{"id":24713,"date":"2023-06-12T11:50:52","date_gmt":"2023-06-12T15:50:52","guid":{"rendered":"https:\/\/world.dan.org\/?post_type=dan_alert_diver&#038;p=24713"},"modified":"2023-07-20T17:30:48","modified_gmt":"2023-07-20T21:30:48","slug":"petar-denoble-solving-practical-issues-for-divers","status":"publish","type":"dan_alert_diver","link":"https:\/\/world.dan.org\/id\/alert-diver\/article\/petar-denoble-solving-practical-issues-for-divers\/","title":{"rendered":"Petar Denoble: Memecahkan Masalah Praktis untuk Penyelam"},"content":{"rendered":"<p><strong>PETAR DENOBLE, MD, D.SC., TELAH MENDEDIKASIKAN KARIRNYA<\/strong> untuk mengeksplorasi dan memecahkan masalah praktis dalam kedokteran selam. Lahir di Kroasia, ia belajar berenang sejak dini dan menghabiskan sebagian besar waktu luangnya untuk menyelam bebas dan memancing di Laut Adriatik. Denoble lulus dari Fakultas Kedokteran Universitas Zagreb dan kemudian bergabung dengan angkatan laut Yugoslavia untuk terlibat dalam pengobatan selam.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-dan-blue-200-color has-text-color\" id=\"h-how-did-you-start-working-at-dan\">Bagaimana Anda mulai bekerja di DAN?<\/h3>\n\n\n\n<p>Pada usia 27 tahun, saya melakukan wawancara untuk program residensi di bidang penyakit dalam dan belajar tentang Institut Selam Angkatan Laut bekas angkatan laut Yugoslavia. Saya terkesan dengan departemen hiperbarik, peralatan canggih mereka, dan apa yang mereka lakukan. Saya bergabung dengan angkatan laut, bukan karena antusiasme terhadap militer, tetapi karena saya ingin mengikuti jalur kedokteran selam.&nbsp;<\/p>\n\n\n\n<p>Selama tiga tahun saya memberikan perawatan medis, mengajar fisiologi dan kedokteran selam, menghabiskan banyak hari dan malam di laut untuk mengawasi keselamatan penyelam, dan menyelam sendiri ketika semua penyelam lain berada di luar air. Saya kemudian menyelesaikan residensi di bidang kedokteran angkatan laut dan selam, studi pascasarjana, dan tesis doktoral di bidang fisiologi selam.<\/p>\n\n\n\n<p class=\"has-dan-black-color has-text-color\">While watching combat divers\u2019 strenuous training, which not all candidates could complete, I started thinking about measuring the physiological cost of their activities and specific predictors of the suitability of candidates. When I transferred to a hyperbaric department and started my residency in naval and dive medicine, I was involved with a variety of practical research and the treatment of injured divers. Most cases were recreational divers with severe forms of decompression sickness (DCS). Observing frequent residual disability in severely injured divers furthered my interest in the prevention of dive injuries.<\/p>\n\n\n\n<p>Saya bergabung dengan DAN pada akhir tahun 1991, berkat Peter Bennett, dan bekerja di bawah Richard Vann, yang merupakan staf pengajar di Pusat Kedokteran Hiperbarik dan Fisiologi Lingkungan Duke dan direktur penelitian paruh waktu di DAN. Meskipun DAN telah melakukan penelitian pada saat itu, sebagian besar di Laboratorium Lingkungan F.G. Hall di Duke, saya menjadi peneliti penuh waktu pertama DAN pada bulan Februari 1992, yang menandai dimulainya secara resmi departemen penelitian DAN.<\/p>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<h3 class=\"wp-block-heading has-dan-blue-200-color has-text-color\">Proyek apa yang paling membanggakan bagi Anda atau yang paling Anda sukai?<\/h3>\n\n\n\n<p>Saya menyukai penelitian yang bertujuan untuk memecahkan masalah praktis bagi para penyelam, itulah sebabnya saya sangat menyukai dua proyek DAN: Database Cedera dan Kematian Penyelaman, dan Project Dive Exploration.&nbsp;<\/p>\n\n\n\n<p>You may think that after centuries of diving we would know everything about what dive injuries can look like, but that\u2019s not the case. Our mental model of decompression illness is quite simplified. Even artificial intelligence (AI) would have difficulties diagnosing DCS in real time because of the gaps in our knowledge. By working on a qualitative and quantitative description of DCS, we help improve our diagnostic abilities.<\/p>\n\n\n\n<p>It\u2019s also important to know how exposure affects the outcome. You\u2019ll hear divers claim that because they didn\u2019t breach standards set by decompression tables or their dive computer that their symptoms couldn\u2019t be DCS, but that isn\u2019t true. We know that there is a continuum of DCS risk from minimal to fatal. The risk is more predictable in severe decompression exposure than in relatively innocuous diving, like recreational diving should be. Yet we\u2019ve witnessed that even in recreational diving, DCS can be unpredictably severe.&nbsp;<\/p>\n\n\n\n<p>Kami memulai Project Dive Exploration (PDE) pada tahun 1995 untuk mengumpulkan data tentang bagaimana penyelam rekreasi menyelam dan seberapa sering mereka mendapatkan DCS. PDE dikelola secara efektif dengan bantuan banyak sukarelawan dan industri selam. Produsen komputer selam berbaik hati memodifikasi perangkat lunak mereka sehingga kami dapat mengambil data mereka. Sangat penting untuk memiliki informasi yang tepat tentang paparan penyelaman untuk menghubungkannya dengan hasilnya. Kami sebelumnya hanya memiliki desas-desus dan laporan yang belum diverifikasi tentang penyelaman apa yang menyebabkan cedera. Sekarang kami bisa mendapatkan data yang nyata dan obyektif serta pengukuran paparan penyelaman.&nbsp;<\/p>\n\n\n\n<p>Komputer selam masih baru di pasaran, jadi kami membutuhkan alat untuk memeriksa data yang dapat mereka kumpulkan. Saat itu DAN tidak memiliki dana untuk mempekerjakan profesional TI, jadi saya memutuskan untuk membuat aplikasi yang akan membantu mengunduh profil penyelaman, mengumpulkan laporan pascapenyelaman, dan menggabungkannya dengan informasi prediktif. Saya tahu sedikit bahasa Inggris tetapi tidak tahu apa-apa tentang pemrograman, jadi saya menerima beberapa tips dari seorang teman yang berpengetahuan luas dan belajar sendiri. Itu adalah pekerjaan yang membosankan, terutama debugging. Itu bukanlah sesuatu yang saya sukai, tetapi itu adalah bagian penting dari pekerjaan ini.&nbsp;<\/p>\n\n\n\n<p>Despite all the difficulties, we learned a lot of things. We confirmed that DCS is quite rare in recreational diving and established a baseline of incidence. We also confirmed that the exposure\u2013outcome relationship is highly variable and that we would need more research to identify the drivers of that variability.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-dan-blue-200-color has-text-color\">Apa peran kolaborator dan sukarelawan di DAN?<\/h3>\n\n\n\n<p>We\u2019ve always relied on volunteers. It\u2019s hard to establish a highly skilled lab with high capabilities to study multiple fields. Labs are usually specialized, but at DAN we don\u2019t focus on only one issue or topic. We\u2019re looking at the needs of divers in a broad sense. From doctors and physiologists to engineers and IT specialists, we need to collaborate with experts in various fields of research that align with our interests. We often are not the researcher ourselves \u2014 we\u2019re the coordinator or inspirator of studies.&nbsp;<\/p>\n\n\n\n<p>In a small organization such as DAN, we have to pick our fights and choose what we can do. I mostly worked on monitoring injuries and fatalities \u2014 trying to learn what issues need attention, engagement, and research. We would also run some studies that encompassed \u201corphan\u201d issues that nobody could address at that time except for DAN.&nbsp;<\/p>\n\n\n\n<p>The Flying After Diving research, for example, was a huge and expensive experimental study. With DAN\u2019s support under Richard Vann, the participation of the entire Duke lab, and volunteer divers, the study lasted for years. In the end, we developed and published results that improved our knowledge of the risks of flying after diving and DCS prevention.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-dan-blue-200-color has-text-color\">Apa strategi mitigasi risiko yang paling efektif untuk penyelam scuba?&nbsp;<\/h3>\n\n\n\n<p>Scuba diving sudah lama tidak lagi populer, dan sampai batas tertentu mungkin itu adalah sebuah kesalahan. Yang paling mengejutkan saya selama di DAN adalah betapa seringnya penyelam melakukan tindakan yang tidak aman. Saya ragu untuk mengatakan itu karena orang mungkin berpikir mereka bisa lolos dengan tindakan yang tidak aman, padahal kenyataannya mereka melakukan hal-hal yang terdokumentasi dengan baik untuk menempatkan mereka dalam risiko.&nbsp;<\/p>\n\n\n\n<p>Data like that isn\u2019t an indicator of an unseen force watching out for drunkards and divers. Instead, it\u2019s further proof of the Swiss cheese model of accidents. Unsafe acts create holes in your dive plan, and it only takes those holes aligning once to cause a devastating accident. The nature of these accidents makes it difficult for divers to grasp that they must <em>selalu<\/em> berjaga-jaga dari tindakan yang tidak aman.&nbsp;<\/p>\n\n\n\n<p>Meskipun demikian, saya bukan penganjur untuk meningkatkan hambatan dan pembatasan partisipasi. Departemen Riset DAN dan saya telah melihat lebih banyak cedera penyelaman daripada orang lain, tetapi menurut saya, data menunjukkan bahwa scuba secara umum adalah aktivitas yang aman. Untuk membuatnya lebih aman, kita tidak boleh membiarkan penyelam perorangan ceroboh; kita harus mengajari mereka. Penyelam yang aman hanyalah mereka yang sadar akan risikonya.&nbsp;<\/p>\n\n\n\n<p>Daftar periksa prediktif adalah alat mitigasi risiko yang efektif dengan keampuhan yang terukur, tetapi bukan obat untuk semua hal. Strategi mitigasi risiko harus disesuaikan dengan jenis aktivitas penyelaman dan profil penyelam, dan DAN melakukan hal ini dengan menyediakan sumber daya pembelajaran seumur hidup untuk penyelam rekreasi dan teknis.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-dan-blue-200-color has-text-color\">Bagaimana lagi kita dapat mencegah kematian akibat penyelaman?<\/h3>\n\n\n\n<p>By staying healthy and being aware of your limitations. I stopped diving in the 1980s back in Croatia. I had an episode of severe arrhythmia that scared me. While I admired and loved diving as a young man, after that I didn\u2019t dare much to go underwater.&nbsp;<\/p>\n\n\n\n<p>I once met a diver who had some serious heart arrythmia issues \u2014 she was banned from diving, and her physician labeled her as unfit to dive. Disregarding this, she bought a full-face mask so that theoretically, if she passed out underwater, she would not drown. Her dive buddy was her husband, and he was well-informed of her condition and location at all times. They continued to dive conservatively and never had any issues.&nbsp;<\/p>\n\n\n\n<p>In most situations, people can find a way, but they have to be aware of their conditions and the risks involved to take proper risk-mitigation measures. I think people need to be honest with themselves. You can\u2019t just pretend that you don\u2019t have health issues when you do. It\u2019s human to have your health naturally decline.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-dan-blue-200-color has-text-color\">Seperti apa masa depan penelitian selam?<\/h3>\n\n\n\n<p>We need to learn more about what constitutes individual variability. Because nitrogen bubbles have a role in DCS, at least in describing severity of decompression stress, I would like DAN\u2019s New Bubble Study on bubble variability within and between divers to be expanded. I hope the data that Frauke Tillmans and her team are collecting will help establish some other new methodologies and new tools, and we may eventually be able to get to customized decompression procedures.<\/p>\n\n\n\n<p>Kami juga membutuhkan para peneliti. Anda tidak akan menemukan sesuatu yang baru dalam AI. AI dapat meringkas apa yang ada di luar sana, tetapi kita sebagai peneliti harus memberikan informasi baru dan membawa penelitian kita ke arah yang baru. AI dapat menjadi alat yang membantu; AI dapat membantu Anda mengekstrak atau menganalisis informasi dari basis data yang sangat besar, tetapi tidak akan menghasilkan atau menciptakan ilmu pengetahuan baru.&nbsp;<\/p>\n\n\n\n<p>The value of these new tools is that they can help you be more precise, more consistent, or faster while doing things. They can increase the impact of research, but researchers still have to lead the way. We can all appreciate technology \u2014 it can help a lot \u2014 but it\u2019s still up to us to develop new ideas and to use the tools in the right ways. AD<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\">\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"338\" height=\"360\" src=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_95_Researchers.jpg\" alt=\"Denoble dan istrinya, Dr. Ubavka Denoble\" class=\"wp-image-24717\" srcset=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_95_Researchers.jpg 338w, https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_95_Researchers-11x12.jpg 11w\" sizes=\"auto, (max-width: 338px) 100vw, 338px\" \/><figcaption class=\"wp-element-caption\">Denoble and his wife, Dr. Ubavka Denoble, enjoy diving during their recent retirement trip in Gal\u00e1pagos.<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"299\" height=\"360\" src=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_94_Researchers.jpg\" alt=\"Denoble memonitor penyelam Edoardo Pavia\" class=\"wp-image-24716\" srcset=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_94_Researchers.jpg 299w, https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_94_Researchers-10x12.jpg 10w\" sizes=\"auto, (max-width: 299px) 100vw, 299px\" \/><figcaption class=\"wp-element-caption\">Denoble memantau penyelam Edoardo Pavia setelah melakukan penyelaman selama ekspedisi Britania pada tahun 2006.<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"446\" height=\"288\" src=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_97_Researchers-1.jpg\" alt=\"Denoble mewawancarai mantan penyelam spons Yunani, Giannis Tsulfas\" class=\"wp-image-24719\" srcset=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_97_Researchers-1.jpg 446w, https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_97_Researchers-1-360x232.jpg 360w, https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_97_Researchers-1-18x12.jpg 18w\" sizes=\"auto, (max-width: 446px) 100vw, 446px\" \/><figcaption class=\"wp-element-caption\">Denoble mewawancarai mantan penyelam spons Yunani, Giannis Tsulfas.<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"288\" height=\"384\" src=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_99_Researchers.jpg\" alt=\"Denoble bersantai setelah konferensi di Tokyo\" class=\"wp-image-24720\" srcset=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_99_Researchers.jpg 288w, https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_99_Researchers-270x360.jpg 270w, https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_99_Researchers-9x12.jpg 9w\" sizes=\"auto, (max-width: 288px) 100vw, 288px\" \/><figcaption class=\"wp-element-caption\">Denoble bersantai setelah konferensi di Tokyo pada tahun 2019.<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"431\" height=\"288\" src=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_98_Researchers.jpg\" alt=\"Denoble menerima UHMS Excellence in Dive Medicine Award\" class=\"wp-image-24721\" srcset=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_98_Researchers.jpg 431w, https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_98_Researchers-360x241.jpg 360w, https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_98_Researchers-18x12.jpg 18w\" sizes=\"auto, (max-width: 431px) 100vw, 431px\" \/><figcaption class=\"wp-element-caption\">Denoble menerima UHMS Excellence in Dive Medicine Award pada tahun 2017.<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"360\" height=\"333\" src=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_100_Researchers.jpg\" alt=\"Denoble menerima penghargaan sebagai pembicara utama bersama Dr.\" class=\"wp-image-24722\" srcset=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_100_Researchers.jpg 360w, https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_100_Researchers-13x12.jpg 13w\" sizes=\"auto, (max-width: 360px) 100vw, 360px\" \/><figcaption class=\"wp-element-caption\">Dia menerima penghargaan sebagai pembicara utama bersama Dr. Shinya Suzuki.<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"360\" height=\"334\" src=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_101_Researchers.jpg\" alt=\"Denoble memonitor pola gelombang jantung seorang sukarelawan studi DAN\" class=\"wp-image-24723\" srcset=\"https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_101_Researchers.jpg 360w, https:\/\/world.dan.org\/wp-content\/uploads\/2023\/06\/Q2_101_Researchers-13x12.jpg 13w\" sizes=\"auto, (max-width: 360px) 100vw, 360px\" \/><figcaption class=\"wp-element-caption\">Denoble memonitor pola gelombang jantung seorang sukarelawan studi DAN. <\/figcaption><\/figure>\n<\/div>\n<\/div>\n\n\n\n<p class=\"has-dan-blue-200-color has-text-color has-small-font-size\">\u00a9&nbsp;<em>Alert Diver<\/em>&nbsp;- Q2 2023<\/p>\n\n\n\n<div style=\"height:10px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>","protected":false},"excerpt":{"rendered":"<p>PETAR DENOBLE, MD, D.SC, TELAH MENDEDIKASIKAN KARIRNYA untuk mengeksplorasi dan memecahkan masalah-masalah praktis dalam pengobatan selam. <\/p>","protected":false},"featured_media":24715,"template":"","dan_alert_diver_categories":[466],"dan_alert_diver_issues":[485],"class_list":["post-24713","dan_alert_diver","type-dan_alert_diver","status-publish","has-post-thumbnail","hentry","dan_alert_diver_categories-researcher-profile","dan_alert_diver_issues-q2-2023"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.0 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Petar Denoble: Solving Practical Issues for Divers - DAN World<\/title>\n<meta name=\"description\" content=\"PETAR DENOBLE, MD, D.SC., HAS DEDICATED HIS CAREER to exploring and solving practical issues in dive medicine.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/world.dan.org\/id\/th\/alert-diver\/article\/petar-denoble-solving-practical-issues-for-divers\/\" 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