Development of a Systematic Review of Public Health Interventions to Prevent Children Drowning

Drowning is the leading cause of death from unintended injury in children globally. Drowning is preventable, and mechanisms exist which can reduce its impact, however the peer-reviewed literature to guide public health interventions is lacking. This paper describes a protocol for a review of drowning prevention interventions for children. Electronic searching will identify relevant peer-reviewed literature describing interventions to prevent child drowning worldwide. Outcome measures will include: drowning rates, water safety behaviour change, knowledge and/or attitude change, water safety policy and legislation, changes to environment and water safety skills. Quality appraisal and data extraction will be independently completed by two researchers using standardised forms recording descriptive and outcome data for each included article. Data analysis and presentation of results will occur after data have been extracted. This review will map the types of interventions being implemented to prevent drowning amongst children and identify gaps within the literature.

The East Japan Great Earthquake and Three Cases of Near-Drowning with Tsunami Due to the Earthquake

We encountered the Great East Japan Earthquake on March 11, 2011. The magnitude of the earthquake is 9.0 and it is one of the greatest from A.D. 1900 to now. The earthquake developed large tsunami and many people living on the pacific coast of east Japan died from lung disorder caused by near drowning with tsunami. We also encountered three cases of lung disorders caused by near drowning. All three were females, and two of them were old elderly. All segments of both lungs were involved in all the three patients, necessitating ICU admission and endotracheal intubation and mechanical ventilation. All three died within three weeks. In at least two cases, misswallowing of oil was suspected from the features noted at the time of the detection. Many bacteria were detected from the phlegm of two cases.

Pollen Findings in a Presumptive Drowning Case

A medicolegal/botanical collaboration has to lead to an interdisciplinary procedure for developing methods when studying dead bodies found in water with no clear circumstances. Hereby we present a report or a preliminary attempt as a basis for encouraging further work in the field. The body of an unidentified 25 - 35 years old woman was found immersed in a fresh water ditch in state of decomposition. Structural alterations avoid any a priori identification of asphyxia or traumatic cervical lesions. The last cause of death was estimated as a cardio respiratory collapse and a drowning investigation was proposed. Taxonomic species identification was carried out to relate the pollen aspiration with the water medium in lung, spleen, liver and water medium. We presented pollen grains in spleen, as a closed organ, as a clue for death investigation in the absence of diatom findings. Information about where and when pollen grains occur may ascertain that a body or an object was in some place at a certain time. Since the consequences of aspiration depend on many factors, such as the quantity, size and solidity of the material aspirated and whether the aspiration is chronically recurrent or acute, the pollen investigation must be done with precaution. We conclude that in the absence of other microscopic structures, biochemical blood analyses, or histological findings, forensic palynology may be of help to relate the presumptive drowned body with its death scenario.

Pulmonary Immunohistochemical Detection of Surfactant Protein A (SP-A) in Fatal Drowning

Drowning still remains one of the most difficult diagnoses in forensic pathology because macroscopic and microscopic autopsy findings are unspecific. An ideal diagnostic marker for drowning still needs to be developed, but some authors have recently studied SP-A as a marker of asphyxiation and drowning. The aim of this study is to compare the histopathological features and the SP-A immunohistochemical expression in lung tissue in the case of drowning with those determined by other causes to discriminate between cadaver submersion and drowning.

Acute and Severe Hypercalcemia in a Near-Drowning Victim

An 80-year-old male was admitted to our hospital because of near-drowning in a hot spring. Besides hypoxia, serum calcium was extremely high at 15.5 mg/dL on admission. After the treatment with normal saline infusion, furosemide and calcitonin, the hypercalcemia was transient and didn’t recur during the course. The hot spring water contained much calcium, so his hypercalcemia was considered to be a result of calcium absorption mainly through the alveoli. In this case, we revealed that serum calcium rose within a short time after drowning, suggesting the necessity to measure the calcium concentration of the drowning fluid in a near-drowning victim.

Automatic Real-Time Detection of Infant Drowning Using YOLOv5 and Faster R-CNN Models Based on Video Surveillance

Infant drowning has occurred frequently in swimming pools recent years,which motivates the research on automatic real-time detection of the accident.Unlike youths or adults,swimming infants are small in terms of size and motion range,and unable to send out distress signals in emergencies,which exerts negative effects on the detection of drowning.Aiming at this problem,a new step is initialized towards detecting infant drowning automatically and efficiently based on video surveillance.Diverse live-scene videos of infant swimming and drowning are collected from a variety of natatoriums and labeled as datasets.A part of the datasets is downscaled or enlarged to enhance generalization ability of the model.On this basis,advantages of Faster R-CNN and a series of YOLOv5 models are specifically explored to enable fast and accurate detection of infant drowning in real-world.Supervised learning experiments are carried out,model test results show that mean Average Precision(mAP)of either Faster R-CNN or YOLOv5s of the series of YOLOv5 can be over 89%;the former can process merely 6 frames of videos per second with the precision of only 62.04%,while the latter can reach an average speed of 75 frames/s with the precision of about 86.6%.The YOLOv5s eventually stands out as an optimal model for detecting infant drowning in view of comprehensive performance,which is of great application value to reduce the accidents in swimming pools.

Postmortem chest computed tomography for the diagnosis of drowning:a feasibility study

It may be difficult to distinguish the cause of death in drowning cases without specific findings.The aim of this study was to explore the forensic value of thoracic postmortem computed tomography(PMCT)using routine images and three-dimensional(3D)image reconstructions.The imaging data of PMCT examinations of six drowning cadavers,aged 21-54years,were analyzed.Twelve victims of sudden death from coronary artery disease(CAD)were chosen as a control group.After 3D bilateral lung images were reconstructed using image processing software,an interactive medical image control system was used to measure and analyze parameters including lung volume,lung volume ratio,mean CT value of the whole lung,and lung CT value distribution curves.Lung volume and lung volume ratio were used to assess the shape changes of the lung.Lung CT value distribution curves showed the corresponding number of pixels of the different CT values in the lung image.Lung volume was not signifi-cantly larger in drowning cases(mean 2958cm^(3))than in controls(mean 2342cm^(3)).Lung vo-lume ratio values in the drowning group(mean 0.3156)were greater than those in the control group(mean 0.2763);(P=0.02).There was no significant difference between the drowning and control group in the mean CT value of the whole lung.There were differences between lung CT value distribution curves in drowning victims and controls,with drowning victims showing a single peak and CAD cases showing a bimodal distribution.Thoracic PMCT is help-ful for the forensic medical diagnosis of drowning.Lung volume ratio and lung CT value distri-bution are potential indicators to distinguish between drowning and CAD.

Bystander resuscitation of a near-drowning child in a rural south China township

We report resuscitation of a near-drowning child by a bystander in a rural south China township.Resuscitation was performed on a 6-year-old,otherwise healthy boy who was witnessed drowning in a river,with submersion for approximately 12 min.Following several resuscitation attempts,spontaneous breathing was established at the scene and the boy was transferred to a nearby hospital.He developed pneumonia but recovered completely on the ward and was discharged without any neurologic disabilities.This case shows that early bystander resuscitation is an important factor for survival after submersion.The search for an ideal approach to resuscitation must continue,and all members of society must work together towards this goal.

Drowning in Illegal Capital

The Chinese Government is cracking down on capital illegally invested in the stock market The Chinese stock market has attracted huge amounts of capital,much of which is speculative or illegal money.

Relationships between Diatom Abundances in Rat Organs and in Environmental Waters

Objective:A diagnosis of drowning remains one of the most challenging issues in forensic science,especially for decomposed bodies.Diatom analysis is considered as an encouraging method for diagnosing drowning.In this study,we developed a drowned rat model using different diatom densities in water.Methods:A total of 120 adult Sprague-Dawley rats were used and divided into six groups,wherein experimental groups 1-5 were drowned rats(group A)and postmortem submersion rats(group B)that were submerged in water with five different Cyclotella sp.diatom densities,while the remaining group was used as a blank control.The combination of microwave digestion and vacuum filtration method was used to accomplish efficient tissue digestion and ascertain higher accuracy of diatom determinations within organs.Results:The abundances of diatoms in the lungs,livers,and kidneys were significantly different.The diatom abundances in the lungs,livers,and kidneys were directly proportional to the water diatom densities,and specific quantitative relationships could be approximated by separate regression equations for each organ type.However,the trends associated with the diatom increases among organs slightly differed.In addition,the diatom abundances in the lungs,livers,and kidneys were all positively correlated.Diatoms were not observed in the postmortem submersion groups nor in the blank control groups.Conclusion:The results of this study provide valuable information for establishing a quantitative diatom framework for informing future forensic medicine efforts.

Post-Rifting Magmatism and the Drowned Reefs in the Xisha Archipelago Domain

Fourteen isolated drowned reefs have been identified around the Xisha Uplift by multibeam and seismic data. The drowning processes of these reefs can be divided into three different stages, which correspond to three different accelerated tectonic subsidence periods. The drowning of the Xisha reefs is the result of the combined action of tectonic subsidence and sea level fluctuations, and the tectonic subsidence rate had to remain above 0.2 mm yr^(-1 )for a long time. Three abrupt accelerated tectonic subsidence events that occurred in the late Miocene, Pliocene and early Quaternary in the Xisha Uplift were closely related to the thermal subsidence processes after three stages of post-rifting magmatism. The magmatism of the middle Miocene and the following thermal subsidence resulted in the drowning of reefs in the northwestern Xisha uplift(Zone A). During the early Pliocene, massive magmatic intrusions and volcanic eruptions occurred in the Xisha Uplift. Then, the subsequent thermal subsidence started the drowning process of reefs in the northeastern and western regions of the Xisha Uplift(Zone B and C). During the early Quaternary, large-scale magmatism also occurred in the Xisha Uplift. The subsequent thermal subsidence resulted in a new rapid tectonic subsidence, which caused the reefs in the southern and southeastern regions of the Xisha Uplift to drown(Zone D and E).

Research advances in forensic diatom testing

In forensic practice,it is difficult to determine whether a dead body in the water resulted from drowning or from disposal after death.Diatom testing is currently an important supporting technique for the determination of death by drowning and of drowning sites,even though it is a time-consuming and laborious task.This article reviews the development of diatom testing over the decades and discusses a new method for the potential application of deep learning in diatom testing.

Evolution of the Late Miocene atoll systems offshore Xisha Islands

Modern atolls have been studied systematically and thoroughly in the South China Sea.However,the knowledge of a paleo-atoll and related sedimentary system is very limited.Here we used the newly acquired high resolution 2D seismic data,and discovered three late Miocene atoll systems in the offshore Xisha Islands for the first time.We named them atoll system A,B,C,respectively.These three atoll systems,all developed on the horsts dominated by normal fault,consist mainly of atoll reefs,patch reefs,fore-reef slope deposits,and lagoons.On the basis of the interpreted sequence stratigraphic framework and the identification of fore-reef slope deposits,we suggested only the atoll system A continued to grow until Quaternary,and both of atoll system B and C had been drowned in Pliocene.In late Miocene,the atoll systems in the study area were most developed,either in magnitude or in maturity,which indicated late Miocene was the most flourishing period of reef builders,and this was in accordance with the drilling result of ODP Leg 184 in the South China Sea.Pliocene was an important reef drowning period in the study area,and both atoll systems B and C were drowned and hemipelagic deposits prevailed gradually.Quaternary was another reef drowning period in the study area,two large atoll reefs grown on the atoll system A were finally drowned,and hemipelagic deposits begun to drape and fill the palaeo-atoll systems.The growth and drowning of atolls are controlled mainly by tectonic subsidence in long term,but global eustatic can impact it in short term also.

Global trends and regional differences in non-transport unintentional injuries mortality among children and adolescents, 1990 to 2019: results from the Global Burden of Disease 2019 study

Background::Non-transport unintentional injuries(NTUIs)are major public concerns,especially among children and adolescents in low-and middle-income countries.With environmental and cognitive changes,a recent systematic description of global trends and regional differences concerning NTUIs is urgently needed for the global agenda of relevant policy-making and intervention target findings.Methods::We used mortality,population,and socio-demographic-index(SDI)data from Global Burden of Disease 2019 to analyze the trends of NTUIs mortality.We applied the slope index of inequality(SII)and relative index of inequality(RII)to measure the absolute and relative inequality between countries and territories.The concentration curve and concentration index(CI)were also used to measure the inequality.We conducted a sensitivity analysis to make our findings credible.Results::In 2019,there were 205,000 deaths due to NTUIs among children and adolescents aged 5 to 24 years,which decreased from 375,000 in 1990.In 2019,the age-standardized mortality rate(ASMR)was 8.13 per 100,000,ranging from the lowest in the Netherlands(0.90 per 100,000)to the highest in the Solomon Islands(29.34 per 100,000).The low-middle SDI group had the highest ASMR of NTUIs,while the low SDI group had the slowest decrease.After excluding the death caused by"exposure to forces of nature"and"other unintentional injuries",drowning accounted for the most deaths in almost every SDI group,gender,and age group,but the major causes of death varied in different subgroups.For example,animal contact was a major cause in low and low-middle SDI groups but less in high SDI groups,while high and high-middle SDI groups had a higher proportion of deaths for foreign body and poisonings.The SII showed a declining trend,but the RII and CI did not,which might indicate that inequality was persistent.Similar results were found in the sensitivity analysis.Conclusions::Despite the declining trend of the mortality rate and the narrowing gap between countries,there were still a large number of children and adolescents dying from NTUIs,and those experiencing social-economic disadvantages remained at high mortality.Embedding the prevention of NTUIs into sustainable development goals might contribute to the progress of reducing death and inequalities,which ensures that no one is left behind.

Nonnatural Deaths of Children under the Age of 5 Years in Ontario, Canada: A Retrospective Autopsy Analysis of 10 Years (2006–2015)

The goal of this study is to unravel the common patterns observed among nonnatural deaths of children under 5 years and suggest ways to prevent such unnecessary deaths.The study was confined to the province of Ontario to allow the identification of regional specific patterns.The database at the Office of the Chief Coroner of Ontario was searched for all pediatric deaths from the years 2006–2015.All nonnatural deaths for children under the age of 5 years,including sudden infant death syndrome,were selected for the study.Manner and cause of death along with the corresponding year were recorded in tables.In the 10‑year period,940 nonnatural deaths were identified in Ontario through autopsy records which are equal to approximately 36.7%of the total childhood deaths.There were 295 accidental cases(11.6%)and 71 homicides(2.8%).The leading causes of nonnatural childhood deaths in Ontario were drowning,traffic accidents,blunt trauma,and asphyxia.Nonnatural deaths are preventable through education and training of parents.Implementation of educational interventions can significantly reduce nonnatural deaths of children in Ontario.

A Future Perspective in Forensic Medicine in China:Diatomological Mapping of Water Bodies

Diatom test(forensic diatomology)is commonly considered as the“gold standard”in the diagnosis of drowning in forensic practices.The diatomology contributes significantly not only in determining the mode of death but also in determining the site of drowning because of various distribution characterizations of diatoms in different water bodies or different seasons.Hence,it is believed that diatomological mapping will be interest to forensic pathologists in the future development.Here,we reviewed the all the studies on the distribution characterizations of diatoms in different water bodies in China recently.The present paper summarized the current situation and the limitations of the previous studies.Moreover,we suggested that it was necessary to establish a systematized and standardized diatomological mapping program nationwide.Our study also encourages diatomological mapping for forensic characterization of water bodies for a prolonged time.

An Autopsy Case of Suspected Anti‑N‑Methyl‑D‑Aspartate Receptor Encephalitis

N-methyl-D-aspartate receptor(NMDAR)encephalitis is a rare type of autoimmune limbic encephalitis.Herein,we report an autopsy case of highly suspected anti‑NMDAR encephalitis,based on the patient’s past psychiatric history and autopsy findings of bilateral hippocampal sclerosis and ovarian teratoma.We found that it can be difficult to accurately diagnose autoimmune encephalitis at postmortem forensic autopsy without a case history and background information.

A sort of iron-manganese nodule developing in drowned platform margin

A sort of purplish red iron-manganese nodules was found in the Middle Ordovician Guniutan-Miaopu period limestone, Anhui Province. About their formational environment, there are two different viewpoints:Yue thought they were deep-water pelagic deposit and Huang et al. believed they were formed inshallow water tide. We think that these nodules were formed in drowned platform margin belonging to atransitional type between shallow-water and deep-water iron-manganese nodules, and different from shoalwater iron-manganese oolites and pelagic iron-manganese nodules in feature and origin. 1 Palaeogeographic setting of iron-manganese nodules