBJECTIVE-Limited information is available regarding the metabolic effects of high altitude trekking in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS-Thirteen individuals with type 2 diabetes took part, in a 12-day expedition to the summit of Mount Toubkal (altitude, 4,167 m), Morocco,

Metabolic effects of high altitude trekking in patients with type 2 diabetes

NARCIS (Netherlands)

Mol, P. de; Fokkert, M.J.; Vries, S.T. de; Koning, E.J. de; Dikkeschei, B.D.; Gans, R.O.; Tack, C.J.J.; Bilo, H.J.

2012-01-01

OBJECTIVE Limited information is available regarding the metabolic effects of high altitude trekking in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Thirteen individuals with type 2 diabetes took part in a 12-day expedition to the summit of Mount Toubkal (altitude, 4,167 m), Morocco,

Science 101: Why Does It Take Longer to Boil Potatoes at High Altitudes?

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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.

Experimental StudyHigh Altitude Forced Convective Cooling of Electromechanical Actuation Systems

Science.gov (United States)

2016-01-01

34 Massachusetts Institute of Technology , 1989. [3] FedBizOps.Gov, " Integrated Vehicle Energy Technology (INVENT) Development Program for the 6th...AFRL-RQ-WP-TR-2016-0043 EXPERIMENTAL STUDY—HIGH ALTITUDE FORCED CONVECTIVE COOLING OF ELECTROMECHANICAL ACTUATION SYSTEMS Evan M. Racine...TITLE AND SUBTITLE EXPERIMENTAL STUDY—HIGH ALTITUDE FORCED CONVECTIVE COOLING OF ELECTROMECHANICAL ACTUATION SYSTEMS 5a. CONTRACT NUMBER In-house

Athletic altitude training protocols and their application in preparation for mountainous operations.

Science.gov (United States)

Heil, K M; Keenan, A C M

2014-01-01

In recent years, small scale counter-insurgency and expeditionary operations have frequently taken place in mountainous, high-altitude areas. Preparation of soldiers for these environments has typically focussed on extended stays at altitude to ensure physiological acclimatisation. However, with the likelihood that future UK deployments may be unpredictable and thus with little time for preparation, is there a means by which the same acclimatisation may be achieved? The field of athletics has been researching such adaptations since the rise of the elite North African long-distance runners in the 1960s. These athletes all lived high above sea level and had become accustomed to performing in the relatively hypoxic environment found at high altitudes. The research has focussed on eliciting physiological acclimatisation in as short a time as possible, while maintaining the ability to train at the correct intensity. In the following review of altitude training we highlight areas for future investigation and assess whether protocols developed for athletes can be applied to military personnel.

HSP70 expression in the copper butterfly Lycaena tityrus across altitudes and temperatures

DEFF Research Database (Denmark)

Karl, I.; Sørensen, Jesper Givskov; Loeschcke, Volker

2009-01-01

temperatures show differences in HSP70 expression. HSP70 expression increased substantially at the higher rearing temperature in low-altitude butterflies, which might represent an adaptation to occasionally occurring heat spells. On the other hand, high-altitude butterflies showed much less plasticity...... in response to rearing temperatures, and overall seem to rely more on genetically fixed thermal stress resistance. Whether the latter indicates a higher vulnerability of high-altitude populations to global warming needs further investigation. HSP70 expression increased with both colder and warmer induction......The ability to express heat-shock proteins (HSP) under thermal stress is an essential mechanism for ectotherms to cope with unfavourable conditions. In this study, we investigate if Copper butterflies originating from different altitudes and/or being exposed to different rearing and induction...

Effect of altitude on the protein metabolism of Bolivian children

International Nuclear Information System (INIS)

San Miguel Simron, J.L.; Berger, J.; Spielvogel, H.; Tellez Castellon, W.; Lujan Medina, C.; Caceres, E.

1996-01-01

The malnutrition is prevalent and is a major problem among Bolivian children. It is caused by several interacting factors: (1) inadequate protein energy intake due to low socio-economic status; (ii) exposure to acute, repeated and chronic bacterial infections; (iii) exposure to multiple and chronic parasitic infections; (iv) high altitude of the capital, La Paz, 3600 m, with a numerous populations compared to the rest of the country. The research objectives in the first phase are: (i) determination of protein utilization with a non-invasive method using stable isotope tracer among children living at high and low altitude; (ii) determination of protein metabolism among eutrophic children without parasitic or acute bacterial infections at both altitudes; (iii) determination of protein requirement among these children. Two groups of 10 pubertal children, matched for age and sex, of same socio-economic status, eutrophic, without malnutrition, infections or intestinal parasites will be studied; the different status being arrived by anthropometric, nutritional intake, biochemical and pediatrical evaluation. For the metabolic study, stable isotopes L-[1-13C] leucine labelled casein will be used and 13 CO 2 excreted will be measured. All the basic nutritional assessment and VCO 2 measurements will be performed in Bolivia, while the samples of expired gas will be stored in Vacutainers for further analysis by isotope radio mass spectrometer (IRMS), in Clermont-Ferrand, France. The plans for future work is based on the study of the effects of the different variables and their interactions. The following will be evaluated: (i) the socio-economic status; (ii) the bacterial infections: (iii) the parasitic infections; (iv) the altitude. As published by Obert, et al., the socio-economic variable is more connected with the nutritional status than with the altitude. 12 refs, 1 fig., 1 tab

Effect of altitude on the protein metabolism of Bolivian children

Energy Technology Data Exchange (ETDEWEB)

San Miguel Simron, J L; Berger, J; Spielvogel, H; Tellez Castellon, W; Lujan Medina, C; Caceres, E [Instituto Boliviano de Boliviano de Biologia de Altura, La Paz (Bolivia). Dept. de Nutricion; Beaufrere, B; Gachons, P; Coudert, J [Laboratoire de Nutrition Humaine, Clermont-Ferrand (France)

1997-12-31

The malnutrition is prevalent and is a major problem among Bolivian children. It is caused by several interacting factors: (1) inadequate protein energy intake due to low socio-economic status; (ii) exposure to acute, repeated and chronic bacterial infections; (iii) exposure to multiple and chronic parasitic infections; (iv) high altitude of the capital, La Paz, 3600 m, with a numerous populations compared to the rest of the country. The research objectives in the first phase are: (i) determination of protein utilization with a non-invasive method using stable isotope tracer among children living at high and low altitude; (ii) determination of protein metabolism among eutrophic children without parasitic or acute bacterial infections at both altitudes; (iii) determination of protein requirement among these children. Two groups of 10 pubertal children, matched for age and sex, of same socio-economic status, eutrophic, without malnutrition, infections or intestinal parasites will be studied; the different status being arrived by anthropometric, nutritional intake, biochemical and pediatrical evaluation. For the metabolic study, stable isotopes L-[1-13C] leucine labelled casein will be used and {sup 13}CO{sub 2} excreted will be measured. All the basic nutritional assessment and VCO{sub 2} measurements will be performed in Bolivia, while the samples of expired gas will be stored in Vacutainers for further analysis by isotope radio mass spectrometer (IRMS), in Clermont-Ferrand, France. The plans for future work is based on the study of the effects of the different variables and their interactions. The following will be evaluated: (i) the socio-economic status; (ii) the bacterial infections: (iii) the parasitic infections; (iv) the altitude. As published by Obert, et al., the socio-economic variable is more connected with the nutritional status than with the altitude. 12 refs, 1 fig., 1 tab.

Reproductive performance of peranakan ongole (PO) bull at different altitudes areas in Lampung province

Science.gov (United States)

Suretno, N. D.; Supriyatna, I.; Purwanto, B.; Priyanto, R.

2018-01-01

Peranakan Ongole (PO) cattle are famous for their bulls and known for their toughness, rapid growth and natural tolerance to tropical heat and disease resistance. This study was conducted to determine the reproductive performance of PO bull in some altitude in Lampung Province. A total of PO bulls used were 48 heads, with age three to four years. The variables observed were volume, consistency, pH, semen colour, concentration, mass movement, motility, percentage of living spermatozoa and abnormality. Data were collected during the rainy season and dry season, calculated with the average and standard deviation and then analyzed descriptively. Based on the macroscopic examination, Peranakan Ongole bull living in low temperature place had a normal semen volume, the consistency mostly watery to moderate, fresh semen pH is in the normal range and the color of semen are all normal both in the rainy and dry seasons. The results of microscopic examination showed that PO cattle had a good reproduction conditions at all three

Training-dependent cognitive advantage is suppressed at high altitude.

Science.gov (United States)

Li, Peng; Zhang, Gang; You, Hai-Yan; Zheng, Ran; Gao, Yu-Qi

2012-06-25

Ascent to high altitude is associated with decreases in cognitive function and work performance as a result of hypoxia. Some workers with special jobs typically undergo intensive mental training because they are expected to be agile, stable and error-free in their job performance. The purpose of this study was to determine the risk to cognitive function acquired from training following hypoxic exposure. The results of WHO neurobehavioral core tests battery (WHO-NCTB) and Raven's standard progressive matrices (RSPM) tests of a group of 54 highly trained military operators were compared with those of 51 non-trained ordinary people and were investigated at sea level and on the fifth day after arrival at high altitudes (3900m). Meanwhile, the plasma levels of brain-derived neurotrophic factor (BDNF), interleukin 1β (IL-1β) and vascular endothelial growth factor (VEGF) were examined. The result showed that at sea level, the trained group exhibited significantly better performance on neurobehavioral and RSPM tests. At high altitude, both groups had decreased accuracy in most cognitive tests and took longer to finish them. More importantly, the highly trained subjects showed more substantial declines than the non-trained subjects in visual reaction accuracy, auditory reaction speed, digit symbol scores, ability to report correct dots in a pursuit aiming test and total RSPM scores. This means that the training-dependent cognitive advantages in these areas were suppressed at high altitudes. The above phenomenon maybe associated with decreased BDNF and elevated inflammatory factor during hypoxia, and other mechanisms could not be excluded. Copyright © 2012 Elsevier Inc. All rights reserved.

Pediatric dermatology training during residency: a survey of the 2014 graduating residents.

Science.gov (United States)

Akhavan, Alaleh; Murphy-Chutorian, Blair; Friedman, Adam

2015-01-01

Knowledge of pediatric dermatology is considered a core competency of dermatology training and should be expected of all practicing dermatologists. While the numbers of both pediatric dermatology fellowships and board certified pediatric dermatologists in the workforce have increased over the years, recent reports suggest that there is a gap in pediatric dermatology education during dermatology residency. The goal of this study is to assess the current state of pediatric education during residency, as well as the clinical experience, satisfaction and expectations of graduating dermatology residents. A 31-question self-report survey was distributed electronically to 294 third-year dermatology residents with questions pertaining to demographics, didactic education, resident experience in pediatric dermatology training, satisfaction with pediatric training and future plans. One hundred and twenty-three residents responded (41.8% response rate) representing approximately 29.1% of the total number of graduating residents. 69 (56.1%) residents reported academic time specifically devoted to pediatric dermatology, the majority (79.7%) of which was led by pediatric dermatologists. 82% of residents reported dedicated pediatric dermatology clinics at their program. 86.8% of respondents felt that their training in pediatric dermatology will allow them to confidently see pediatric dermatology patients in practice. This survey highlights a promising state of pediatric dermatology training among current graduating dermatology residents. The majority of current graduating dermatology residents are satisfied with their pediatric dermatology education, feel confident treating pediatric patients, and plan to see pediatric patients in clinical practice. © 2015 Wiley Periodicals, Inc.

Aspirated Compressors for High Altitude Engines, Phase I

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...

Selection criteria of residents for residency programs in Kuwait.

Science.gov (United States)

Marwan, Yousef; Ayed, Adel

2013-01-19

In Kuwait, 21 residency training programs were offered in the year 2011; however, no data is available regarding the criteria of selecting residents for these programs. This study aims to provide information about the importance of these criteria. A self-administered questionnaire was used to collect data from members (e.g. chairmen, directors, assistants …etc.) of residency programs in Kuwait. A total of 108 members were invited to participate. They were asked to rate the importance level (scale from 1 to 5) of criteria that may affect the acceptance of an applicant to their residency programs. Average scores were calculated for each criterion. Of the 108 members invited to participate, only 12 (11.1%) declined to participate. Interview performance was ranked as the most important criteria for selecting residents (average score: 4.63/5.00), followed by grade point average (average score: 3.78/5.00) and honors during medical school (average score: 3.67/5.00). On the other hand, receiving disciplinary action during medical school and failure in a required clerkship were considered as the most concerning among other criteria used to reject applicants (average scores: 3.83/5.00 and 3.54/5.00 respectively). Minor differences regarding the importance level of each criterion were noted across different programs. This study provided general information about the criteria that are used to accept/reject applicants to residency programs in Kuwait. Future studies should be conducted to investigate each criterion individually, and to assess if these criteria are related to residents' success during their training.

High altitude and hemoglobin function in the vultures Gyps rueppelli and Aegypius monachus

DEFF Research Database (Denmark)

Weber, Roy E.; Hiebl, Inge; Braunitzer, Gerhard

1988-01-01

Functional characteristics of the stripped composite hemoglobins (Hbs) of lhevultures Gyps rueppellii and Aegypills monachus that can fly at extremely high altitudes, and of component Hbs of G. rueppellii are reported, in relation to influences of pH, temperalure and inositol hexaphosphate. G...... structures of the constituent polypeptide chains to trace molecular adaptations to high-altitude respiration, and to physiological factors (pulmonary hypoxia and hypocapnia, body temperature shifts, and lung and nasal gas and heat exchange) to discern their possible survival value at altitudes of 11300 m....

Civilian Training in High-Altitude Flight Physiology

Science.gov (United States)

1991-08-01

A survey was conducted to determine if training in high-altitude physiology should : be required for civilian pilots; what the current status of such training was; and, : if required, what should be included in an ideal curriculum. The survey include...

Altitude Testing of Large Liquid Propellant Engines

Science.gov (United States)

Maynard, Bryon T.; Raines, Nickey G.

2010-01-01

The National Aeronautics and Space Administration entered a new age on January 14, 2004 with President Bush s announcement of the creation the Vision for Space Exploration that will take mankind back to the Moon and on beyond to Mars. In January, 2006, after two years of hard, dedicated labor, engineers within NASA and its contractor workforce decided that the J2X rocket, based on the heritage of the Apollo J2 engine, would be the new engine for the NASA Constellation Ares upper stage vehicle. This engine and vehicle combination would provide assured access to the International Space Station to replace that role played by the Space Shuttle and additionally, would serve as the Earth Departure Stage, to push the Crew Excursion Vehicle out of Earth Orbit and head it on a path for rendezvous with the Moon. Test as you fly, fly as you test was chosen to be the guiding philosophy and a pre-requisite for the engine design, development, test and evaluation program. An exhaustive survey of national test facility assets proved the required capability to test the J2X engine at high altitude for long durations did not exist so therefore, a high altitude/near space environment testing capability would have to be developed. After several agency concepts the A3 High Altitude Testing Facility proposal was selected by the J2X engine program on March 2, 2007 and later confirmed by a broad panel of NASA senior leadership in May 2007. This facility is to be built at NASA s John C. Stennis Space Center located near Gulfport, Mississippi. 30 plus years of Space Shuttle Main Engine development and flight certification testing makes Stennis uniquely suited to support the Vision For Space Exploration Return to the Moon. Propellant handling infrastructure, engine assembly facilities, a trained and dedicated workforce and a broad and varied technical support base will all ensure that the A3 facility will be built on time to support the schedule needs of the J2X engine and the ultimate flight

The airglow layer emission altitude cannot be determined unambiguously from temperature comparison with lidars

Science.gov (United States)

Dunker, Tim

2018-05-01

I investigate the nightly mean emission height and width of the OH* (3-1) layer by comparing nightly mean temperatures measured by the ground-based spectrometer GRIPS 9 and the Na lidar at ALOMAR. The data set contains 42 coincident measurements taken between November 2010 and February 2014, when GRIPS 9 was in operation at the ALOMAR observatory (69.3° N, 16.0° E) in northern Norway. To closely resemble the mean temperature measured by GRIPS 9, I weight each nightly mean temperature profile measured by the lidar using Gaussian distributions with 40 different centre altitudes and 40 different full widths at half maximum. In principle, one can thus determine the altitude and width of an airglow layer by finding the minimum temperature difference between the two instruments. On most nights, several combinations of centre altitude and width yield a temperature difference of ±2 K. The generally assumed altitude of 87 km and width of 8 km is never an unambiguous, good solution for any of the measurements. Even for a fixed width of ˜ 8.4 km, one can sometimes find several centre altitudes that yield equally good temperature agreement. Weighted temperatures measured by lidar are not suitable to unambiguously determine the emission height and width of an airglow layer. However, when actual altitude and width data are lacking, a comparison with lidars can provide an estimate of how representative a measured rotational temperature is of an assumed altitude and width. I found the rotational temperature to represent the temperature at the commonly assumed altitude of 87.4 km and width of 8.4 km to within ±16 K, on average. This is not a measurement uncertainty.

Preliminary study on alterations of altitude road traffic in China from 2006 to 2013

Science.gov (United States)

Zhao, Hui; Yin, Zhiyong; Xiang, Hongyi; Liao, Zhikang; Wang, Zhengguo

2017-01-01

Introduction Road traffic can play an important role in strengthening regional economic activities, especially at high altitude, and it is necessary to know important traffic-related information. Although previous studies reported on road traffic in China, there has been little research on high-altitude road traffic to date. Method The annual official census of road traffic safety from 2006 to 2013 was used to obtain data on the general population, registered drivers, registered vehicles, newly built roads, road traffic accidents (RTAs), mortality rate per 100 000 populations and per 10 000 vehicles in high-altitude provinces, including Tibet, Qinghai, Xinjiang, Gansu, Yunnan, Sichuan, and Chongqing. These provincial data were reviewed retrospectively, with the national data as the reference. Statistical analysis (i.e., t test) was used to compare the estimated average annual change rate of population, number of registered drivers, registered vehicles, and newly built roads in high-altitude provinces with the national rates. Results Compared with the national data, there are significantly higher annual rates of population growth in Tibet and Xinjiang, registered drivers in Gansu, registered vehicles in Gansu, Sichuan, and Chongqing, and newly built roads in Tibet and Qinghai. Among the investigated provinces, Tibet, Qinghai, and Yunnan had a higher proportion of the roads with the high class. RTAs and RTA-induced casualties in the high-altitude provinces indicated a decreasing trend. The mortality rate per 10 000 vehicles and per 100 000 populations showed a decreasing trend, while the RTA-related mortality rate in Tibet, Qinghai, Xinjiang and Gansu remained high. Conclusions Major changes for road traffic in high-altitude provinces have occurred over the past decade; however, the RTA-related mortality rate in high-altitude provinces has remained high. This study furthers understanding about road traffic safety in China; further studies on road traffic safety at

Preliminary study on alterations of altitude road traffic in China from 2006 to 2013.

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Hui Zhao

Full Text Available Road traffic can play an important role in strengthening regional economic activities, especially at high altitude, and it is necessary to know important traffic-related information. Although previous studies reported on road traffic in China, there has been little research on high-altitude road traffic to date.The annual official census of road traffic safety from 2006 to 2013 was used to obtain data on the general population, registered drivers, registered vehicles, newly built roads, road traffic accidents (RTAs, mortality rate per 100 000 populations and per 10 000 vehicles in high-altitude provinces, including Tibet, Qinghai, Xinjiang, Gansu, Yunnan, Sichuan, and Chongqing. These provincial data were reviewed retrospectively, with the national data as the reference. Statistical analysis (i.e., t test was used to compare the estimated average annual change rate of population, number of registered drivers, registered vehicles, and newly built roads in high-altitude provinces with the national rates.Compared with the national data, there are significantly higher annual rates of population growth in Tibet and Xinjiang, registered drivers in Gansu, registered vehicles in Gansu, Sichuan, and Chongqing, and newly built roads in Tibet and Qinghai. Among the investigated provinces, Tibet, Qinghai, and Yunnan had a higher proportion of the roads with the high class. RTAs and RTA-induced casualties in the high-altitude provinces indicated a decreasing trend. The mortality rate per 10 000 vehicles and per 100 000 populations showed a decreasing trend, while the RTA-related mortality rate in Tibet, Qinghai, Xinjiang and Gansu remained high.Major changes for road traffic in high-altitude provinces have occurred over the past decade; however, the RTA-related mortality rate in high-altitude provinces has remained high. This study furthers understanding about road traffic safety in China; further studies on road traffic safety at high altitude should be

Magnetic Pair Creation Attenuation Altitude Constraints in Gamma-Ray Pulsars

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