Publications

Selected scientific publications on diving medicine and physiology.

2020 Feb 12
Hyperoxia Alters Ultrastructure and Induces Apoptosis in Leukemia Cell Lines
David De Bels, Frauke Tillmans, Francis Corazza, Mariano Bizzarri, Peter Germonpre, Peter Radermacher, Keziban Günce Orman, and Costantino Balestra

Oxygenation conditions are crucial for growth and tumor progression. Recent data suggests a decrease in cancer cell proliferation occurring after exposure to normobaric hyperoxia. Those changes are associated with fractal dimension. The purpose of this research was to study the impact of hyperoxia on apoptosis and morphology of leukemia cell lines. Two hematopoietic lymphoid cancer cell lines (a T-lymphoblastoid line, JURKAT and a B lymphoid line, CCRF-SB) were tested under conditions of normobaric hyperoxia (FiO2 > 60%, ± 18h) and compared to a standard group (FiO2 = 21%). We tested for apoptosis using a caspase-3 assay.

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2019 Nov 27
Doppler ultrasound dataset for the development of automatic emboli detection algorithms
Paola Pierleoni, Marco Mercuri Alberto Belli, Massimo Pieri, Alessandro Marroni, Lorenzo Palma

The article describes a dataset of doppler ultrasound audio tracks taken on a sample of 30 divers according to the acquisition protocol defined by the Divers Alert Network. The audio tracks are accompanied by a medical evaluation for the decompression sickness risk according to the Spencer's scale levels. During the acquisition campaign, each diver in the post-dive phase was subjected to a double doppler ultrasound examination of approximately 45 seconds each one in the precordial area using a Huntleigh FD1 Fetal doppler probe. The two measurements were separated by a time of 8-10 seconds necessary for carrying out specific physical exercises designed to free the bubbles trapped in the tissues.

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2019 Nov 8
Evaluation of Divers’ Neuropsychometric Effectiveness and High-Pressure Neurological Syndrome via Computerized Test Battery Package and Questionnaires in Operational Setting
Berenji Ardestani Simin, Balestra Costantino, Bouzinova Elena V., Loennechen Øyvind, Pedersen Michael

Introduction: When divers are compressed to water depths deeper than 150 meter sea water (msw), symptoms of high-pressure neurological syndrome (HPNS) might appear due to rapid increase in pressure on the central nervous system during compression. The aim of this study was to first operate a new computerized tool, designed to monitor divers’ wellbeing and cognitive function, and to record the results. The second aim was to evaluate the feasibility and validity of the Physiopad software and HPNS questionnaires as a new tool for monitoring divers wellbeing in an operational setting, including sensible visualization and presentation of results. Methods: The Physiopad was operated onboard Deep Arctic (TechnipFMC Diving Support Vessel). The diving work was performed between 180 and 207 msw. The data from 46 divers were collected from the HPNS questionnaires, Hand dynamometry test, Critical Flicker Fusion Frequency test (CFFF), Adaptive Visual Analog Scale (AVAS), Simple Math Process (MathProc test), Perceptual Vigilance Task (PVT), and Time Estimation Task (time-wall).

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2019 Oct 1
Diving physiopathology: the end of certainties? Food for thought
Balestra C, Germonpre P, Rocco M, Biancofiore G & Kot J.

Our understanding of decompression physiopathology has slowly improved during this last decade and some uncertainties have disappeared. A better understanding of anatomy and functional aspects of patent foramen ovale (PFO) have slowly resulted in a more liberal approach toward the medical fitness to dive for those bearing a PFO. Circulating vascular gas emboli (VGE) are considered the key actors in development of decompression sickness and can be considered as markers of decompression stress indicating induction of pathophysiological processes not necessarily leading to occurrence of disease symptoms.

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2019 Jul 24
An EMD-Based Algorithm for Emboli Detection in Echo Doppler Audio Signals
Pierleoni P, Palma L, Belli A, Pieri M, Maurizi L, Pellegrini M & Marroni A.

Divers’ health state after underwater activity can be assessed after the immersion using precordial echo Doppler examination. An audio analysis of the acquired signals is performed by specialist doctors to detect circulating gas bubbles in the vascular system and to evaluate the decompression sickness risk. Since on-site medical assistance cannot always be guaranteed, we propose a system for automatic emboli detection using a custom portable device connected to the echo Doppler instrument. The empirical mode decomposition method is used to develop a real-time algorithm able to automatically detect embolic events and, consequently, assess the decompression sickness risk according to the Spencer’s scale. The proposed algorithm has been tested according to an experimental protocol approved by the Divers Alert Network. It involved 30 volunteer divers and produced 37 echo Doppler files useful for the algorithm’s performances evaluation. The results obtained by the proposed emboli detection algorithm (83% sensitivity and 76% specificity) make the system particularly suitable for real-time evaluation of the decompression sickness risk level. Furthermore, the system could also be used in continuous monitoring of hospitalized patients with embolic risks such as post surgery ones.

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