{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:56:14Z","timestamp":1791377774568,"version":"4.3.2"},"reference-count":270,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This paper is a narrative review and theoretical perspective presenting principles, concepts, and perspectives for improving decompression procedures. It distinguishes three levels of evidence: established observations, hypotheses with experimental support, and mechanistic scenarios that remain hypothetical.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We organize decompression around two linked dimensions: bubbles as the primary physical event and microparticles (MPs) as a physiological consequence. We hypothesize that a substantial proportion of decompression-related microbubbles originate from pre-existing gas micronuclei associated with active hydrophobic sites (AHS) at three locations: distal arterial, venous, and extravascular. From these assumptions, five bubble scenarios are considered: growth and detachment from distal arterial AHS; growth and detachment from venous AHS; pulmonary bubble filtration; survival of arterial gas microbubbles and their potential target organs; and intravascular bubble development. Physiological factors may generate MPs, endothelial dysfunction, systemic inflammation, and possibly a secondary generation of microbubbles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and discussion<\/jats:title>\n                    <jats:p>The proposed scenarios align with decompression sickness (DCS) pathophysiology across five target organ systems: skin, brain, inner ear, spinal cord, and musculoskeletal tissue. Inflammatory stress appears important for defining post-dive intervals and multiday diving patterns. Designing decompression procedures therefore requires integrating individual variability and dive history; dive characteristics such as rapid ascents, yo-yo diving, and surface decompression; the bubble scenarios triggered during ascent; and accumulated oxidative stress, oxy-inflammation, and endothelial damage that modify susceptibility to DCS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is no single ultimate decompression algorithm; rather, different strategies reflect different experience, assumptions, and operational contexts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphys.2026.1943519","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:58:01Z","timestamp":1791374281000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Principles, concepts, and perspectives for the improvement of decompression procedures: a Neo-Haldanian approach bridging bubble physics and decompression physiology"],"prefix":"10.3389","volume":"17","author":[{"given":"Jean-Pierre","family":"Imbert","sequence":"first","affiliation":[{"name":"Environmental and Occupational, Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B)","place":["Brussels, Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Arieli","sequence":"additional","affiliation":[{"name":"The Israel Naval Medical Institute","place":["Haifa, Israel"]},{"name":"Eliachar Research Laboratory, Western Galilee Medical Center","place":["Nahariya, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costantino","family":"Balestra","sequence":"additional","affiliation":[{"name":"Environmental and Occupational, Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B)","place":["Brussels, Belgium"]},{"name":"Europe Research Division, Divers Alert Network (DAN)","place":["Brussels, Belgium"]},{"name":"Europe Research Division, Divers Alert Network (DAN)","place":["Roseto, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1109\/tac.1974.1100705","article-title":"A new look at the statistical model identification","volume":"19","author":"Akaike","year":"2003","journal-title":"IEEE Trans. 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