ABSTRACT High-altitude platforms (HAPs) are aircraft, usually unmanned airships or airplanes positioned above 20 km, in the stratosphere, in order to compose a telecommunications network or perform ...remote sensing. In the 1990 and 2000 decades, several projects were launched, but very few had continued. In 2014, 2 major Internet companies (Google and Facebook) announced investments in new HAP projects to provide Internet access in regions without communication infrastructure (terrestrial or satellite), bringing back attention to the development of HAP. This article aims to survey the history of HAPs, the current state-of-the-art (April 2016), technology trends and challenges. The main focus of this review will be on technologies directly related to the aerial platform, inserted in the aeronautical engineering field of knowledge, not detailing aspects of the telecommunications area.
After ascent to high altitude (≥2500 m), the inability of the human body to adapt to the hypobaric and hypoxia environment can induce tissue hypoxia, then a series of high altitude illnesses ...including acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE) would develop. Symptoms of AMS include headache, dizziness, nausea, and vomiting; HAPE is characterized by orthopnea, breathlessness at rest, cough, pink frothy sputum, and results in obvious pulmonary edema that poses significant harm to people; HACE is characterized by ataxia and decreased consciousness, leading to coma and brain herniation which would be fatal if not treated promptly. This review article provides a current understanding of the pathophysiology of these three forms of high altitude illness and elaborates the current prevention and treatment measures of these diseases.
•AHAI refers to a series of syndromes including AMS, HAPE and HACE.•HAPE is related with hypoxic pulmonary hypertension and alveolar fluid clearance.•AMS and HACE is related with cerebral hemodynamics and cytokines variation.•Current chemical drugs used to prevent AHAI have obvious toxic side effects.•Foodborne natural substances should be developed to prevent against AHAI.
Significance
The discovery of the archaic Denisovan hominins is one of the most significant findings in human evolutionary biology in the last decade. However, as of today, we have more questions ...than answers regarding this mysterious hominin group. This study leverages the information from the well-known example of adaptive introgression on the
EPAS1
gene in Tibetans, to gain insight on the history of our species’ interaction with Denisovans. We show that the Tibetan-
EPAS1
haplotype came from the East Asian-specific Denisovan introgression event, and it remained selectively neutral for a long time in the population before positive selection occurred, which may be concurrent with the permanent inhabitation of the Tibetan Plateau after the Last Glacial Maximum (LGM).
Recent studies suggest that admixture with archaic hominins played an important role in facilitating biological adaptations to new environments. For example, interbreeding with Denisovans facilitated the adaptation to high-altitude environments on the Tibetan Plateau. Specifically, the
EPAS1
gene, a transcription factor that regulates the response to hypoxia, exhibits strong signatures of both positive selection and introgression from Denisovans in Tibetan individuals. Interestingly, despite being geographically closer to the Denisova Cave, East Asian populations do not harbor as much Denisovan ancestry as populations from Melanesia. Recently, two studies have suggested two independent waves of Denisovan admixture into East Asians, one of which is shared with South Asians and Oceanians. Here, we leverage data from
EPAS1
in 78 Tibetan individuals to interrogate which of these two introgression events introduced the
EPAS1
beneficial sequence into the ancestral population of Tibetans, and we use the distribution of introgressed segment lengths at this locus to infer the timing of the introgression and selection event. We find that the introgression event unique to East Asians most likely introduced the beneficial haplotype into the ancestral population of Tibetans around 48,700 (16,000–59,500) y ago, and selection started around 9,000 (2,500–42,000) y ago. Our estimates suggest that one of the most convincing examples of adaptive introgression is in fact selection acting on standing archaic variation.
Acute high-altitude illnesses are of great concern for physicians and people traveling to high altitude. Our recent article “Acute Mountain Sickness, High-Altitude Pulmonary Edema and High-Altitude ...Cerebral Edema, a View from the High Andes” was questioned by some sea-level high-altitude experts. As a result of this, we answer some observations and further explain our opinion on these diseases. High-Altitude Pulmonary Edema (HAPE) can be better understood through the Oxygen Transport Triad, which involves the pneumo-dynamic pump (ventilation), the hemo-dynamic pump (heart and circulation), and hemoglobin. The two pumps are the first physiologic response upon initial exposure to hypobaric hypoxia. Hemoglobin is the balancing energy-saving time-evolving equilibrating factor. The acid-base balance must be adequately interpreted using the high-altitude Van Slyke correction factors. Pulse-oximetry measurements during breath-holding at high altitude allow for the evaluation of high altitude diseases. The Tolerance to Hypoxia Formula shows that, paradoxically, the higher the altitude, the more tolerance to hypoxia. In order to survive, all organisms adapt physiologically and optimally to the high-altitude environment, and there cannot be any “loss of adaptation”. A favorable evolution in HAPE and pulmonary hypertension can result from the oxygen treatment along with other measures.
The key elements in acclimatization aim at securing the oxygen supply to tissues and organs of the body with an optimal oxygen tension of the arterial blood. In acute exposure, ventilation and heart ...rate are elevated with a minimum reduction in stroke volume. In addition, plasma volume is reduced over 24–48 h to improve the oxygen‐carrying capacity of the blood, and is further improved during a prolonged sojourn at altitude through an enhanced erythropoiesis and larger Hb mass, allowing for a partial or full restoration of the blood volume and arterial oxygen content. Most of these adaptations are observed from quite low altitudes ∼1000 m above sea level (m a.s.l.) and become prominent from 2000 m a.s.l. At these higher altitudes additional adaptations occur, one being a reduction in the maximal heart rate response and consequently a lower peak cardiac output. Thus, in spite of a normalization of the arterial oxygen content after 4 or more weeks at altitude, the peak oxygen uptake reached after a long acclimatization period is essentially unaltered compared with acute exposure. What is gained is a more complete oxygenation of the blood in the lungs, i.e. SaO2 is increased. The alteration at the muscle level at altitude is minor and so is the effect on the metabolism, although it is debated whether a possible reduction in blood lactate accumulation occurs during exercise at altitude. Transient acute mountain sickness (headache, anorexia, and nausea) is present in 10–30% of subjects at altitudes between 2500 and 3000 m a.s.l. Pulmonary edema is rarely seen below 3000 m a.s.l. and brain edema is not seen below 4000 m a.s.l. It is possible to travel to altitudes of 2500–3000 m a.s.l., wait for 2 days, and then gradually start to train. At higher altitudes, one should consider a staged ascent (average ascent rate 300 m/day above 2000 m a.s.l.), primarily in order to sleep and feel well, and minimize the risk of mountain sickness. A new classification of altitude levels based on the effects on performance and well‐being is proposed and an overview given over the various modalities using hypoxia and altitude for improvement of performance.
To provide guidance to clinicians about best preventive and therapeutic practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for prevention ...and treatment of acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. Recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks/burdens according to criteria put forth by the American College of Chest Physicians. The guidelines also provide suggested approaches to prevention and management of each form of acute altitude illness that incorporate these recommendations. This is an updated version of the original WMS Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness published in 2010 and subsequently updated as the WMS Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness in 2014.
High-altitude cerebral edema (HACE) and acute mountain sickness (AMS) are neuro-pathologies associated with rapid exposure to hypoxia. However, speculation remains regarding the exact etiology of ...both HACE and AMS and whether or not they share a common mechanistic pathology. This mini-review outlines the basic principles of HACE development, highlighting how edema could develop from 1) a progression from cytotoxic swelling to ionic edema, or 2) permeation of the blood brain barrier (BBB) with or without ionic edema. Thereafter, discussion turns to the available neuroimaging literature in the context of cytotoxic, ionic or vasogenic edema in both HACE and AMS. While HACE is clearly caused by an increase in brain water of ionic and/or vasogenic origin, there is very little evidence that this type of edema is present when AMS develops. However, cerebral vasodilation, increased intracranial blood volume and concomitant intracranial fluid shifts from the extracellular to the intracellular space, as interpreted from changes in diffusion indices within white matter, are observed consistently in persons acutely exposed to hypoxia and with AMS. Therefore, herein we explore the idea that intracellular swelling occurs alongside AMS, and is a critical pre-cursor to extracellular ionic edema formation. We propose that this process produces a subtle modulation of the BBB, which either together with or independent of vasogenic edema provides a transvascular segue from the end-stage of AMS to HACE. Ultimately, this mini-review seeks to shed light on the possible processes underlying HACE pathophysiology, and thus highlight potential avenues for future prevention and treatment.
The unexpectedly high flux of cosmic-ray positrons detected at Earth may originate from nearby astrophysical sources, dark matter, or unknown processes of cosmic-ray secondary production. We report ...the detection, using the High-Altitude Water Cherenkov Observatory (HAWC), of extended tera–electron volt gamma-ray emission coincident with the locations of two nearby middle-aged pulsars (Geminga and PSR B0656+14). The HAWC observations demonstrate that these pulsars are indeed local sources of accelerated leptons, but the measured tera–electron volt emission profile constrains the diffusion of particles away from these sources to be much slower than previously assumed. We demonstrate that the leptons emitted by these objects are therefore unlikely to be the origin of the excess positrons, which may have a more exotic origin.
•Attention network functions and physiological activity were tracked while traveling to and from high altitudes.•Attention network functions did not decline after acute high-altitude exposure at the ...behavioral level.•Attention network functions enhanced after returning to sea level.•Percutaneous arterial oxygen saturation (SpO2) and vital capacity elevation related to the improvement of orienting function.
Previous studies have not reached a definitive conclusion regarding the effect of high-altitude hypoxia and reoxygenation on attention. To clarify the influence of altitude and exposure time on attention and the relations between physiological activity and attention, we conducted a longitudinal study to track attention network functions in 26 college students. The scores on the attention network test and physiological data, including heart rate, percutaneous arterial oxygen saturation (SpO2), blood pressure, and vital capacity in pulmonary function measurement, were collected at five time-points: two weeks before arriving at high altitude (baseline), within 3 days after arriving at high altitude (HA3), 21 days after arriving at high altitude (HA21), 7 days after returning to sea level (POST7) and 30 days after returning to sea level (POST30). The alerting scores at POST30 were significantly higher than those at baseline, HA3 and HA21; the orienting scores at HA3 were lower than those at POST7 and POST30; the executive control scores at POST7 were significantly lower than those at baseline, HA3, HA21, and POST30; and the executive control scores at HA3 were significantly higher than those at POST30. The change in SpO2 during high-altitude acclimatization (from HA3 to HA21) was positively correlated with the orienting score at HA21. Vital capacity changes during acute deacclimatization positively correlated with orienting scores at POST7. Attention network functions at the behavioral level did not decline after acute hypoxia exposure compared with baseline. Attention network functions after returning to sea level were improved compared with those during acute hypoxia; additionally, alerting and executive function scores were improved compared with those at baseline. Thus, the speed of physiological adaptation could facilitate the recovery of orienting function during acclimatization and deacclimatization.
Despite a potential high risk of acute mountain sickness (AMS) in the Swiss Alps, there is a lack of analyses concerning its relevance over longer periods. In consequence, the aim of this study is to ...analyze the prevalence of AMS in comparison to other causes of mountain emergencies in recent years in Switzerland.
Based on the central registry of mountain emergencies of the Swiss Alpine Club (SAC), all cases in the period between 2009 and 2020 were analyzed for AMS including the most severe forms of high-altitude pulmonary edema (HAPE) and high-altitude cerebral edema (HACE). Emergencies were assessed for the severity of the event with a National Advisory Committee for Aeronautics (NACA) score.
From a total of 4596 high-altitude mountaineering emergencies identified in the observational period, a total number of 352 cases of illnesses were detected. Detailed analysis revealed 85 cases of AMS, 5 cases of HAPE, and 1 case of HACE. The average altitude was 3845 ± 540 m. Most cases were in the canton of Valais, especially in the Monte Rosa region and the mountains of the Mischabel group (Täschhorn, Dom, Südlenz, Nadelhorn, Hohberghorn). There were only three deaths related to high-altitude illnesses; all the other events could be identified as moderate to severe but not life-threatening.
An emergency due to AMS that requires rescue is unlikely in the Swiss Alps. This does not imply that AMS is not a concern. However, the facts that the maximal altitude is relatively low and that fast self-descents often seem possible probably minimize the likelihood that mountaineers with symptoms contact emergency services.
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