Oxy-Inflammation in Humans during Underwater Activities.

Underwater activities are characterized by an imbalance between reactive oxygen/nitrogen species (RONS) and antioxidant mechanisms, which can be associated with an inflammatory response, depending on O2 availability. This review explores the oxidative stress mechanisms and related inflammation status (Oxy-Inflammation) in underwater activities such as breath-hold (BH) diving, Self-Contained Underwater Breathing Apparatus (SCUBA) and Closed-Circuit Rebreather (CCR) diving, and saturation diving. Divers are exposed to hypoxic and hyperoxic conditions, amplified by environmental conditions, hyperbaric pressure, cold water, different types of breathing gases, and air/non-air mixtures. The "diving response", including physiological adaptation, cardiovascular stress, increased arterial blood pressure, peripheral vasoconstriction, altered blood gas values, and risk of bubble formation during decompression, are reported.

Altitude Diving on a Closed Circuit Oxygen Rebreather.

Closed-circuit rebreather diving is becoming more common. Rebreathers are complicated, adding to the stress of diving. Also adding to this complexity in the presented case is diving at a high-altitude, cold-water reservoir in Colorado. One diver experienced an oxygen-induced seizure at depth. The other diver had a rapid ascent with loss of consciousness. In this case, two experienced divers recovered from a possible devastating dive. Fortunately, they both returned to their pre-dive baseline health. Dive plan- ning is important, but as in this case, dive execution is paramount. This is a clinical case for an uncommon event presenting to an emergency department.

Physiological effects of mixed-gas deep sea dives using a closed-circuit rebreather: a field pilot study.

PURPOSE: Deep diving using mixed gas with closed-circuit rebreathers (CCRs) is increasingly common. However, data regarding the effects of these dives are still scarce. This preliminary field study aimed at evaluating the acute effects of deep (90-120 msw) mixed-gas CCR bounce dives on lung function in relation with other physiological parameters. METHODS: Seven divers performed a total of sixteen open-sea CCR dives breathing gas mixture of helium, nitrogen and oxygen (trimix) within four days at 2 depths (90 and 120 msw). Spirometric parameters, SpO2, body mass, hematocrit, short term heart rate variability (HRV) and critical flicker fusion frequency (CFFF) were measured at rest 60 min before the dive and 120 min after surfacing. RESULTS: The median [1st-3rd quartile] of the forced vital capacity was lower (84% [76-93] vs 91% [74-107] of predicted values; p = 0.029), whereas FEV1/FVC was higher (98% [95-99] vs 95% [89-99]; p = 0.019) after than before the dives. The other spirometry values and SpO2 were unchanged. Body mass decreased from 73.5 kg (72.0-89.6) before the dives to 70.0 kg (69.2-85.8) after surfacing (p = 0.001), with no change of hematocrit or CFFT. HRV was increased as indicated by the higher SDNN, RMSSD and pNN50 after than before dives. CONCLUSION: The present observation represents the first original data regarding the effects of deep repeated CCR dives. The body mass loss and decrease of FVC after bounce dives at depth of about 100 msw may possibly impose an important physiological stress for the divers.

Balloon Eustachian tuboplasty in a professional Navy SEAL diver: case report.

Middle ear barotrauma due to dilatory Eustachian tube dysfunction (ETD) is probably the most common medical disorder related to diving. Moreover, ETD makes divers prone to other diving-related accidents, including inner ear barotrauma and alternobaric vertigo. Until the development of Eustachian tube balloon dilation no diving-compatible surgical options existed to effectively and safely prevent recurrence. We present a case of an Israeli Navy SEAL diver who dives in extreme strenuous combat-related closed-circuit rebreather (CCR) dives. Due to repeated middle ear barotrauma, the patient underwent Eustachian tube balloon dilation of the affected side. Following surgery, the patient returned to both CCR and scuba dives but still suffered from middle ear symptoms and repeated barotrauma hence was eventually disqualified from further combat diving.

Fish biodiversity of Saint Peter and Saint Paul's Archipelago, Mid-Atlantic Ridge, Brazil: new records and a species database.

Saint Peter and Saint Paul's Archipelago (SPSPA), one of the smallest and most isolated island groups in the world, is situated on the Mid-Atlantic Ridge, between Brazil and the African continent. SPSPA has low species richness and high endemism; nonetheless, the diversity of fishes from deep habitats (>30 m depth) had not been previously studied in detail. Several expeditions conducted between 2009 and 2018 explored the shallow and deep reefs of SPSPA using scuba, closed-circuit rebreathers, manned submersibles, baited remote underwater stereo-videos (stereo-BRUV) and fishing between 0 and 1050 m depth. These expeditions yielded 41 new records of fishes for SPSPA: 9 in open waters, 9 in shallow waters (0-30 m), 8 in mesophotic ecosystems (30-150 m) and 15 in deeper reefs (>150 m). Combined with literature records of adult pelagic, shallow and deep-reef species, as well as larvae, the database of the fish biodiversity for SPSPA currently comprises 225 species (169 recorded as adult fishes and 79 as larvae, with 23 species found in both stages). Most of them (112) are pelagic, 86 are reef-associated species and 27 are deep-water specialists. Species accumulation curves show that the number of fish species has not yet reached an asymptote. Whereas the number of species recorded in SPSPA is similar to that in other oceanic islands in the Atlantic Ocean, the proportion of shorefishes is relatively lower, and the endemism level is the third highest in the Atlantic. Twenty-nine species are listed as threatened with extinction. Observations confirm the paucity of top predators on shallow rocky reefs of the island, despite the presence of several pelagic shark species around SPSPA. Because all of the endemic species are reef associated, it is argued that the new marine-protected areas created by the Brazilian government do not ensure the protection and recovery of SPSPA's biodiversity because they allow exploitation of the most vulnerable species around the archipelago itself. This study suggests a ban on reef fish exploitation inside an area delimited by the 1000 m isobath around the islands (where all known endemics are concentrated) as the main conservation strategy to be included in the SPSPA management plan being prepared by the Brazilian government.

Two new species of Plectranthias (Teleostei, Serranidae, Anthiadinae) from mesophotic coral ecosystems in the tropical Central Pacific.

Two new species of Plectranthias perchlets are described, collected from mesophotic coral ecosystems in French Polynesia and the Republic of the Marshall Islands, in the tropical Central Pacific. Plectranthias polygonius sp. nov. was collected at a depth of 105 m in Tahiti, French Polynesia, and 120 m in Maloelap Atoll, Republic of the Marshall Islands. It was also observed in Moorea and Rangiroa (French Polynesia), and at Majuro and Erikub Atolls, Republic of the Marshall Islands. Plectranthias hinano sp. nov. was collected at a depth of 90-98 m in Tahiti, French Polynesia, and observed in Moorea. The barcode fragment of the cytochrome oxidase I gene of Plectranthias polygonius sp. nov. does not closely match any published sequence of Plectranthias, with approximately 15% uncorrected divergence from several species. Plectranthias polygonius sp. nov. can be distinguished from all of its congeners by coloration and morphology. The barcode fragment of the COI gene of Plectranthias hinano sp. nov. is closest to Plectranthias bennetti, with 5.4% uncorrected divergence. Plectranthias hinano sp. nov. is also distinguished from all of its congeners by morphology, and a coloration that includes two indistinct black spots along the base of the dorsal-fin, and transparent yellow dorsal and anal fin membranes. With this publication, the genus Plectranthias now comprises 58 valid species, with representatives from tropical to temperate waters of the Atlantic, Pacific, and Indian oceans. These two new discoveries add to the growing body of research highlighting the rich biodiversity of mesophotic ecosystems.

Performance of cartridge and granular carbon dioxide absorbents in a closed-circuit diving rebreather.

INTRODUCTION: Scrubbers in closed-circuit rebreather systems remove carbon dioxide (CO2) from the exhaled gas. In an attempt to be more user-friendly and efficient, the ExtendAir® non-granular, pre-formed scrubber cartridge has been developed. The cartridge manufacturer claims twice the absorptive capacity of granular CO2 absorbent, with less variability, lower work of breathing, and reduced exposure to caustic chemicals after a flood. To our knowledge there are no published data that support these claims. METHODS: Cartridge (ExtendAir®) and granular (Sofnolime® 797) scrubbers of equal volume and mass were tested five times in an immersed and mechanically ventilated O2ptima rebreather. Exercise protocols involving staged (90 minutes 6 MET, followed by 2 MET) and continuous (6 MET) activity were simulated. We compared: duration until breakthrough, and variability in duration, to endpoints of 1.0 kPa and 0.5 kPa inspired partial pressure of CO2; inspiratory-expiratory pressure difference in the breathing loop; and pH of eluted water after a 5 minute flood. RESULTS: Mean difference in scrubber endurance was 0-20% in favour of the ExtendAir® cartridge, depending on exercise protocol and chosen CO2 endpoint. There were no meaningful differences in endpoint variability, inspiratory-expiratory pressure in the loop, or pH in the eluted water after a flood. CONCLUSIONS: Cartridge and granular scrubbers were very similar in duration, variability, ventilation pressures, and causticity after a flood. Our findings were not consistent with claims of substantial superiority for the ExtendAir® cartridge.

Liopropomaincandescens sp. nov. (Epinephelidae, Liopropominae), a new species of basslet from mesophotic coral ecosystems of Pohnpei, Micronesia.

A new species of the genus Liopropoma Gill found on the lower mesophotic coral ecosystem of Pohnpei, Micronesia, is herein described. Liopropomaincandescens sp. nov. differs from its congeners in coloration, number of lateral-line scales, number of pectoral fin rays, body depth, and snout length. Liopropomaincandescens sp. nov. is the 31st species in the genus. It was collected from a small rocky crevice in a steep slope at 130 m depth. Water temperature was 20 °C and benthic habitat was dominated by gorgonians, sponges and tunicates.

Pulse oximeter to detect peripheral oxygen saturation in underwater rebreather ECCR diver: a preliminary study.

Hypoxia is one of the main problems an underwater diver may have to face. The probability of experiencing hypoxia is related to the type of dive and the equipment used. Hypoxia in diving is a potentially fatal event for the diver, as it can lead to the loss of brain functions and consequently to the loss of breathing control, all in the absence of specific premonitory symptoms. It is a risk that may be encountered more frequently by divers who use a closed-circuit rebreather (CCR). For those who use this type of equipment, hypoxia is usually the most frequent cause of death [1]. Our study was aimed at the detection of peripheral oxygen saturation in order to identify, in the future, a preclinical hypoxic condition. We combined the use of pulse oximetry with two forehead sensors on an underwater diver subject who was using an electronic closed-circuit rebreather (ECCR). Despite the known limits of this method and the preliminary status of these findings [2], the recorded data show a clear validity in the use of pulse oximetry in immersion for the detection of peripheral oxygen saturation. In the future, the pulse oximeter could become part of the instrumentation of the diver who uses CCR gear. The device could easily be implemented in these rebreathers. The possibility of being able to perform a basic instrumental analysis means that the diver can become more quickly aware of imminent hypoxia, characterized by the absence of clearly identifiable warning symptoms, and can put in place all the correct procedures for an emergency ascent, avoiding serious consequences.

Prognathodesgeminus, a new species of butterflyfish (Teleostei, Chaetodontidae) from Palau.

A new species of the butterflyfish genus Prognathodes (Chaetodontidae) is described from two specimens collected at a depth of 116 m off Ngemelis Island, Palau. Prognathodesgeminus sp. n. is similar to P.basabei Pyle & Kosaki, 2016 from the Hawaiian archipelago, and P.guezei (Maugé & Bauchot, 1976) from the western Indian Ocean, but differs from these species in the number of soft dorsal-fin rays, size of head, body width, and body depth. There are also subtle differences in life color, and substantial differences in the mtDNA cytochrome oxidase I sequence (d ≈ 0.08). Although genetic comparisons with P.guezei are unavailable, it is expected that the genetic divergence between P.guezei and P.geminus will be even greater than that between P.geminus and P.basabei. It is named for the strikingly similar color pattern it shares with P.basabei.

Tosanoidesannepatrice, a new basslet from deep coral reefs in Micronesia (Perciformes, Percoidei, Serranidae).

The new species Tosanoidesannepatrice sp. n. is described from four specimens collected at depths of 115-148 m near Palau and Pohnpei in Micronesia. It differs from the other three species of this genus in life color and in certain morphological characters, such as body depth, snout length, anterior three dorsal-fin spine lengths, caudal-fin length, and other characters. There are also genetic differences from the other four species of Tosanoides (d ≈ 0.04-0.12 in mtDNA cytochrome oxidase I). This species is presently known only from Palau and Pohnpei within Micronesia, but it likely occurs elsewhere throughout the tropical western Pacific.

Oxygen Toxicity and Special Operations Forces Diving: Hidden and Dangerous.

In Special Operations Forces (SOF) closed-circuit rebreathers with 100% oxygen are commonly utilized for covert diving operations. Exposure to high partial pressures of oxygen (PO2) could cause damage to the central nervous system (CNS) and pulmonary system. Longer exposure time and higher PO2 leads to faster development of more serious pathology. Exposure to a PO2 above 1.4 ATA can cause CNS toxicity, leading to a wide range of neurologic complaints including convulsions. Pulmonary oxygen toxicity develops over time when exposed to a PO2 above 0.5 ATA and can lead to inflammation and fibrosis of lung tissue. Oxygen can also be toxic for the ocular system and may have systemic effects on the inflammatory system. Moreover, some of the effects of oxygen toxicity are irreversible. This paper describes the pathophysiology, epidemiology, signs and symptoms, risk factors and prediction models of oxygen toxicity, and their limitations on SOF diving.

Prognathodes basabei, a new species of butterflyfish (Perciformes, Chaetodontidae) from the Hawaiian Archipelago.

A new species of the butterflyfish genus Prognathodes is described from specimens collected at a depth of 55-61 m off Pearl and Hermes Atoll, Northwestern Hawaiian Islands. This species has been observed by mixed-gas divers and from submersibles at depths ranging from 45-187 m throughout the Hawaiian Archipelago, with shallower sightings in the Northwestern Hawaiian Islands and deeper in the Main Hawaiian Islands. It is similar to Prognathodes guezei (Maugé and Bauchot 1976) from the western Indian Ocean, and at least one other undescribed species of Prognathodes from Palau, differing from these species in the number of soft dorsal-fin rays, size of head, and body depth. There are also differences in the life color, and a substantial genetic difference from the Palauan species (d ¼ .08 in mtDNA cytochrome oxidase I).

Tosanoides obama, a new basslet (Perciformes, Percoidei, Serranidae) from deep coral reefs in the Northwestern Hawaiian Islands.

The new species Tosanoides obama is described from two specimens collected at a depth of 90-92 m off Kure Atoll and Pearl and Hermes Atoll, Northwestern Hawaiian Islands. It differs from the other two species of this genus in life color and in certain morphological characters, such as number of pored lateral-line scales, pectoral-fin rays, snout length, anterior three dorsal-fin spine lengths, dorsal-fin profile, and other characters. There are also substantial genetic differences from the other two species of Tosanoides (d ≈ 0.10 in mtDNA cytochrome oxidase I). The species is presently known only from the Northwestern Hawaiian Islands within the Papahanaumokuakea Marine National Monument.