Notes

Theoretical insights in to the cineole-based deep eutectic chemicals.
Primary issues of concern were emergency planning (20%); technical (not medical/physiology) questions (16%); otorhinolaryngological (12%); and decompression sickness-related (7%). Categorisation was 52% INF, 28% MOP, 13% PUR, 7% NLT, and 0.1% ILT, with 0.2% lacking sufficient detail to categorise. The nature of the diving activity of interest was determined in 67% of cases 48% (n = 1,039) professional; 46% (n = 1,008) recreational; and 1% (n = 11) breath-hold.

The call centre serves as a resource to the community, providing information on health and safety for diving in addition to being available to assist with emergent needs.
The call centre serves as a resource to the community, providing information on health and safety for diving in addition to being available to assist with emergent needs.
The aim of this study was to re-examine the mortality rate among participants in the Professional Association of Diving Instructors' (PADI)'s Discover Scuba Diving (DSD) programme.

Fatalities reported to PADI as having occurred during DSD scuba dives were counted for each year between 1992 and 2019. DSD participant registrations were also counted for each year. The data were conveniently divided into two equal 14-year periods, 1992-2005 ('early') and 2006-2019 ('late'). To smooth out the year-to-year variation in raw rates, Monte Carlo simulations were performed on the mean rate per 100,000 participants per year during each period.

There were a total of 7,118,731 DSD participant registrations and 79 fatalities during the study period. The estimated overall mean mortality rate in the early period was 2.55 per 100,000 DSD registrations whereas the estimated rate of 0.87 per 100,000 DSD registrations was significantly lower in the late period (P < 0.0001).

PADI's contemporary Discover Scuba Diving introductory scuba experiences, at 0.87 fatalities per 100,000 participants, have a calculated mortality rate that is less than half that calculated for 1992-2008. The late period's rate improvement appears due either to significant under-registration in the early period, or to significant safety-performance improvement in the late period or, more likely, some combination of the two.
PADI's contemporary Discover Scuba Diving introductory scuba experiences, at 0.87 fatalities per 100,000 participants, have a calculated mortality rate that is less than half that calculated for 1992-2008. The late period's rate improvement appears due either to significant under-registration in the early period, or to significant safety-performance improvement in the late period or, more likely, some combination of the two.
Decompression sickness (DCS) is considered a 'bubble disease'. Intravascular bubbles activate inflammatory responses associated with endothelial dysfunction. Breathing gas has been proposed as a potential risk factor but this is inadequately studied. Different gases are used in scuba diving. Helium-containing 'trimix' could theoretically mitigate inflammation and therefore reduce DCS risk. This study determined the effect of air and trimix on the inflammatory response following dives to 50 metres of sea water, and evaluated the differences between them in advanced recreational divers.

Thirty-three divers were enrolled in this observational study and were divided in two groups 17 subjects were included in the air group, and 16 different subjects were included in the trimix (21% oxygen, 35% helium, 44% nitrogen) group. Each subject conducted a single dive, and both groups used a similar diving profile of identical duration. A venous blood sample was taken 30 min before diving and 2 h after surfacing to evaluate changes in interleukins (IL) IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, tumour necrosis factor α (TNFα), vascular endothelial growth factor (VEGF), Interferon γ (IFN-γ), monocyte chemoattractant protein 1 (MCP-1) and epithelial growth factor (EGF) after diving.

No differences were observed between groups in demographic data or diving experience. Following the dive, IL-6 values showed a slight increase, while IL-8 and EGF decreased in both groups, without significant variation between the groups.

In physically fit divers, trimix and air gas mixture during deep diving did not cause relevant changes in the inflammatory markers tested.
In physically fit divers, trimix and air gas mixture during deep diving did not cause relevant changes in the inflammatory markers tested.
Exposure to very high oxygen partial pressure may cause central nervous system oxygen toxicity (CNS-OT). The role of necroptosis in the pathogenesis of CNS-OT is still unclear.

In experiment one, male C57BL/6 mice in the oxygen toxicity (OT) group (n = 5) and necrostatin-1 (Nec-1; a necroptosis inhibitor) (1.5 mg·kg-1, intraperitoneal) group (n = 5) were exposed to pure oxygen at 600 kPa, and the latency to tonic-clonic seizure was recorded. In experiment two, mice were divided into three groups control group (n = 11), OT group (n = 12) and Nec-1 group (n = 12). Nec-1 was intraperitoneally administered 30 min before oxygen exposure. JTE 013 mouse Mice in the OT group and Nec-1 group were exposed to pure oxygen at 400 kPa for 30 min, and then sacrificed; the brain was harvested for the assessment of inflammation, oxidative stress and necroptosis.

Experiment one. Nec-1 pre-treatment significantly prolonged the latency to seizure (245 [SD 18] seconds in the OT group versus 336 (34) seconds in the Nec-1 group). Experiment two. Nec-1 pre-treatment markedly reduced inflammatory cytokines and inhibited cerebral necroptosis, but failed to significantly suppress cerebral oxidative stress.

These findings indicate necroptosis is involved in the pathogenesis of CNS-OT, and inhibition of necroptosis may prolong seizure latency, but the specific mechanisms should be investigated further.
These findings indicate necroptosis is involved in the pathogenesis of CNS-OT, and inhibition of necroptosis may prolong seizure latency, but the specific mechanisms should be investigated further.
Axillary staging via sentinel lymph node biopsy (SLNB) is performed for clinically node-negative (N0) breast cancer patients. The Skåne University Hospital (SUS) nomogram was developed to assess the possibility of omitting SLNB for patients with a low risk of nodal metastasis. Area under the receiver operating characteristic curve (AUC) was 0.74. The aim was to validate the SUS nomogram using only routinely collected data from the Swedish National Quality Registry for Breast Cancer at two breast cancer centres during different time periods.

This retrospective study included patients with primary breast cancer who were treated at centres in Lund and Malmö during 2008-2013. Clinicopathological predictors in the SUS nomogram were age, mode of detection, tumour size, multifocality, lymphovascular invasion and surrogate molecular subtype. Multiple imputation was used for missing data. Validation performance was assessed using AUC and calibration.

The study included 2939 patients (1318 patients treated in Lund and 1621 treated in Malmö).
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