Outbreak of Invasive Group A Streptococcus in Children-Colorado, October 2022-April 2023.

Background: In the fall of 2022, we observed a sharp rise in pediatric Invasive Group A Streptococcus (iGAS) hospitalizations in Colorado. We compared the epidemiology, clinical features, and patient outcomes in this outbreak to prior years.

Methods: Between October 2022 and April 2023, we prospectively identified and reviewed iGAS cases in hospitalized pediatric patients at Children's Hospital Colorado.

Fairness and Risk: An Ethical Argument for a Group Fairness Definition Insurers Can Use.

Algorithmic predictions are promising for insurance companies to develop personalized risk models for determining premiums. In this context, issues of fairness, discrimination, and social injustice might arise: Algorithms for estimating the risk based on personal data may be biased towards specific social groups, leading to systematic disadvantages for those groups. Personalized premiums may thus lead to discrimination and social injustice.

How I Would have been Differently Treated. Discrimination Through the Lens of Counterfactual Fairness.

The widespread use of algorithms for prediction-based decisions urges us to consider the question of what it means for a given act or practice to be discriminatory. Building upon work by Kusner and colleagues in the field of machine learning, we propose a counterfactual condition as a necessary requirement on discrimination. To demonstrate the philosophical relevance of the proposed condition, we consider two prominent accounts of discrimination in the recent literature, by Lippert-Rasmussen and Hellman respectively, that do not logically imply our condition and show that they face important objections.

Childhood Obesity and the Cryptic Language of the Microbiota: Metabolomics' Upgrading.

The growing obesity epidemic in childhood is increasingly concerning for the related physical and psychological consequences, with a significant impact on health care costs in both the short and the long term. Nonetheless, the scientific community has not yet completely clarified the complex metabolic mechanisms underlying body weight alterations. In only a small percentage of cases, obesity is the result of endocrine, monogenic, or syndromic causes, while in much more cases, lifestyle plays a crucial role in obesity development.

Multi-institutional experience with COVID-19 convalescent plasma in children.

Background And Objectives: Convalescent COVID-19 plasma (CCP) was developed and used worldwide as a treatment option by supplying passive immunity. Adult studies suggest administering high-titer CCP early in the disease course of patients who are expected to be antibody-negative; however, pediatric experience is limited. We created a multi-institutional registry to characterize pediatric patients (<18 years) who received CCP and to assess the safety of this intervention.

Risk Factors for Venous Thromboembolic Events in Children With Acute Musculoskeletal Infections.

Background And Objectives: Venous thromboembolic events (VTE) complicate acute hematogenous musculoskeletal infections (MSKIs) among hospitalized children. However, there is limited guidance for which specific MSKI patients are at the greatest VTE risk. This study aimed to identify VTE risk factors for children hospitalized with MSKIs.

Serum lactate is associated with increased illness severity in immunocompromised pediatric hematology oncology patients presenting to the emergency department with fever.

Introduction: Determining which febrile pediatric hematology/oncology (PHO) patients will decompensate from severe infection is a significant challenge. Serum lactate is a well-established marker of illness severity in general adult and pediatric populations, however its utility in PHO patients is unclear given that chemotherapy, organ dysfunction, and cancer itself can alter lactate metabolism. In this retrospective analysis, we studied the association of initial serum lactate in febrile immunosuppressed PHO patients with illness severity, defined by the incidence of clinical deterioration events (CDE) and invasive bacterial infection (IBI) within 48 hours.

Outcomes of Critically Ill Children With Acute Lymphoblastic Leukemia and Cytokine Release Syndrome Due to Chimeric Antigen Receptor T Cell Therapy: US, Multicenter PICU, Cohort Database Study.

Objectives: Cytokine release syndrome (CRS) is a potentially lethal toxicity associated with chimeric antigen receptor T cell therapy for pediatric acute lymphoblastic leukemia (ALL). Outcomes after critical illness due to severe CRS are poorly described. Our aim was to characterize critical illness outcomes across a multicenter cohort of PICU patients with ALL and CRS.

Highway to (Digital) Surveillance: When Are Clients Coerced to Share Their Data with Insurers?

Clients may feel trapped into sharing their private digital data with insurance companies to get a desired insurance product or premium. However, private insurance must collect some data to offer products and premiums appropriate to the client's level of risk. This situation creates tension between the value of privacy and common insurance business practice.

Transparency as design publicity: explaining and justifying inscrutable algorithms.

In this paper we argue that transparency of machine learning algorithms, just as explanation, can be defined at different levels of abstraction. We criticize recent attempts to identify the explanation of black box algorithms with making their decisions (post-hoc) interpretable, focusing our discussion on counterfactual explanations. These approaches to explanation simplify the real nature of the black boxes and risk misleading the public about the normative features of a model.

A Multicenter, Prospective, Observational, Cohort-Controlled Study of Clinical Outcomes Following Coronavirus Disease 2019 (COVID-19) Convalescent Plasma Therapy in Hospitalized Patients With COVID-19.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused high inpatient mortality and morbidity throughout the world. COVID-19 convalescent plasma (CCP) has been utilized as a potential therapy for patients hospitalized with coronavirus disease 2019 (COVID-19) pneumonia. This study evaluated the outcomes of hospitalized patients with COVID-19 treated with CCP in a prospective, observational, multicenter trial.

Trust does not need to be human: it is possible to trust medical AI.

In his recent article 'Limits of trust in medical AI,' Hatherley argues that, if we believe that the motivations that are usually recognised as relevant for interpersonal trust have to be applied to interactions between humans and medical artificial intelligence, then these systems do not appear to be the appropriate objects of trust. In this response, we argue that it is possible to discuss trust in medical artificial intelligence (AI), if one refrains from simply assuming that trust describes human-human interactions. To do so, we consider an account of trust that distinguishes trust from reliance in a way that is compatible with trusting non-human agents.

How to fairly incentivise digital contact tracing.

Digital apps using Bluetooth to log proximity events (henceforth, digital contact tracing) are increasingly supported by technologists and governments. By and large, the public debate on this matter focuses on privacy, with experts from both law and technology offering very concrete proposals and participating to a lively debate. Far less attention is paid to effective incentives and their fairness.

Accuracy of Bedside Ultrasound Femoral Vein Diameter Measurement by PICU Providers.

Objectives: Perform a needs assessment by evaluating accuracy of PICU provider bedside ultrasound measurement of femoral vein diameter prior to utilization of the catheter-to-vein ratio for central venous catheter size selection.

Design: Prospective observational cohort study.

Setting: PICU within a quaternary care children's hospital.

A comparison of different methods of red blood cell leukoreduction and additive solutions on the accumulation of neutrophil-priming activity during storage.

Background: Three methods of leukoreduction (LR) are used worldwide: filtration, buffy coat removal (BCR), and a combination of the previous two methods. Additionally, there are a number of additive solutions (ASs) used to preserve red blood cell (RBC) function throughout storage. During RBC storage, proinflammatory activity accumulates; thus, we hypothesize that both the method of LR and the AS affect the accumulation of proinflammatory activity.

Ethical sharing of health data in online platforms - which values should be considered?

Intensified and extensive data production and data storage are characteristics of contemporary western societies. Health data sharing is increasing with the growth of Information and Communication Technology (ICT) platforms devoted to the collection of personal health and genomic data. However, the sensitive and personal nature of health data poses ethical challenges when data is disclosed and shared even if for scientific research purposes.

Chordoma Occurs in Young Children With Tuberous Sclerosis.

Chordomas are rare bony neoplasms usually unassociated with a familial tumor predisposition syndrome. The peak incidence of this midline axial skeletal tumor is in adulthood but when very young children are affected, consideration should be given to occurrence within the tuberous sclerosis (TS) complex, especially when presenting in neonates <3 months of age. To call attention to this association, we present a brachyury-immunopositive chordoma occurring in the skull base of a 2-month-old male infant who was later realized to have metastases to the subcutaneous tissues and lungs, as well as rhabdomyoma of the heart and renal cysts/angiomyolipomas, that is, characteristic features of the TS complex.

Direct to consumer genetic testing and the libertarian right to test.

I sketch a libertarian argument for the right to test in the context of 'direct to consumer' (DTC) genetic testing. A libertarian right to genetic tests, as defined here, relies on the idea of a moral right to self-ownership. I show how a libertarian right to test can be inferred from this general libertarian premise, at least as a prima facie right, shifting the burden of justification on regulators.