Effect of hypobaric hypoxia, simulating conditions during long-haul air travel, on coagulation, fibrinolysis, platelet function, and endothelial activation

CONTEXT: The link between long-haul air travel and venous thromboembolism is the subject of continuing debate. It remains unclear whether the reduced cabin pressure and oxygen tension in the airplane cabin create an increased risk compared with seated immobility at ground level. OBJECTIVE: To determine whether hypobaric hypoxia, which may be encountered during air travel, activates hemostasis. DESIGN, SETTING, AND PARTICIPANTS: A single-blind, crossover study, performed in a hypobaric chamber, to assess the effect of an 8-hour seated exposure to hypobaric hypoxia on hemostasis in 73 healthy volunteers, which was conducted in the United Kingdom from September 2003 to November 2005. Participants were screened for factor V Leiden G1691A and prothrombin G20210A mutation and were excluded if they tested positive. Blood was drawn before and after exposure to assess activation of hemostasis. INTERVENTIONS: Individuals were exposed alternately (> or =1 week apart) to hypobaric hypoxia, similar to the conditions of reduced cabin pressure during commercial air travel (equivalent to atmospheric pressure at an altitude of 2438 m), and normobaric normoxia (control condition; equivalent to atmospheric conditions at ground level, circa 70 m above sea level). MAIN OUTCOME MEASURES: Comparative changes in markers of coagulation activation, fibrinolysis, platelet activation, and endothelial cell activation. RESULTS: Changes were observed in some hemostatic markers during the normobaric exposure, attributed to prolonged sitting and circadian variation. However, there were no significant differences between the changes in the hypobaric and the normobaric exposures. For example, the median difference in change between the hypobaric and normobaric exposure was 0 ng/mL for thrombin-antithrombin complex (95% CI, -0.30 to 0.30 ng/mL); -0.02 [corrected] nmol/L for prothrombin fragment 1 + 2 (95% CI, -0.03 to 0.01 nmol/L); 1.38 ng/mL for D-dimer (95% CI, -3.63 to 9.72 ng/mL); and -2.00% for endogenous thrombin potential (95% CI, -4.00% to 1.00%). CONCLUSION: Our findings do not support the hypothesis that hypobaric hypoxia, of the degree that might be encountered during long-haul air travel, is associated with prothrombotic alterations in the hemostatic system in healthy individuals at low risk of venous thromboembolism.

Space and Motion Perception and Discomfort in Air Travel

RAMOS RT, MATTOS DA, REBOUCAS ITS, RANVAUD RD. Space and motion perception and discomfort in air travel. Aviat Space Environ Med 2012; 83:1162-6. Introduction: The perception of comfort during air trips is determined by several factors. External factors like cabin design and environmental parameters (temperature, humidity, air pressure, noise, and vibration) interact with individual characteristics (anxiety traits, fear of flying, and personality) from arrival at the airport to landing at the destination. In this study, we investigated the influence of space and motion discomfort (SMD), fear of heights, and anxiety on comfort perception during all phases of air travel. Methods: We evaluated 51 frequent air travelers through a modified version of the Flight Anxiety Situations Questionnaire (FAS), in which new items were added and where the subjects were asked to report their level of discomfort or anxiety (not fear) for each phase of air travel (Chronbach's alpha = 0.974). Correlations were investigated among these scales: State-Trait Anxiety Inventory (STAB, Cohen's Acrophobia Questionnaire, and the Situational Characteristics Questionnaire (SitQ, designed to estimate SMD levels). Results: Scores of SitQ correlated with discomfort in situations involving space and movement perception (Pearson's rho = 0.311), while discomfort was associated with cognitive mechanisms related to scores in the anxiety scales (Pearson's rho = 0.375). Anxiety traits were important determinants of comfort perception before and after flight, while the influence of SMD was more significant during the time spent in the aircraft cabin. Discussion: SMD seems to be an important modulator of comfort perception in air travel. Its influence on physical well being and probably on cognitive performance, with possible effects on flight safety, deserves further investigation.

Meteorology for all; facts about the atmosphere, air travel, weather forecasting, clouds, winds, storms [and] how to read the weather map,

Mode of access: Internet.

A depth study of the meaning of air travel in the jet age.

Mode of access: Internet.

Adequacy of flight schedules at Newark airport. Survey of air travel plan cardholders who work in northern New Jersey,

Mode of access: Internet.

Multidimensional analysis of perceived risk in commercial air travel

This study attempts to assess the role of perceived risk in air passenger behaviour. A survey of 889 respondents is used to investigate a multidimensional concept of perceived risk and to analyse the differences between socio-demographic characteristics regarding passengers' risk assessment. The results indicate that financial risk and temporal risk are the most important in the context of commercial air travel. All perceived risk dimensions differ according gender, age, cultural background, income, previous experience, and reason for travelling. (C) 2006 Elsevier Ltd. All rights reserved.

Obesity and Air Travel: Weighing Up the Issues

It may soon be the norm for many airline passengers arriving at the check-in desk of any international airline with both stow- away and carry-on luggage to be asked to step onto the weighing scale as the airlines attempt to compete and remain operationally viable in what has become for most a cut-throat and highly litigious operating environment. The author's commentary seeks to highlight a number of the issues surrounding the current impasse. It is also intended to catalyze a more healthy and informed debate aimed at finding an acceptable resolution to this crisis prior to one being imposed which fails to satisfy the needs of either camp.

Price differences between domestic and international air markets : an empirical application to routes from Gran Canaria

In this paper we examine whether airline prices on national routes are higher than those charged on international routes. Drawing on a database prepared specifically for this study, we estimate a pricing equation for all routes originating from Gran Canaria, Canary Islands, Spain; differentiating between national and international routes. A key difference between these two route types is that island residents benefit from discounts on domestic flights. When controlling for variables related to airline characteristics, market structure and demand, we find that national passengers who are non-residents on the islands are paying higher prices than international passengers.

Is there a connection between long airplane flight, venous thromboembolism, and sleep-disordered breathing?

Commercial passenger flights have been increasing around the world. The effect of these flights on health is unclear. Venous thromboembolism has been noted after recent long-distance airplane flight, even in the absence of other risk factors. Hypoxia caused by the low ambient pressure during flights could contribute, and individuals with obstructive sleep apnea may be particularly vulnerable. The association between the effects of long airplane travel and sleep-disordered breathing deserves further study. (C) 2008 Elsevier B.V. All rights reserved.

Estimation of infection rate in epidemic models with multiple populations

Dissertação para obtenção do Grau de Mestre em Matemática e Aplicações Especialização em Actuariado, Estatística e Investigação Operacional

Differential activation of the default mode network in jet lagged individuals

Long-term exposure to transmeridian flights has been shown to impact cognitive functioning. Nevertheless, the immediate effects of jet lag in the activation of specific brain networks have not been investigated. We analyzed the impact of short-term jet lag on the activation of the default mode network (DMN). A group of individuals who were on a transmeridian flight and a control group went through a functional magnetic resonance imaging acquisition. Statistical analysis was performed to test for differences in the DMN activation between groups. Participants from the jet lag group presented decreased activation in the anterior nodes of the DMN, specifically in bilateral medial prefrontal and anterior cingulate cortex. No areas of increased activation were observed for the jet lag group. These results may be suggestive of a negative impact of jet lag on important cognitive functions such as introspection, emotional regulation and decision making in a few days after individuals arrive at their destination.

Lymphangioléiomyomatose pulmonaire [Lymphangioleiomyomatosis]

Lymphangioleiomyomatosis is a rare pulmonary disease encountered almost exclusively in women of reproductive age. Pulmonary involvement is characterized by multiple thin-walled cysts in the lungs, recurrent pneumothorax, obstructive lung disorders, and progression to chronic respiratory failure over a mean period of 10 years. Certainty of diagnosis requires a lung biopsy, but international criteria have been proposed for a diagnosis without such a biopsy. International recommendations were recently issued for the diagnosis and treatment of lymphangioleiomyomatosis. Treatment is principally symptomatic and relies on the management of bronchial obstruction by bronchodilators; of hypoxemia by oxygen therapy; of pleural complications by pleurodesis, most often surgical; and of renal angiomyolipomas by percutaneous embolization in cases of hemorrhagic risk. Hormone treatment is not recommended. Hopes are high for mTor inhibitors (sirolimus and everolimus) and treatment trials are currently underway. Lung transplantation must be considered when chronic respiratory failure occurs in patients younger than 60 years.

Chicago to Iowa City Passenger Rail Project Financial Plan, September 2009

The Chicago to Iowa City Intercity Passenger Rail Program (Program) is a joint undertaking of the Iowa Department of Transportation (Iowa DOT) and the Illinois Department of Transportation (Illinois DOT). The purpose of the Program is to reestablish passenger rail services from Chicago to Iowa City, independently and in concert with the MWRRI (Midwest Regional Rail Initiative). The Chicago to Iowa City Corridor is one part of the vision established by the MWRRI to expand existing and develop new regional passenger rail service to meet existing and future travel demands in the Midwest. This project will expand and create a rail transportation alternative to supplant private automobile, bus, and air travel between Chicago and Iowa City, and intermediate points, and to create new transportation opportunity and capability for people who cannot meet their transportation needs with private automobile, bus and air modes.

Intercontinental fligths from European Airports: Towards hub concentration or not?

This paper empirically analyzes changes in the supply of non-stop intercontinental flights from European airports. We take advantage of OAG data for air services from a rich sample of European airports to intercontinental destinations in the period 2004-2008. Results of the empirical analysis indicate a tendency towards a more balanced distribution of intercontinental flights across European airports. We also find that the demographic size of a region, its sector specialization, the political role of its central city and the proportion of connecting traffic explain the amount of and changes in long-haul air services supplied from European airports.