Future of maritime education and training: blending hard and soft skills

The 21st century endeavour bring new challenges for the maritime industry. The challenges facing the professionals within the industry are multifaceted and complex due to globalization, cross-cultural interrelationships, and technological change that are permeating the maritime industry. The aim of this article is to contribute to better understanding the problem of developing the future maritime industry professional, filling the existing gap between education and training programmes, while integrating the 21st century professional skills. The contents of a comprehensive education and training programme shall be proposed within a knowledge triangle encompassing academia, the industry and relevant authority or regulatory institutions, so all interested parties’ “voices” will be considered. Besides raising awareness for the educational and training challenges ahead, more effective teaching methods are suggested in order to meet the needs, particularly supporting double loop learning, together with a pragmatic proposal for a realistic programme at master’s level. The proposed programme is based on the EU MarLEM project, which aims towards the development of the 21st century maritime industry professional, focusing on logistics, engineering and management contents

Useless or useful? - A literature review

Publisher Copyright: © 2021 Baishideng Publishing Group Co., Limited. All rights reserved.Radiotherapy (RT) is the backbone of multimodality treatment of more than half of cancer cases. Despite new modern RT techniques, late complications may occur such as radiation proctitis (RP). The natural history of RP is unpredictable. Minor symptoms may resolve spontaneously or require conservative treatment. On the other hand, for similar and uncomplicated clinical contexts, symptoms may persist and can even be refractory to the progressive increase in treatment measures. Over the last decades, an enormous therapeutic armamentarium has been considered in RP, including hyperbaric oxygen therapy (HBOT). Currently, the evidence regarding the impact of HBOT on RP and its benefits is conflicting. Additional prospective and randomised studies are necessary to validate HBOT's effectiveness in the 'real world' clinical practice. This article reviewed the relevant literature on pathophysiology, clinical presentation, different classifications and discuss RP management including a proposal for a therapeutic algorithm with a focus on HBOT.publishersversionpublishe

The Role of Hyperbaric Oxygen Therapy in Pneumatosis Cystoides Intestinalis—A Scoping Review

Pneumatosis cystoides intestinalis (PCI) is characterized by gas-filled cysts within gastrointestinal tract wall from esophagus to rectum, with preferential involvement of large and small intestine. PCI is rare with an estimated incidence of 0.03 to 0–2% in general population. PCI can be distinguished into idiopathic (15%) or secondary (85%) and the clinical picture ranges from completely asymptomatic to life-threatening intraabdominal complications. Although etiology of PCI appears to be multifactorial, the exact pathophysiology is poorly understood and two main theories have been proposed (mechanical and bacterial). Over the last decades, an enormous therapeutic armamentarium was considered in PCI's management, including hyperbaric oxygen therapy (HBOT). Treatment comprises conservative treatment in mild cases to surgery in highly symptomatic and complicated PCI. In the late 70s, HBOT started to be used in selected cases of PCI not responding to conservative measures. Since then, several case reports, case series, and reviews have been published in the literature with variable outcomes. The overall response rate and complete response were 92.1% (n = 82/89) and 65.2% (n = 58/89), respectively, with a median follow-up of 7 months. Furthermore, HBOT is extremely safe, with few reported complications in the literature when used for PCI. Nevertheless, a randomized, controlled, and double-blind clinical trial is unlikely to occur given the rarity of PCI, logistical issues of HBOT, and methodological considerations related to adequate blinding with a sham-controlled group. HBOT in combination with personalized diet and antibiotics may be beneficial for moderate to severe PCI in patients with no indication for emergency exploratory laparotomy. The purpose of this article is to synthesize the existing data, analyse results of previous studies, identify gaps in knowledge, and discuss PCI' management, including the proposal of an algorithm, with a special focus on HBOT.</jats:p

Future of maritime education and training

The 21st century endeavour bring new challenges for the maritime industry. The challenges facing the professionals within the industry are multifaceted and complex due to globalization, cross-cultural interrelationships, and technological change that are permeating the maritime industry. The aim of this article is to contribute to better understanding the problem of developing the future maritime industry professional, filling the existing gap between education and training programmes, while integrating the 21st century professional skills. The contents of a comprehensive education and training programme shall be proposed within a knowledge triangle encompassing academia, the industry and relevant authority or regulatory institutions, so all interested parties’ “voices” will be considered. Besides raising awareness for the educational and training challenges ahead, more effective teaching methods are suggested in order to meet the needs, particularly supporting double loop learning, together with a pragmatic proposal for a realistic programme at master’s level. The proposed programme is based on the EU MarLEM project, which aims towards the development of the 21st century maritime industry professional, focusing on logistics, engineering and management contents.</jats:p

Hyperbaric Oxygen Therapy as a Complementary Treatment in Glioblastoma—A Scoping Review

Glioblastoma (GBM) is the most common and aggressive malignant brain tumor in adults. The mainstay of management for GBM is surgical resection, radiation (RT), and chemotherapy (CT). Even with optimized multimodal treatment, GBM has a high recurrence and poor survival rates ranging from 12 to 24 months in most patients. Recently, relevant advances in understanding GBM pathophysiology have opened new avenues for therapies for recurrent and newly diagnosed diseases. GBM's hypoxic microenvironment has been shown to be highly associated with aggressive biology and resistance to RT and CT. Hyperbaric oxygen therapy (HBOT) may increase anticancer therapy sensitivity by increasing oxygen tension within the hypoxic regions of the neoplastic tissue. Previous data have investigated HBOT in combination with cytostatic compounds, with an improvement of neoplastic tissue oxygenation, inhibition of HIF-1α activity, and a significant reduction in the proliferation of GBM cells. The biological effect of ionizing radiation has been reported to be higher when it is delivered under well-oxygenated rather than anoxic conditions. Several hypoxia-targeting strategies reported that HBOT showed the most significant effect that could potentially improve RT outcomes, with higher response rates and survival and no serious adverse events. However, further prospective and randomized studies are necessary to validate HBOT's effectiveness in the ‘real world' GBM clinical practice.</jats:p

Hyperbaric Oxygen Therapy as a Complementary Treatment in Glioblastoma—A Scoping Review

Funding Information: The authors would like to acknowledge CUF Oncologia and the Portuguese Navy. Publisher Copyright: Copyright © 2022 Alpuim Costa, Sampaio-Alves, Netto, Fernandez, Oliveira, Teixeira, Daniel, Bernardo and Amaro.Glioblastoma (GBM) is the most common and aggressive malignant brain tumor in adults. The mainstay of management for GBM is surgical resection, radiation (RT), and chemotherapy (CT). Even with optimized multimodal treatment, GBM has a high recurrence and poor survival rates ranging from 12 to 24 months in most patients. Recently, relevant advances in understanding GBM pathophysiology have opened new avenues for therapies for recurrent and newly diagnosed diseases. GBM's hypoxic microenvironment has been shown to be highly associated with aggressive biology and resistance to RT and CT. Hyperbaric oxygen therapy (HBOT) may increase anticancer therapy sensitivity by increasing oxygen tension within the hypoxic regions of the neoplastic tissue. Previous data have investigated HBOT in combination with cytostatic compounds, with an improvement of neoplastic tissue oxygenation, inhibition of HIF-1α activity, and a significant reduction in the proliferation of GBM cells. The biological effect of ionizing radiation has been reported to be higher when it is delivered under well-oxygenated rather than anoxic conditions. Several hypoxia-targeting strategies reported that HBOT showed the most significant effect that could potentially improve RT outcomes, with higher response rates and survival and no serious adverse events. However, further prospective and randomized studies are necessary to validate HBOT's effectiveness in the ‘real world' GBM clinical practice.publishersversionpublishe