Cause Of Fatalities Research Articles

Establishment and characterization of novel autologous pair cell lines from two Indian non‑habitual tongue carcinoma patients.

Oral tongue squamous cell carcinoma (OTSCC) is one of the major causes of fatality in India due to very high percentage of patients with habits of smoking and chewing tobacco and associated products. Being highly heterogeneous in nature, every patient poses a different challenge clinically. To understand disease progression in an improved way, knowledge of cross‑talk between tumor stroma and the tumor cells becomes indispensable. Patient‑derived invitro cell line models are helpful to understand the complexity of diseases. However, they have very low efficiency of establishment from the tumor samples, particularly the cancer‑associated fibroblasts (CAFs). In the present study, two novel autologous pairs were immortalized spontaneously from non‑habitual, HPV‑positive patients, who presented with OTSCC. The epithelial and fibroblast cell lines had typical polygonal and spindle‑shaped morphology, respectively. Positive staining with epithelial specific Pan‑cytokeratin (PanCK) and fibroblast specific protein (FSP‑1) further confirmed their epithelial and fibroblast origin. Unique Short Tandem Repeat (STR) profile of the cultures confirmed their novelty, while the similarity of the STR profiles between the epithelial and fibroblast cells from the same patient, confirmed their autologous nature. DNA analysis revealed aneuploidy of the established cultures. An increase in the tumorigenic potential of the established epithelial cultures upon treatment with CAF‑conditioned medium proved the 'CAF‑ness' of the established fibroblast cells. The established cultures are the first of their kind which would serve as a useful platform in understanding the tumor‑stroma cross‑talk in tongue cancer progression.

Evaluation of onboard stability assessment techniques under real operational conditions

Stability-related accidents and crew lack of training are among the main causes of fatalities in the fishing fleet. Onboard stability guidance systems have been proposed by many authors as a possible solution. These guidance systems have been evolving from colour-coded posters to computer-based systems. However, their real-time operation without crew interaction is not solved yet.This work presents the validation of a methodology proposed by the authors in previous works for estimating the natural roll frequency of the vessel in real-time and thus the metacentric height. The performance of this method, based on the analysis of the roll motion, is tested during a fishing campaign of a mid-sized trawler, showing very promising results.

Biomarkers of Oxidative Stress Tethered to Cardiovascular Diseases.

Cardiovascular disease (CVD) is a broad term that incorporated a group of conditions that affect the blood vessels and the heart. CVD is a foremost cause of fatalities around the world. Multiple pathophysiological mechanisms are involved in CVD; however, oxidative stress plays a vital role in generating reactive oxygen species (ROS). Oxidative stress occurs when the concentration of oxidants exceeds the potency of antioxidants within the body while producing reactive nitrogen species (RNS). ROS generated by oxidative stress disrupts cell signaling, DNA damage, lipids, and proteins, thereby resulting in inflammation and apoptosis. Mitochondria is the primary source of ROS production within cells. Increased ROS production reduces nitric oxide (NO) bioavailability, which elevates vasoconstriction within the arteries and contributes to the development of hypertension. ROS production has also been linked to the development of atherosclerotic plaque. Antioxidants can decrease oxidative stress in the body; however, various therapeutic drugs have been designed to treat oxidative stress damage due to CVD. The present review provides a detailed narrative of the oxidative stress and ROS generation with a primary focus on the oxidative stress biomarker and its association with CVD. We have also discussed the complex relationship between inflammation and endothelial dysfunction in CVD as well as oxidative stress-induced obesity in CVD. Finally, we discussed the role of antioxidants in reducing oxidative stress in CVD.

Discovering Innate Driver Variants for Risk Assessment of Early Colorectal Cancer Metastasis.

Metastasis is the main fatal cause of colorectal cancer (CRC). Although enormous efforts have been made to date to identify biomarkers associated with metastasis, there is still a huge gap to translate these efforts into effective clinical applications due to the poor consistency of biomarkers in dealing with the genetic heterogeneity of CRCs. In this study, a small cohort of eight CRC patients was recruited, from whom we collected cancer, paracancer, and normal tissues simultaneously and performed whole-exome sequencing. Given the exomes, a novel statistical parameter LIP was introduced to quantitatively measure the local invasion power for every somatic and germline mutation, whereby we affirmed that the innate germline mutations instead of somatic mutations might serve as the major driving force in promoting local invasion. Furthermore, via bioinformatic analyses of big data derived from the public zone, we identified ten potential driver variants that likely urged the local invasion of tumor cells into nearby tissue. Of them, six corresponding genes were new to CRC metastasis. In addition, a metastasis resister variant was also identified. Based on these eleven variants, we constructed a logistic regression model for rapid risk assessment of early metastasis, which was also deployed as an online server, AmetaRisk (http://www.bio-add.org/AmetaRisk). In summary, we made a valuable attempt in this study to exome-wide explore the genetic driving force to local invasion, which provides new insights into the mechanistic understanding of metastasis. Furthermore, the risk assessment model can assist in prioritizing therapeutic regimens in clinics and discovering new drug targets, and thus substantially increase the survival rate of CRC patients.

Neuronal infection is a major pathogenetic mechanism and cause of fatalities in human acute Nipah virus encephalitis.

Acute Nipah (NiV) encephalitis is characterised by a dual pathogenetic mechanism of neuroglial infection and ischaemia-microinfarction associated with vasculitis-induced thrombotic occlusion. We investigated the contributions of these two mechanisms in fatal cases. We analysed brain tissues (cerebrum, brainstem and cerebellum) from 15 autopsies using light microscopy, immunohistochemistry (IHC), in situ hybridisation and quantitative methods. Three types of discrete plaque-like parenchymal lesions were identified: Type 1 with neuroglial IHC positivity for viral antigens and minimal or no necrosis; Type 2 with neuroglial immunopositivity and necrosis; and Type 3 with necrosis but no viral antigens. Most viral antigen/RNA-positive cells were neurons. Cerebral glial immunopositivity was rare, suggesting that microinfarction played a more important role in white matter injury. Type 1 lesions were also detected in the brainstem and cerebellum, but the differences between cerebral cortex and these two regions were not statistically significant. In the cerebral cortex, Type 1 lesions overwhelmingly predominated, and only 14% Type 1 vs 69% Type 2 lesions were associated with thrombosis. This suggests that neuronal infection as a mechanism of pathogenesis was more important than microinfarction, both in general and in Type 1 lesions in particular. Between the 'early' group (<8-day fever) and the 'late' group (≥8-day fever), there was a decrease of Type 1 and Type 2 lesions with a concomitant increase of Type 3 lesions, suggesting the latter possibly represented late-stage microinfarction and/or neuronal infection. Neuronal infection appears to play a more important role than vasculopathy-induced microinfarction in acute NiV encephalitis.

Death by Lightning: Effective Public Health Strategies Needed

Lightning is one of the leading causes of weather-related fatalities. A man, approximately 30 years old, was brought to the morgue of Kishoreganj District Hospital, Bangladesh, in July 2021, known to be lightning strike victim. During postmortem examination, various types of skin burns were found in the body, at an entry site on and near the head, and at an inferiorly located exit site. The skin injuries consisted of superficial burns, charring, and singed hair; however, there was no deep burn. „Lichtenberg figures‟ were found. Internal findings at autopsy were nonspecific. Epidemiologically, the total number of global annual lightning fatalities range from 6,000 to 24,000 per year. In recent years, Bangladesh experiences a high rate of lightning deaths. We feel that the number of deaths by lightning should be seen as a call to action. Hence, deaths by lightning should be regarded as a public health problem in the country and necessary measures must be taken. Our case study aims to draw the attention of the physicians and public health department on injuries and deaths due to lightning strike. It is also important for forensic professionals to be familiar with the nature of injuries caused by lightning and lightning strike deaths.&#x0D; CBMJ 2022 January: vol. 11 no. 01 P: 52-55

Inaction, silencing, and ignorance in disaster prevention: the case of Rıza Bey Apartment collapse in the earthquake in Turkey

PurposeThis article examines the inaction, silencing and ignorance in ex ante disasters whilst conducting a case study analysis of the Izmir/Samos earthquake, a 6.6 Mw (moment magnitude) earthquake that occurred at a depth of 14.9 km from the ground on 30 October 2020 at 2:51 PM. The 8-floor Riza Bey Apartment in Bayrakli/Izmir was demolished in the earthquake approximately 100 km from the epicenter. After the earthquake, several lawsuits started to conduct investigations on an apartment basis. Focusing on the causes of disasters in engaging with adoptive thinking in disasters, the current article posits the following research question: what are the ex ante socio-technical dynamics and causes of fatality in disasters?Design/methodology/approachThe methodological tools and advice related to disaster prevention in ex ante disasters originate from the actor network theory (ANT). Although ANT probes complex and dynamic multiplicities in disaster prevention management, this may be unsatisfactory for conceptualizing and operationalizing a disaster, as it is heavily reliant on discerning between humans and non-humans. Data were gathered (February 2021–February 2022) from 15 face-to-face interviews, 2 phone interviews, official documents, archival records, open-sourced public interviews, political speeches, newspaper articles, public reports, expert reports stories, videos, legal transcriptions and photographs. Additionally, data were gathered from the commission minutes officially published on the government website.FindingsThis article revealed the confusion of authority between the local and central governments and the gap between institutions and citizens in understanding and implementing the disaster prevention laws and regulations. It found that the causes of disasters beyond any dichotomies, such as surface versus site and ground versus grounded, rely not only on the technical roles of disaster prevention but also the non-technical roles assigned to it.Research limitations/implicationsSince the lawsuit has been in continuation, the process is still alive, and data gathering is limited to the litigation conditions of public servants in terms of sharing information. Since many of the flat owners died, it is difficult to access information on the apartment meetings to learn more about the resistance of flat owners against urban transformation and the possibility of ignoring or hiding the risk assessment report.Practical implicationsDisaster prevention is such a complex process which generates complex adaptation mechanisms (physical, behavioral, biological, cognitive through training, learning and experiencing). Also, there is a need to understand the scale of adaptive behavior and its function to improve adoptive mechanisms. With a transdisciplinary focus, each discipline needs to embrace one another's calculation and calculative practices while they measure, observe, analyze and implement risk and uncertainties.Social implicationsIt is hard to prevent disasters without knowing the flow of root relations between actors and elements that are in movement with different directions, forms and motions. These unbalanced, uneven and endless root relationships between actors' movements create a constant state of tension of organizing, recording, auditing, quantifying, computing, mapping (geology, Earth information system and micro-zonation), budgeting, bookkeeping, measuring, performance, regulating, controlling, monitoring and auditing with all the numbers and data.Originality/valueThere is a gap in the literature in terms of the interaction between accounts and institutions in ex ante disaster.

Nurses knowledge toward post open heart surgeries complications in Nasiriyah heart center

Introduction: One of the leading causes of death in the world is cardiovascular disease; it is treated with surgery, medication, and by establishing healthy habits. In postoperative cardiac surgery, involving the respiratory systems, cardiovascular, kidneys, and central nervous system complications represent an important and possibly fatal cause of morbidity and mortality. To improve educational preparation and quality of healthcare, it is important to understand how knowledge is used in everyday nursing practice. An effective nurse and appropriate interventions must anticipate the possibility of complications can be initiated to ensure a positive outcome in a timely manner. Objectives: To assess nurses' knowledge toward post open heart surgeries complications and studying the relationship between nurses' knowledge and certain demographical and employment variables. Methodology: A cross-sectional study, the researchers conducted a study to assessment of knowledge about post open heart surgeries complications for nurses of Nasiriyah heart center at Nasiriyah district in Thiqar governorate from September 2021 to august 2022.The study conducted on nurse’s staff of Nasiriyah Heart Center at Thiqar Province in Nasiriyah District to assess nurses` knowledge about post open heart surgeries complications.

Recent Advances in Combretastatin A-4 Inspired Inhibitors of Tubulin Polymerization: An Update.

Cancer is one of the leading causes of fatality and mortality worldwide. Investigations on developing therapeutic strategies for cancer are supported throughout the world. The massive achievements in molecular sciences involving biochemistry, molecular chemistry, medicine, and pharmacy, and high throughput techniques such as genomics and proteomics have helped create new potential drug targets for cancer treatment. Microtubules are very attractive targets for cancer therapy because of the crucial roles they play in cell division. In recent years, lots of efforts have been put into the identification of new microtubule-targeting agents (MTAs) in anticancer therapy. Combretastatin A-4 (CA-4) is a natural compound that binds to microtubules' colchicine binding site and inhibits microtubule polymerization. Due to CA-4's structural simplicity, many analogs have been synthesized. This article summarises the new molecule development efforts to reach CA-4 analogues by pharmacophore group modifications, which have been reported since 2015.

Breast Cancer Detection Using Machine Learning Techniques

Abstract: Cancer is one of the most prominent cause of fatalities around the world, accounting over 1 crore deaths in past year out of which 22.6% deaths were due to Breast cancer (BC). BC is the most common type of cancer among women, it accounts for 14.7 % of cancer cases in India. Multiple pieces of research have been conducted over the early detection of BC that can help begin treatment on time thus decreasing the mortality rate. Out of the total diagnosed, only about 86% are diagnosed correctly. Biopsy images of cells have a risk of false detection which may endanger the life of a person. There is a dire need of discovering new alternative methods that have an easy implementation with different data sets, are cost-effective, reliable, and safer, that can give an accurate prediction. This paper proposes a model combined with several Machine Learning algorithms(ML) that are Decision Trees, Artificial Neural Network, K-Nearest Neighbour, Support Vector Machine for an effective and accurate breast cancer diagnosis. Index Terms - Breast Cancer; Breast Cancer Detection; Machine Learning Key Words: Breast Cancer (BC); Artificial neural networks (ANN); Wisconsin breast cancer data set.

Risk Factors for Exercise-Associated Sudden Cardiac Death in Thoroughbred Racehorses.

Simple SummaryUnderstanding the causes of racehorse deaths is an important step in addressing this welfare concern. Previous studies have identified that during Thoroughbred racing, catastrophic musculoskeletal injuries, which necessitate euthanasia, account for approximately 75% of fatalities, with sudden athletic death occurring in the remaining 25% of cases. In sudden athletic death cases a post-mortem examination is needed to determine the cause of death. Approximately half of these sudden athletic deaths are attributed to a fatal cardiac arrhythmia, which is termed sudden cardiac death. In order to investigate risk factors for sudden cardiac death, we reviewed the post-mortem reports from horses that died on metropolitan racetracks in Melbourne, Australia and grouped horses into sudden cardiac death and all other fatal injuries. We found that horses with sudden cardiac death were more likely to die during training than during racing, had fewer lifetime starts and were less likely to be entire (uncastrated) males. Exercise intensity appears not to be critically important in precipitating sudden cardiac death in horses. Sudden cardiac death occurred early in the careers of affected horses.Cardiac arrhythmias resulting in sudden cardiac death (SCD) are an important cause of racehorse fatalities. The objective of this study was to determine risk factors for SCD in Thoroughbreds by evaluating a sample with a policy of mandatory post-mortem following racing or training fatalities. Risk factors were compared between case horses with SCD (n = 57) and control horses with other fatal injury (OFI, n = 188) by univariable and multivariable logistic regression. Survival in years for horses with SCD was compared to OFI using the Kaplan–Meier method with log rank test. The following variables were most important in the multiple logistic model: Horses with SCD were more likely to die during training than during racing, SCD (42/57, 74%) vs. OFI (82/188, 44%; odds ratio [OR], 95% confidence interval [CI], 2.5, 1.2–5.4; p = 0.01), had fewer lifetime starts, median (interquartile range [IQR]), SCD (3.0 [0.0–9.0]) vs. OFI (9.0 [0.0–22.8]; OR, 95% CI, 0.96, 0.9–1.0; p = 0.02 and were less likely to be entire (uncastrated) males, SCD 9/57 (16%) vs. OFI (46/188, 25%; OR, 95% CI, 0.47, 0.1–0.9; p = 0.03). Survival in years (median (IQR)) for horses with SCD was 3.6 (3.1–4.4), which was shorter than OFI (4.5 [3.1–6.0], hazard ratio, 95%CI, 1.6,1.2–2.3; p < 0.001). SCD occurs more commonly in training than racing, which suggests exercise intensity is less important in precipitating this fatality. In this study, SCD occurred early in the careers of affected horses.

Development of health mix powder to combat anaemia

In India, anaemia is a leading cause of death. According to statistics, anaemia is the cause of every maternal fatality. Anaemia is a nutritional illness that affects both adults and children of both sexes, however it is more common in pregnant women and teenage girls and is caused mostly by iron deficiency. Iron and other critical elements required for iron metabolism are abundant in leaves of Moringa oleifera. An increasing finding have found extracts of M. oleifera leaves that aqueous alcohol, or hydro alcohol have a variety of extra activities of biologically, including antiulcer, tissue protective (heart, kidneys, testes, liver, or lungs), radio protective, antioxidant, analgesic, immunomodulatory and antihypertensive properties. The Central Council for Ayurvedic Research has issued preliminary recommendations for standardising commonly used formulas. Standardization of herbal formulations is necessary for determining the quality of pharmaceuticals based on the quantity of active ingredients, as well as physical and chemical parameters. We will briefly discuss many elements of herbal medicinal properties of Moringa oleifera.

Improved multi-classification of breast cancer histopathological images using handcrafted features and deep neural network (dense layer)

Breast cancer (BC) classification has become a point of concern within the field of biomedical informatics in the health care sector in recent years. This is because it is the second-largest cause of cancer-related fatalities among women. The medical field has attracted the attention of researchers in applying machine learning techniques to the detection, and monitoring of life-threatening diseases such as breast cancer (BC). Proper detection and monitoring contribute immensely to the survival of BC patients, which is largely dependent on the analysis of pathological images. Automatic detection of BC based on pathological images and the use of a Computer-Aided Diagnosis (CAD) system allow doctors to make a more reliable decision. Recently, Deep Learning algorithms like Convolution Neural Network have been proven to be reliable in detecting BC targets from pathological images. Several research efforts have been undertaken in the binary classification of histopathological images. However, few approaches have been proposed for the multi-classification of histopathological images. The classification accuracy produced by these approaches are inefficient since they considered only texture-based extracted features and they used some techniques that cannot extract some of the main features from the images. Also, these techniques still suffered from the issue of overfitting. In this work, handcrafted feature extraction techniques (Hu moment, Haralick textures, and color histogram) and Deep Neural Network (DNN) are employed for breast cancer multi-classification using histopathological images on the BreakHis dataset. The features extracted using the handcrafted techniques are used to train the DNN classifiers with four dense layers and Softmax. Further, the data augmentation method was employed to address the issue of overfitting. The results obtained reveal that the use of handcrafted approach as feature extractors and DNN classifiers had a better performance in breast cancer multi-classification than other approaches in the literature. Moreover, it was also noted that augmentation of data plays a key role in further improvement of classification accuracy. The proposed method achieved an accuracy score of 97.87% for 40x, 97.60% for 100x, 96.10% for 200x, and 96.84% for 400x for the magnification-dependent histopathological images classification. The results also showed that the proposed method for using the Handcrafted feature extraction method with DNN classifier had a better performance in multi-classification of breast cancer using histopathological images than most of the related works in the literature.

Considerations for a Balanced Scorecard of Leading and Lagging Indicators for Your Electrical Safety Program: Leading and Lagging Indicators

Lost time electrical injuries are among the rarest injuries in the workplace, contributing less than 0.2% of all workplace injuries in the United States. Yet, contact with electrical energy is among the top 10 causes of occupational fatalities. These two attributes, very low frequency and very severe consequence, create a serious challenge in measuring the effectiveness of electrical safety programs. The traditional measurement of injury rates, a lagging indicator, may blind an organization to future injury potential. The low frequency of electrical injuries may result in an organization having insufficient data points to be statistically valid. This article explores opportunities to complement traditional methods of measuring safety performance with leading indicators to provide a balanced scorecard of lagging and leading indicators to drive continual improvement in reducing the risk of electrical injuries. The article will incorporate recent advancements in regulatory guidance and voluntary standards in safety performance measurement. Specific references will include Work Safe Alberta, <i>Leading Indicators in Workplace Safety and Health</i> (published in 2015) <xref ref-type="bibr" rid="ref20">[20]</xref> and U.S. Occupational Safety and Health Administration (OSHA), <i>Using Leading Indicators to Improve Safety and Health Outcomes</i> (published in 2019) <xref ref-type="bibr" rid="ref15">[15]</xref>. The article will include a method for an organization to benchmark current metrics for its electrical safety program against advanced practices to measure and manage continual improvement.

Serum trace element levels of liver cirrhosis and pancreatic cancer patients

The incidence of liver cirrhosis and pancreatic cancer varies between countries and stands out as an important health problem worldwide. Liver cirrhosis is the most advanced stage of chronic liver disease and is a widespread result of chronic liver damage. The etiology of liver cirrhosis and pancreatic cancer, which are major causes of cancer fatalities in developed countries, is poorly understood. Many metabolic and physiological processes in the human body utilize trace elements. The creation and development of many diseases like cancer, cardiovascular, and diabetes mellitus occur with the disruption of trace element metabolism in the body as a result of improper nutrition, environmental, and occupational exposure, and impaired digestion and absorption. Methods and materials: In this study, copper (Cu), cadmium (Cd), iron (Fe), cobalt (Co), manganese (Mn), magnesium (Mg), nickel (Ni), zinc (Zn), and lead (Pb) concentrations were researched in the serum of liver cirrhosis and Pancreatic Cancer (PC) patients and healthy controls. Analysis of the elements was carried out by flame atomic absorption spectrophotometer. Results: Fe and Zn serum levels were considerably lower in individuals with liver cirrhosis and pancreatic cancer than in controls (p &lt;0.001). Furthermore, mean serum levels of Cd and Mn in patients with liver cirrhosis and pancreatic Ca were considerably lower than in controls (p &lt;0.01). In addition, when compared to pancreatic cancer, mean serum Cu and Ni levels in liver cirrhosis patients and controls were considerably lower (p &lt;0.05). Mean serum levels of Pb in pancreatic Ca patients were significantly lower compared to liver cirrhosis patients and controls (p &lt;0.05). When comparing all cancer patients to controls, mean serum Co and Mg levels were not substantially different. Conclusion: Deficiency in four trace elements (Cd, Mn, Fe, and Zn) was determined in patients with liver cirrhosis and pancreatic cancer. In addition, we have determined the deficiency of Cu and Ni trace elements (TEs) in pancreatic cancer patients. TE insufficiencies in cancer patients may be due to excessive consumption of foods and undernourishment. Epidemiological and physiological causes of trace element changes should be investigated further.

EGFR and HER2/NEU immunoexpression in ovarian neoplasms in Bundelkhand Region

Introduction: Ovarian Cancers account for the greatest number of deaths from malignancies of female genital tract and it is the fifth leading cause of cancer fatalities in women. Surface epithelial tumours are the most common, followed by germ cell tumours. Objective: To analyse the expression of EGFR and HER 2neu using Immunohistochemisty in different Ovarian tumours with special reference to surface Epithelial tumours. Material and Methods: 52 cases of different ovarian tumours were studied. Cases included total abdominal hysterectomy with bilateral saphingoophorectomy, oophorectomy, and cystectomy specimens. Expression of EGFR (ErbB1) and HER2-neu (ErbB2) was determined by immunohistochemical reactions performed with the Super SensitiveTM IHC Detection system by the BiogenixTM. Tests were performed according to the instructions of each kit. Results: The mean age of presentation for epithelial tumours was found to be 42.48 years. For malignant epithelial tumours mean age of presentation was found to be 51.1 years. EGFR positivity was found in 28.57 % of surface epithelial ovarians tumours, and HER2/neu positivity was seen in 20% of surface epithelial ovarian tumours. As far as malignant serous papillary adenocarcinoma is concerned, we found 33.3% positivity for HER2/neu and 50% positivity for EGFR.

A 15-year partnership between UK coastal scientists and the international beach lifeguard community

Drowning is a leading cause of unintentional fatalities around the world, yet on beaches is often preventable through public education campaigns and intervention activities from lifeguards. In 2006, the UK beach lifeguarding community approached the Coastal Processes Research Group (CPRG) at University of Plymouth, UK, with a need to better understand the key hazards on UK beaches and how to foresee and manage the associated risks. In some cases there simply was not sufficient scientifically-robust understanding of certain hazards (for example rip currents) available for lifeguard managers to make objective, data-driven decisions on how to manage them. This paper documents the resulting 15-year body of work, and reflects upon the education, outreach, and other research impacts that have been created, and lessons learned along the way. By furthering fundamental coastal processes understanding of such things as beach classification and rip current dynamics, as well as applying science to challenges such as predicting beach life-risk and times of peak bathing hazard, the ongoing collaboration between lifeguards and academics continues to inform beach safety management in a number of countries around the world. Initiating research with clear aims and objectives that are driven by, and developed in conjunction with, the end-user, as opposed to starting with outcomes prescribed to the end-user by academics, has been an important factor in the success (or failure) of these scientific ventures. CPRG's research activities in the field of beach safety has been scientifically rewarding and have achieved significant impacts. We attribute this to: (1) sustained level of high-quality research; (2) continued effort spent on building long-term relationships with end-users; (3) co-creation of dissemination material and tools; (4) acceptance that it takes time and effort to achieve research impact; and (5) critically evaluating and reflecting on the research impacts. Ultimately, the ongoing collaboration has contributed to a ‘continuing trend of decline in accidental fatalities around our coastlines’, and such collaborations in other parts of the world continue to play a vital role in reducing coastal drowning globally.

Spontaneous Non-Traumatic Emphysema in Toddler: The Neglected Foreign Body

Foreign body aspiration is a major cause of fatality and morbidity in children. The child may present acutely with signs of respiratory distress or chronically with symptoms suggestive of respiratory infection. Variable presentations make it difficult to diagnose a case of foreign body aspiration, especially in the absence of a clear history of aspiration. Subcutaneous emphysema and pneumomediastinum are rare presentations. Here, we report a case of 2-year-old child who presented with non-traumatic extensive neck and upper chest subcutaneous emphysema. Computed tomography revealed there was presence of foreign body in left bronchus. Emergency bronchoscopy found a piece of peanut in the left main bronchus. It was successfully removed and the patient was discharged well after three days.

Gentle Giant: An Unusual Cause of Heart Block

<h3>Introduction</h3> Inflammatory cardiomyopathies can be a diagnostic dilemma. Early management can lead to reduced morbidity and mortality for patients. We describe a rare presentation of an unusual cardiomyopathy. <h3>Case Report</h3> A 58-year-old female presented with a 10-day prodrome of cough, NYHA class III dyspnea, and fatigue with minimal symptoms of orthopnea, paroxysmal nocturnal dyspnea or peripheral edema. She was previously healthy with no cardiac medications. Family history was significant for granulomatosis with polyangiitis. COVID-19 swab was negative. She was symptomatic with transient complete heart block and junctional escape of 20bpm. A temporary transvenous pacemaker was placed. Echocardiogram showed biventricular dysfunction with left ventricular ejection fraction < 30%. Troponin and brain-natriuretic peptide were elevated. Coronary angiogram showed no significant occlusions. CT excluded pulmonary embolism, pneumonia, or adenopathy. She was initiated on heart failure medications but beta blocker was not started given heart block. Six days into admission, her heart failure improved but she developed transient complete heart block without junctional escape. There was no ventricular ectopy. Evaluation for rheumatologic, infectious, and inflammatory causes showed elevated C-reactive protein and antineutrophil cytoplasmic antibodies. The remainder of the workup was negative. Leading diagnoses were idiopathic giant cell myocarditis or cardiac sarcoidosis. An endomyocardial biopsy revealed multinucleated giant cells and myocyte necrosis. She was diagnosed with giant cell myocarditis. Prior to discharge, she had defibrillator insertion and was initiated on prednisone and tacrolimus. Shortly after this time, she returned with critical cardiogenic shock despite intensification of immunosuppressive therapies and was listed for cardiac transplant. <h3>Summary</h3> Giant cell myocarditis (GCM) is a rare and often fatal autoimmune cause of heart failure. Patients frequently present with congestive heart failure, ventricular arrhythmia and a rapid progression of symptoms. In GCM, it is rare to present with atrioventricular conduction delays. Given the crossover in symptoms with sarcoidosis and GCM, diagnosis may be challenging. In this case of an acute presentation of heart failure and complete heart block, endomyocardial biopsy was central to the diagnosis and management of GCM.

A rare case of a Low Grade Appendiceal Mucinous Neoplasm in a 46-year-old Middle Eastern female - A case report.

Introduction and importanceMucinous cell neoplasia are rare and conceivably fatal causes of surgical abdomen. Adult manifestations can be obscure and ill-defined, yielding misdiagnoses and wasting precious time and effort to reach the correct one. Clinical awareness ought to be present once presented with a surgical abdomen in such a patient because this neoplasm may present with misleading presentations which mask the actual diagnosis and masquerade as a different one, and in turn, may result in performing a dissimilar treatment intervention. Rapid learnt surgical judgments must be taken and put into action to diminish the morbidity and mortality consequential to this pathology.Case presentationOur case is of a 46-year-old female, who was admitted into our hospital with a 2-month-history of general fatigue. Colicky abdominal pain and discomfort developed shortly prior to admission. Multi-Slice Computed Tomography (MSCT) scan exposed cystic formation in the terminal ileum. Exploratory laparotomy was warranted, in addition to performing a right hemicolectomy.Clinical discussionWe treated our patient via open surgery and performing an appendectomy with right hemicolectomy in addition to the excision of several surrounding lymph nodes. Diagnosis is traditionally reached intraoperatively relying on gross morphology and postoperatively through histopathological analysis of the excised specimens.ConclusionLow Grade Appendiceal Mucinous Neoplasm is a scarce entity and varies critically in its manifestations, hence, it is existential to thoroughly study this kind of neoplasia, document it, and consider it, so that we can construct precise decisions to reach ideal results for patients who suffer from this neoplasm.