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Abstract
Wilderness medicine (WM) and lifestyle medicine (LM) both aim to use creative methods to promote health. The purpose of this review is to elucidate the effects of wilderness environments on health and elaborate on the intersections of WM and LM. The three theories describing potential mechanisms of health promotion in the wilderness environment-biophilia theory, stress reduction theory (SRT), and attention restoration theory (ART)-are presented. Activity in the wilderness environment is associated with improved cardiovascular fitness and cognitive performance, better sleep/wake cycles when not at altitude or extremely cold weather, better stress management, positive social interactions, and avoidance of risky substances. Wilderness is medicine and may be used as such to promote vigor and vitality in our patients.
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Affiliation(s)
- Michael S. Moore
- Medical Laboratory Sciences, Weber State University, Ogden, UT, USA (MSM)
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Bellovary BN, Wells AD, Fennel ZJ, Ducharme JB, Houck JM, Mayschak TJ, Gibson AL, Drum SN, Mermier CM. Could Orthostatic Stress Responses Predict Acute Mountain Sickness Susceptibility Prior to High Altitude Travel? A Pilot Study. High Alt Med Biol 2023; 24:19-26. [PMID: 36473199 DOI: 10.1089/ham.2021.0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Bellovary, Bryanne N., Andrew D. Wells, Zachary J. Fennel, Jeremy B. Ducharme, Jonathan M. Houck, Trevor J. Mayschak, Ann L. Gibson, Scott N. Drum, and Christine M. Mermier. Could orthostatic stress responses predict acute mountain sickness susceptibility before high altitude travel? A pilot study. High Alt Med Biol. 24:19-26, 2023. Purpose: This study assessed head-up tilt (HUT) responses in relation to acute mountain sickness (AMS)-susceptibility during hypoxic exposure. Materials and Methods: Fifteen participants completed three lab visits: (1) protocol familiarization and cycle maximal oxygen consumption (VO2max) test; (2) HUT test consisting of supine rest for 20 minutes followed by 70° tilting for ≤40 minutes; and (3) 6 hours of hypobaric hypoxic exposure (4,572 m) where participants performed two 30-minute cycling bouts separated by 1 hour at a 50% VO2max workload within the first 3 hours and rested when not exercising. During HUT, systolic blood pressure (SBP), diastolic blood pressure, heart rate (HR), and variability (blood pressure variability [BPV] and HR variability [HRV]) were measured continuously. The AMS scores were determined after 6 hours of exposure. Correlations determined relationships between HUT cardiovascular responses and AMS scores. Repeated-measures analysis of variance (ANOVA) assessed differences between those with and without AMS symptoms during HUT. Results: Higher AMS scores correlated with greater change in SBP variability (r = 0.52, p = 0.048) and blunted changes in HRV (root mean square of successive differences between normal heartbeats r = 0.81, p = 0.001, percentage of adjacent normal sinus intervals that differ by more than 50 milliseconds [pNN50] r = 0.87, p < 0.001) during HUT. A pNN50 interaction (p = 0.02) suggested elevated cardiac sympathetic activity at baseline and a blunted increase in cardiac sympathetic influence throughout HUT in those with AMS (pNN50 baseline: AMS = 26.2% ± 15.3%, no AMS = 51.0% ± 13.5%; first 3 minutes into HUT: AMS = 17.2% ± 19.1%, no AMS = 17.1% ± 10.9%; end of HUT: AMS = 6.2% ± 9.1%, no AMS 11.0% ± 10.0%). Conclusions: The results suggest autonomic responses via HUT differ in AMS-susceptible individuals. Changes in HRV and BPV during HUT may be a promising predictive measurement for AMS-susceptibility, but further research is needed for confirmation.
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Affiliation(s)
- Bryanne N Bellovary
- Kinesiology Department, State University of New York at Cortland, Cortland, New York, USA
- Department of Health, Exercise, and Sport Sciences, University of New Mexico, Albuquerque, New Mexico, USA
| | - Andrew D Wells
- Department of Health, Exercise, and Sport Sciences, University of New Mexico, Albuquerque, New Mexico, USA
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Zachary J Fennel
- Department of Health, Exercise, and Sport Sciences, University of New Mexico, Albuquerque, New Mexico, USA
- Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Jeremy B Ducharme
- Department of Health, Exercise, and Sport Sciences, University of New Mexico, Albuquerque, New Mexico, USA
| | - Jonathan M Houck
- Department of Health, Exercise, and Sport Sciences, University of New Mexico, Albuquerque, New Mexico, USA
- Department of Science, Husson University, Bangor, Maine, USA
| | - Trevor J Mayschak
- Department of Health, Exercise, and Sport Sciences, University of New Mexico, Albuquerque, New Mexico, USA
- Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Ann L Gibson
- Department of Health, Exercise, and Sport Sciences, University of New Mexico, Albuquerque, New Mexico, USA
| | - Scott N Drum
- Department of Health Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| | - Christine M Mermier
- Department of Health, Exercise, and Sport Sciences, University of New Mexico, Albuquerque, New Mexico, USA
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Li X, Shi R, Meng Q, Zhang X, Chen X. Does arterial stiffness affect orthostatic hypotension among high-altitude Tibetans? Postgrad Med 2020; 133:173-180. [PMID: 32926805 DOI: 10.1080/00325481.2020.1823683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This study aimed to investigate the association between arterial stiffness and orthostatic hypotension (OH) and orthostatic blood pressure (BP) changes among Tibetans living at high altitude. METHODS A total of 630 high-altitude Tibetans were included (56.53 ± 10.16 years; 246 men). Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV). OH was defined as a decrease in systolic BP (SBP) >20 mmHg or a decrease in diastolic BP (DBP) >10 mmHg after 1 min or 3 min of moving from supine to standing position. RESULTS The prevalence of OH in this population was 6.3%. Compared with subjects without OH, the subjects with OH had a higher baPWV (P < 0.001). Multiple logistical regression found that baPWV was significantly associated with the occurrence of OH (OR 1.147, CI 95% 1.028-1.280, P = 0.014). Spearman correlation analysis showed that baPWV was negatively associated with orthostatic changes in SBP and DBP(r = -0.256, P < 0.001 and r = -0.194, P < 0.001, respectively). Further multiple stepwise linear regression analysis showed that baPWV was independently correlated with orthostatic BP changes (SBP: β = -0.599, P < 0.001; DBP: β = -0.333, P < 0.001). Moreover, increased baPWV was correlated with attenuation of orthostatic heart rate changes. No significant association was observed between hematocrit or hemoglobin concentration and OH. CONCLUSION BaPWV was significantly associated with the occurrence of OH and orthostatic changes in the SBP and DBP, which suggests that arterial stiffness may be a potential mechanism of impaired hemodynamic response to orthostatic challenges among high-altitude Tibetans.
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Affiliation(s)
- Xinran Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Rufeng Shi
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qingtao Meng
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xin Zhang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoping Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Leaman R, Wei CH, Allot A, Lu Z. Ten tips for a text-mining-ready article: How to improve automated discoverability and interpretability. PLoS Biol 2020; 18:e3000716. [PMID: 32479517 PMCID: PMC7289435 DOI: 10.1371/journal.pbio.3000716] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/11/2020] [Indexed: 12/22/2022] Open
Abstract
Data-driven research in biomedical science requires structured, computable data. Increasingly, these data are created with support from automated text mining. Text-mining tools have rapidly matured: although not perfect, they now frequently provide outstanding results. We describe 10 straightforward writing tips—and a web tool, PubReCheck—guiding authors to help address the most common cases that remain difficult for text-mining tools. We anticipate these guides will help authors’ work be found more readily and used more widely, ultimately increasing the impact of their work and the overall benefit to both authors and readers. PubReCheck is available at http://www.ncbi.nlm.nih.gov/research/pubrecheck. Your published research is already being processed with automated tools, and text mining will become more common; this Community Page article describes how you can help these tools process your work more accurately, including a web tool, PubReCheck.
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Affiliation(s)
- Robert Leaman
- National Center for Biotechnology Information (NCBI), National Library of Medicine (NLM), National Institutes of Health (NIH), Bethesda, Maryland, United States of America
| | - Chih-Hsuan Wei
- National Center for Biotechnology Information (NCBI), National Library of Medicine (NLM), National Institutes of Health (NIH), Bethesda, Maryland, United States of America
| | - Alexis Allot
- National Center for Biotechnology Information (NCBI), National Library of Medicine (NLM), National Institutes of Health (NIH), Bethesda, Maryland, United States of America
| | - Zhiyong Lu
- National Center for Biotechnology Information (NCBI), National Library of Medicine (NLM), National Institutes of Health (NIH), Bethesda, Maryland, United States of America
- * E-mail:
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Niebauer JH, Niebauer J, Wille M, Burtscher M. Systemic Blood Pressure Variation During a 12-Hour Exposure to Normobaric Hypoxia (4500 m). High Alt Med Biol 2020; 21:194-199. [PMID: 32186921 DOI: 10.1089/ham.2019.0130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study was aimed at evaluating a potential association between blood pressure variation and acute mountain sickness (AMS) during acute exposure to normobaric hypoxia. A total of 77 healthy subjects (43 males, 34 females) were exposed to a simulated altitude of 4500 m for 12 hours. Peripheral oxygen saturation, heart rate, systemic blood pressure, and Lake Louise AMS scores were recorded before and during (30 minutes, 3, 6, 9, and 12 hours) hypoxic exposure. Blood pressure dips were observed at 3-hour mark. However, systolic blood pressure fell more pronounced from baseline during the initial 30 minutes in normobaric hypoxia (-17.5 vs. -11.0 mmHg, p = 0.01) in subjects suffering from AMS (AMS+; n = 56) than in those remaining unaffected from AMS (AMS-; n = 21); values did not differ between groups over the subsequent time course. Our data may suggest a transient autonomic dysfunction resulting in a more pronounced blood pressure drop during initial hypoxic exposure in AMS+ compared with AMS- subjects.
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Affiliation(s)
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Maria Wille
- Department of Sports Science, University of Innsbruck, Innsbruck, Austria
| | - Martin Burtscher
- Department of Sports Science, University of Innsbruck, Innsbruck, Austria.,Austrian Society for Alpine- and High-Altitude Medicine, Innsbruck, Austria
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Davis JE, Wagner DR, Thorington J, Schall C. Orthostatic responses at 4860 m in low, moderate, and high altitude residents. High Alt Med Biol 2013; 14:251-5. [PMID: 24028639 DOI: 10.1089/ham.2012.1069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study evaluated the influence of altitude of residence on orthostatic responses when exposed to high altitude. Data collection took place at the Carrel hut (4860 m) on Chimborazo in Ecuador. After being transported to the hut by vehicle, 69 people volunteered for the study. A 3-min stand test (rapid change from supine to standing) provided an orthostatic challenge while resting heart rate (RHR), systolic (SBP) and diastolic (DBP) blood pressures, and arterial oxygen saturation (SpO2) were measured. Participants were separated into four groups based on altitude of residence and ethnicity: LOW (<1500 m; n=15), MOD (1500-3000 m, n=30), and HIGH (>3000 m, n=11) Ecuadorians, and non-Ecuadorian lowlanders (NE-LOW, n=13). Supine and standing RHRs were lower (p<0.05) for HIGH compared to other groups. Furthermore, standing increased RHR in LOW, MOD, and NE-LOW by 11.9 ± 5.3, 9.5 ± 4.1, and 11.6 ± 7.4 bpm, respectively, while HIGH stayed the same (0.6 bpm increase ± 3.3). Additionally, mean arterial pressure decreased slightly but not significantly upon standing in all groups except HIGH. The difference in Spo2 among groups was not significant (p>0.05). Altitude of residence influences the cardiovascular responses to orthostatic stress with HIGH having blunted responses and greater tolerance.
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Affiliation(s)
- John E Davis
- 1 Department of Integrative Physiology and Health Science, Alma College , Alma, Michigan
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Thomas KN, Burgess KR, Basnyat R, Lucas SJ, Cotter JD, Fan JL, Peebles KC, Lucas RA, Ainslie PN. Initial Orthostatic Hypotension at High Altitude. High Alt Med Biol 2010; 11:163-7. [DOI: 10.1089/ham.2009.1056] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
| | | | - Rishi Basnyat
- Nepal International Clinic, Kathmandu, Nepal
- Himalayan Rescue Association, Kathmandu, Nepal
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Higgins JP, Tuttle T, Higgins JA. Altitude and the heart: is going high safe for your cardiac patient? Am Heart J 2010; 159:25-32. [PMID: 20102863 DOI: 10.1016/j.ahj.2009.10.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Accepted: 10/21/2009] [Indexed: 11/24/2022]
Abstract
Our aging population combined with the ease of travel and the interest in high altitude recreation pursuits exposes more patients to the acute physiologic effects of high altitude and lower oxygen availability. Acute exposure to high altitude is associated with significant alterations to the cardiovascular system. These may be important in patients with underlying cardiovascular disease who are not able to compensate to such physiologic changes. Exacerbating factors pertinent to patients with cardiovascular disease include acute hypoxia, increased myocardial work, increased epinephrine release, and increased pulmonary artery pressures. This review summarizes the physiology and clinical evidence regarding acute altitude exposure on the cardiopulmonary system with practical recommendations to address the question: "Is it safe for me to ski in the Rockies or climb Mt. Kilimanjaro?"
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