Effects of moderate alcohol consumption and hypobaric hypoxia: implications for passengers' sleep, oxygen saturation and heart rate on long-haul flights.

BACKGROUND: Passengers on long-haul flights frequently consume alcohol. Inflight sleep exacerbates the fall in blood oxygen saturation (SpO2) caused by the decreased oxygen partial pressure in the cabin. We investigated the combined influence of alcohol and hypobaric hypoxia on sleep, SpO2 and heart rate. METHODS: Two groups of healthy individuals spent either two nights with a 4-hour sleep opportunity (00:00-04:00 hours) in the sleep laboratory (n=23; 53 m above sea level) or in the altitude chamber (n=17; 753 hPa corresponding to 2438 m above sea level, hypobaric condition). Participants consumed alcohol before one of the nights (mean±SE blood alcohol concentration 0.043±0.003%). The order of the nights was counterbalanced. Two 8-hour recovery nights (23:00-07:00 hours) were scheduled between conditions. Polysomnography, SpO2 and heart rate were recorded. RESULTS: The combined exposure to alcohol and hypobaric condition decreased SpO2 to a median (25th/75th percentile) of 85.32% (82.86/85.93) and increased heart rate to a median (25th/75th percentile) of 87.73 bpm (85.89/93.86) during sleep compared with 88.07% (86.50/88.49) and 72.90 bpm (70.90/78.17), respectively, in the non-alcohol hypobaric condition, 94.97% (94.59/95.33) and 76.97 bpm (65.17/79.52), respectively, in the alcohol condition and 95.88% (95.72/96.36) and 63.74 bpm (55.55/70.98), respectively, in the non-alcohol condition of the sleep laboratory group (all p<0.0001). Under the combined exposure SpO2 was 201.18 min (188.08/214.42) below the clinical hypoxia threshold of 90% SpO2 compared with 173.28 min (133.25/199.03) in the hypobaric condition and 0 min (0/0) in both sleep laboratory conditions. Deep sleep (N3) was reduced to 46.50 min (39.00/57.00) under the combined exposure compared with both sleep laboratory conditions (alcohol: 84.00 min (62.25/92.75); non-alcohol: 67.50 min (58.50/87.75); both p<0.003). CONCLUSIONS: The combination of alcohol and inflight hypobaric hypoxia reduced sleep quality, challenged the cardiovascular system and led to extended duration of hypoxaemia (SpO2 <90%).

NO2 levels inside vehicle cabins with pollen and activated carbon filters: A real world targeted intervention to estimate NO2 exposure reduction potential.

Traffic related nitrogen dioxide (NO2) poses a serious environmental and health risk factor in the urban environment. Drivers and vehicle occupants in general may have acute exposure to NO2 levels. In order to identify key controllable measures to reduce vehicle occupant's exposure, this study measures NO2 exposure inside ten different vehicles under real world driving conditions and applies a targeted intervention by replacing previously used filters with new standard pollen and new activated carbon cabin filters. The study also evaluates the efficiency of the latter as a function of duration of use. The mean in-vehicle NO2 exposure across the tested vehicles, driving the same route under comparable traffic and ambient air quality conditions, was 50.8 ± 32.7 µg/m3 for the new standard pollen filter tests and 9.2 ± 8.6 µg/m3 for the new activated carbon filter tests. When implementing the new activated carbon filters, overall we observed significant (p < 0.05) reductions by 87 % on average (range 80 - 94.2 %) in the in-vehicle NO2 levels compared to the on-road concentrations. We further found that the activated carbon filter NO2 removal efficiency drops by 6.8 ± 0.6 % per month; showing a faster decay in removal efficiency after the first 6 months of use. These results offer novel insights into how the general population can control and reduce their exposure to traffic related NO2. The use and regular replacement of activated carbon cabin air filters represents a relatively inexpensive method to significantly reduce in-vehicle NO2 exposure.

Sleep-Induced Hypoxia under Flight Conditions: Implications and Countermeasures for Long-Haul Flight Crews and Passengers.

PURPOSE: Recuperation during sleep on board of commercial long-haul flights is a safety issue of utmost importance for flight crews working extended duty periods. We intended to explore how sleep and blood oxygenation (in wake versus sleep) are affected by the conditions in an airliner at cruising altitude. METHODS: Healthy participants' sleep was compared between 4-h sleep opportunities in the sleep laboratory (n = 23; sleep lab, ie, 53 m above sea level) and in an altitude chamber (n = 20; flight level, ie, 753 hPa, corresponding to 2438 m above sea level). A subgroup of 12 participants underwent three additional conditions in the altitude chamber: 1) 4-h sleep at ground level, 2) 4-h sleep at flight level with oxygen partial pressure equivalent to ground level, 3) 4-h monitored wakefulness at flight level. Sleep structure and blood oxygenation were analysed with mixed ANOVAs. RESULTS: Total sleep time at flight level compared to in the sleep laboratory was shorter (Δ mean ± standard error -11.1 ± 4.2 min) and included less N3 sleep (Δ -17.6 ± 5.4 min), while blood oxygenation was decreased. Participants spent 69.7% (± 8.3%) of the sleep period time but only 13.2% (± 3.0%) of monitored wakefulness in a hypoxic state (<90% oxygen saturation). Oxygen enrichment of the chamber prevented oxygen desaturation. CONCLUSION: Sleep - but not wakefulness - under flight conditions induces hypobaric hypoxia which may contribute to impaired sleep. The results caution against the assumption of equivalent crew recovery in-flight and on the ground but hold promise for oxygen enrichment as a countermeasure. The present results have implications for flight safety and possible long-term consequences for health in crews.

Chemical source profiles of fine particles for five different sources in Delhi.

Increasing emissions from sources such as construction and burning of biomass from crop residues, roadside and municipal solid waste have led to a rapid increase in the atmospheric concentrations of fine particulate matter (≤2.5 µm; PM2.5) over many Indian cities. Analyses of their chemical profiles are important for receptor models to accurately estimate the contributions from different sources. We have developed chemical source profiles for five important pollutant sources - construction (CON), paved road dust (PRD), roadside biomass burning (RBB), solid waste burning (SWB), and crop residue burning (CPB) - during three intensive campaigns (winter, summer and post-monsoon) in and around Delhi. We obtained chemical characterisations of source profiles incorporating carbonaceous material such as organic carbon (OC) and elemental carbon (EC), water-soluble ions (F-, Cl-, NO2-, NO3-, SO42-, PO43-, Na+ and NH4+), and elements (Mg, Al, Si, P, S, Cl, K, Ca, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Br, Rb, Sr, Ba, and Pb). CON was dominated by the most abundant elements, K, Si, Fe, Al, and Ca. PRD was also dominated by crustal elements, accounting for 91% of the total analysed elements. RBB, SWB and CPB profiles were dominated by organic matter, which accounted for 94%, 86.2% and 86% of the total PM2.5, respectively. The database of PM emission profiles developed from the sources investigated can be used to assist source apportionment studies for accurate quantification of the causes of air pollution and hence assist governmental bodies in formulating relevant countermeasures.

Influence of transient pressure changes on speech intelligibility: Implications for next-generation train travel.

High-speed trains are operated in increasingly complex railway networks and continual improvement of driver assistance systems is necessary to maintain safety. Speech offers the opportunity to provide information to the driver without disrupting visual attention. However, it is not known whether the transient pressure changes inside trains passing through tunnels interfere with speech intelligibility. Our primary goal was to test whether the most severe pressure variations occurring in high-speed trains (25 hPa in 2 s) affect speech intelligibility in individuals with normal hearing ability and secondly whether a potential effect would depend on the direction of the pressure change. A cross-over design was used to compare speech intelligibility, measured with the monosyllable word test by Wallenberg and Kollmeier, in steady ambient pressure versus subsequent to pressure events, both realised in a pressure chamber. Since data for a power calculation did not exist, we conducted a pilot study with 20 participants to estimate variance of intra-individual differences. The upper 80% confidence limit guided sample size of the main campaign, which was performed with 72 participants to identify a 10% difference while limiting alpha (5%) and beta error (10%). On average, a participant understood 0.7 fewer words following a pressure change event compared to listening in steady ambient pressure. However, this intra-individual differences varied strongly between participants, standard deviation (SD) ± 4.5 words, resulting in a negligible effect size of 0.1 and the Wilcoxon signed rank test (Z = -1.26; p = 0.21) did not distinguish it from chance. When comparing decreasing and increasing pressure events an average of 0.2 fewer words were understood (± 3.9 SD). The most severe pressure changes expected to occur in high-speed trains passing through tunnels do not interfere with speech intelligibility and are in itself not a risk factor for loss of verbal information transmission.

Choosing an Adequate Test to Determine Fitness for Air Travel in Obese Individuals.

BACKGROUND: Air travel is physically demanding and, because obesity is rising, physicians increasingly need to assess whether such patients can fly safely. Our aim was to compare the diagnostic accuracy of two routinely used exercise tests, 50-m walk test and 6-min walk test, and hypoxic challenge testing (HCT) in obese individuals. We further explored the diagnostic potential of perceived dyspnea as measured with the Borg scale because this is often recorded subsequent to walking tests. METHODS: In this prospective study, we examined 21 obese participants (10 women, age 51 ± 15 [mean  ±  SD], BMI 36 ± 5  kg/m2). The most prevalent comorbidity was COPD (n = 11). The reference standard for in-flight hypoxia, defined as oxygen saturation below 90%, was established in an altitude chamber. Diagnostic accuracy of each index test was estimated by area under the receiver operating characteristic curve (AUC). RESULTS: Of the 21 participants, 13 (9 with COPD) were identified with in-flight hypoxia. HCT was the only test separating the reference groups significantly with AUC 0.87 (95% CI,  0.62-0.96). Neither of the walking tests predicted noticeably above chance level: 50 m walk test had an AUC of 0.63 (0.36-0.84) and 6MWT had an AUC of 0.64 (0.35-0.86). We further observed good prognostic ability of subjective dyspnea assessment when recorded after 6MWT with an AUC of 0.80 (0.55-0.93). CONCLUSIONS: In-flight hypoxia in obese individuals can be predicted by HCT but not by simple walking tests.

Distinct branches of the N-end rule pathway modulate the plant immune response.

The N-end rule pathway is a highly conserved constituent of the ubiquitin proteasome system, yet little is known about its biological roles. Here we explored the role of the N-end rule pathway in the plant immune response. We investigated the genetic influences of components of the pathway and known protein substrates on physiological, biochemical and metabolic responses to pathogen infection. We show that the glutamine (Gln) deamidation and cysteine (Cys) oxidation branches are both components of the plant immune system, through the E3 ligase PROTEOLYSIS (PRT)6. In Arabidopsis thaliana Gln-specific amino-terminal (Nt)-amidase (NTAQ1) controls the expression of specific defence-response genes, activates the synthesis pathway for the phytoalexin camalexin and influences basal resistance to the hemibiotroph pathogen Pseudomonas syringae pv tomato (Pst). The Nt-Cys ETHYLENE RESPONSE FACTOR VII transcription factor substrates enhance pathogen-induced stomatal closure. Transgenic barley with reduced HvPRT6 expression showed enhanced resistance to Ps. japonica and Blumeria graminis f. sp. hordei, indicating a conserved role of the pathway. We propose that that separate branches of the N-end rule pathway act as distinct components of the plant immune response in flowering plants.

Oxygen sensing coordinates photomorphogenesis to facilitate seedling survival.

Successful emergence from the soil is essential for plant establishment in natural and farmed systems. It has been assumed that the absence of light in the soil is the preeminent signal perceived during early seedling development, leading to a distinct morphogenic plan (skotomorphogenesis) [1], characterized by traits providing an adaptive advantage until emergence and photomorphogenesis. These traits include suppressed chlorophyll synthesis, promotion of hypocotyl elongation, and formation of a closed apical hook that protects the stem cell niche from damage [2, 3]. However, absence of light by itself is not a sufficient environmental signal for early seedling development [4, 5]. Reduced oxygen levels (hypoxia) can occur in water-logged soils [6-8]. We therefore hypothesized that below-ground hypoxia may be an important, but thus far undiscovered, ecological component regulating seedling development. Here, we show that survival and establishment of seedlings following darkness depend on their ability to sense hypoxia, through enhanced stability of group VII Ethylene Response Factor (ERFVII) transcription factors. Hypoxia is perceived as a positive environmental component in diverse taxa of flowering plants, promoting maintenance of skotomorphogenic traits. Hypoxia greatly enhances survival once light is perceived, while oxygen is necessary for the subsequent effective completion of photomorphogenesis. Together with light perception, oxygen sensing therefore allows an integrated response to the complex and changing physical microenvironment encountered during early seedling growth. We propose that plants monitor the soil's gaseous environment after germination, using hypoxia as a key external cue to protect the stem cell niche, thus ensuring successful rapid establishment upon emergence above ground.

Passenger comfort on high-speed trains: effect of tunnel noise on the subjective assessment of pressure variations.

When passing through a tunnel, aerodynamic effects on high-speed trains may impair passenger comfort. These variations in atmospheric pressure are accompanied by transient increases in sound pressure level. To date, it is unclear whether the latter influences the perceived discomfort associated with the variations in atmospheric pressure. In a pressure chamber of the DLR-Institute of Aerospace Medicine, 71 participants (M = 28.3 years ± 8.1 SD) rated randomised pressure changes during two conditions according to a crossover design. The pressure changes were presented together with tunnel noise such that the sound pressure level was transiently elevated by either +6 dB (low noise condition) or +12 dB (high noise condition) above background noise level (65 dB(A)). Data were combined with those of a recent study, in which identical pressure changes were presented without tunnel noise (Schwanitz et al., 2013, 'Pressure Variations on a Train - Where is the Threshold to Railway Passenger Discomfort?' Applied Ergonomics 44 (2): 200-209). Exposure-response relationships for the combined data set comprising all three noise conditions show that pressure discomfort increases with the magnitude and speed of the pressure changes but decreases with increasing tunnel noise. Practitioner Summary: In a pressure chamber, we systematically examined how pressure discomfort, as it may be experienced by railway passengers, is affected by the presence of tunnel noise during pressure changes. It is shown that across three conditions (no noise, low noise (+6 dB), high noise (+12 dB)) pressure discomfort decreases with increasing tunnel noise.

Gravity-dependent ventilation distribution in rats measured with electrical impedance tomography.

Ventilation in larger animals and humans is gravity dependent and mainly distributed to the dependent lung. Little is known of the effect of gravity on ventilation distribution in small animals such as rodents. The aim of this study was to investigate gravity-dependent ventilation distribution and regional filling characteristics in rats. Ventilation distribution and regional lung filling were measured in six rats using electrical impedance tomography (EIT). Measurements were performed in four body positions (supine, prone, left and right lateral), and all animals were ventilated with increasing tidal volumes from 3 to 8 mL kg(-1). The effect of gravity on regional ventilation distribution was assessed with profiles of relative impedance change and calculation of the geometric centre. Regional filling was measured by calculating the slope of the plot of regional versus global relative impedance change on a breath-by-breath basis. Ventilation was significantly distributed to the non-dependent lung regardless of body position and tidal volume used. The geometric centre was located in the dependent lung in all but prone position. The regional filling characteristics followed an anatomical pattern with the posterior and the right lung generally filling faster. Gravity had little impact on regional filling. Ventilation distribution in rats is gravity dependent, whereas regional filling characteristics are dependent on anatomy.