Silent Mass Research Articles

Management of unidentified and unclaimed bodies: a comparison of model from four countries in the Asia Pacific Region.

Managing mass fatality incidents or disasters involving multiple deaths are not uncommon among forensic practitioners. In fact, management of unidentified or unknown bodies is also a vital component of the day-to-day mortuary work practice. The unidentified and subsequently unclaimed bodies have always been a "silent mass disaster," a problem that needs to be tackled within the forensic community and raises the global issue of ethics, law, and human rights. Unidentified bodies' in Malaysia make up an average of 4.02% of all death cases where a total postmortem examination was performed which is comparable with other developing countries within 4-10% which can go up to 25%. Moreover, unstandardized procedures in all mortuaries in different states and districts in Malaysia have worsened the scenario even with guidelines in place. This study aims to address the issues surrounding unidentified and unclaimed bodies including body disposal from a social and legal perspective using case study methodology by comparing four different countries in the Asia Pacific Region through document analysis and interview methods. One of the major findings is evident in 3 out of the 4 models, whereby there is a considerable gap in consolidating the missing person report and information to match with the unidentified bodies received in forensic institutions in an attempt to enhance the identification process which ultimately intends as a closure for the family members. It is also timely to think out of the box beyond dental records and DNA profiling to improve the identification rate for skeletonized remains through means of anthropology biometrics comparison. With the limited literature published surrounding this domain, it is hoped that the suggestions and recommendations to standardize the management of unidentified and unclaimed bodies can benefit many forensic institutions and public mortuaries in this region.

ВІДГОМІН СЕЛЯНСЬКОЇ КАТАСТРОФИ: КОЛЕКТИВІЗАЦІЯ ТА ГОЛОДОМОР В ІСТОРИЧНІЙ ПАМ’ЯТІ ПРИАЗОВСЬКИХ БОЛГАР

The article explores the socio-economic transformations of the 1920s and 1930s in a Bulgarian village in the Northern Azov region, drawing on oral histories. It elucidates the mechanism behind the construction of the "collectivization" image in the historical memory of Ukrainian Bulgarians. The thesis posits the existence of a distinct corpus of oral narratives as an alternative historical and cultural model, contrasting with the official Soviet narrative of "modernization". The narrative portrays the disintegration of the peasant community and the instigation of an atmosphere of mistrust and fear, as recounted in personal stories. The study identifies historical memory narratives about violent collectivization as influential in shaping a complex of socially significant personal stories among Bulgarians in the Northern Azov region. Moreover, by integrating documentary evidence on collectivization and the Holodomor in southern Ukraine, the article highlights the informational potential of oral historical sources. Specifically, it reconstructs the primary stages of the Soviet authorities' defragmentation of peasant society through economic and non-economic pressures. The authors illustrate the process of forming and actively navigating the informational environment among the Bulgarian population in the Northern Azov region, depicting verbal images of collectivization functionaries/activists and the "silent mass" of victims of the economic system's collapse during the Holodomor. The article also delves into the phenomenon of emotional and cultural conflict within the historical memory structure, particularly concerning "Komsomol" functionaries. This investigation considers the respondents' narrative structuring and the establishment of cause-and-effect relationships. Conclusively, the authors assert that the transmission of past images to the younger generation occurred with corresponding emotional and value attitudes, particularly towards disarmament, collectivization, and the Holodomor. These attitudes were notably reinvigorated during the 1990s-2000s, influenced by socio-political and economic transformations.

The Crowd Crush at Mount Meron: Emergency Medical Services Response to a Silent Mass Casualty Incident.

On April 30, 2021, a total of 45 died and 112 were injured in a crowd crush at a religious festival on Mount Meron, Israel. Unlike a bomb blast, building collapse, mass shooting, or stampede, the incident lacked a dramatic, noticeable trigger and may be termed a "silent mass casualty incident (MCI)." This may have resulted in a slight delay in response. Magen David Adom (MDA)-Israel's National Emergency Medical Services Organization-was the main prehospital response to the MCI. MDA's intense planning, organization of medical infrastructure, and on-site MCI drill before the event allowed for the rapid, coordinated treatment and evacuation of casualties by ambulance and helicopter. The use of volunteers facilitated an effective response to the event. A "rolling reinforcement" system of ambulances helped treat and transport those at the scene while placing staff at stations throughout the country to serve routine emergency calls.

Plurihormonal pituitary macroadenoma:\xa0 a case report

BackgroundPlurihormonal pituitary adenomas are a unique type of pituitary adenomas that secrete two or more pituitary hormones normally associated with separate cell types that have different immunocytochemical and ultrastructural features. Although they represent 10–15% of all pituitary tumors, only a small fraction of plurihormonal pituitary adenomas clinically secrete multiple hormones. The most common hormone combinations secreted by plurihormonal pituitary adenomas are growth hormone, prolactin, and one or more glycoprotein hormones. The most common hormonal symptom is acromegaly (50%). The aim of this case report is to bring awareness about this rare type of pituitary adenomas and to describe the unique presentation of our patient, even though plurihormonal pituitary adenomas are known mostly as a clinically silent tumors.Case presentationHerein, we describe an unusual case of plurihormonal pituitary adenoma with triple-positive staining for adrenocorticotropic hormone, growth hormone, and prolactin. The patient is a 65-year-old Egyptian woman who presented with mass effect symptoms of the pituitary tumor, which primarily manifested as severe headache and visual field defects. She also presented with some cushingoid features, and further analysis confirmed Cushing’s disease; slightly high prolactin and normal growth hormone levels were observed. She underwent transsphenoidal surgery and has been in remission thus far. Only a few cases have been reported in the literature, but none has exhibited silent acromegaly or mass effect symptoms as the initial presentation.ConclusionThis case highlights an unusual plurihormonal pituitary adenoma case with a rare combination of secreted hormones; mass effect symptoms were dominant, as were uncommon visual field defects. Our case further proves that immunohistochemical analyses of all pituitary hormones are needed to ensure correct diagnosis and to alert clinicians to the need for more rigorous follow-up due to the higher morbidity of these patients. Our case report approval number Federal Wide Assurance NIH, USA is FWA00018774 IRB registration number with OHRP/NIH is IRB00010471.

What is the image of refugees in Central European media?

Of late, the national and the international politics of Central Europe have been preoccupied with the issue of migration, an issue labelled ‘the refugee crisis’ by the media. This article examines whether the strong anti-immigrant rhetoric which has become common in the countries of the Visegrad Group (CZ, SK, PL, HU) can also be found in the photographs of refugees produced and circulated by their most popular online media. The systematically designed mixed-method visual analysis, which is applied to pictures from a 1-year period between April 2015 and April 2016, reveals a set of repeatedly displayed visual figures such as a young female victim, children imprisoned behind a fence or a silent mass of bodies. The research shows that these figures are not only common to all the Visegrad countries, but they also significantly correspond to the transnational image of refugees. The text deconstructs a three-part story of the ‘refugee crisis’ and how it was told by Central European online media. It emphasises the stereotypical gender construction of the figures of refugees, links the visual analysis to several theories of the photography of suffering and, finally, provides a description of how a collective symbolic imagination of refugees operates through media in the Central European region.

Case Report: 18F-FDG PET/CT in Nonfunctioning Adrenocortical Carcinoma Relapse

Case report of adrenocortical carcinoma recurrence after adrenalectomy and combined treatment.We report the case of a 46 year old man with silent adrenal mass. Imaging showed a large left adrenal mass with no evidence of distant metastasis. Complete surgical excision of the tumor was performed. After 5 years after surgical treatment, a local relapse of the disease was detected according to the results of CT, followed by PET/ CT with 18F-FDG — no evidence of distant metastases were detected. After complex treatment metastases were diagnosed by follow up PET/CT.This case report demonstrates possibilities of PET/CT with 18F-FDG in determination of adrenal mass malignancy and in cases of recurrent adrenocortical cancer, in cases of metastatic lesions.

A mycobacterial disease is associated with the silent mass mortality of the pen shell Pinna nobilis along the Tyrrhenian coastline of Italy

Disease is an increasing threat for marine bivalves worldwide. Recently, a mass mortality event (MME) impacting the bivalve Pinna nobilis was detected across a wide geographical area of the Spanish Mediterranean Sea and linked to a haplosporidian parasite. In 2017–2018, mass mortality events affecting the pen shell Pinna nobilis were recorded in two different regions of Italy, Campania and Sicily, in the Tyrrhenian Sea (Mediterranean Sea). Histopathological and molecular examinations of specimens showed the presence of Haplosporidium sp. in only one specimen in one area. Conversely, in all of the surveyed moribund animals, strong inflammatory lesions at the level of connective tissue surrounding the digestive system and gonads and linked to the presence of intracellular Zhiel-Neelsen-positive bacteria were observed. Molecular analysis of all of the diseased specimens (13) confirmed the presence of a Mycobacterium. Blast analysis of the sequences from all of the areas revealed that they were grouped together with the human mycobacterium M. sherrisii close to the group including M. shigaense, M. lentiflavum and M. simiae. Based on pathological and molecular findings, it is proposed that a mycobacterial disease is associated with the mortality episodes of Pinna nobilis, indicating that, at this time, Haplosporidium sp. is not responsible for these events in Campanian and Sicilian waters.

Autopsy based analysis of unidentified dead bodies in a tertiary care hospital of South India

Increasing number of the unknown dead body is also described as the silent mass disaster. The identification of cadavers is a key issue in autopsy and equally important for ethical, criminal and civil reasons. This prospective study was conducted during the period from January 2016 to December 2016 at Coimbatore Medical College Hospital. Over 152 cases of unidentified dead bodies, brought for postmortem examination were included in this study. The study observed seasonal variation in the unidentified corpse brought for autopsy, with a male sex predilection. Most of the victims were in the age group of 50 to 60 years with the majority of the cases being reported as road traffic accidents. The cause of death in unidentified dead bodies was highly variable. The most commonly applied method for identification of dead bodies in India is visual and other customary means of identification. Identifying the dead body is the essential criteria in the process of medico-legal autopsy and we are supporting the investigating officers in identifying the deceased by various techniques like fingerprints, superimposition, blood grouping and DNA fingerprinting. Even though the modern and more accurate techniques are available for identification, the usage is limited than the expected outcome because of the limited availability of data for comparison. By improving and increasing the availability of data by means of Aadhar linking or data bank we could ensure that the suffering of a family comes to an end, and for dignified disposal of corpses.

Syncope due to a silent mass

A middle-aged man presented to the emergency department with syncope. Point-of-care echocardiography was performed and helped made the diagnosis. The patient thereby received the definitive treatment in the shortest possible time.

Neoplasms in wild animals in India

Neoplasm or tumour occurs as an unexplained, clinically silent mass in tissue. It can be due to epigenetic or genetic alterations. However, precise clinical examination, observation and biopsy and other diagnostic procedures can be used for confirmatory diagnosis and helps in identification and treatment of the various tumours. They are classified as benign and malignant neoplasms on basis of metastasis. Neoplasm is a condition commonly affecting the animal kingdom as compared with plant because of the presence of cell wall in them. Carcinogenesis involves both the genetic and epigenetic alterations. Genetics involves changes with the DNA, and epigenetics involves alterations without changes in the DNA. Cancer is most commonly studied in companion animals; however, wild animals though equally affected by neoplasms are rarely reported as they are most commonly encountered during post-mortem, and often signs and symptoms are noticed which coincide with tumour development. The article presents the information about neoplastic occurrence in various wild animals and birds. The related safety issues as wild animals act as source of disease to humans, especially the zoo keepers in contact with them.

Unknown and Unclaimed Descendents: A Silent Mass Disaster

Unknown and Unclaimed Descendents: A Silent Mass Disaster

Woodrow Wilson and World War I: A Burden Too Great to Bear. By RichardStriner. Lanham, MD: Rowman & Littlefield, 2014. 290 pp.

Woodrow Wilson and World War I: A Burden Too Great to Bear. By Richard Striner. Lanham, MD: Rowman & Littlefield, 2014. 290 pp. Richard Striner considers Woodrow Wilson the worst wartime president ever to straddle a pot. Striner has previously written on Lincoln, whom he praised for combining moral idealism with strategic cunning (see, e.g., Lincoln and Race [Carbondale: Southern Illinois University Press, 2012]). Wilson, in his view, never understood the threat that a German victory in World War I would pose to national security. He neglected to prepare seriously for mobilization. And he failed to grasp how he could leverage American participation to achieve his diplomatic objectives. In seven hard-hitting chapters, each focused chronologically on one of the wartime or postwar years, Striner flays Wilson's miserable judgment, managerial incompetence, naive suppositions, disdain for Congress, unsystematic work habits, as well as such character flaws as petulance and grandiosity. Even Wilson's rhetoric leaves the author cold. He echoes H. L. Mencken's description of its ideational hollowness, its ludicrous strutting and bombast, its heavy dependence upon greasy and meaningless words, its frequent descents into mere sound and fury (pp. 240-41). Striner bases his interpretation on a close reading of the inclusive 69-volume Papers of Woodrow Wilson (A. S. Link, ed., The Papers of Woodrow Wilson, 1856-1924, vols. 1-69 [Princeton, NJ: Princeton University Press, 1966-94]). He does not engage Wilson's numerous hagiographers, except for John Milton Cooper, Jr., whom he uses as a foil (Woodrow Wilson: A Biography [New York: Alfred A. Knopf, 2009]). Scholars who revere Wilson as the model for American missionary idealism and humanitarian interventionism in our own day will find Striner's formulations heavyhanded and ungenerous. Still, the author has marshaled some arresting evidence that previous analysts preferred to overlook out of respect for the president's noble motives. Where others have portrayed Wilson as a resourceful defender of neutral rights through 1917, Striner depicts him as prey to confused emotions and as reactive rather than strategic in approaching substantive issues. Moved by Christian piety and a conviction that he alone represented the silent mass of mankind, Wilson not only advocated peace without victory, but also felt that white civilization depended on preserving neutrality (p. 98). He pursued wholly unrealistic efforts at mediation and in December 1916 almost embroiled the country with England until Secretary of State Robert Lansing toned down his proposed note. Colonel Edward M. House and Lansing figure in this narrative as sensible men who kept Wilson's mania within bounds, quite opposite to Cooper's description of Lansing's dastardly act of duplicity (p. …

Leiomiosarcoma primario de la glándula adrenal. Presentación de caso

Primary leiomyosarcoma of the adrenal glandis a rare malignant tumor. Few reports aredescribed in the international literature. We report the case of a 50 year old patient, who was diagnosed with a tumor in the right adrenal gland by ultrasonographic examination routine, also confirmed by computed tomography (CT) and magnetic resonance imaging (MRI). Right adrenalectomy was performed. Pathological study reported primary adrenal leiomyosarcoma.This primary malignant tumor of the adrenal gland is a very rare, clinically silent mass or with nonspecific symptoms, often detectable by imaging studies as large masses, but definitive diagnosis is made by immunohistochemistry.

Delayed Pancreatic Metastasis of Renal Clear Cell Carcinoma

Abstract Here, we report surgical treatment of a patient presenting with pancreatic metastasis (MTS) of renal clear cell carcinoma (RCC) 11 years after nephrectomy. RCC is one of few cancers that metastasise in pancreas. Jaundice, abdominal pain or gastrointestinal bleeding can develop; however, asymptomatic MTS can be discovered by follow-up after removal of the primary tumour. The patient, 67-year-old female was radiologically diagnosed with a clinically silent mass in the pancreatic body and underwent distal pancreatic resection. The postoperative period was smooth. Four months after the surgery, there were no signs of disease progression.

How public relations functions as news sources in China

This study re-conceptualizes the interaction between public relations (PR) practitioners and journalists in news construction. Proposing a new conceptual framework of “news-source involvement,” this study applies two dimensions – “involvement width” and “involvement density” – when examining how information and/or stories generated by PR people affect news coverage. Empirically, this study identifies seven types of news sources derived from a systematic content analysis of 1600 stories in four selected Chinese newspapers from 2001 to 2010 – 10-year period. The major findings include: (1) information subsidy has become a popular phenomenon in China; (2) over the past decade, the Chinese government has been slowly but surely becoming more tolerant of public's expression of their opinions relating to social and political issues. Though the government remains as the dominating “news source” for newspapers, other non-mainstream news sources (e.g. grass-root civilian) have emerged. Growing from the used-to-be “silent mass,” they have become the “subordinate majority” nowadays, having strong influence in certain coverage; and (3) PR people as one of the major news sources, interact with media in a selective manner; and such interaction takes places largely on tactical level.

HIV/AIDS profile and realities at a regional antiretroviral therapy clinic in Jerusalem: 12 years analysis

The diagnosis of HIV, quality of follow-up, and treatment among immigrants are greatly influenced by cultural factors and access to the healthcare system. Israel, an immigrant-based society, features 3 cardinal HIV-positive patient groups, namely non-immigrant Israelis, legal immigrants (mainly from Ethiopia), and illegal African work-immigrants. While the first 2 groups are covered by a national health insurance, the latter group depends on an unstructured system of antiretroviral therapy (ART) supply. In the early 1990s, a national mentoring programme was implemented for legal immigrants. The programme involves community-based Ethiopian mentors who follow HIV-positive Ethiopians. In this retrospective cohort study we reviewed the files of HIV-positive patients diagnosed between 1995 and 2007, focusing on comparison between HIV-positive non-immigrant populations with both legal Ethiopian immigrants and the often overlooked illegal immigrants. Our results point to a substantial rate of loss to follow-up among the illegal immigrants. When comparing non-immigrants to legal immigrants, both feature similar adherence to follow-up, exposure and response to ART, despite profound cultural differences. Our results suggest that ethnic-related obstacles in HIV diagnosis and treatment may be overcome by 'cultural mediators', yet, addressing the silent mass of HIV-positive illegal work-immigrants, who are deprived of such programme benefits, poses a major challenge to Western health authorities.

Sister Mary Joseph's Nodule as a Presenting Sign of Internal Malignancy

CASE 1: A 64-year-old, otherwise healthy woman was referred to the surgery clinic for a presumed umbilical hernia. On physical examination, a cutaneous nodule was noted on the umbilical region and the patient was referred to the dermatology clinic. The patient was reexamined and an erythematous nodule was observed in the umbilicus measuring 2.5 cm in diameter. The patient denied pain, change in bowel habits, or weight loss. There were no other abdominal masses, no sign of ascites, and no regional lymphadenopathy. A skin biopsy from the nodule showed mucinous adenocarcinoma. Immunohistochemical staining was positive for carcinoembryonic antigen, and negative for cytokeratin (CK)7 and CK20. These results were consistent with a Sister Mary Joseph's nodule and led to the diagnosis of an occult colon carcinoma. The patient had no risk factors for colorectal carcinoma. The patient underwent surgery in another hospital, and died 3 months after the initial diagnosis of Sister Mary Joseph's nodule. CASE 2: A 73-year-old woman was referred to the dermatology clinic for evaluation of a painful, ulcerated, 3-cm lesion in the umbilicus (Figure 1). She was otherwise asymptomatic. A skin biopsy showed neoplastic glandular cells infiltrating among collagen bundles (Figure 2). Stainings for mucin and for CK7 were positive, while staining for CK20 was negative. An abdominopelvic CT scan demonstrated a 3.5-cm space-occupying lesion in the liver. Results of gastroscopy, colonoscopy, chest computed tomographic (CT) scan, and mammography were normal. Serum levels of the tumor-associated protein CA125 were elevated to 164 units, while those of CA 19-9 and carcinoembryonic antigen were within normal range. A gynecologic examination and a transvaginal ultrasound were normal. The patient had no personal or family history of any malignancy or any risk factors for developing a carcinoma. The patient was scheduled for a palliative resection of the umbilical nodule, combined with a laparoscopic inspection in search of the undetected primary tumor. She refused surgery and was lost to follow-up. She died 4 months after the initial diagnosis of umbilical metastasis. CASE 3: A 51-year-old man was aware of a silent mass in his umbilicus for 2 years without seeking medical advice. Following 2 weeks of increasing pain in this area, he was referred to the emergency room for a suspected incarcerated umbilical hernia. Surgery revealed a mass attached to the fascia and peritoneal fat. The mass was removed and diagnosed as a poorly differentiated adenocarcinoma, staining positively for carcinoembryonic antigen, and negatively for CK20, CK7, prostate-specific antigen, and prostatic acid phosphatase. Both gastroscopy and colonoscopy failed to detect the primary tumor. An abdominopelvic CT scan was normal, but a CT scan of the chest disclosed a nodule measuring 2.5 x 1.5 cm in the lower lobe of the right lung. On bronchoscopy, it was found to be an invasive adenocarcinoma, consistent with a primary tumor of the lung. The patient was a heavy smoker (45 pack-years). The patient received 4 cycles of combined chemotherapy with carboplatine and gemcitabine, with no improvement. A month later, the patient complained of abdominal pain. Following demonstration of intra-abdominal spread of disease by CT scan, a second line chemotherapy was instituted with paclitaxel. A month later the patient's condition deteriorated and he complained of cough, sweating, and pain along the right leg. A bone scan revealed bone metastases in the right femur and left tibia. Two weeks later he was admitted to the hospital with intestinal obstruction and underwent laparotomy. He had massive intra-abdominal spread of cancer and ascites. Only a palliative colostomy was performed. The patient died 3 weeks later, 9 months after the diagnosis of adenocarcinoma of the lung. The clinical data on the three patients are summarized in Table I.

Metal-backed patellar component failure in total knee arthroplasty presenting as a giant calf mass

Failure of total knee arthroplasty (TKA) caused by wear of the polyethylene-bearing surface of a metal-backed tibial platform or a metal-backed patellar component is a recognized complication. We present a case of a 78-year-old woman with a cystic mass in the left calf caused by metal wear debris from the failure of a Miller-Galante I TKA. The patient received a left TKA to treat advanced osteoarthritis in July 1990 and was lost to follow-up immediately after the operation. In December 1998, she presented at our clinic 2 days before admission, when an originally silent mass over the calf turned intolerably painful. A series of examinations revealed a calf mass caused by wear debris of total knee prosthesis and subsequent inflammation of the knee joint. Curettage of the cyst and simultaneous revision TKA were successful in relieving her symptoms. Copyright 2003, Elsevier Science (USA). All rights reserved.

Globalization and the Inner Periphery: A Mid-Bronx View

The globalization literature on New York and other metropolises has focused mainly on control centers of the world system, typically located in central business districts, edge cities, transportation hubs, technology parks, and exclusive residential areas. The remainder of the metropolis is often depicted as just a source of labor power and consumers. Taking the case of CB-Six, a bureaucratically defined locality and low-income residential area in the Bronx, this article reviews the global dimensions of local history in the outer boroughs of New York City. Local and global issues are tightly interwoven through the changing numbers and origins of immigrants and through the impact of world wars, economic crises, and restructuring. The locality affects the world through its real and fictional roles in popular entertainment and through the missions of Fordham University, the Bronx Zoo, the Botanical Garden, and such bygone institutions as the Home for Incurables and the Starlight Amusement Park. Glory or notoriety could have resulted from silent movies, political assassination, soap opera, mass murder, or music and movie stars, but CB-Six never reached the Hall of Fame!

Malignant Brenner tumour presenting with lower motor neurone paralysis

SummaryBrenner tumours form only 1•5 to 2•5 per cent of ovarian tumours and are rarely malignant. Their origin is uncertain although the concensus is that they arise from coelomic surface ovarian epithelium. Malignancy may be defined by criteria laid down by Hull and Campbell (1973). Benign tumours often present as a silent mass, most frequently in the fourth, fifth and sixth decades (Fox, 1972). An association with oestrogen production has been postulated, in relation to the coincidental finding of abnormal endometrial histology (Idelson, 1963). Mucinous and serous cystadenomas occur more often when a Brenner tumour is present (Silverberg, 1971). Extensive calcification has been seen in up to 50 per cent of cases.