Selected scientific publications on diving medicine and physiology.

2018 Mar 23
Safety Priorities and Underestimations in Recreational Scuba Diving Operations: A European Study Supporting the Implementation of New Risk Management Programmes
Lucrezi S., Egi S. M., Pieri M., Burman F., Ozyigit T., Cialoni D., Thomas G., Marroni A., Saayman M.

Introduction: Scuba diving is an important marine tourism sector, but requires proper safety standards to reduce the risks and increase accessibility to its market. To achieve safety goals, safety awareness and positive safety attitudes in recreational scuba diving operations are essential. However, there is no published research exclusively focusing on scuba divers’ and dive centres’ perceptions toward safety. This study assessed safety perceptions in recreational scuba diving operations, with the aim to inform and enhance safety and risk management programmes within the scuba diving tourism industry.

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2018 Jan 1
Design and Implementation of an Underwater Telemetric Glucose Monitoring System for Scuba Divers
Egi S. M., Altepe C., Pieri M., Ruzgar Sinoplu D., Cialoni D., Özyiğit T., Pierleoni P., Marroni A.

Despite the abundance of telemetric applications for ecology, behavior and physiology of marine life, few efforts were reported about the use of acoustic telemetry for SCUBA divers. Such systems are required to study the medical conditions of some type of divers such as diabetic ones. This study communicates the details of a study to design, manufacture and test a prototype system that measures the blood glucose while diving and transmit the results in real time to the surface. The system design consists of a subcutaneous sensor to measure interstitial glycaemia, a microcontroller based RF receiver board in a custom built waterproof casing, a pair of acoustic modems to transmit data underwater and a computer on the surface to log the received data.

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2017 Dec 7
A Software Tool for the Annotation of Embolic Events in Echo Doppler Audio Signals
Pierleoni P., Maurizi L., Palma L., Belli A., Valenti S., and Marroni A.

The use of precordial Doppler monitoring to prevent decompression sickness (DS) is well known by the scientific community as an important instrument for early diagnosis of DS. However, the timely and correct diagnosis of DS without assistance from diving medical specialists is unreliable. Thus, a common protocol for the manual annotation of echo Doppler signals and a tool for their automated recording and annotation are necessary. We have implemented original software for efficient bubble appearance annotation and proposed a unified annotation protocol. The tool auto-sets the response time of human “bubble examiners,” performs playback of the Doppler file by rendering it independent of the specific audio player, and enables the annotation of individual bubbles or multiple bubbles known as “showers.” The tool provides a report with an optimized data structure and estimates the embolic risk level according to the Extended Spencer Scale. The tool is built in accordance with ISO/IEC 9126 on software quality and has been projected and tested with assistance from the Divers Alert Network (DAN) Europe Foundation, which employs this tool for its diving data acquisition campaigns.

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2017 Dec 1
Evidence of Heritable Determinants of Decompression Sickness in Rats
Lautridou J., Buzzacott P., Belhomme M., Dugrenot E., Lafère P., Balestra C., Guerrero F.

INTRODUCTION: Decompression sickness (DCS) is a complex and poorly understood systemic disease caused by inadequate desaturation after a decrease of ambient pressure. Strong variability between individuals is observed for DCS occurrence. This raises questions concerning factors that may be involved in the interindividual variability of DCS occurrence. This study aimed to experimentally assess the existence of heritable factors involved in DCS occurrence by selectively breeding individuals resistant to DCS from a population stock of Wistar rats.

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2017 Sep 19
Dive Risk Factors, gas bubble formation, and decompression illness in recreational SCUBA diving: Analysis of DAN Europe DSL Data Base
Cialoni D, Pieri M, Balestra C & Marroni A.

Introduction: The popularity of SCUBA diving is steadily increasing together with the number of dives and correlated diseases per year. The rules that govern correct decompression procedures are considered well known even if the majority of Decompression Sickness (DCS) cases are considered unexpected confirming a bias in the "mathematical ability" to predict DCS by the current algorithms. Furthermore, little is still known about diving risk factors and any individual predisposition to DCS. This study provides an in-depth epidemiological analysis of the diving community, to include additional risk factors correlated with the development of circulating bubbles and DCS.

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