Practical Guidance for Crafting Original Research Manuscripts.

Scientific writing relies on an extensive array of written and unwritten rules to balance clarity, relevance, and economy. Careful development can strengthen each element of original research manuscripts. Some strategies are straightforward, including general organization and compliance with submission guidelines. Some aspects are more controversial, such as the subtleties of organizational structure, including claims of novelty, and presentation of limitations in the text. Manuscript crafting is usually improved through mindfulness of economy in presentation and objective restraint in interpretations. Submission to credible peer-reviewed journals can help refine the product. Practical guidelines can help develop reports that are readable, objective, and informative.

Gender Distribution Associated With the Journal Wilderness & Environmental Medicine.

INTRODUCTION: Publication and peer review are fundamental to career advancement in science and academic medicine. Studies demonstrate that women are underrepresented in science publishing. We evaluated the gender distribution of contributors to Wilderness & Environmental Medicine (WEM) from 2010 through 2019. METHODS: We extracted author data from ScienceDirect, reviewer data from the WEM Editorial Manager database, and editorial board data from journal records. Gender (female and male) was classified using automated probability-based assessment with Genderize.io software. RESULTS: A total of 2297 unique authors were published over the 10-y span, generating 3613 authorships, of which gender was classified for 96% (n=3480). Women represented 26% (n=572) of all authors, which breaks down to 22% of all, 19% of first, 28% of second, and 18% of last authorships. Women represented 20% of peer reviewers (508/2517), 20% of reviewers-in-training (19/72), and 16% of editorial board members (7/45). The proportion of female authors, first authors, and reviewers increased over time. Women received fewer invitations per reviewer than men (mean 2.1 [95% CI 2.0-2.3] vs 2.4 [95% CI 2.3-2.5]; P=0.004), accepted reviews at similar rates (mean 73 vs 71%; P=0.214), and returned reviews 1.4 d later (mean 10.4 [CI 9.5-11.3] vs 9.0 d [95% CI 8.5-9.6]; P=0.005). CONCLUSIONS: While female representation increased over the study period, women comprise a minority of WEM authors, peer reviewers, and editorial board members. Gender equity could be improved by identifying and eliminating barriers to participation, addressing any potential bias in review processes, implementing strategies to increase female-authored submissions, and increasing mentorship and training.

Gender Equity in Membership, Leadership, and Award Recognition in the Wilderness Medical Society.

INTRODUCTION: Despite near gender parity for women entering medical careers, women remain underrepresented in medical societies. This study evaluated the gender distribution associated with Wilderness Medical Society (WMS) activities. METHODS: A retrospective review was performed on the gender breakdown of the following WMS members: a single-day 2020 snapshot, conference attendees 2012 through 2020, conference presenters from winter 2017 through winter 2021, and leadership and awards data from 1984 through 2021. Genderize.io was used to generate probability-based gender categorizations (male/female) based on first names or pronoun associations. RESULTS: Gender was assigned in 91% (4043/4461) of 2020 WMS members, 92% (6179/6720) of 2012-2020 conference attendees, and 100% of remaining categories. Women represented 28% (1143/4043) of members, 27% (1679/6179) of conference attendees, 31% (143/465) of all conference presenters, 20% (62/303) of mainstage presenters, 23% (17/75) of all board members, 38% (14/37) of committee chairs, and 10% (2/20) of board presidents. Women received 18% (42/228) of recognition awards and 31% (15/48) of research grants issued. CONCLUSIONS: Although women comprise a minority of WMS participants, gender distribution was similar across categories for membership, conference presenters, total board positions, and research grant awards. Relative underrepresentation was seen in the highest leadership levels, in recognition awards, and in mainstage presenters. Ongoing auditing may help to identify and address sources of bias and/or barriers to participation. Although it is only one of many components of equity, identifying successes and future opportunities for gender balance can strengthen the base of the WMS, promote growth, and ensure a strong leadership pipeline.

Effect of repetitive SCUBA diving on humoral markers of endothelial and central nervous system integrity.

During SCUBA diving decompression, there is a significant gas bubble production in systemic veins, with rather frequent bubble crossover to arterial side even in asymptomatic divers. The aim of the current study was to investigate potential changes in humoral markers of endothelial and brain damage (endothelin-1, neuron-specific enolase and S-100ß) after repetitive SCUBA diving with concomitant assessment of venous gas bubble production and subsequent arterialization. Sixteen male divers performed four open-water no-decompression dives to 18 msw (meters of sea water) lasting 49 min in consecutive days during which they performed moderate-level exercise. Before and after dives 1 and 4 blood was drawn, and bubble production and potential arterialization were echocardiographically evaluated. In addition, a control dive to 5 msw was performed with same duration, water temperature and exercise load. SCUBA diving to 18 msw caused significant bubble production with arterializations in six divers after dive 1 and in four divers after dive 4. Blood levels of endothelin-1 and neuron-specific enolase did not change after diving, but levels of S-100ß were significantly elevated after both dives to 18 msw and a control dive. Creatine kinase activity following a control dive was also significantly increased. Although serum S-100ß levels were increased after diving, concomitant increase of creatine kinase during control, almost bubble-free, dive suggests the extracranial release of S-100ß, most likely from skeletal muscles. Therefore, despite the significant bubble production and sporadic arterialization after open-water dives to 18 msw, the current study found no signs of damage to neurons or the blood-brain barrier.

Protective mechanisms in hypobaric decompression.

BACKGROUND: To reduce bubble formation and growth during hypobaric exposures, a denitrogenation or nitrogen "washout" procedure is performed. This procedure consists of prebreathing oxygen fractions as close to one as possible (oxygen prebreathe) prior to depressurization before ascending to the working altitude or low spacesuit pressures. During the NASA prebreathe reduction program (PRP), it was determined that the addition of a light arm exercise to short, individually designed, performance-based heavy exercise (dual cycle ergometry) during an abbreviated 2-h prebreathe (F1O2 - 1.0) reduced the occurrence of decompression sickness (DCS). Heavy-exercise-induced DCS reduction is likely to be related to the enhancement of the tissue nitrogen washout during the oxygen prebreathe. In addition to the heavy-exercise-induced microcirculatory adaptation, we hypothesized that the light exercise would not cause sufficient microcirculatory changes in the limbs to explain alone this further DCS protection. We evaluated microcirculatory changes as minimal by replicating the exercise characteristics of the PRP trials in 13 healthy subjects. METHODS: Noninvasive near infrared spectroscopy (NIRS) allowed observation of instantaneous variations of total, oxygenated, and deoxygenated hemoglobin/myoglobin concentrations in the microcirculatory networks (probes facing the vastus lateralis and deltoid muscles) of active limbs during dynamic exercise. RESULTS: The high-intensity leg exercise alone produced the changes in NIRS parameters; the light arm exercise induced minimal microcirculatory volume changes. However, this coupling appeared to be critical in previous altitude PRP chamber studies by reducing DCS. DISCUSSION: With only minimal microcirculatory blood volume changes, it is unlikely that light exercise alone causes significant nitrogen tissue washout. Therefore, our results suggest that in addition to nitrogen tissue washout, another unknown exercise-induced effect may have further enhanced the DCS protection, possibly mediated via the anti-inflammatory effect of exercise, gas micronuclei reduction, NO pathways, or other molecular mechanisms.