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In this randomized trial involving 15 children with neurotoxic symptoms after a scorpion sting, children treated with a scorpion-specific antivenom had a faster resolution of neurologic signs and symptoms and received lower doses of midazolam than children treated with placebo. Children with neurotoxic symptoms after a scorpion sting who were treated with a scorpion-specific antivenom had a faster resolution of neurologic signs and symptoms and received lower doses of midazolam than children treated with placebo. In North America, envenomation by neurotoxic scorpions affects more than a quarter of a million people annually, mostly in Mexico. 1 , 2 The sting produces a syndrome that ranges in severity from a simple sting mark to a life-threatening illness. Mild envenomation, which is more common in adults than in children and consists mainly of local pain, resolves without specific treatment over the course of hours or days. Severe envenomation, which is more common in small children, affects approximately 200 patients annually in Arizona, on the basis of our consultation records. The clinical syndrome includes uncoordinated neuromotor hyperactivity, oculomotor and visual . . .

Coccidioidomycosis, a fungal infection endemic in the southwestern United States, can cause life-threatening infections in immunosuppressed patients. We report the contrasting cases of two adolescents with lupus nephritis, treated with intravenous pulse cyclophosphamide and daily oral corticosteroids, who developed pulmonary coccidioidomycosis. One patient developed a fatal form of fulminant disseminated coccidioidomycosis, while the other patient developed a solitary pulmonary Coccidioides immitis abscess which was responsive to intravenous liposomal amphotericin and fluconazole therapy. Because serologies and initial X-ray studies can be negative, definitive diagnostic studies including bronchoaveolar lavage and needle aspiration should be performed when there is clinical suspicion of coccidioidomycosis in an immunocompromised patient. Immunosuppressed patients with coccidioidomycosis should receive early intravenous amphotericin therapy and may benefit from long-term suppressive antifungal therapy to prevent relapse.

Different people have different perceptions about artificial intelligence (AI). It is extremely important to bring together all the alternative frames of thinking—from the various communities of developers, researchers, business leaders, policymakers, and citizens—to properly start acknowledging AI. This article highlights the ‘fruitful collaboration’ that sociology and AI could develop in both social and technical terms. We discuss how biases and unfairness are among the major challenges to be addressed in such a sociotechnical perspective. First, as intelligent machines reveal their nature of ‘magnifying glasses’ in the automation of existing inequalities, we show how the AI technical community is calling for transparency and explainability, accountability and contestability. Not to be considered as panaceas, they all contribute to ensuring human control in novel practices that include requirement, design and development methodologies for a fairer AI. Second, we elaborate on the mounting attention for technological narratives as technology is recognized as a social practice within a specific institutional context. Not only do narratives reflect organizing visions for society, but they also are a tangible sign of the traditional lines of social, economic, and political inequalities. We conclude with a call for a diverse approach within the AI community and a richer knowledge about narratives as they help in better addressing future technical developments, public debate, and policy. AI practice is interdisciplinary by nature and it will benefit from a socio-technical perspective.

Many high-level ethics guidelines for AI have been produced in the past few years. It is time to work towards concrete policies within the context of existing moral, legal and cultural values, say Andreas Theodorou and Virginia Dignum.

As the global population of older persons increases, age-related medical conditions will have a greater impact on public health. DXA-derived bone and soft tissue metrics are associated with adverse clinical events in aging persons. This study aims to investigate the regional body composition of the appendices by whole-body DXA scans, and the age-related relationships between measures of bone and soft tissue in healthy Caucasian females of a Greek origin residing in the Mediterranean area. Body composition of the legs and the arms was analyzed, and lean mass (LM) and fat mass (FM) metrics were calculated in 330 women aged 20–85 years, using DXA. Peak bone mineral density (BMD) of the legs and arms was achieved between ages 20–30 and 41–50 years, respectively. The overall BMD reduction with age was for the legs 43% and the arms 32.2% (p < 0.001). Peak %LM of the legs and the arms was achieved between ages 20–30. The overall reduction of %LM with age was for the legs 22.5% (p < 0.001) and arms 6.6% (p < 0.05). Peak %FM of the legs and arms was attained between ages 31–40 and 61–70, respectively. The overall %FM reduction with age was for the legs and arms 7.5% and 1.9% (p > 0.05). In appendicular sites, Greek women reach peak values of bone mass in the legs first, in early adulthood. Bone loss predominates in the legs as women age. Also, with advancing age Greek women show preferential significant decreases of %LM and %FM in the legs as opposed to the arms. Although variation in appendicular bone and soft tissue metrics is present, the implications of variable biological crosstalks among the tissue components as women age may ultimately lay the foundation for future clinical trials aimed at healthy aging.

We explored the regional variations in body composition with advancing age in healthy Caucasian females living in the Mediterranean area. The objectives of this study were to establish body composition values for the trunk in healthy women of a Greek origin and to evaluate the effects of aging on the distribution of truncal bone mass, fat mass (FM) and lean mass (LM). Body composition of the trunk and detailed analysis of its anatomical components—the ribs, the thoracic spine, the lumbar spine and the pelvis, and FM and LM ratios––were calculated in 330 women aged 20–85 years, using DXA. Peak bone mineral density (BMD) of the trunk was attained between ages 30 and 33. The overall truncal BMD reduction with age was 20.7% (p < 0.001). Peak %LM of the trunk was achieved at age 20. The overall reduction of %LM with age for the trunk was 9.8% (p < 0.001). Peak %FM of the trunk was attained between ages 68 and 73, and the overall %FM reduction with age was 2.8% (p > 0.05). Multiple comparative analyses showed that the 51–60 years age group was the landmark age for significant changes of truncal bone mass measures across all age groups (p = 0). For truncal LM and FM metrics, multigroup comparative analysis showed the turning point of significant changes in soft tissue was the 41–50 age bracket (p = 0 and p = 0, respectively). In Greek women, truncal %LM exceeded by far %FM across all ages (p = 0). Our results suggest that aging affects body composition of the trunk in ambulatory healthy women of a Greek origin differently, leading to menopausal loss of bone mass, senior adulthood loss of lean mass, and middle-age storage of fat mass. In adult women, these age-related associations between bone and soft tissue metrics on DXA exams carry implications for the attainment of optimal peak values and shifts in body composition overtime, impacting lifelong skeletal health.

Background and Objectives: Anastomotic leak following total gastrectomy and Roux-en-Y reconstruction remains a challenging and potentially morbid clinical scenario. Systemic support and resuscitation with simultaneous local sepsis control remain pillars of treatment. The therapeutic strategy may vary among different centers depending on the severity of clinical presentation, the degree of contamination and the hospital resources. The aim of this study is to introduce the rendezvous stenting technique, which combines washout of the abdominal cavity and endoscopic stenting under direct vision in selected patients who require reoperation. Materials and Methods: A retrospective descriptive analysis of severely ill patients suffering an anastomotic leak from an esophagojejunal anastomosis, who had been operated on in our department during the last five years was performed. Patient demographics, perioperative data and surgical outcomes were collected. Results: Since 2018, six anastomotic leak patients underwent stenting of anastomotic leak using the rendezvous technique during reoperation. Stenting was effective in controlling local contamination in five out of six patients (83.3%). One patient required repeat stent placement due to improper stent width. Conclusions: Anastomotic stenting using the rendezvous technique is a safe and feasible technique. Combining drainage of the abdominal cavity and stent fixation allows for control of the contaminated field as well as minimizing the risk of stent migration.

Atherosclerosis, a major contributor to vascular damage and plaque formation, is brought on by cellular senescence and chronic inflammation. A crucial matter that emerges is the classification of the disease in order to understand the pathogenic mechanisms before treatment. Given that oxidative stress, DNA damage, and inflammation contribute to cellular senescence, an increase in pro-inflammatory factors is detected in the atherosclerotic plaque, which exacerbates its instability while impeding vascular repair. This study emphasizes the importance of pathways such as Nrf2, ICAM-1, and p38 MAPK/p16 in the development of atherosclerosis. It also underscores the potential of senescence-targeting interventions to complement the conventional treatments for atherosclerosis. The study promotes using senolytic approaches that may serve as effective adjuncts to conventional pharmacological treatments for atherosclerosis. Particularly, quercetin, a flavonoid, demonstrates a potential action as senolytic agent by mitigating macrophage senescence, improving lipid profiles, and reducing plaque size of up to 56% in experimental models. This review article advocates for integrating senolytic approaches, including nutraceuticals like quercetin and combination therapies, to improve cardiovascular health and age-related vascular disorders.

Patellar tendinopathy (PT), or jumper’s knee, is an overuse injury that occurs in professional, as well as recreational, athletes. This condition is a noncontact injury, typically characterized by gradually increasing pain in the patellar tendon. It is prevalent in participants of several sports, but it occurs mostly in jumping sports. The diagnosis of PT is primarily clinical; however, imaging techniques can be useful as well. Risk factors differ between sexes, playing conditions, the kind of sport, playing level and personal characteristics. Screening is an essential tool to assess PT. This condition affects athletic performance and often persists for years. The use of preventative methods is imperative because of the persistence of this condition, especially in elite athletes who sometimes end their career after long and failed treatments. There are a wide variety of treatment and rehabilitation options available, the majority of which are non-operative, such as eccentric exercises, cryotherapy, platelet-rich plasma (PRP) injections, and anti-inflammatory strategies. If conservative treatment fails, surgery is the next most preferable step. Even though there are many surgical treatment methods, there is no clear evidence on what is the most effective approach to address PT. Taking this into consideration, as well as the extent of this clinical entity, novel therapeutic techniques, as well as screening and prevention methods, are expected to emerge in the near future.