{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T01:17:08Z","timestamp":1793495828948,"version":"4.5.0"},"reference-count":41,"publisher":"National Academy of Sciences","issue":"33","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"HHS | NIH | National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["1T32HL160494-01"],"award-info":[{"award-number":["1T32HL160494-01"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.pnas.org"],"crossmark-restriction":true},"short-container-title":["Proc. Natl. Acad. Sci. U.S.A."],"published-print":{"date-parts":[[2026,8,18]]},"abstract":"<jats:p>\n                    Decompression sickness (DCS) risk limits human undersea operations through tissue inert gas supersaturation and pathological bubble formation. Switching the inert breathing gas prior to decompression to a gas with lower diffusivity could allow faster and safer decompression. This principle was tested in 20 kg swine after a helium-oxygen (He\/O\n                    <jats:sub>2<\/jats:sub>\n                    ) dive using carbon tetrafluoride. Sedated swine breathed He\/O\n                    <jats:sub>2<\/jats:sub>\n                    79\/21 at a pressure equivalent of 200 feet of seawater (714 kPa) in a hyperbaric chamber for 50 min until randomized to continuing He\/O\n                    <jats:sub>2<\/jats:sub>\n                    or switching to carbon tetrafluoride and oxygen (CF\n                    <jats:sub>4<\/jats:sub>\n                    \/O\n                    <jats:sub>2<\/jats:sub>\n                    79\/21) for 10 min before decompression. The CF\n                    <jats:sub>4<\/jats:sub>\n                    \/O\n                    <jats:sub>2<\/jats:sub>\n                    group had reduced DCS with lower mortality, hypoxemia, pulmonary edema, venous gas emboli, gait disturbance, rash, and central nervous system hemorrhage. CF\n                    <jats:sub>4<\/jats:sub>\n                    \/O\n                    <jats:sub>2<\/jats:sub>\n                    has the potential to expand human exploration through enabling deeper dives, longer dives, and rapid decompression while maintaining safety.\n                  <\/jats:p>","DOI":"10.1073\/pnas.2600125123","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T19:09:16Z","timestamp":1786388956000},"update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":1,"title":["Isobaric counterdiffusion of carbon tetrafluoride breathing gas to prevent severe decompression sickness"],"prefix":"10.1073","volume":"123","author":[{"given":"Rachel M.","family":"Lance","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00py81415","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Anesthesiology, Duke University School of Medicine","place":["Durham"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6486-771X","authenticated-orcid":false,"given":"Matthew S.","family":"Makowski","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00py81415","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Anesthesiology, Duke University School of Medicine","place":["Durham"]},{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine","place":["Durham"]},{"name":"Division of Aerospace Medicine, School of Public and Population Health, University of Texas Medical Branch","place":["Galveston"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard T.","family":"Mahon","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04q9tew83","id-type":"ROR","asserted-by":"publisher"}],"name":"Henry M. 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