scientific-2023-a

Scientific papers 2023 - Part A

Authors: Feiko J. M. de Jong, Thijs T. Wingelaar, Paul Brinkman, Pieter-Jan A. M. van Ooij, Anke H. Maitland-van der Zee, Markus W. Hollmann, and Rob A. van Hulst The COMEX-30 hyperbaric treatment table is used to manage decompression sickness in divers but may result in pulmonary oxygen toxicity (POT). Volatile organic compounds (VOCs) in exhaled breath are early markers of hyperoxic stress that may be linked to POT. The present study assessed whether VOCs following COMEX-30 treatment are early markers of hyperoxic stress and/or POT in ten healthy, nonsmoking volunteers.

Authors: Simona Mrakic-Sposta, Maristella Gussoni, Mauro Marzorati, Simone Porcelli, Gerardo Bosco, Costantino Balestra, Michela Montorsi, Claudio Lafortuna, and Alessandra Vezzoli. Exposure to acute hypoxia elicits several functional changes in the human body to cope with the decreased oxygen availability. Whereas some of these adjustments (increased pulmonary ventilation and heart rate) are well characterized, others are still poorly understood. Excesses in the accumulation of reactive oxygen species (ROS), generated within the mitochondria, drive mechanisms contributing to injury including the induction of oxidative damage.

Authors: Junjie Wei, Peng Xiao, and Tao Chen Conductive gels have been developing as superior wearable sensing materials due to their intrinsic conductivity, softness, stretchability, and biocompatibility, showing great potential in many aspects of our lives. However, it is challenging for traditional conductive gels to realize sensing applications underwater. The swelling of gels and the loss of conductive components in the aqueous environment, resulting from the diffusion across the interface, lead to structural instability and sensing performance decline. Fortunately, significant efforts have been devoted to improving the water resistance of conductive gels and employing them in underwater wearable sensing in recent years, and some are exciting.

22 - Oxygen uptake (VO2) and pulmonary ventilation (V E) during military surface fin swimming in a swimming flume: Effects of surface immersion.

Authors: Olivier Castagna, Jean-Eric Blatteau, Arnaud Druelle, Jordan Amara, and Jean-René Lacour The authors suspected that oxygen uptake (VO2) and pulmonary ventilation (VE) might be much higher than expected during military fin swimming. In this framework, they compared these variables in the responses of trained military divers during land cycling and snorkeling exercises: Eighteen male military divers participated in this study. They performed two test exercises on two days: A maximal incremental cycle test (land condition), and an incremental fin swimming (fin condition) in a motorized swimming flume.

Author: Ran Arieli The author and his team suggest that in a “distal arterial bubble formation”, in the bifurcating arterial tree, the vessel’s wall becomes thinner and wall surface to the volume of the vessel increases, both of these circumstances enhance inert gas diffusion from the surrounding tissue into the blood.

Authors: Yu-Yao Zhang, Yi-Jun Zhou, Yuan-Yuan Jia, Tian-Tian Wang, Dian-Huai Meng Hyperbaric oxygen therapy is one of the common clinical treatments, but adverse effects have hampered and limited the clinical application and promotion of hyperbaric oxygen therapy. The authors conducted a systematic review and meta-analysis of the adverse effects of hyperbaric oxygen therapy to provide a theoretical basis for clinical treatment.

Authors: Chunqin Liu, Mingyi Qin, Xiaojuan Hou, Yu Li, Zongze He This paper reports on the treatment experience in a case of microscope-assisted auricular replantation, targeted postoperative treatment, early intervention with hyperbaric oxygen therapy, and individualized nursing care.

Authors: Mariana Ríos-Gómez, Viviana Gómez-Ortega, Cesar Cardona, and Jose A. De la Hoz-Valle This systematic review aims to identify and evaluate the clinical outcomes of hyperbaric oxygen therapy in the field of plastic, reconstructive, and aesthetic surgery, found in the literature from the year 2000 to the present

Authors: Armaan K. Malhotra, Ashton P. Chang, Joseph P. Lawton, Aderaldo Costa Alves Jr., Angela Jerath, Bourke W. Tillmann, Harry Foster, Azad Mashari, Leodante da Costa, and Ashish Kumar This report describes the use of hyperbaric oxygen therapy for the acute management of an intraoperative air embolism encountered during a neurosurgical procedure. Furthermore, the authors highlight the concomitant diagnosis of tension pneumocephalus requiring evacuation prior to hyperbaric therapy.

23 - Scientific shallow saturation dive expedition using diving rebreathers and a specific dry habitat: medical management of the “Capsule” programme.

Authors: Emmanuel Gouin, Jean Eric Blatteau, Emmanuel Dugrenot, François Guerrero, Bernard Gardette; on behalf of Under the Pole Consortium Scientific underwater exploration could benefit from professional diving facilities. This could allow marine research for durations far exceeding anything currently possible. The closed-circuit rebreather expansion provides new perspectives by unleashing divers and their diving bell. “Under the Pole Expeditions” developed an innovative compact underwater habitat for this purpose.

27 - Effect of Anesthetic Carrier Gas on In Vivo Circulation Times of Intravenously Administered Phospholipid Oxygen Microbubbles in Rats.

Authors: Phillip G. Durham, Awaneesh Upadhyay, Angel Navarro- Becerra, Richard E. Moon, Mark A. Borden, Paul A. Dayton, Virginie Papadopoulou The method described aims to treat tumor hypoxia microbubbles comprising oxygen as a majority component of the gas core with a stabilizing shell that may be used to deliver and release oxygen locally at the tumor site through ultrasound destruction. Previous work has revealed differences in circulation half-life in vivo for perfluorocarbon-filled microbubbles, typically used as ultrasound imaging contrast agents, as a function of anesthetic carrier gas.

Authors: David Q. LeID, Andrew H. Hoang, Arian Azarang, Rachel M. Lance, Michael Natoli, Alan Gatrell, Lesley Blogg, Paul A. Dayton, Frauke Tillmans, Peter Lindholm, Richard E. Moon, Virginie PapadopoulouI The authors report a method to generate synthetic post- dive data using doppler ultrasound signals collected in both precordium and subclavian vein with varying degrees of bubbling matching field-standard grading metrics. This method is adaptable, modifiable, and reproducible, allowing for researchers to tune the produced dataset for their desired purpose.

Authors: Ali Boolani, Joel Martin, Fulvio D’Acquisto, and Costantino Balestra. Fatigue is a complex and often misunderstood mood. Most biomedical researchers interested in fatigue conceptually defining fatigue as the absence of energy. However, Loy et al. (2018) provided evidence that biologically energy and fatigue may indeed be two distinct unipolar moods. Since then, multiple studies have provided evidence that energy and fatigue may have both distinct and overlapping biological, behavioral, and bio-mechanical correlates.

Authors: Romain Guenneugues, Anne Henckes, Vincent Mansourati, and Jacques Mansourati Hyperbaric oxygen therapy (HBOT) is the standard adjuvant treatment for life-threatening or disabling pathologies. Currently, mechanical and electronic variations of implantable cardioverter-defibrillators (ICD) in hyperbaric conditions have not been evaluated. As a result, many patients eligible for HBOT but ICD recipients cannot undergo this therapy, even in emergency situations.

33 - Contribution of Hyperbaric Oxygen Therapy in the Management of Gas Gangrene, Necrotizing Fasciitis and Suppuration of the Limbs

Authors: Mehdi Abakka, MJ Mekkaoui, M. Bouffetal, RA Bassir, M. Kharmaze, MO Lamrani, MS Berrada Hyperbaric oxygen therapy (HBOT) is defined as a method of administering inhaled oxygen (O2) for therapeutic purposes under a pressure greater than atmospheric pressure. The therapeutic benefits of HBO result, on the one hand, from the physical effects linked to the increase in barometric pressure and the partial pressure of O2 in the tissues and, on the other hand, from the biological effects linked to the production reactive species of O2 and nitrogen. These are likely to interact with many molecular processes responsible for the main anti-ischemic, pro- healing and anti-infective effects.

38 - Evaluation of the cardiac functions with tissue doppler before and after hyperbaric oxygen therapy of patients with carbon monoxide poisoning.

Authors: Ahmet Burak Simsek, Hazım Alper Gursu, Emine Azak, Yasemin Ozdemir Sahan, Ayse Esin Kibar Gul, Funda Kurt, Ibrahim Ilker Cetin The authors aimed to determine whether systolic and diastolic functions of patients who presented to the pediatric emergency clinic because of carbon monoxide poisoning and were treated with hyperbaric oxygen therapy. These patients were examined with tissue doppler imaging method before and after the treatment.

39 - Safety of Hyperbaric Oxygenation Treatment and Evaluation of Associated Clinical Parameters: A Single-Institutional Prospective Cohort Study.

Authors: Gonzalo Monge-Martínez, Matías Otto-Yáñez, Nicole Norambuena, Verónica Martínez, Daniela Retamales, Rodrigo Torres-Castro This study aims to analyze the safety of the hyperbaric oxygen treatment at 1.45 atmosphere absolute (ATA) and compare it with reports at the same and higher pressures of treatment.

Authors: Katarzyna Latusek, Adrianna Słotwinska-Pawlaczyk, Aleksandra Warakomska, Magdalena Kubicka-Musiał, Rafał Wiench, and Bogusława Orzechowska-Wylegała Periodontitis is a chronic inflammatory disease with multifactorial aetiology. The relationship between periodontal disease and systemic diseases such as diabetes, obesity, metabolic syndrome, atherosclerotic, cardiovascular disease, and cognitive disorders has been the subject of many studies. The purpose of this study was to evaluate the effectiveness of hyperbaric oxygen therapy on periodontal health in patients suffering from periodontitis and type 2 diabetes.

Authors: Connor T. A. Brenna, Shawn Khan, Rita Katznelson, Katherine Marseu Neurologic injury is relatively common in the context of spinal surgery, and is often treated with physiotherapy, pharmacotherapy, or surgical intervention. Emerging evidence supports a possible role for hyperbaric oxygen therapy (HBOT) in the treatment of peripheral and spinal nerve injuries. The authors describe the successful use of HBOT in improving neurologic recovery after complex spine surgery with new-onset postoperative unilateral foot drop.

Authors: Alain Boussuges, Guillaume Chaumet, Martin Boussuges, Amelie Menard, Stephane Delliaux, and Fabienne Brégeon Although previous studies have determined limit values of normality for diaphragm excursion and thickening, it would be beneficial to determine the normal diaphragm motion-to-inspired volume ratio that integrates the activity of the diaphragm and the quality of the respiratory system.

Authors: Clément Leveque, Simona Mrakic Sposta, Sigrid Theunissen, Peter Germonpré, Kate Lambrechts, Alessandra Vezzoli, Maristella Gussoni, Morgan Levenez, Pierre Lafère, François Guerrero, Costantino Balestra This study investigated the metabolic responses of hypoxic breathing for one hour to inspired fractions of 10% and 15% oxygen. To this end blood samples of 14 nonsmoking volunteers were taken before and at 30 min, 2 h, 8 h, 24 h, and 48 h after exposure. The level of oxidative stress was evaluated while antioxidant systems were observed in terms of the total antioxidant capacity (TAC) and urates.

Authors: Kent J. MacLaughlin, gregory P. Barton, udolf K. Braun, Julia E. MacLaughlin, Jacob J. Lamers, Mathew D. Marcou, and Marlowe W. Eldridge Hyperbaric air (HBA) was first used pharmaceutically in 1662 to treat lung disease. Extensive use in Europe and North America followed throughout the 19th century to treat pulmonary and neurological disorders. Since that time the 78% Nitrogen fraction in HBA has been completely displaced by 100% oxygen to create the modern pharmaceutical hyperbaric oxygen therapy (HBOT), a powerful treatment that is approved for multiple indications.

Authors: Olivier Castagna, Arnaud Druelle, Guillaume Michoud, Thibaut Prevautel, and Jean René Lacour Immersion pulmonary edema (IPE) is a frequent diving accident, and it is the primary cause of hospitalization for young military divers during training. The objective of this study was to identify immersion-induced parameters predicting individual susceptibility to IPE.

19 - A hypoarousal model of neurological post-COVID syndrome: the relation between mental fatigue, the level of central nervous activation and cognitive processing speed

Authors: Eva Maria Martin, Sven Rupprecht, Simon Schrenk, Fabian Kattlun, Isabelle Utech, Monique Radscheidt, Stefan Brodoehl, Matthias Schwab, Philipp A. Reuken, Andreas Stallmach, Thomas Habekost, Kathrin Finke The authors assumed that cognitive dysfunction and fatigue in post-COVID syndrome are critically linked via hypoarousal of the brain. Thus, we assessed whether tonic alertness as a neurocognitive index of arousal is reduced in these patients and how this relates to the level of central nervous activation and subjective mental fatigue as further indices of arousal.

Author: Desi Rahmah Sari, Ismi Dian Meiliana, Dewangga Sakti Satria Kinasih, Hamidah Kurniasari, Purwo Sri Rejeki Suicide is the second most common cause of death and a major public health problem in many countries. Chemical poisoning, such as hydrochloric acid, accounts for 18.8% of total suicide cases in Indonesia. This study aimed to provide a better understanding on hyperbaric oxygen's biomolecular mechanism as a potential adjuvant therapy in hydrochloric acid poisoning.

18 - Risk Related Incorrect Decompression, Stage Ascent Procedures with the Use of Decompression Tables as a type of Preventive Actions Against the Effects of Decompression

Authors: Katarzyna Mielniczek, Grzegorz Rutkowski This article presents what decompression is and how to perform it correctly using dive ascent tables, and the typical symptoms of decompression sickness. This article also describes typical diving accidents caused by poorly planned dives without decompression. stops being performed. The article emphasizes that important factors contributing to diving safety are: Proper training of the diver and a properly prepared diving plan, including the decompression stops. The divers’ mental state and their so-called adaptive training.

Authors: Richard Viking Lundell, and Tommi Ojanen Heart rate variability (HRV) is a useful method for studying the autonomic nervous system (ANS). As measuring devices have developed and become smaller, many researchers have become interested in the possibilities of implementing the method for diving medicine research. The aim of this study was to review human ANS responses in cold water diving (water temperature <5°C), and to comprise the current knowledge of HRV studies in diving and hyperbaric exposure into one review article.

Authors: Tanya Palmer, Steven J. Obst, Craig R. Aitken, James Walsh, Surendran Sabapathy, Lewis Adams, and Norman R. Morris Exertional dyspnea is the primary diagnostic symptom for chronic cardiopulmonary disease populations. While a number of exercise tests are used, there remains no gold standard clinical measure of exertional dyspnea. The aim of this review was to comprehensively describe and evaluate all types of fixed-intensity exercise tests used to assess exertional dyspnea in chronic cardiopulmonary populations and, where possible, report the reliability and responsiveness of the tests.

36 - Effect of Hyperbaric Oxygen Intervention on Oxidative Stress and Expression of Nerve Growth Factor in Patients with Craniocerebral Injury

Authors: Bingyan Ren, Hanbin Ye Wenyuan Shan, Xuelei Tao, Zi Ye Using the random number table method, 40 patients with craniocerebral injury who were treated at the First People’s Hospital of Nantong were randomly assigned to either the control group or the hyperbaric oxygen group, with 20 patients in each group. The control group received routine intervention for clinical traumatic brain injury, while the hyperbaric oxygen group received additional hyperbaric oxygen intervention during the 7 to 30 days of routine intervention. Indicators of oxidative stress and nerve growth factor levels were compared between the two groups at the time of admission and 30 days after therapy.

37 - Sequence of Rare Diagnoses in a Young Patient: Altitude Barotrauma Hemopneumothorax and Desquamative Interstitial Pneumonia

Authors: Lustina Leonte, Karina Ivanov, Angela-Stefania Marghescu, Serban-Radu Matache, Florica Valeria Negru, Ana-Luiza Iorga, Silviu Mihail Dumitr, and Beatrice Mahle The authors present the case of a 35-year-old patient without a pathological history who developed hemopneumothorax due to altitude barotrauma during a commercial airline flight. The computed tomography of the chest identified the presence of emphysema "blebs" and bubbles, while the histopathological examination of the lung fragment identified elements suggestive of the diagnosis of respiratory bronchiolitis associated with desquamative interstitial pneumonia

Authors: Eric A. Aloko, Munkaila Seibu, Daniel Apaak, Emmanuel O. Sarpong, Stephen R. Sorkpor, Edward W. Ansah The aging process is characterized by reduced physical activity, accumulation of fat, and loss of muscle mass, resulting in weight gain and reduced cardiorespiratory function, which leads to a loss of physical function capacity. Therefore, the purpose of this study was to determine the extent to which body weight and cardiorespiratory endurance predict the physical functional capacity of older adults in Navrongo, Ghana. This study employed a quantitative cross-sectional design, using a multistage sampling method with 998 participants aged (60yrs+).

Authors: Neil Wright, Katherine Newell, Ka Hung Chan, Simon Gilbert, Alex Hacker, Yan Lu, Yu Guo, Pei Pei, Canqing Yu, Jun Lv, Junshi Chen, Liming Li, Om Kurmi, Zhengming Chen, Kin Bong Hubert Lam, and Christiana Kartsonaki Existing evidence on the long-term ambient air pollution (AAP) exposure and the risk of cardiorespiratory diseases in China mainly focuses on mortality and is based on area- average concentrations from fixed-site monitors for individual exposure. The authors aimed to examine the relationships between AAP exposure and the risk of cardiorespiratory diseases using predicted local levels of AAP.

47 - The Potential Role of Hyperbaric Oxygen Therapy in Psoriasis Treatment: A Review of PI3K/AKT/FOXO Signaling Cascade and Interleukin-1B

Authors: Ahmad Fawzy, Ismiralda Oke Putranti, Erni Setiyawati Psoriasis is a chronic, immune-mediated inflammatory skin disorder that affects 2-3% of the worldwide population. Hyperbaric oxygen therapy, a safe and well-tolerated procedure, has been suggested as a potential treatment for psoriasis due to its ability to increase tissue oxygenation and reduce inflammation. This review article summarizes the current understanding of the pathophysiology of psoriasis and the potential benefits of hyperbaric oxygen therapy as a treatment modality.

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Authors: Marta Ruiz-Mambrilla, Antonio Dueñas-Ruiz, José L. Pérez- Castrillón, Iciar Usategui-Martín, Antonio Dueñas-Laita A 27-year-old experienced aphasia and other symptoms following CO poisoning. The authors underwent speech therapy* (speech therapy* = assessment and treatment of communication problems and speech disorders) and hyperbaric oxygen treatments for two months. This combined approach effectively resolved the patient's symptoms. Further research is needed, but this case shows promise for treating similar conditions post-CO intoxication.

Authors: Leigh C. Ward, & Steven Brantlov The measurement of phase angle by bioimpedance analysis (BIA) is an indicator of "cellular health”, broadly related to cellular water balance, membrane integrity, and cell mass. However, much of the research is based on empirical observations and less on the biophysical principles of BIA or an explanation of the reasoning behind the results.This review aims to clarify the electrical models used to describe tissue properties, with a focus on phase angle. It also highlights practical issues in measuring phase angle and the advantages of using bioimpedance spectroscopy (BIS).

Authors: Gregory H. Grossman, & Marianne K. Henderson Artificial intelligence (AI) is defined as an automated software system capable of ingesting, assembling, and analyzing data and domain knowledge to provide context-specific outputs. This article discusses the impact of artificial intelligence (AI) on improving various aspects of biobanking, such as donor recruitment, biobank operations, education, data annotation, ethical data deposition, and many others.

Authors: Pamela Tozzo, Arianna Delicati, Beatrice Marcante, & Luciana Caenazzo Big data biobanks provide essential insights for improving operations, creating innovative solutions, and addressing inefficiencies. Effectively analyzing and using this data requires information sharing, specific skills, training, integration across the healthcare system, advanced infrastructure, and robust security measures. These elements are critical for developing and managing big data biobanks, which may require new governance models different from those used for traditional large sample biobanks.

Authors: Feiko J. M. de Jong, Thijs T. Wingelaar, Rob A. van Hulst This paper is a summary of the various methods implemented to control the adverse effects of oxygen.

Authors: Jan-Peter Schaap, Margy E Zuluaga Fernandez, Antoinette Houtkooper , Edwin L Endert, Pieter-Jan AM van Ooij In the diving community there is a special need to know if asymptomatic or mild COVID-19 disease impacts the cardiopulmonary functioning of individuals with occupational exposure to extreme environments. To date, no controlled studies have been conducted comparing COVID-19-infected hyperbaric employees and non- COVID-19-infected peers in a military setting.

1 - Commentary: Comparison of newer hand-held ultrasound devices for post-dive venous gas emboli quantification to standard echocardiography

Authors: Metelkina Asya & Barbaud Axel This paper critically reviews a study titled "Comparison of newer hand-held ultrasound devices for post-dive venous gas emboli quantification to standard echocardiography "conducted by Karimpour et al. in 2022. The authors of the text express interest in the study but also indicate that there are several important aspects that need to be considered, suggesting they may offer further critique or discussion on the study's methodology, findings, or implications.

Authors: Wendy Sullivan-Kwantes & Peter Tikuisis This study examined the vulnerability of military divers to non-freezing cold injury (NFCI) during Arctic ice-diving operations. It involved monitoring the temperature of divers' extremities to assess the risk of NFCI and found that the feet were particularly vulnerable. It also compared the thermal comfort and protective qualities of different diving suit configurations and highlighted the need for further investigation into factors like hydrostatic pressure and repetitive diving as potential risk factors for NFCI.

25 - Polish Studies on Saturation Diving and Practical Application of Their Findings. Part III: Technical and Organisational Issues of the implementation of Saturation Diving in Poland from the 1990s onwards. Part 1

Author: Stanisław Skrzynski This paper provides an informative overview of the history, development, and implementation of saturation diving technology in Poland, particularly in relation to the offshore industry. It aims to highlight the economic and historical context, key players, technological advancements, and organizational efforts that have contributed to the establishment and growth of saturation diving practices in the Polish economic zone of the Baltic Sea. It also emphasizes significant milestones and collaborations that have shaped the current state of saturation diving in Poland.

Authors: Richard Viking Lundell &Tommi Ojanen) This study reviews the current knowledge on heart rate variability (HRV) in diving medicine, particularly focusing on human autonomic nervous system (ANS) responses in cold water diving. It outlines the methodology used for the literature review, including the search terms and databases, and summarizes the findings from the selected articles. In addition, it aims to consolidate existing research on HRV and hyperbaric exposure to better understand how cold water and increased pressure affect the ANS, especially the parasympathetic nervous system (PNS).

Authors: Jan Risberg, Pieter-Jan van Ooij, Lyubisa Matity This document presents the ESOT (equivalent surface oxygen time) procedure as a more practical and intuitive alternative to the current measures (K and UPTD) for assessing pulmonary oxygen toxicity (POT) in surface- oriented diving. It argues that ESOT offers similar accuracy in predicting POT while being easier to calculate and interpret, especially in operational environments. It also provides specific ESOT threshold limits to guide safe diving practices over multiple days.

Authors: Rita I. Sharma, Anna B. Marcinkowska, Natalia D. Mankowska, Monika Wa´skow, Jacek Kot, and Pawel J. Winklewski This paper discusses the safety concerns and potential cognitive effects associated with scuba diving, particularly focusing on the need for more research into the chronic effects of diving on cognitive functions. It highlights the lack of sufficient studies on technical divers and calls for further investigation into the long-term impacts of diving on cognitive health.

14 - Polish Studies on Saturation Diving and Practical Application of Their Findings. Part IIIB: Technical and Organizational Issues of the Implementation of Saturation Diving in Poland from the 1990s onwards. Part 2

Authors: Stanisław Skrzynski This article intends to inform readers about the history, development, and implementation of saturation diving technology in Poland, particularly in relation to the offshore mining industry. It highlights the economic and historical context, key players, and technological advancements that have contributed to this technology's establishment and growth in the Baltic Sea's Polish economic zone. The article also aims to acknowledge the challenges faced during periods of financial instability and the collaboration with international and national entities that facilitated the progress of saturation diving in Poland.

Authors: Mika Onitsuka, Shinya Tada, Yoko Nozawa, Youichi Yanagawa This paper presents the findings of a retrospective study investigating the degree of completion of a diving accident checklist by a physician-staffed helicopter emergency medical service (HEMS) during or immediately after diving accidents. It compared the checklist completion rates between patients who experienced cardiac arrest and those who did not and concluded that the checklist completion was lower in cases with cardiac arrest.

Authors: John Lippmann, Christopher Lawrence, Andrew Fock This study investigated compressed gas diving deaths in Australia from 2014 to 2018 to identify ongoing problems and assess countermeasures by comparing these findings with data from 2001 to 2013. It outlines the methods used for data collection, the results of the analysis, and the conclusions drawn regarding the factors contributing to diving fatalities, such as advancing age, obesity, and cardiac-related issues. In addition, it emphasizes the importance of assessing fitness to dive to prevent such incidents.

This document provides a detailed report and analysis of diving activities, specifically saturation and surface-oriented diving, on the Norwegian and foreign continental shelves under Norwegian jurisdiction for the year 2022 to inform about the volume of diving activities, incidents reported, and trends in diving operations, including new reporting practices for onshore facilities and future expectations for offshore diving activities.

5 - Neuroinflammation with increased glymphatic flow in a murine model of decompression sickness.

Authors: Stephen R. Thom, Veena M. Bhopale, Abid R. Bhat, Awadhesh K. Arya, Deepa Ruhela, Guanda Qiao, Xin Li, Shiyu Tang, and Su Xu This project studied how glial lymphatic function affects decompression sickness (DCS) in mice. It found that after high air pressure, certain inflammatory microparticles increase, leading to neuroinflammation and disrupted blood-brain barrier. Injecting these microparticles into mice caused similar effects, which could be blocked by an antibody. High pressure and decompression increase glymphatic flow and sustain neuroinflammation.

15 - A critical review of physiological bubble formation in hyperbaric decompression

Authors: Virginie Papadopoulou, Robert J. Eckersley, Costantino Balestra, Bubbles can form in the body after dives, even if guidelines are followed, leading to decompression sickness. Understanding bubble formation and growth remains challenging, with unanswered questions. Recent studies focus on heterogeneous nucleation and theories related to micronuclei stability. The importance of bubble formation, growth, and behavior is also discussed.

16 - The risk of decompression illness in breath-hold divers: a systematic Review

Author: S Lesley Blogg, Frauke Tillmans, Peter Lindholm Breath-hold (BH) diving has risks like drowning, pulmonary oedema, and barotrauma, along with dangers of decompression illness (DCI) such as decompression sickness (DCS) and arterial gas embolism (AGE). A systematic review identified 17 articles covering 44 DCI cases in BH diving, supporting DCS and AGE as risks for these divers.

35 - Right-to-Left Shunt in Divers with Neurological Decompression Sickness: A Systematic Review and Meta-Analysis.

Author: Spyros Peppas, Leonidas Palaiodimo, Sanjana Nagraj, Damianos G. Kokkinidis, Nidhish Tiwari, Amrin Kharawala, Mohammad K. Mojadidi, Sanauallah Mojaddedi, George Ntaios, Robert T. Faillace, and Jonathan M. Tobis This study evaluated the link between right-to-left shunt (RLS) and neurological decompression sickness (NDCS) in divers. It reviewed nine studies with 1830 divers, showing RLS was more common in those with NDCS (62. 6% vs. 27. 3%). High-grade RLS was linked to NDCS and was notably associated with inner ear conditions. No significant link was found between RLS and asymptomatic brain lesions.