scientific-2022-part-a

Scientific papers 2022 - Part A

Authors: Alexandre Guimard, Fabrice Joulia, Fabrice Prieur, Gauthier Poszalczyk, Kader Helme, and François J. Lhuissier. It is well known that the duration of apnea is longer in static than in dynamic conditions, but the impact of exercise intensity on the apnea duration needs to be investigated. The aim of this study was to determine the relationship between apnea duration and exercise intensity, and the associated metabolic parameters.

Authors: Khodor Haidar Hassan, Joelle Azzi, Gian Marco Oppo, Hadi Raef Rida, Roberto Vecchioni, Mohamad Ali Chahrour, Mehdi Raef Rida, Fadel Nahle, Hadi Farhat, Edwin Parra Prada, and Ahmad Najib Ballout. Hyperbaric Oxygen Therapy (HBOT) is a recommended treatment for all hypoxic pathologies and has been used for decades as a recommended treatment for hypoxic- ischemic and infectious disorders. The pressures utilized vary from 2.2 to 2.8 ATA. 20 Osteoporosis patients treated underwent HBOT at 1.5 ATA and 100% oxygen for 15 sessions.

Authors: Danilo Cialoni, Andrea Brizzolari, Alessandra Barassi, Gerardo Bosco, Massimo Pieri, Valentina Lancellotti, and Alessandro Marroni. Diving can influence changes in several hematological parameters (HP) but the changes in HP in the decompression phases are still unclear. This study investigated any possible relationship between HP and predisposition to inert gas bubble formation after a single recreational dive. Blood, obtained from 32 divers, was tested for differences in white blood cells, granulocytes, lymphocytes, monocytes, red blood cells, and platelets between bubblers and non-bubblers.

Authors: Sven Dreyer, Andreas Deussen, Dietmar Berndt, and Jochen D. Schipke. In 2012, a severe accident happened during the mission of a saturation diver working at a depth of 90 m in the North Sea. The dynamic positioning system of the diver support vessel crashed, and the ship drifted away from the working place, while one diver’s umbilical became snagged on a steel platform and was severed. After 33 min, he was rescued into the diving bell without exhibiting any apparent neurological injury. The present case report tries to reconstruct, on rational grounds, how the diver could have survived after he was cut off from breathing gas, hot water, light, and communication while 90 m deep at the bottom of the sea.

Authors: Anders Rosén, Mikael Gennser, Nicklas Oscarsson, Andreas Kvarnström, Göran Sandström, Helen Seeman Lodding, Joel Simrén, Henrik Zetterberg. This study aimed to determine if established markers of neuronal injury were increased in the blood after diving. Thirty-two divers performed two identical dives, 48 h apart, in a water-filled hyperbaric chamber pressurized to an equivalent of 42 m of seawater for 10 min. After one of the two dives, normobaric oxygen was breathed for 30 min, with air breathed after the other. Blood samples were obtained before and at 30–45 and 120 min after diving.

Authors: Jerka Dumi, Ana Cvetko, Irena Abramovi, Sandra Šupraha Goreta, Antonija Perovi , Marina Njire Braticevi, Domagoj Kifer, Nino Sincic, Olga Gornik, and Marko Žarak. A previous publication of the authors suggested that repeated diving triggers an adaptive response of the cardiovascular and immune systems. To elucidate further molecular events underlying cardiac and immune system adaptation and exclude possible adverse effects, the authors measured blood levels of specific cardiac and inflammation markers.

Authors: Hugo F. Posada-Quintero, Carol S. Landon, Nicole M. Stavitzski, Jay B. Dean, and Ki H. Chon. The authors tested the hypothesis that changes in electrodermal activity (EDA), a measure of sympathetic nervous system activation, precedes seizures in rats breathing 5 atmospheres absolute (ATA) HBO 2 . Radio telemetry and a rodent tether apparatus were adapted for use inside a sealed hyperbaric chamber.

20 - The Effect of Hemoglobin Concentration on Hyperbaric Oxygen and Non-hyperbaric Oxygen in the Treatment of Hypertensive Intracerebral Hemorrhage After Operation at the High Altitude.

Authors: Linjie Wei, Chi Lin, Xingsen Xue, Shiju Jila, Yalan Dai, Li Pan, Wei Wei, Guodong Dun, Yong Shen, Taoxi Zong, Jingjing Wu, Yafang Li, Lixia Wu, Jishu Xian 3 and Anyong Yu IThe prognosis of hypertensive intracerebral hemorrhage (HICH) is poor at high altitudes. The objective of this study was to explore whether hyperbaric oxygen (HBO) can improve the results of computed tomography perfusion (CTP) imaging and the neurological function of patients with HICH, and influence the hemoglobin concentration. This document is not directly related to diving. However, it allows us to better understand the effect of oxygen on the human body.

Authors: Kate Lambrechts, Peter Germonpré, Joaquim Vandenheede, Manon Delorme, Pierre Lafère, and Costantino Balestra. Despite evolution in decompression algorithms, decompression illness is still an issue nowadays. Reducing vascular gas emboli (VGE) production or preserving endothelial function by other means such as diving preconditioning is of great interest. Several methods have been tried, either mechanical, cardiovascular, desaturation aimed or biochemical, with encouraging results. In this study, the authors tested mini trampoline (MT) as a preconditioning strategy.

Authors: Simon J. Mitchell, Michael H. Bennett, and Richard E. Moon Decompression sickness from dissolved gas causes tissue and vascular injury after a reduction in environmental pressure may occur in diving, aviation, and space flights. Arterial gas embolism, in which bubbles introduced into the arterial circulation cause multifocal ischemia, may occur after diving-related, iatrogenic, accidental pulmonary barotrauma or by the direct iatrogenic introduction of gas into the vasculature. Because it may be difficult to clinically differentiate decompression sickness from an arterial gas embolism in divers and the treatment protocols for the two disorders are the same, the term decompression illness” is sometimes used to indicate the presence of decompression sickness, arterial gas embolism, or both, but the separate terms are used here.

30 - Systematic Review and Dosage Analysis: Hyperbaric Oxygen Therapy Efficacy in Mild Traumatic Brain Injury Persistent Post Concussion Syndrome.

Author: Paul G. Harch This paper is a systematic review of hyperbaric oxygen therapy (HBOT) in Persistent Postconcussion Syndrome, a condition with significant consequences and limited treatment options, using a dose-analysis based on the scientific definition of hyperbaric oxygen therapy as a dual- component drug composed of increased barometric pressure and hyperoxia. This document is not directly linked to diving. However, it allows for a better understanding of the properties of oxygen and its potential usage in the treatment of injuries.

Authors: Feiko J. M. de Jong, Thijs T. Wingelaar, Paul Brinkman, Pieter-Jan A. M. van Ooij, Anke-Hilse Maitland-van der Zee, Marcus W. Hollmann, and Rob A. van Hulst The hyperbaric oxygen treatment USN table 6 can have adverse effects, such as pulmonary oxygen toxicity (POT). It is caused by reactive oxygen species ’ damaging effect on lung tissue and is often experienced after multiple days of therapy. The subclinical pulmonary effects have not been determined. The primary aim of this study was to measure volatile organic compounds (VOCs) in breath, indicative of subclinical POT after a table 6 implementation. Since the exposure would be limited, the secondary aim of this study was to determine whether these VOCs decreased to baseline levels within a few hours.

Authors: Kamellia Karimpour, Rhiannon J. Brenner, Grant Z. Dong, Jayne Cleve, Stefanie Martina, Catherine Harris, Gabriel J. Graf, Benjamin J. Kistler, Andrew H. Hoang, Olivia Jackson, Virginie Papadopoulou, and Frauke Tillmans. Venous gas emboli (VGE) are a marker of decompression stress, and large amounts of VGE are associated with an increased probability of Decompression Sickness (DCS). Thus, there is a need for small, portable devices with long battery lives to obtain ultrasonic data in the field to assess this variability better. The authors compared two new handheld ultrasound devices against a standard device currently used to monitor post-dive VGE in the field.

Authors: Gordon Slater, Martin O’Malley, Tayla Slater, and Tandose Sambo. Hyperbaric Oxygen Therapy (HBOT) has been a recognized treatment for a multitude of injuries for decades and presents significant opportunities for the improvement of wound healing, blood vessel restoration, reduction in recovery time after surgery, treatment of neurological and neurodegenerative disorders, improvement of memory and cognition, sports injury rehabilitation, cartilage regeneration, and overall quality of life. This paper investigates HBOT and its indications for use.

Authors: Zachary M. Harris, Ying Sun, John Joerns, Brian Clark, Buqu Hu, Asawari Korde, Lokesh Sharma, Hyeon Jun Shin, Edward P. Manning, Lindsey Placek, Derya Unutmaz, Gail Stanley, Hyung Chun, Maor Sauler, Govindarajan Rajagopalan, Xuchen Zhang, Min-Jong Kang, and Jonathan L. Koff Studies have linked severe hyperoxia, or prolonged exposure to very high oxygen levels, with worse clinical outcomes. This study investigated the role of epidermal growth factor receptor (EGFR) in hyperoxia-induced lung injury at very high oxygen levels (>95%)

Authors: Enrico Marchetti, Daniela Pigini, Mariangela Spagnoli, Giovanna Tranfo, Flavia Buonaurio, Fabio Sciubba, Ottavia Giampaoli, lfredo Miccheli, Alessandro Pinto, Nazzareno De Angelis, and Luigi Fattorini Oxidative stress after scuba diving has been explored by measuring urinary biomarkers in volunteers under controlled conditions. Dive depth and duration, water temperature, and workload are all variables that can elicit metabolic responses. A controlled diving experiment was performed in an indoor pool at 20, 30, and 40 m depths at a water temperature of 32C on three different days.

Publisher: Agilent - https://www.agilent.com/en Reactive oxygen species (ROS) have long been known to be a component of the killing response of immune cells to microbial invasion. Recent evidence has shown that ROS play a key role as a messenger in normal cell signal transduction and cycling. These reactive molecules are formed by several different mechanisms and can be detected by various techniques. This white paper briefly describes the biology behind some of these molecules and the means for their detection.

Authors: Ningfang Lian, Sijiao Wang, Lijuan Hu, Liping Xue, Ying Gong, Li Li, Yanjie Yang, and Lei Zhu This study aimed to evaluate the effects of a 500 m simulated single saturation dive on lung function. Nine professional divers aged (36 ± 7) years were enrolled. Three days after the dive, the parameters related to expiratory flow forced vital capacity (FVC)) were decreased; the parameters about small airway function decreased compared to those before the dive. Additionally, after the dive, the parameters related to pulmonary diffusion function were decreased compared with those before the dive.,

Authors: Ran Arieli The authors of this study suggested a mechanism for distal arterial bubble formation (Arieli and Marmur 2017). In the bifurcating arterial tree, the vessel’s wall becomes thinner, and wall surface to the volume of the vessel increases. Both of these enhance nitrogen diffusion from the surrounding tissue into the blood.

Authors: Sérgio Rhein Schirato, Vitor Silva, Kátia Iadocicco, Alessandro Marroni, Massimo Pieri, Danilo Cialoni, José Guilherme Chaui-Berlinck The present study aims to put forward a mathematical model of bubble formation associated with an inflammatory process related to decompression. The model comprises four state-variables (inert gas pressure, inert gas bubbles, proinflammatory and inflammatory factors) in a set of non-linear differential equations.

41 - Chest CT scan for the screening of air anomalies at risk of pulmonary barotrauma for the initial medical assessment of fitness to dive in a military population

Authors: Brieuc Bonnemaison , Olivier Castagna, Sébastien de Maistre, and Jean-Éric Blatteau The presence of intra-pulmonary air lesions such as cysts, blebs and emphysema bullae, predisposes to pulmonary barotrauma during pressure variations, especially during underwater diving activities. Chest radiography has long been the baseline examination for the detection of respiratory pathologies in occupational medicine. It has been replaced since 2018 by the thoracic CT scan for military diving fitness in France. The objective of this work was to evaluate the prevalence of the pulmonary abnormalities of the thoracic CT scan and to relate them to this population's characteristics and the spirometry results

Authors: Feiko J. M. de Jong, Paul Brinkman, Thijs T. Wingelaar, Pieter-Jan A. M. van Ooij, and Rob A. van Hulst Diving or hyperbaric oxygen therapy with increased partial pressures of oxygen (pO2) can have adverse effects such as central nervous system oxygen toxicity or pulmonary oxygen toxicity (POT). One of the most promising techniques to determine early signs of POT is the analysis of volatile organic compounds (VOCs) in exhaled breath. This study aimed to reanalyze the data of five previous studies to compose a library of potential exhaled markers for early POT detection.

Authors: Maria Ludovica Carerj, Giuseppe Bucolo, Silvio Mazziotti, Alfredo Blandino, Christian Booz, Giuseppe Cicero, Tommaso D’Angelo. Pneumothorax and pneumomediastinum are life- threatening conditions especially in critically ill patients. One of the most common situations in which they occur is prolonged invasive and non-invasive mechanical ventilation with high end-expiratory pressure. Probably due to the high number of patients with SARS-CoV-2 respiratory infection being treated with mechanical ventilation, increasing number of pulmonary barotrauma cases have been reported.

Authors: Dhan Bahadur Shrestha, Yub Raj Sedhai, Pravash Budhathoki, Ayush Adhikari, Nisheem Pokharel, Richa Dhakal, Satyasuna Kafle, Wasey Ali Yadullahi Mir, Roshan Acharya, Markos G. Kashiouris, Mark S. Parker Numerous studies have reported an increased incidence of spontaneous pulmonary barotrauma, such as pneumothorax, pneumomediastinum, and subcutaneous emphysema in patients with COVID-19. The authors conducted this systematic review and meta-analysis to assess the value and significance of the available data.

Authors: Sergio A Angelini, Lorenzo Tonetto, Michael A Lang In dissolved gas decompression algorithms, the ceiling is the depth at which the dissolved gas pressure in at least one tissue equals the maximum tolerated value defined by the algorithm. Staged decompression prescribes stationary stops in three-metre intervals so as to never exceed this maximum tolerated value. This keeps the diver deeper than the ceiling until the ceiling itself decreases to coincide with the next, three-metre shallower stage. Ceiling-controlled decompression follows the ceiling in a continuous ascent.

Diving and Hyperbaric Medicine said: We write to inform the community of an update to our previously published guidelines in Diving and Hyperbaric Medicine regarding evaluation of divers who have recovered from COVID-19. 1 We originally developed these guidelines for the dive clinic at the University of California, San Diego (UCSD).

Authors: Ian L Millar, Folke G Lind, Karl-Åke Jansson, Michal Hájek, David R Smart, Tiago D Fernandes, Rosemary A McGinnes, Owen D Williamson, Russell K Miller, Catherine A Martin, Belinda J Gabbe, Paul S Myles, Peter A Cameron, for the HOLLT investigator group Hyperbaric oxygen treatment (HBOT) is sometimes used in the management of open fractures and severe soft tissue crush injury, aiming to reduce complications and improve outcomes. - Patients with open tibial fractures were randomly assigned within 48 hours of injury to receive standard trauma care or standard care plus 12 sessions of HBOT. The primary outcome was the incidence of necrosis or infection or both occurring within 14 days of injury.

Authors: Karin Biering, Kent J. Nielsen, Ole Carstensen, & Anette Kærgaard To examine whether demographic and health factors are associated with risk of electrical shocks and compared mental and physical health before and after an electrical shock, a 6-month cohort study of 6960 electricians involved weekly questionnaires regarding exposure to electrical shocks, and health. The authors examined the association between health and demographic factors and the risk of eventual electrical shocks and health before and after a shock.

Authors: Luis-Miguel Pascual-Gomez, Lauren Petrass This scoping review aimed to identify common drowning characteristics to support bystanders in recognizing drowning. Studies were identified through a systematic search of databases from the year 2000 until 2020, with the review guided by the PRISMA Scoping review process. Two hundred and nineteen potentially relevant articles were identified, of which 23 met all inclusion criteria.

Authors: Nanna Yr Arnardottir, Sigridur Sia Jonsdottir, Hannes Petersen The working environment abroad a ship is unique, with constant stimuli such as rolling of the vessel, noise, and vibration. The objective of this study is to explore the impact of seasickness-related symptoms, i.e., seasickness, seasickness symptoms and “mal de debarquement” on seaman´s health, and how their working environment may affect those factors.

Authors: Connor TA Brenna, Shawn Khan, George Djaiani, Jay C Buckey Jr. , Rita Katznelson Respiratory injury during or following hyperbaric oxygen treatment (HBOT) is rare, but associated pressure changes can cause iatrogenic pulmonary barotrauma with potentially severe sequelae such as pneumothoraces. Pulmonary blebs, bullae, and other emphysematous airspace abnormalities increase the risk of respiratory complications and are prevalent in otherwise healthy adults.

Authors: Johan Ullman, David Hengst, Ronald Carpenter, Yohan Robinson Many operators of professional high-speed boats suffer severe, acute, and permanent injuries caused by slamming-induced hull impacts. As the number of professional high-speed boats and their speed capabilities increase, operators are reporting increasing numbers and severity of injuries. However, the actual incidence rate of acute injuries and the prevalence of chronic musculoskeletal disorders are still unknown.

Authors: Amilkar Almanza-Hurtado, Camilo Polanco Guerra, Marıa Cristina Martınez-Avila, Diana Borre-Naranjo, Tomas Rodrıguez-Yanez, and Carmelo Dueñas-Castell Hypercapnia is the elevation in the partial pressure of carbon dioxide (PaCO2) above 45 mmHg in the bloodstream, pathophysiological mechanisms of hypercapnia include the decrease in minute volume, an increase in dead space, or an increase in carbon dioxide (CO2) production per sec. They generate a compromise at the cardiovascular, cerebral, metabolic, and respiratory levels with a high burden of morbidity and mortality. It is essential to know the triggers to provide therapy directed at the primary cause and avoid possible complications.

Authors: Najmuddin Noorzad , Sırrı Sunay Gürleyük With the increasing growth of industrialization and mechanization of workplaces, electric accidents are becoming quite common, and many workers and individuals are unaware of the potential electrical hazards that their workplaces present and increase their vulnerability. Electrical currents have a wide range of impacts on the human body, from a barely slight tingling to sudden cardiac arrest. Therefore, a sound understanding of the engineering perspective and the occupational health and safety risk assessments are essential to prevent and manage these hazards.

Authors: (W. Rainey Johnson, Nicholas G. Roney, Hanbing Zhou, Geoffrey E. Ciarlone, Brian T. Williams, William T. Green, Richard T. Mahon, Hugh M. Dainer, Brett B. Hart, Aaron A. Hall In severe decompression illness (DCI) cases, the central nervous system is often compromised (>80%), making DCI among the most morbid of diving-related injuries. While hyperbaric specialists suggest initiating recompression therapy with either a Treatment Table 6 (TT6) or 6A (TT6A), the optimal initial recompression treatment for severe DCI is unknown.

Authors: Gerardo Bosco,Tommaso Antonio Giacon, Nazareno Paolocci, Alessandra Vezzoli, Cinzia Della Noce, Matteo Paganini, Jacopo Agrimi, Giacomo Garetto, Danilo Cialoni, Natalie D’Alessandro, Enrico M. Camporesi,Simona Mrakic-Sposta Divers can experience cognitive impairment due to inert gas narcosis (IGN) at depth. Brain-derived neurotrophic factor (BDNF) rules neuronal connectivity/metabolism to maintain cognitive function and protect tissues against oxidative stress (OxS). Dopamine and glutamate enhance BDNF bioavailability. Thus, the authors hypothesized that lower circulating BDNF levels underpin IGN in divers, while testing if BDNF loss is associated with increased OxS.

Authors: Gianluca Paternoster, Gianfranco Belmonte, Enrico Scarano, Pietro Rotondo, Diego Palumbo , Alessandro Belletti, Francesco Corradi , Pietro Bertini, Giovanni Landoni, Fabio Guarracino This is an observational, case-control study. Consecutive COVID-19 patients who underwent chest CT scan at hospital admission during the study time period (October 1st, 2020 – April 31st, 2021) were identified. Macklin effect accuracy for prediction of spontaneous barotrauma was measured in terms of sensitivity, specificity, positive (PPV) and negative predictive values (NPV)..

47 - Pneumoscrotum, a rare presentation of barotrauma following noninvasive positive pressure ventilation in patients with severe COVID-19 pneumonia.

Authors: Mohsen Shafiepour, Mohammad Javad Najafzadeh, Seyed Mehdi Hashemi Bajgani, Behnam Dalfardi Patients with Coronavirus disease 2019 (COVID-19) pneumonia are at risk of hypoxemic respiratory failure. Hence, many patients may require noninvasive positive pressure ventilation (NIPPV) during their hospital course. Using mechanical ventilation to provide NIPPV may result in adverse events, including barotrauma. Two cases of severe COVID-19 pneumonia and hypoxemic respiratory failure were complicated by barotrauma that manifested with "pneumoscrotum", a rare medical condition in which gas accumulates in the scrotum, an element of the male reproductive structure located at the base of the penis.

Authors: Levent Demir & Mustafa Avci The objective of the study was to compare pulmonary function tests results of hyperbaric chamber inside attendants (HCIAs) working in a hyperbaric chamber before and after sessions.

Authors: Xavier C. E. Vrijdag, Hanna van Waart, Chris Sames, Simon J. Mitchell, & Jamie W. Sleigh This study evaluated whether hyperbaric oxygen causes similar narcotic effects to nitrogen, and investigated oxygen's hyperexcitability effect. Twelve human participants breathed “normobaric” air and 100% oxygen, and “hyperbaric” 100% oxygen at 142 and 284 kPa, while psychometric performance, electroencephalography (EEG), and task load perception were measured. EEG was analyzed with functional connectivity and temporal complexity algorithms.

Authors: Stella E. Hines, Joanna M. Gaitens, Clayton H. Brown, Danielle R. Glick, Katherine H. Chin, Maxwell A. Reback, Melissa A. McDiarmid Blast lung overpressure has received interest as a cause of chronic respiratory disease in Service members who deployed in support of U.S. military operations in Southwest Asia and Afghanistan since 2001. The authors studied whether veterans who experienced blast exposure report more chronic respiratory symptoms and di- agnoses compared to deployed veterans who did not.

Authors: Saleh Eltarabily The purpose of this study was to determine whether there is a correlation between a hyperbaric environment, or increased oxygen partial pressure, and the corrosion of dental alloys used for dental restorations in divers.

Authors: Dr. med. Jens Strohäker, Dr. med. Malte Bongers, Dr. med. Robert Bachmann A 63-year-old man experienced a coughing fit and felt a tearing sensation in the right hemithorax. Clinical examination showed thoracic instability with attenuated breath sounds and an extensive soft tissue hematoma. The patient’s dyspnea worsened, and he was transferred to Tübingen University Hospital for surgery.

Authors: Jochen D. Schipke, Thomas Muth, Clark Pepper, Johannes Schneppendahl, Martin Hoffmanns, Sven Dreyer Hyperoxia has been described to induce bradycardia through direct stimulation of the parasympathetic nervous system. Also, hyperoxia has been found to increase blood pressure through an elevation of vascular resistance. However, the latter effect itself would induce bradycardia through baroreceptor stimulation. This study aims to evaluate the correlation between these effects by investigating the relationship between oxygen (O2) administration and heart rate over time.

Authors: Nan-Chieh Huang, Yu-Lung Wu, and Ren-Fang Chao Hyperbaric oxygen therapy (HBOT) is a professional medical regimen with a wide range of clinical applications in various research fields. In addition to treating diving- related decompression sickness and air embolism, HBOT is used as an adjunct in the management of various diseases. A large number of studies have been published to confirm its efficacy. Although HBOT has been clinically applied to the treatment of many diseases, the effectiveness of these treatments remains controversial.

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Authors: Anne-Virginie Desruelle, Sébastien de Maistre, Sandrine Gaillard, Simone Richard, Catherine Tardivel, Jean-Charles Martin, Jean-Eric Blatteau, Alain Boussuges, Sarah Rives, Jean-Jacques Risso, and Nicolas Vallee The authors studied a conventional strain of rats resistant to accidental hyperbaric exposure and hypothesized that the metabolomic signature might correspond to a physiological response adapted to the stress induced by diving. The aim was to verify and characterize whether the cecal compounds of rats resistant to the provocative dive have a cecal* metabolomic signature different from those of non-diving rats. (*cecal: pouch-like structures in the large intestine that play a crucial role in the digestion of carbohydrates and the production of fatty acids)

Authors: Giuliana Spadaro, Ilaria Tiddi, Simon Columbus, Shuxian Jin, Annette ten Teije, CoDa Team, and Daniel Balliet The authors describe the Cooperation Databank, a concept they created that defines and relates concepts in cooperation research and can represent the relationships between the results of correlational and experimental studies. This research platform allows users to retrieve studies, test the relationship between variables and cooperation, visualize the results, and perform meta- analyses, meta-regressions, estimates of publication bias, and statistical power analyses for future studies. This study should be considered as a guideline for creating research and company management databases.

Authors: lan G. Fraser, Mark J. Monaghan, Antonius F.W. van der Steen, and George R. Sutherland The authors of this document have compiled a timeline and summary of key developments in various echocardiography techniques, linking them to original publications and historical accounts by early researchers. The success of echocardiography has largely depended on technological advances and effective collaboration between engineers and clinicians, allowing open exchange across centres and disciplines. Today, advances are as much about software as hardware, with ongoing collaboration essential to address unmet needs and assess the impact of new imaging techniques.

Authors: Santiago Veiga, Robin Pla, Xiao Qiu, David Boudet, and alexandre Guimard The authors of this study examined the effects of changes in underwater sections of swimming races on the physiological and biomechanical parameters of competitive swimmers. The results indicate that while overall performance was maintained and underwater section durations increased as expected, heart rate and blood lactate concentration did not differ significantly between conditions. However, perceived exertion was higher in constrained underwater than free underwater conditions, leading to the conclusion that controlled increases in underwater sections can optimize performance despite a slight increase in perceived discomfort.

Authors: Robert P. Ostrowski, Emanuela Pucko and Ewa Matyja This study investigates the role of the proteasome in hyperbaric oxygen preconditioning (HBO-PC) to protect the brain from ischaemic injury. It documents experiments in male Wistar rats subjected to global cerebral ischaemia and preconditioned with HBO and details the methods, results, and significance of the findings, highlighting that HBO-PC reduces neuronal damage and improves functional outcomes, possibly through proteasome involvement and modulation of apoptosis-related proteins.

Authors: Mirela Zec, Vesna Anticevic, Linda Lušis Kalcina, Zoran Valic, Joško Božic This study investigates the relationship between negative automatic thoughts, negative emotions, and psychophysiological stress responses in military and recreational divers to determine whether these psychological factors, rather than diving experience, contribute to variations in stress responses, as measured by anxiety levels and cortisol secretion. It also highlights the importance of considering cognitive and emotional experiences, especially in recreational divers, to prevent negative stress responses before diving.

Authors: Xavier C. E. Vrijdag, Hanna van Waart, Rebecca M. Pullon, Chris Sames, Simon J. Mitchell, and Jamie W. Sleigh This study investigates the effects of nitrogen narcosis on cognitive function during hyperbaric conditions, using electroencephalogram (EEG) functional connectivity metrics by comparing the effects of breathing air, which contains nitrogen, and heliox, which does not have narcotic effects at the pressure mwentioned. The findings suggest that nitrogen narcosis increases functional connectivity in the brain, which is associated with cognitive impairment, while heliox does not cause such changes.

13 - Hypercapnia elicits differential vascular and blood flow responses in the cerebral circulation and active skeletal muscles in exercising humans

Authors: Shodai Moriyama, Masashi Ichinos, Kohei Dobashi, Ryoko Matsutake, Mizuki Sakamoto, Naoto Fuji, Takeshi Nishiyasu This study investigated the effects of increased arterial carbon dioxide pressure on vascular and blood flow responses in the cerebral circulation and active skeletal muscles during dynamic exercise in humans by comparing hypercapnia and normocapnia trials to observe differences in blood flow and vascular conductance in the brain and exercising muscles. The results highlight contrasting vascular responses in the cerebral circulation and skeletal muscles under hypercapnic conditions.

Authors: Danilo A. Massini, Danilo Scaggion, Thiago P. de Oliveira, Anderson G. Macedo, Tiago A. Almeida, Dalton M. Pessôa Filho. The authors of this document present the findings of a systematic review and meta-analysis that aimed to identify and evaluate the effectiveness of different training methods used to improve static apnea time performance in freediving. The review summarizes the evidence acquisition and synthesis, highlighting the effectiveness of three different training methods, and concludes that while all methods were effective, it is not possible to recommend an ideal protocol for improving apnea time and freediving performance based on the existing studies.

19 - Designing a Questionnaire for a Research Paper: A Comprehensive Guide to Design and Develop an Effective Questionnaire

Author: Hamed Taherdoost This document provides information about the importance of designing an effective questionnaire for research studies, outlining the challenges researchers face in questionnaire design and aiming to review the main steps involved in creating a questionnaire. This includes defining the information required, identifying the type of survey and questions, writing questions, constructing the questionnaire, pre-testing, and finalizing it for conducting a study.

Authors: Paul-Alexandre Moyaux, Gabriel Fernandez de Grado, Anne-Marie Musset, Damien Offner This study assessed the prevalence of orofacial problems among civilian SCUBA divers in France and analyzed their dental preventive behaviors, highlighting the frequency of oral issues related to diving, such as barodontalgia and dental fractures, and emphasizing the importance of dental examinations to reduce these problems. The text also points out a gap in divers' awareness and utilization of preventive dental care.

6 - Does hyperbaric oxygen therapy facilitate peripheral nerve recovery in upper extremity injuries? A prospective study of 74 patients.

Authors: Bilsev Ince, Majid Ismayilzada, Abdullah Arslan, Mehmet Dadaci This study assessed the effectiveness of hyperbaric oxygen therapy (HBOT) in upper extremity nerve injuries. Patients with ulnar and median nerve injuries from 2015 to 2019 were included and divided into two groups: one received HBOT after surgery, while the other did not. Follow-ups were done at 3, 6, and 12 months using various tests. Results showed that the HBOT group had faster nerve recovery and better muscle strength than the group without HBOT, suggesting that HBOT is beneficial.

18 - Simulating Multi-Scale Pulmonary Vascular Function by Coupling Computational Fluid Dynamics With an Anatomic Network Model

Authors: Behdad Shaarbaf Ebrahimi, Haribalan Kumar, Merryn H. Tawhai, Kelly S. Burrowes, Eric A. Hoffman, and Alys R. Clark The pulmonary circulation transports blood through vessels of different sizes, with mechanisms affecting flow. Few models address the physics of blood flow across these scales. The presented multi-scale model represents 3D blood flow and capillary perfusion factors, predicting how changes affect flow distribution and gas exchange. It also estimates posture's impact on artery wall shear stress, predicting variations of 0. 75 – 1. 35 dyne/cm².

2 - Editorial: The Role of Reactive Oxygen Species in Protective Immunity

Authors: Denis Martinvalet, and Michael Walch Reactive oxygen species (ROS) are a type of oxygen reduction that contributes to various physiological processes, including inflammation, vasoconstriction, signal transduction, cell migration, differentiation, and proliferation. They can modulate genes expression and transcriptional levels, and regulate gene expression at the posttranscriptional level. ROS are crucial for cell biology, organ function, and system physiology, including the immune system. This Research Topic aims to explore how ROS contribute to protective immunity, despite their potential harm.

31 - VOxygen Uptake Measurements and Rate of Perceived Exertion During a Marathon

Authors: Véronique Billat, Luc Poinsard, Florent Palacin, Jean Renaud Pycke, and Michael Maron This study focused on recreational marathon runners and analyzed their breath-by-breath gas exchange during the race. It found that only respiratory frequency and heart rate steadily increased, while oxygen uptake varied among individuals. The results suggest that runners should pace themselves using their Rate of Perceived Exertion (RPE)..