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Int J Equity Health 2020 Jul 1;19(1):108. Epub 2020 Jul 1.

The George Institute for Global Health India, 311-312, Third Floor, Elegance Tower, Plot No. 8, Jasola District Centre, New Delhi, 110025, India.

Background: Community-based programs in rural low-and middle-income country settings are well-placed to conduct gender transformative activities that aid program sustainability and catalyse wider social change, such as reducing gender inequities that in turn improve health outcomes. The Anchal program is a drowning prevention intervention for children aged 1-5 years old in rural Bangladesh. It provides community crèche-based supervision delivered by local trained paid-female volunteers. Read More

Oral Maxillofac Surg 2020 Jun 29. Epub 2020 Jun 29.

Otolaryngology and Facial Plastic Surgery Associates, 923 Pennsylvania Ave, Fort Worth, TX, 76104, USA.

Purpose: Water recreation is one of the most popular activities for both fitness and leisure. The dangers of water activities have mostly been examined in the context of drowning and general bodily injuries. Despite the existing research, little is known about adult maxillofacial injuries in these settings. Read More

Rev Esp Salud Publica 2020 Jun 30;94. Epub 2020 Jun 30.

Sociedad Brasileña de Salvamento Acuático (SOBRASA). Rio de Janeiro. Brasil.

Severe acute respiratory syndrome (SARS-CoV-2), which causes coronavirus disease 2019 (Covid-19), is highly contagious. Lifeguards are the first line of response in aquatic emergencies and they will suffer a strong exposure to risk this first summer of the Covid-19 era, so their occupational health must be rethought in their professional practice during the new normal. The main public health measure to prevent drowning is prevention, but when this fails and assistance or rescue is required, in most interventions, distancing will not be possible. Read More

Forensic Sci Int 2020 Jun 10;313:110362. Epub 2020 Jun 10.

Centro Universitário Christus: Street Adolfo Gurgel, 133, Cocó, Fortaleza-Ceará, Brazil.

Human identification and postmortem intervals can be difficult to estimate when corpses are found in drowning situations, and forensic odontologists can bring valuable input to forensic science investigations of this type. Studies that simulate real scenarios are crucial for providing parameters that can be used in real cases. The present study created the necessary circumstances, i. Read More

Indian J Public Health 2020 Apr-Jun;64(2):198-200

DGHS, GoI, India.

A daily surveillance for disease detection and response at the Simhastha Kumbh Mela, in Ujjain, Madhya Pradesh, April-May 2016, was established. Existing weekly reporting of the Integrated Disease Surveillance Programme (IDSP) was modified to report 17 diseases or events from 22 public hospitals and three private hospitals in Ujjain. Water samples were also tested for fecal contamination in areas reporting diarrhea. Read More

Eur Spine J 2020 Jun 24. Epub 2020 Jun 24.

Department of Trauma Surgery (Orthopaedics), AIIMS, Rishikesh, Uttarakhand, 249203, India.

J Sports Sci 2020 Jun 23:1-11. Epub 2020 Jun 23.

School of Psychology, Curtin University , Perth, Australia.

This study examined the swimming competence of primary school children, and how it was related to swimming activity, non-fatal aquatic events, and demographic factors. Primary school students (N = 4959; female = 2705, male = 2241; age range = 5 to 14 years) across 28 schools in the 15 districts of Hong Kong completed the Swimming Competence Questionnaire, and questions about their swimming experience, non-fatal aquatic events, and demographic variables. Descriptive statistics showed that over 60% of children could swim more than 5m, but less than 50% could swim over 25m. Read More

Eur Spine J 2020 Jun 21. Epub 2020 Jun 21.

Spinal Surgery Department, Royal Stoke University Hospital, Newcastle Rd, Stoke-on-Trent, ST4 6QG, UK.

Case Rep Crit Care 2020 6;2020:9270791. Epub 2020 Jun 6.

Anesthesia and Intensive Care Department, University Department of Thoracic Surgery General Hospital "Pugliese-Ciaccio", Catanzaro, Italy.

Drowning is an acute respiratory failure as a result from immersion or submersion of the airways in a liquid medium (predominantly water). Inhalation of water causes severe lung damage due to the destruction of pulmonary surfactant, resulting in decreased lung elasticity, alveolar collapse, alteration of ventilation-perfusion ratio, intrapulmonary blood shunting, hypoxia, acute lung injury, and Acute Respiratory Distress Syndrome (ARDS). Poractant alfa (Curosurf®), a natural surfactant effective in the treatment of newborn respiratory distress, has been used in various forms of ARDS, but in drowning syndromes, experience is still poor. Read More

Front Psychol 2020 29;11:969. Epub 2020 May 29.

Faculty of Sports, University of Ljubljana, Ljubljana, Slovenia.

Fear of water is the strongest predictor for no or low swimming competencies. Some individuals will never learn to swim due to their complete avoidance of water, whereas others might have difficulty with learning due to the fact that they cannot sufficiently relax their body to facilitate floating or swimming. Therefore, it is important to identify these people and to establish effective teaching strategies that can best help this specific population. Read More

Fa Yi Xue Za Zhi 2020 Apr;36(2):239-242

Department of Forensic Medicine, Inner Mongolia Medical University, Hohhot 010030, China.

Abstract: Objective To discuss the application of artificial intelligence automatic diatom identification system in practical cases, to provide reference for quantitative diatom analysis using the system and to validate the deep learning model incorporated into the system. Methods Organs from 10 corpses in water were collected and digested with diatom nitric acid; then the smears were digitally scanned using a digital slide scanner and the diatoms were tested qualitatively and quantitatively by artificial intelligence automatic diatom identification system. Results The area under the curve （AUC） of the receiver operator characteristic （ROC） curve of the deep learning model incorporated into the artificial intelligence automatic diatom identification system, reached 98. Read More

BMC Pregnancy Childbirth 2020 Jun 10;20(1):356. Epub 2020 Jun 10.

Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland, 4020, Australia.

BMC Public Health 2020 Jun 10;20(1):903. Epub 2020 Jun 10.

Department of Disaster and Emergency Medicine, Shanghai East Hospital, Tongji University, 1239 Siping Road, Shanghai, 200092, China.

Background: Injuries are of growing public health concern in China, and the trends of urban-rural injury mortality disparity for the last decade are still being explored. This study aims to analyze trends in injury mortality disparity between urban and rural areas of China by region, sex, and age from 2010 to 2016.

Methods: Using data from the Disease Surveillance Points system (DSPs) collected by the Chinese Center for Disease Control and Prevention (CDC) from 2010 to 2016, injury age-standardized mortality rates (ASMRs) and rate ratios (RRs) were calculated for different groups. Read More

Natl Health Stat Report 2019 12(136):1-22

Background-External cause-of-injury frameworks, or matrices, based on the International Classification of Diseases (ICD) provide standardized categories for reporting injuries by mechanism and intent of injury. In 2014, the National Center for Health Statistics (NCHS) and the National Center for Injury Prevention and Control (NCIPC) published a proposed external cause-of-injury matrix for use with data coded using the ICD, 10th Revision, Clinical Modification (ICD-10-CM). At the time the proposed matrix was developed, ICD-10-CM coded data were not available to evaluate the performance of the proposed matrix. Read More

J Family Med Prim Care 2020 Mar 26;9(3):1370-1375. Epub 2020 Mar 26.

Family Medicine Consultant and Trainer in Family Medicine Residency Training Program of Prince Sultan Military Medical City, Riyadh, KSA.

Background: Children are the most affected age group by home and traffic accidents. Parents, as the primary caregiver to their children, play an important role in saving their lives during an accident, therefore, more attention should be focused to assess and improve the parents' knowledge and skills of first aid (FA).

Aim: Determining the parent's awareness level regarding choking, drowning, and burn FA, their readiness to attend an FA course and solutions from their perspective to improve the awareness level regarding FA for children. Read More

Wilderness Environ Med 2020 Jun 4. Epub 2020 Jun 4.

Universita degli Studi di Cagliari Facolta di Medicina e Chirurgia, Cagliari, Italy. Electronic address:

Sci Adv 2020 May 22;6(21):eaaz5512. Epub 2020 May 22.

Department of Earth and Environmental Sciences, Tulane University, 6823 St. Charles Avenue, New Orleans, LA 70118-5698, USA.

Coastal marshes are threatened by relative sea-level (RSL) rise, yet recent studies predict marsh survival even under the high rates of RSL rise expected later in this century. However, because these studies are mostly based on short-term records, uncertainty persists about the longer-term vulnerability of coastal marshes. We present an 8500-year-long marsh record from the Mississippi Delta, showing that at rates of RSL rise exceeding 6 to 9 mm year, marsh conversion into open water occurs in about 50 years. Read More

Wilderness Environ Med 2020 May 29. Epub 2020 May 29.

International Lifesaving Federation Medical Commission Leuven, Belgium.

Injury 2020 May 25. Epub 2020 May 25.

Australian Institute of Health Innovation, Macquarie University, Macquarie Park, NSW, 2109, Australia.. Electronic address:

Background: Adult injury severity metrics are often applied to paediatric populations despite differences in anatomy, physiological and mortality risk. Measures to assess paediatric mortality have not been conducted on a population-wide basis.

Purpose: To determine the predictive ability of the International Classification of Injury Severity Score (ICISS) in assessing 30-day mortality in a paediatric population, and to examine temporal trends for serious injury for common paediatric injury mechanisms. Read More

Int J Environ Res Public Health 2020 May 28;17(11). Epub 2020 May 28.

Department of Physical Performance, Norwegian School of Sport Sciences, 0863 Oslo, Norway.

In this study, we compared adolescents' actual (expert assessed) front crawl swimming skills to their self-assessment in two conditions: in standard swimming (wearing a swimsuit and goggles) and in a simulated risk scenario (swimming in plain clothes without goggles). We postulated that education focused on water competencies is fundamental in preventing drownings. Experts evaluated the skills of 21 female and 21 male adolescents in both standard and challenging conditions. Read More

Forensic Sci Int 2020 Jul 4;312:110297. Epub 2020 May 4.

Algae Research & Development Centre, Environment and Conservation Sciences, College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, Western Australia 6150, Australia; Centre for Sustainable Aquatic Ecosystems, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia. Electronic address:

Crime scene investigation protocols and procedures are well established when concerning terrestrial environments, but are limited when associated with aquatic environments. In aquatic contexts, the soil, sediments and microscopic algae (e.g. Read More

Scand J Trauma Resusc Emerg Med 2020 May 24;28(1):41. Epub 2020 May 24.

Department of Thoracic and Cardiovascular Surgery, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Gwanpyeong-ro 170 beon-gil 22, Dongan-gu, Anyang-si, Gyeonggi-do, 14068, South Korea.

Background: Therapeutic extracorporeal membrane oxygenation (ECMO) is a challenging procedure in patients who have experienced severe trauma. Particularly, patients with traumatic lung injury and posttraumatic acute respiratory distress syndrome (ARDS) have a high risk of bleeding during this procedure. This study aimed to determine the safety and feasibility of ECMO in patients with traumatic ARDS. Read More

BMC Vet Res 2020 May 24;16(1):153. Epub 2020 May 24.

Laboratory of Wildlife Comparative Pathology, Department of Pathology, School of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo, SP, 05508-270, Brazil.

Background: Penguin interaction with gillnets has been extensively reported in the Atlantic and Pacific Oceans, and is considered a major conservation threat. Among penguin species, Magellanic penguins (Spheniscus magellanicus) are currently considered of great concern, particularly in Brazil, where they are highly susceptible to gillnet bycatch. Nevertheless, information about drowning-associated microscopic findings in penguins is limited. Read More

PLoS One 2020 22;15(5):e0231861. Epub 2020 May 22.

College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.

Introduction: Unintentional drowning deaths are only part of the drowning profile, with little attention being paid to intentional drowning in Australia. Strategies for the prevention of intentional drowning deaths are likely to be different from unintentional. Quality documentation, analysis and dissemination of intentional deaths data is crucial for developing appropriate strategies for prevention. Read More

Int J Environ Res Public Health 2020 May 19;17(10). Epub 2020 May 19.

Royal Life Saving Society, Australia, Sydney, NSW 2007, Australia.

Learning to swim via a structured program is an important skill to develop aquatic competencies and prevent drowning. Fear of water can produce phobic behaviors counterproductive to the learning process. No research examines the influence of negative aquatic experiences on learning to swim. Read More

J Forensic Odontostomatol 2020 May 15;1(38):34-38. Epub 2020 May 15.

Forensic Odontology, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.

Background: In contemporary forensic practice, Medicine and Dentistry combine forces to improve the search for the cause of death and human identification. The pink tooth phenomenon (PTP) is a cadaveric sign that allegedly manifests more often in victims of asphyxia. However, the scientific literature is scarce and controversial on this aspect. Read More

Child Care Health Dev 2020 May 16. Epub 2020 May 16.

Violence, Injury and Peace Research Unit, South African Medical Research Council, Cape Town, South Africa.

Introduction: Drowning is amongst the leading causes of death of children and young people worldwide, with high concentrations in Southeast Asia and Sub-Saharan Africa. In the Western Cape province in South Africa, drowning mortality rates for children were reported at 3.8 per 100,000 population. Read More

BMC Public Health 2020 May 15;20(1):704. Epub 2020 May 15.

Injury Division, The George Institute for Global Health, New Delhi, 110025, India.

Background: Four million people living in the Indian Sundarbans region in the state of West Bengal face a particularly high risk of drowning due to rurality, presence of open water, lack of accessible health systems and poor infrastructure. Although the World Health Organization has identified several interventions that may prevent drowning in rural low-and middle-income country contexts, none are currently implemented in this region. This study aims to conduct contextual policy analysis for the development of a drowning program. Read More

Forensic Sci Int 2019 10;1:68-70. Epub 2019 Apr 10.

Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-Sen University & Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Zhongshan 2nd Road 74, Yuexiu District, 510080, Guangzhou, China.

It is a difficult task to determine the cause of death for decomposed bodies found in water. Diatom test has been shown to provide supportive evidence for the diagnosis of drowning. According to our previous studies, the ratio of diatom content in lung tissue to diatom content in drowning medium (L/D ratio) is a very useful indicator to distinguish between drowning and postmortem immersion. Read More

Inj Epidemiol 2020 May 11;7(1):17. Epub 2020 May 11.

Milken Institute School of Public Health, George Washington University, Washington DC, USA.

Background: This paper estimates the impact on childhood drowning rates of community-based introduction of crèches or playpens or both in rural Bangladesh for children aged 0-47 months.

Methods: A baseline census of the whole population of 270,387 households in 51 unions, 451 villages from 7 rural sub-districts in Bangladesh was conducted in 2013. The baseline census determined retrospective, age-specific, and cumulative drowning incidence rates (IR) experienced in the target households in the 12 months prior to the intervention. Read More

Med Klin Intensivmed Notfmed 2020 May 7. Epub 2020 May 7.

Notfall- und OP-Management, Kreiskrankenhaus Freiberg gGmbH, Donatsring 20, 09599, Freiberg, Deutschland.

Background: Diseases of travelers upon returning home are described in numerous publications. However, we have limited data on the disease spectrum and the reasons for medical consultations during a trip.

Methods: Over the period of one year, we analyzed all patient visits to the inhouse medical center of a major 5‑star beach resort of an international chain in the Maldives. Read More

Biomed Res Int 2020 21;2020:7303897. Epub 2020 Apr 21.

School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.

Objective: To investigate the temporal trends in mortality and disease burden of injuries in Anhui province from 2008 to 2017, so as to provide reference for injury control and prevention.

Methods: Data of mortality were collected from 9 national surveillance points in Anhui province during 2008-2017 in the Information System for Death Cause Register and Management. The surveillance data were analyzed by using crude mortality, standardized mortality rate (SMR), potential year of life lost (PYLL), PYLL rate (PYLLR), and average of year life lost (AYLL). Read More

Am J Forensic Med Pathol 2020 Jun;41(2):104-109

Department of Forensic Medicine, Faculty of Medicine, Ataturk University.

Drowning is one of the major causes of unintentional injury death worldwide. As there are no pathomorphological findings specific to the diagnosis of drowning, definitive postmortem diagnosis of drowning continues to be a significant problem in forensic medicine. This study aims to present an additional diagnostic sign in cases of freshwater drowning by investigating the histopathological changes of renal tissue in the postmortem diagnosis of freshwater drowning. Read More

Glob Public Health 2020 May 7:1-16. Epub 2020 May 7.

Department of Surgery, Division of Trauma & Critical Care, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Addressing the burden of injury in low-resource settings requires development of trauma systems. This study aimed to describe perceptions of trauma in Santa Cruz, Bolivia to better inform strategies for trauma system development. In 2015-2016, we conducted 16 individual and 11 group interviews with key stakeholders involved with or exposed to trauma. Read More

Bull Hist Med 2020 ;94(1):29-63

This article examines resuscitation practices in the second half of the eighteenth century, especially the new use of tobacco smoke enema machines on people who had been extracted from water with no signs of life. Drownings accounted for a small number and proportion of urban deaths, yet governments promoted resuscitation techniques at considerable expense in order to prevent such deaths. The visibility of drowning in religious, urban, and civic life encouraged engagement with new approaches. Read More

J Comp Pathol 2020 Apr 16;176:67-70. Epub 2020 Mar 16.

North Fluminense State University-Darcy Ribeiro, Campos dos Goytacazes, Rio de Janeiro, Brazil.

Among studies of drowning in green sea turtles (Chelonia mydas), none have associated drowning with injuries of organs other than the lung. We describe the gross and microscopical findings in 23 green sea turtles found dead in a fishing net. Deprived of air, these animals experienced hypoxia and anoxia before dying, which caused congestion, hydropic degeneration and necrosis in several organs. Read More

Int J Legal Med 2020 Jul 28;134(4):1375-1385. Epub 2020 Apr 28.

Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Yixueyuan Road 1#, Yuzhongqu, Chongqing, China.

The diagnosis of drowning is one of the most difficult in forensic medicine. Forensic diatomology has been proposed to be useful in solving the diagnosis of drowning and considered to be a reliable indicator of the site of drowning. The Yangtze River and Jialing River are the main rivers in the Chongqing area (China), and a large number of corpses are found in the rivers every year. Read More

Pharmacoepidemiol Drug Saf 2020 Jun 22;29(6):684-691. Epub 2020 Apr 22.

Division of Pharmacovigilance, U.S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Surveillance and Epidemiology, Silver Spring, Maryland, USA.

Purpose: To identify and analyze postmarketing cases of complex sleep behaviors (CSBs) resulting in serious injuries, including death, associated with eszopiclone, zaleplon, or zolpidem (Z-drugs).

Methods: Retrospective analysis of the U.S. Read More

Medicine (Baltimore) 2020 Apr;99(16):e19888

Department of Pediatrics.

Rationale: Although percutaneous endoscopic gastrojejunostomy (PEG-J) tubes are believed to reduce the side effect of aspiration, cautious catheter management is required. Intussusception is a serious complication of these tubes.

Patient Concerns: A 7-year-old boy bedridden with hypoxic encephalopathy owing to drowning at the age of 1 year was admitted our hospital with urinary retention for 1 month. Read More

Open Access Emerg Med 2020 2;12:73-79. Epub 2020 Apr 2.

Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.

Purpose: Using a supraglottic airway (SGA) may provide more effective ventilations compared with a mouth-to-pocket-mask for drowning victims. SGAs are widely used by nurse anesthetists but it is unknown whether surf lifeguards can use SGAs effectively. We aimed to compare the use of SGA by surf lifeguards and experienced nurse anesthetists. Read More

Transplantation 2020 Apr 13. Epub 2020 Apr 13.

Division of Pediatric Cardiothoracic Surgery, University of Pittsburgh Medical Center, The Children's Hospital of Pittsburgh, Pittsburgh, PA.

Background: Donors with drowning or asphyxiation (DA) as a mechanism of death (MOD) are considered high risk in pediatric lung transplantation. We sought to evaluate whether recipients of DA donors had negatively impacted outcomes.

Methods: Pediatric recipients recorded in the United Network for Organ Sharing (UNOS) registry between 2000 and 2019 were included. Read More

J Trauma Acute Care Surg 2020 Apr 14. Epub 2020 Apr 14.

UPMC Children's Hospital of Pittsburgh UPMC Children's Hospital of Pittsburgh General Hospital Nuremberg, University Hospital of Paracelsus Medical University, Nuremberg, Germany UPMC Children's Hospital of Pittsburgh.

Background: Extracorporeal life support (ECLS) utilizing extracorporeal membrane oxygenation (ECMO) techniques has been used in the pediatric population for numerous indications, but its use in trauma has been understudied. We sought to examine the indications, characteristics, and outcomes of children placed on ECMO for trauma, and hypothesized that outcomes would be equivalent to those of patients placed on ECMO for other indications.

Methods: We performed a retrospective review of all pediatric trauma patients in the Extracorporeal Life Support Organization registry from 1989 - 2018. Read More

Sud Med Ekspert 2020 ;63(2):47-51

Saint-Petersburg State Budgetary Institution «Bureau of Forensic Medical Expertise», Saint-Petersburg, Russia.

Relevance of studying the conditions and mechanisms for the formation of water transport trauma is evaluated on the example of forensic medical situational examination of a young girl, who received multiple injuries with a propeller and keel of a speedboat. The victim died from drowning in water. Authors present the features of the morphology of chopped injuries on the skin and flat bones of the skull, proving the fact that they were caused by the screw of one of the three vehicles suspected of hitting victim and causing her severe traumatic brain injury during swimming time. Read More

Eur Spine J 2020 Apr 15. Epub 2020 Apr 15.

Spinal Surgery Department, Royal Stoke University Hospital, Newcastle Rd, Stoke-on-Trent, ST4 6QG, UK.

Purpose: To systematically review the published techniques for dural tear (DT) repair in spinal surgery to determine the repair method associated with the lowest failure rate.

Method: A systematic literature search was conducted. Studies reporting the treatment of accidental DT in elective spinal surgery were selected and reviewed with regards to the incidence of DT, repair techniques and outcome. Read More

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2020 Feb;32(2):177-182

Department of Critical Care Medicine, the Fifth Center Hospital in Tianjin, Tianjin 300450, China.

Objective: To compare the effects of freshwater and seawater drowning on sheep's pulmonary circulation hemodynamics and respiratory mechanics.

Methods: According to the random number table method, healthy crossbred sheep were divided into freshwater drowning group (n = 12) and seawater drowning group (n = 12). 30 mL/kg of freshwater or seawater was infused respectively through trachea for approximately 5 minutes. Read More